[Severe rhabdomyolysis in a patient receiving lovastatin, danazol, and doxycycline].

Abstract Combinations of lovastatin and other drugs have been reported to cause rhabdomyolysis and myoglobinuria. The authors report such a case in a 72-year-old man who had been receiving atenolol, acetylsalicylic acid (ASA), dipyridamole, lovastatin, danazol, prednisone and doxycycline. The ASA, lovastatin and danazol were discontinued. The symptoms resolved, and laboratory test results were normal within 2 weeks. Lovastatin was strongly suspected; danazol was the most likely potentiator by diminishing the metabolism of lovastatin and its metabolites in the liver or by having a direct toxic effect on the muscles. Full text PDFSelected References These references are in PubMed. This may not be the complete list of references from this article. - Ayanian J. Z., Fuchs C. S., Stone R. M. Lovastatin and rhabdomyolysis. Ann Intern Med. 1988 Oct 15;109(8):682–683. doi: 10.7326/0003-4819-109-8-682. [DOI] [PubMed] [Google Scholar] - Betz G., Miller H. H., Hales D. B. Actions of danazol in vivo on cytochrome P-450 and steroidogenic enzymes in rat testis and liver microsomal preparations. Am J Obstet Gynecol. 1981 Dec 15;141(8):962–972. doi: 10.1016/s0002-9378(16)32688-6. [DOI] [PubMed] [Google Scholar] - Corpier C. L., Jones P. H., Suki W. N., Lederer E. D., Quinones M. A., Schmidt S. W., Young J. B. Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients. JAMA. 1988 Jul 8;260(2):239–241. [PubMed] [Google Scholar] - East C., Alivizatos P. A., Grundy S. M., Jones P. H., Farmer J. A. Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation. N Engl J Med. 1988 Jan 7;318(1):47–48. doi: 10.1056/NEJM198801073180111. [DOI] [PubMed] [Google Scholar] - Henwood J. M., Heel R. C. Lovastatin. A preliminary review of its pharmacodynamic properties and therapeutic use in hyperlipidaemia. Drugs. 1988 Oct;36(4):429–454. doi: 10.2165/00003495-198836040-00003. [DOI] [PubMed] [Google Scholar] - Koneru B., Hartner C., Iwatsuki S., Starzl T. E. Effect of danazol on cyclosporine pharmacokinetics. Transplantation. 1988 May;45(5):1001–1001. doi: 10.1097/00007890-198805000-00038. [DOI] [PubMed] [Google Scholar] - Manoukian A. A., Bhagavan N. V., Hayashi T., Nestor T. A., Rios C., Scottolini A. G. Rhabdomyolysis secondary to lovastatin therapy. Clin Chem. 1990 Dec;36(12):2145–2147. [PubMed] [Google Scholar] - Norman D. J., Illingworth D. R., Munson J., Hosenpud J. Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin. N Engl J Med. 1988 Jan 7;318(1):46–47. doi: 10.1056/NEJM198801073180110. [DOI] [PubMed] [Google Scholar] - Pierce L. R., Wysowski D. K., Gross T. P. Myopathy and rhabdomyolysis associated with lovastatin-gemfibrozil combination therapy. JAMA. 1990 Jul 4;264(1):71–75. [PubMed] [Google Scholar] - Reaven P., Witztum J. L. Lovastatin, nicotinic acid, and rhabdomyolysis. Ann Intern Med. 1988 Oct 1;109(7):597–598. doi: 10.7326/0003-4819-109-7-597_2. [DOI] [PubMed] [Google Scholar] - Spaulding W. B. Myalgia and elevated creatine phosphokinase with Danazol in hereditary angioedema. Ann Intern Med. 1979 May;90(5):854–854. doi: 10.7326/0003-4819-90-5-854_2. [DOI] [PubMed] [Google Scholar] - Tobert J. A. Efficacy and long-term adverse effect pattern of lovastatin. Am J Cardiol. 1988 Nov 11;62(15):28J–34J. doi: 10.1016/0002-9149(88)90004-5. [DOI] [PubMed] [Google Scholar] - Vyas K. P., Kari P. H., Wang R. W., Lu A. Y. Biotransformation of lovastatin--III. Effect of cimetidine and famotidine on in vitro metabolism of lovastatin by rat and human liver microsomes. Biochem Pharmacol. 1990 Jan 1;39(1):67–73. doi: 10.1016/0006-2952(90)90649-6. [DOI] [PubMed] [Google Scholar] - Wallace C. S., Mueller B. A. Lovastatin-induced rhabdomyolysis in the absence of concomitant drugs. Ann Pharmacother. 1992 Feb;26(2):190–192. doi: 10.1177/106002809202600209. [DOI] [PubMed] [Google Scholar]