Fibrat-/Statin-Myopathie

Abstract

Fibrates and statines are useful in preventing arteriosclerosis and thromboembolic events. However, they should be administered with caution. The risk of fibrate/statine myopathy, the most common side effect of fibrate/statine therapy, increases with dosage, combination of a fibrate with a statine,hypothyroidism, renal insufficiency, and intake of cytochrome P450 inhibitors. In case of clinical signs of a fibrate/statine myopathy such as proximal myalgias, stiffness,weakness, and dark urine, appropriate investigations should be initiated. If they establish the diagnosis of fibrate/statine myopathy, lipid lowering drugs should be immediately withdrawn. If rhabdomyolysis is present, prompt and adequate therapy is required. Though muscle abnormalities are rare side effects, fibrate/statine therapy should be regularly monitored with regard to clinical and laboratory alterations. The new "superstatines" rosuvastatine and pitavastatine reduce serum cholesterol more effectively than the established statines, but it is not known if they also have fewer muscular side effects than established statines.

Colchicine triggered severe rhabdomyolysis after long-term low-dose simvastatin therapy: a case report

“…Rhabdomyolysis as a major statin-associated adverse effect has been reported for all available statins [2] with the highest rate reported for simvastatin [2]. The incidence of clinically relevant rhabdomyolysis is not well defined, but large cohort studies showed incidences of 0.1% [3]. Rhabdomyolysis is defined by creatine kinase (CK) levels at least 10 times normal and reflects acute and massive muscle fiber necrosis accompanied by the release of muscle-related metabolites into the bloodstream [4].…”

Medikamenteninduzierte Myopathien

“…Die häufigste symptomatische Manifestation sind Myalgien mit 25 [14]. Neben den Myalgien manifestieren Statin-/ Fibratmyopathien in Form von Muskelkrämpfen, Muskelsteifigkeit, druckdolenter Muskulatur und proximal betonten Paresen [5,8,14,23,24]. Symptomatische Formen können mit und ohne CK-Erhöhung einhergehen [5,14].…”

Anti-atherosclerotic effects of Camellia chrysantha and Gynostemma pentaphyllum extracts mixture

“…Fibrates and statins are useful in preventing arteriosclerosis and thromboembolic events (8)(9)(10). However, long-term use of these medicines can have side effects, especially when these medicines are used together (8)(9)(10)(11)(12)(13). Therefore, there has been an increasing need to develop medicines derived from herbs with both high effectiveness and safety.…”