Document Detail


Myopathy and rhabdomyolysis with lipid-lowering drugs.
MedLine Citation:
PMID:  11869826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Drug-induced myopathy and rhabdomyolysis are rare adverse drug reactions (ADR). They have been seen after the introduction of modern lipid-lowering drugs more regularly. The first description after medication with clofibrate dates back to 1968. Apparently, all fibrates can induce myopathy. It usually starts after a few days of medication, or after prolonged use, showing muscle weakness and/or pain. Concomitantly, the enzyme creatininephosphokinase (CPK) is raised dramatically. Muscular necrosis can follow leading secondarily to kidney failure, and eventually to death. For the class of statins, myopathy was more often seen after their introduction, and it became their most feared adverse effect, especially in combination of statins with other drugs (mibefradil, gemfibrozil, cyclosporin). In animal models the evolution of the disease and the mechanism of action may be elucidated. Though strong epidemiological data are lacking, the incidence of myopathy is probably similar for all lipid-lowering drugs and is in the range of 0.1-0.5% with monotherapy, increasing to 0.5-2.5% with combination therapy. Severe cases of rhabdomyolysis are rarer, but may have a significant mortality. The market success of cerivastatin within a short period has led to 100s of myopathies and some dozens of deaths. Though interactions on metabolism and ensuing high plasma levels can partially explain myopathy as intoxication, there are strong indications that other (endocrine, metabolic, genetic) factors might play a role in the pathophysiology. The patient population at risk should better be defined and withheld from myopathy-inducing drugs.
Authors:
Christian Hodel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Toxicology letters     Volume:  128     ISSN:  0378-4274     ISO Abbreviation:  Toxicol. Lett.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-02-28     Completed Date:  2002-05-10     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7709027     Medline TA:  Toxicol Lett     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  159-68     Citation Subset:  IM    
Affiliation:
HOVAT Pharma Consulting, Neubadstrasse 83, CH-4054 Basel, Switzerland. hovat@hodel.net
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MeSH Terms
Descriptor/Qualifier:
Animals
Antilipemic Agents / adverse effects*
Clofibrate / adverse effects
Female
Humans
Lovastatin / adverse effects
Male
Middle Aged
Muscular Diseases / chemically induced*
Rhabdomyolysis / chemically induced*
Chemical
Reg. No./Substance:
0/Antilipemic Agents; 637-07-0/Clofibrate; 75330-75-5/Lovastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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