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Abstract

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OBJFXTTVE:

To describe two cases of rhabdomyolysis in patients taking lovastatin that were precipitated by the use of the newer macrolide antibiotics clarithromycin and azithromycin.

CASE SUMMARIES:

In each case, the patients were treated over 5 years with lovastatin and developed rhabdomyolysis that coincided with the completion of a prescribed regimen of a newer macrolide antibiotic. Following intravenous hydration and administration of bicarbonate, the patients' condition resolved without permanent sequelae.

DISCUSSION:

Rhabdomyolysis is a clinical syndrome resulting from the destruction of skeletal muscle that may progress to renal failure. Several drugs have been associated with rhabdomyolysis, including lovastatin, a hydroxymethylglutaryl-coenzyme A reductase inhibitor. Erythromycin is a macrolide antibiotic that may increase the risk of lovastatin-induced rhabdomyolysis. To our knowledge, these cases are the first published reports of lovastatin-induced rhabdomyolysis associated with azithromycin and clarithromycin.

CONCLUSIONS:

The risk of drug-induced rhabdomyolysis due to the potential interaction between lovastatin and azithromycin or clarithromycin should be considered before the concomitant use of these agents.

Keywords

lovastatin clarithromycin azithromycin rhabdomyolysis

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Lovastatin-Induced Rhabdomyolysis Possibly Associated with Clarithromycin and Azithromycin