単腎患者に対してロスバスタチンとベザフィブラートを併用し横紋筋融解症を発症した1症例

抄録

Precautionary warnings for rhabdomyolysis from the coadministration of HMG-CoA reductase inhibitors (statins) and fibric acid derivatives (fibrates) have been well publicized so far. However, contraindications for the coadministration of statins and fibrates were lifted in October 2018. We report a case of rhabdomyolysis that might be associated with the combination use of rosuvastatin and bezafibrate in a female patient with unilateral kidney resection for her renal cancer. A 60-year-old female patient was prescribed rosuvastatin (5 mg/day) and bezafibrate (400 mg/day) for hyperlipidemia in a clinic. She was immediately hospitalized in our hospital 22 days after starting the combination use. She had muscle pain and weakness in addition to abnormally high levels of serum creatine kinase and blood myoglobin. Discontinuation of both medications and initiation of rehydration therapy improved the symptoms. This is the first report of a case of rhabdomyolysis caused by the coadministration of rosuvastatin and bezafibrate and moderate renal impairment in a single kidney patient. Physicians and pharmacists should pay attention to single kidney as risk factors for statin/fibrate induced rhabdomyolysis, as well as renal impairment and diabetes complications.