Open AccessFatal Rhabdomyolysis in a Patient with Liver Cirrhosis after Switching from Simvastatin to Fluvastatin
Author(s) -
Seung Don Baek,
Sun Joo Jang,
So Eun Park,
Tae Jin Ok,
Jaechan Leem,
HoSu Lee,
SooYoung Park,
Tae Hee Kim
Publication year - 2011
Publication title -
journal of korean medical science/journal of korean medical science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.743
H-Index - 66
eISSN - 1598-6357
pISSN - 1011-8934
DOI - 10.3346/jkms.2011.26.12.1634
Subject(s) - rhabdomyolysis , fluvastatin , medicine , simvastatin , cirrhosis , rosuvastatin , gastroenterology , creatine kinase , statin , cerivastatin , adverse effect , pharmacology , urology , pravastatin , cholesterol
HMG-CoA reductase inhibitors (statins) are widely used to treat hypercholesterolemia. Among the adverse effects associated with these drugs are statin-associated myopathies, ranging from asymptomatic elevation of serum creatine kinase to fatal rhabdomyolysis. Fluvastatin-induced fatal rhabdomyolysis has not been previously reported. We describe here a patient with liver cirrhosis who experienced fluvastatin-induced fatal rhabdomyolysis. This patient had been treated with simvastatin (20 mg/day) for coronary artery disease and was switched to fluvastatin (20 mg/day) 10 days before admission. He was also taking aspirin, betaxolol, candesartan, lactulose, and entecavir. Rhabdomyolysis was complicated and continued to progress. He was treated with massive hydration, urine alkalization, intravenous furosemide, and continuous renal replacement therapy for acute renal failure, but eventually died due to rhabdomyolysis complicated by hepatic failure. In conclusion, fluvastatin should be used with caution in patients with liver cirrhosis, especially with other medications metabolized with CYP2C9.