The Journal of the Arkansas Medical Society Med Journal Feb 2019 Final 2 | Page 21

Cardiovascular disease. JAMA Cardiol 2017;
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3. Fernandez G, Spatz E, Jablecki C, Phillips P.
Statin myopathy: A common dilemma not re-
flected in clinical trials. Cleveland Clinic Jour-
nal of Medicine 2011; 78: 393-403.
4. Tomaszewski M, Stepien K, Tomaszweski J,
Czucwar S. Stain-induced myopathies. Phar-
macological Reports 2011; 63: 859-866.
5. Mendes P, Robles P, Mathur S. Statin-induced
rhabdomyolysis: A comprehensive review of
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6. Korzets A, Gafter U, Dicker D, Herman M, Ori
Y. Levofloxacin and rhabdomyolysis in a renal
transplant patient. Nephrol Dial Transplant
2006; 21: 3304-3305.
Figure 1 and 2.
Rhabdomyolysis, if related to this drug alone,
should have been observed much earlier. This
indicates that co-administration is likely respon-
sible for this toxicity. Rhabdomyolysis has been
reported after co-administration of simvastatin
and levofloxacin in a patient with normal renal
function. 9 Our patient had received simvastatin
along with levofloxacin a year earlier when she
also suffered acute renal impairment from con-
trast nephropathy; despite this, rhabdomyolysis
was not observed. The mechanism underlying
rhabdomyolysis due to co-administration of
these drugs remains unclear. This may be due
to intrinsic myotoxicity of levofloxacin or due
to inhibition of P-gp mediated drug efflux. Co-
administration of these drugs should be discour-
aged especially in elderly patients with renal im-
pairment. Muscle injury markers are still above
normal at four months; however, muscle weak-
ness shows improvement. This improvement,
along with creatinine kinase level being less
than 10 times normal, argues against statin-
associated autoimmune myopathy. 11
References
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cin-induced rhabdomyolysis in a hemodialysis
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rhabdomyolysis associated with co-adminis-
tration of levofloxacin and simvastatin in a pa-
tient with normal renal function. Case Reports
in Medicine 2014; Article ID562929, 4 pages.
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669.
SAVE THE DATE
2019
ANNUAL
MEETING
friday, april 26
AMS Membership Meeting | DoubleTree Hotel | Little Rock, Arkansas
Join us for the 2019 AMS Membership Meeting on Friday, April 26 at the DoubleTree Hotel in Little Rock. This educational activity is open to
all AMS members and will feature topics on opioids regulations, physician wellness and burnout, legislative updates, and more!
More information coming soon at arkmed.org.
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FEBRUARY 2019 • 189