Rhabdomyolysis Associated With Simvastatin–Gemfibrozil Therapy

A, Tal; Rajeshawari, M; Isley, William L.

doi:10.1097/00007611-199705000-00018

Cited by 65 publications

(26 citation statements)

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“…These results suggest that BTE intake of 1 g/ day is safe. Although current cholesterol-lowering drugs, such as HMG-CoA reductase inhibitors (statins) are available, they are not without side effects; namely, liver impairments [25] , myopathy [26] and rhabdomyolysis [27] . Unlike fiber and plant sterols, which nondiscriminatively inhibit absorption of nutrients and fat-soluble vitamins, BTE selectively inhibits reabsorption of cholesterol without affecting fat-soluble vitamins [22] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Chinese Black Tea (Pu-Ehr) Extract in Healthy and Hypercholesterolemic Subjects

Fujita¹,

Yamagami²

2008

Ann Nutr Metab

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Background/Aims: Water-extracted Chinese black tea (Pu-Ehr) exerts a precipitating effect on mixed bile salt micelles in foods. The amount of black tea extract (BTE) effective for hypercholesterolemia (HC) was examined in humans. Materials and Methods: Animals (test 1) and humans (tests 2–5) were given BTE in the following studies: (test 1) an acute 2-week toxicity test conducted in mice with 2,000 mg/kg BTE or saline; (test 2) a dose-finding 8-week toxicity study with excessive BTE ingestion (0.75 or 1 g/day) in 10 healthy and 10 borderline HC subjects; (test 3) a 1-day acute toxicity test using a (10 g) single-bolus study (n = 10); (test 4) a 5-week long-term safety test (5 g/day, n = 11), and (test 5) a 4-month noncomparative study in 21 HC patients ingesting 1 g/day. Results: The safety study showed no changes in hematological or relevant biochemical parameters in both mice and humans in the acute and long-term toxicity tests. In test 5, significant reductions in total and low-density lipoprotein cholesterol levels accompanied by significant decreases in body weight were observed without affecting other biochemical parameters. Conclusions: BTE significantly reduced blood cholesterol levels in humans and may prove safe and useful in preventing and improving metabolic syndrome-induced arteriosclerosis and/or obesity.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Chinese Black Tea (Pu-Ehr) Extract in Healthy and Hypercholesterolemic Subjects

Fujita¹,

Yamagami²

2008

Ann Nutr Metab

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“…There are other cholesterol lowering drugs available, such as HMG-CoA reductase inhibitor (statins), but these are known to have side effects such as rhabdomyolysis (Tal et al, 1997). Fibres and plant sterols also show a tendency to inhibit the absorption of nutrients and fat-soluble vitamins.…”

Section: Discussionmentioning

confidence: 99%

Extract of black tea (pu‐ehr) inhibits postprandial rise in serum cholesterol in mice, and with long term use reduces serum cholesterol and low density lipoprotein levels and renal fat weight in rats

Fujita¹,

Yamagami²

2008

Phytotherapy Research

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A water-soluble extract of a traditional Chinese fermented black tea, pu-ehr, decomposes bile acid cholesterol micelles. This black tea extract (BTE) was studied to see if it could decrease the postprandial elevation of blood cholesterol levels after a single administration in ddY mice. It was found that BTE (0.3 g/kg) significantly decreased the postprandial rise in blood cholesterol levels after oral administration of cholesterol (130 mg/kg). A non-fermented tea (i.e. green tea) extract did not prevent the postprandial increase in blood cholesterol. In a subsequent study, 5-week-old Sprague-Dawley (SD) rats were fed BTE for 3 weeks, following which a dose-dependent and significant decrease in serum total cholesterol levels (1.36 mmol/L, 0.1% BTE, p < 0.05) was found and also in renal fat weight (0.3% BTE, p < 0.05). LDL cholesterol levels (0.51 mmol/L, 0.1% BTE, p < 0.05) were also significantly decreased. There were no significant changes in the weights of other organs or in the serum levels of other clinical markers. Thus, BTE has a specific antihypercholesterol effect in rodents, which might potentially aid in the management of hyperlipidaemia in man.

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“…Clinical data also exist that describe the adverse impact of this DDI. Several case reports have described severe adverse effects, such as rhabdomyolysis with both simvastatin and atorvastatin (77)(78)(79). An analysis of the FDA reporting system revealed 384 reports of rhabdomyolysis with a statin-fibrate combination, with most of these (88%) requiring hospital stay for renal failure (80).…”

Section: Statinsmentioning

confidence: 99%

Drug–Drug Interactions in Cardiovascular Catheterizations and Interventions

Dunn

Holmes

Moliterno

2012

JACC: Cardiovascular Interventions

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Patients presenting for invasive cardiovascular procedures are frequently taking a variety of medications aimed to treat risk factors related to heart and vascular disease. During the procedure, antithrombotic, sedative, and analgesic medications are commonly needed, and after interventional procedures, new medications are often added for primary and secondary prevention of ischemic events. In addition to these prescribed medications, the use of over-the-counter drugs and supplements continues to rise. Most elderly patients, for example, are taking 5 or more prescribed medications and 1 or more supplements, and they often have some degree of renal insufficiency. This polypharmacy might result in drug-drug interactions that affect the balance of thrombotic and bleeding events during the procedure and during long-term treatment. Mixing of anticoagulants, for instance, might lead to periprocedural bleeding, and this is associated with an increase in long-term adverse events. Furthermore, the range of possible interactions with thienopyridine antiplatelets is of concern, because these drugs are essential to immediate and extended interventional success. The practical challenges in the field are great-some drug-drug interactions are likely present yet not well understood due to limited assays, whereas other interactions have well-described biological effects but seem to be more theoretical, because there is little to no clinical impact. Interventional providers need to be attentive to the potential for drug-drug interaction, the associated harm, and the appropriate action, if any, to minimize the potential for medication-related adverse events. This review will focus on drug-drug interactions that have the potential to affect procedural success, either through increases in immediate complications or compromising longer-term outcome.

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Rhabdomyolysis Associated With Simvastatin–Gemfibrozil Therapy

Cited by 65 publications

References 0 publications

Efficacy and Safety of Chinese Black Tea (Pu-Ehr) Extract in Healthy and Hypercholesterolemic Subjects

Efficacy and Safety of Chinese Black Tea (Pu-Ehr) Extract in Healthy and Hypercholesterolemic Subjects

Extract of black tea (pu‐ehr) inhibits postprandial rise in serum cholesterol in mice, and with long term use reduces serum cholesterol and low density lipoprotein levels and renal fat weight in rats

Drug–Drug Interactions in Cardiovascular Catheterizations and Interventions

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