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Severe rhabdomyolysis due to rosuvastatin in a liver transplant subject with human immunodeficiency virus and immunosuppressive therapy–related dyslipidemia
Author(s) -
Moreno Ana,
Fortún Jesús,
Graus Javier,
RodriguezGandía Miguel A.,
Quereda Carmen,
PérezElías María J.,
Nuño Javier,
Wikman Philip,
Moreno Santiago,
Bárcena Rafael
Publication year - 2011
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.22225
Subject(s) - rosuvastatin , dyslipidemia , medicine , rhabdomyolysis , ritonavir , liver transplantation , pravastatin , pharmacology , statin , tacrolimus , lopinavir , transplantation , immunology , viral load , diabetes mellitus , human immunodeficiency virus (hiv) , cholesterol , antiretroviral therapy , endocrinology
Abstract Statins are relatively safe first‐line agents to use in the setting of dyslipidemia associated with immunosuppressive therapy in subjects undergoing liver transplantation, and also in HIV‐infected patients with dyslipidemia due to antiretroviral drugs, especially ritonavir‐boosted protease inhibitors. Rosuvastatin, a new statin, has demonstrated higher potency than previously released statins and is not extensively metabolized by the liver P450 system; therefore, the probability of deleterious pharmacokinetic interactions with commonly used immunosuppressants and antiretroviral drugs is reduced. We present the first case of severe rhabdomyolysis in a liver transplant patient receiving rosuvastatin for the treatment of immunosuppressive therapy–related grade IV dyslipidemia, an HIV‐infected subject on protease inhibitor‐sparing HAART, that resolved after rosuvastatin withdrawal, probably related to interactions between calcineurin inhibitors and hepatic rosuvastatin uptake transporters such as Organic Anion Transporting Polypeptides (OATPs). Liver Transpl, 2011. © 2011 AASLD.