Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function

We report a rare case of severe acute rhabdomyolysis in association with coadministration of levofloxacin and simvastatin in a patient with normal renal function. A 70-year-old Caucasian male was treated due to community acquired pneumonia with levofloxacin in a dosage of 500 mg once and then twice...

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Main Authors: Maria Paparoupa, Sebastian Pietrzak, Adrian Gillissen
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2014/562929
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author Maria Paparoupa
Sebastian Pietrzak
Adrian Gillissen
author_facet Maria Paparoupa
Sebastian Pietrzak
Adrian Gillissen
author_sort Maria Paparoupa
collection DOAJ
description We report a rare case of severe acute rhabdomyolysis in association with coadministration of levofloxacin and simvastatin in a patient with normal renal function. A 70-year-old Caucasian male was treated due to community acquired pneumonia with levofloxacin in a dosage of 500 mg once and then twice a day. On the 8th day of hospitalization the patient presented with acute severe rhabdomyolysis requiring an intensive care support. After discontinuation of levofloxacin and concomitant medication with simvastatin 80 mg/day, clinical and laboratory effects were totally reversible. Up to now, levofloxacin has been reported to induce rhabdomyolysis mainly in patients with impaired renal function, as the medication has a predominant renal elimination. In our case renal function remained normal during the severe clinical course. According to a recent case report rhabdomyolysis was observed due to interaction of simvastatin and ciprofloxacin. To our best knowledge this is the first case of interaction between simvastatin and levofloxacin to be reported. This case emphasizes the need of close monitoring of creatine kinase in patients under more than one potentially myotoxic medication especially when patients develop muscle weakness.
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spelling doaj-art-373fe6a3764547e39692b4e4934780132025-08-20T03:55:02ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/562929562929Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal FunctionMaria Paparoupa0Sebastian Pietrzak1Adrian Gillissen2Department of Pulmonary Diseases, General Hospital Kassel, Kassel School of Medicine, Mönchebergstraße 41-43, 53125 Kassel, GermanyDepartment of Pulmonary Diseases, General Hospital Kassel, Kassel School of Medicine, Mönchebergstraße 41-43, 53125 Kassel, GermanyDepartment of Pulmonary Diseases, General Hospital Kassel, Kassel School of Medicine, Mönchebergstraße 41-43, 53125 Kassel, GermanyWe report a rare case of severe acute rhabdomyolysis in association with coadministration of levofloxacin and simvastatin in a patient with normal renal function. A 70-year-old Caucasian male was treated due to community acquired pneumonia with levofloxacin in a dosage of 500 mg once and then twice a day. On the 8th day of hospitalization the patient presented with acute severe rhabdomyolysis requiring an intensive care support. After discontinuation of levofloxacin and concomitant medication with simvastatin 80 mg/day, clinical and laboratory effects were totally reversible. Up to now, levofloxacin has been reported to induce rhabdomyolysis mainly in patients with impaired renal function, as the medication has a predominant renal elimination. In our case renal function remained normal during the severe clinical course. According to a recent case report rhabdomyolysis was observed due to interaction of simvastatin and ciprofloxacin. To our best knowledge this is the first case of interaction between simvastatin and levofloxacin to be reported. This case emphasizes the need of close monitoring of creatine kinase in patients under more than one potentially myotoxic medication especially when patients develop muscle weakness.http://dx.doi.org/10.1155/2014/562929
spellingShingle Maria Paparoupa
Sebastian Pietrzak
Adrian Gillissen
Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function
Case Reports in Medicine
title Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function
title_full Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function
title_fullStr Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function
title_full_unstemmed Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function
title_short Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function
title_sort acute rhabdomyolysis associated with coadministration of levofloxacin and simvastatin in a patient with normal renal function
url http://dx.doi.org/10.1155/2014/562929
work_keys_str_mv AT mariapaparoupa acuterhabdomyolysisassociatedwithcoadministrationoflevofloxacinandsimvastatininapatientwithnormalrenalfunction
AT sebastianpietrzak acuterhabdomyolysisassociatedwithcoadministrationoflevofloxacinandsimvastatininapatientwithnormalrenalfunction
AT adriangillissen acuterhabdomyolysisassociatedwithcoadministrationoflevofloxacinandsimvastatininapatientwithnormalrenalfunction