RHABDOMYOLYSIS ASSOCIATED WITH SIMVASTATIN-GEMFIBROZIL THERAPY

Simvastatin is a potent inhibitor of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase intended for use as a hypocholesterolemic agent. T he long-term clinical experience with simvastatin indicates that it is a safe, effective, and well-tolerated hypolipidemic agent. Laboratory adverse events involving elevations of serum transaminase levels and serum creatine kinase (CK) levels to more than three times the upper l imit of normal range have been seen in 1.5% and 3.4% of cases, respect ively. We describe a case of severe myopathy and rhabdomyolysis associ ated with concomitant use of simvastatin and gemfibrozil. Seven days a fter discontinuing administration of gemfibrozil and simvastatin, the patient's condition improved and she was discharged home. Although thi s is the first report to indicate an association between myopathy and concomitant use of simvastatin and gemfibrozil, we strongly recommend caution and careful monitoring if simvastatin is given to patients rec eiving gemfibrozil.