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  • Title: Rhabdomyolysis and acute renal failure due to combination therapy with simvastatin and warfarin.
    Author: Mogyorósi A, Bradley B, Showalter A, Schubert ML.
    Journal: J Intern Med; 1999 Dec; 246(6):599-602. PubMed ID: 10620105.
    Abstract:
    Simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, is widely used to treat hyperlipidaemia. Although myalgias are recognized adverse effects, clinically significant elevations in serum creatine phosphokinase (CPK) levels are uncommon. We describe a case of rhabdomyolysis and acute renal failure associated with concomitant use of simvastatin and warfarin. Rhabdomyolysis and renal failure occurred 7 days after warfarin (5 mg day-1) was added to a chronic stable dose of simvastatin (20 mg day-1) and resolved abruptly after discontinuation of simvastatin. We recommend careful monitoring when warfarin is given to patients receiving simvastatin.
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