Rhabdomyolysis with Concurrent Atorvastatin and Diltiazem

Lewin, John J.; Nappi, Jean M.; Taylor, Marian H

doi:10.1345/aph.1a481

Cited by 56 publications

(17 citation statements)

References 17 publications

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“…However, the blood concentration is not greatly affected, and the effect is not clinically significant 31. Similar to amlodipine, diltiazem is metabolised by CYP3A4, and the MAE onset risk may increase 30, 32. Nevertheless, the concomitant use of atorvastatin and diltiazem did not cause changes in the onset timing of MAEs (Table 2).…”

Section: Discussionmentioning

confidence: 98%

Onset timing of statin‐induced musculoskeletal adverse events and concomitant drug‐associated shift in onset timing of MAEs

Akimoto

Negishi

Oshima

et al. 2018

Pharmacology Res & Perspec

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To evaluate the onset timing of musculoskeletal adverse events (MAEs) that develop during statin monotherapy and to determine whether concomitant drugs used concurrently with statin therapy shifts the onset timing of MAEs. Cases in which statins (atorvastatin, rosuvastatin, simvastatin, lovastatin, fluvastatin, pitavastatin, and pravastatin) were prescribed were extracted from the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) Data Files. The onset timing of MAEs during statin monotherapy was evaluated by determining the difference between statin start date and MAE onset date. The use of concomitant drugs with statin therapy was included in the analysis. Statins used in combination with concomitant drugs were compared with statin monotherapy to determine if the use of concomitant drugs shifted the onset timing of MAEs. The onset of MAEs was significantly faster with atorvastatin and rosuvastatin than with simvastatin. A difference in onset timing was not detected with other statins because the number of cases was too small for analysis. When evaluating concomitant drug use, the concomitant drugs that shifted the onset timing of MAEs could not be detected. Statins with strong low‐density lipoprotein cholesterol‐lowering effects (atorvastatin and rosuvastatin) contributed not only to a high risk of MAE onset, but also to a shorter time‐to‐onset. No concomitant drug significantly shifted the onset timing of MAEs when used concurrently with statins.

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Section: Discussionmentioning

confidence: 98%

Onset timing of statin‐induced musculoskeletal adverse events and concomitant drug‐associated shift in onset timing of MAEs

Akimoto

Negishi

Oshima

et al. 2018

Pharmacology Res & Perspec

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“…39 Both verapamil and diltiazem, which are weak inhibitors of CYP3A4, 28 increase the plasma concentration of simvastatin up to 4-fold, and diltiazem increases the plasma concentration of lovastatin to the same magnitude. 40,41 Cases of rhabdomyolysis have also been reported with the association of diltiazem with atorvastatin or simvastatin, 42,43 suggesting a need for some caution in using these agents simultaneously.…”

Section: Statins and Calcium Antagonistsmentioning

confidence: 99%

Safety of Statins

2004

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Abstract-Statin monotherapy is generally well tolerated, with a low frequency of adverse events. The most important adverse effects associated with statins are myopathy and an asymptomatic increase in hepatic transaminases, both of which occur infrequently. Because statins are prescribed on a long-term basis, however, possible interactions with other drugs deserve particular attention, as many patients will typically receive pharmacological therapy for concomitant conditions during the course of statin treatment.

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“…(2013) e Lewin e cols. (2002) destacaram a relevância dessa interação, sendo necessário avaliar custo e benefício do tratamento ao paciente, embora nenhum relato de reação adversa tenha sido associado a essa interação (26,27). O paciente foi encaminhado para acompanhamento junto do farmacêutico da Unidade Central de Saúde.…”

Section: Galato E Cols (2008) Destacam Que a Informaçãounclassified

“…Apesar disso, o resultado difere de dois trabalhos realizados em farmácias comunitárias, onde no primeiro houve 53% de aceite das intervenções envolvendo o médico e/ou paciente, e no segundo estudo, somente 47% de aceite para as intervenções envolvendo o médico; sendo que outro trabalho realizado em uma policlínica da Universidade atingiu 79% de aceitação envolvendo intervenções com médico e/ou paciente (15,27,28). A situação pode demonstrar que intervenções que necessitam do auxílio do prescritor apresentam maior dificuldade de resolução, seja por apresentarem-se mais complexa ou mesmo, por ainda enfrentarem outras barreiras no contato profissional.…”

Section: Galato E Cols (2008) Destacam Que a Informaçãounclassified

Revisão Da Farmacoterapia De Pacientes Do Programa Componente Especializado Da Assistência Farmacêutica Em Um Município De Santa Catarina, Brasil

Alano

Leguizamonn²,

Vargas³

2017

Infarma

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The specialized component for pharmaceutical services (Componente Especializado da Assistência Farmacêutica -CEAF) consists of a strategy to access high-cost treatments and new diseases that seeks to ensure full pharmaceutical treatment at the outpatient level. The aim of this study was to carry out a pharmacotherapy review in patients attending the CEAF program in a county at Santa Catarina, Brazil. This was a cross-sectional study through interviews conducted from August through September 2014. Twenty-two patients (59.9% men; mean age 47.9 years; SD 15.2) were interviewed. Among them, 42.9% had completed high school, and 33.3% had completed primary school. The average number of drugs per patient was 4.7 (SD 3.5), of which 30.1% were for the cardiovascular system and 26.2% for the nervous system. The most prevalent disease was schizophrenia (23.1%). Among the participants, 54.6% had problems with the use of medications, such as dose schedule, interaction between medicines and interaction with food, and 90.9% had problems related to pharmaceutical therapy, such as medication storage and transport. These patients received oral instructions and review reports with written guidelines, schedules, and pictograms. The higher the number of drugs used, the more frequent the problems were. The participants reported that the pharmaceutical services helped them to take their medications correctly. This study highlights the importance of the specialized pharmaceutical services to achieve better therapeutic results, considering the high cost of treatments offered by the CEAF program.Keywords: Pharmaceutical services; patient safety; Adherence to medication. RESUMOO CEAF (Componente Especializado da Assistência Farmacêutica) consiste em uma estratégia de acesso a tratamentos de alto custo e novas doenças que busca garantir a integralidade do tratamento medicamentoso em nível ambulatorial. O objetivo do estudo foi realizar a Revisão da Farmacoterapia em pacientes atendidos pelo programa CEAF em um município do Sul Catarinense. Tratou-se de um estudo transversal por meio de entrevistas realizadas entre agosto e setembro de 2014. Foram 22 pacientes com idade média de 47,9 (SD 15,2) anos, dos quais 59,9% eram homens. Do total de entrevistados, 42,9% tinham o ensino médio completo e 33,3%, nível fundamental. A média de medicamentos por paciente foi 4,7 (SD 3,5), sendo 30,1% para o sistema cardiovascular e 26,2% para o sistema nervoso. A doença mais prevalente foi a esquizofrenia (23,1%). Foram identificados problemas relacionados com os medicamentos em 54,6%

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Rhabdomyolysis with Concurrent Atorvastatin and Diltiazem

Cited by 56 publications

References 17 publications

Onset timing of statin‐induced musculoskeletal adverse events and concomitant drug‐associated shift in onset timing of MAEs

Onset timing of statin‐induced musculoskeletal adverse events and concomitant drug‐associated shift in onset timing of MAEs

Safety of Statins

Revisão Da Farmacoterapia De Pacientes Do Programa Componente Especializado Da Assistência Farmacêutica Em Um Município De Santa Catarina, Brasil

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