Rhabdomyolysis in a hepatitis C virus infected patient treated with telaprevir and simvastatin
Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 4
Abstract
A 46-year old man with a chronic hepatitis C virus infection received triple therapy with ribavirin, pegylated interferon and telaprevir. The patient also received simvastatin. One month after starting the antiviral therapy, the patient was admitted to the hospital because he developed rhabdomyolysis. At admission simvastatin and all antiviral drugs were discontinued because toxicity due to a drug-drug interaction was suspected. The creatine kinase peaked at 62,246 IU/L and the patient was treated with intravenous normal saline. The patient’s renal function remained unaffected. Fourteen days after hospitalization, creatine kinase level had returned to 230 IU/L and the patient was discharged. Telaprevir was considered the probable causative agent of an interaction with simvastatin according to the Drug Interaction Probability Scale. The interaction is due to inhibition of CYP3A4-mediated simvastatin clearance. Simvastatin plasma concentration increased 30 times in this patient and statin induced muscle toxicity is related to the concentration of the statin in blood. In conclusion, with this case we illustrate that telaprevir as well as statins are susceptible to clinical relevant drug-drug interactions.
Authors and Affiliations
Clara TMM de Kanter, Caroline Solas, Matthijs van Luin, David M Burger, Jan Maarten Vrolijk
Keywords
Related Articles
- EP ID EP78424
- DOI -
- Views 151
- Downloads 0
Genomic determinants of hepatitis C virus antiviral
Hepatitis C virus (HCV) is an important global health problem with an estimated prevalence of more than 170 million infected individuals worldwide. Currently, the standard antiviral therapy, based on pegylated interferon...
Cultural validation of the post-Liver transplant quality of life (pLTQ) questionnaire for the Brazilian population
Background and rationale. The post-Liver Transplant Quality of Life (pLTQ) questionnaire, developed in the United States, is adisease-targeted instrument designed to evaluate health-related quality of life (HRQoL) in li...
Comments from the Editor-in-Chief on a New Section in the Journal
It is a pleasure to announce a new section in Annals of Hepatology, «Liver News Elsewhere». It has the main purpose to give readers a section for the discussion, comments and feedback about new articles published elsewhe...
Advanced hepatocellular carcinoma. Review of targeted molecular drugs
Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world in terms of incidence, accounting for approximately 630 thousand new cases per year; in addition, HCC is the third most common cause of cancer d...
Increased mortality from acute liver failure in Mexico
Introduction. There is significant geographic variation in the etiology and prognosis of acute liver failure (ALF). Since, little information is available for Latin America. We analyzed ALF mortality trends in Mexico. Ma...