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Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt

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Abstract

Statins and colchicine co-administration consists of a potentially catastrophic drug–drug interaction since it provokes myotoxicity, myopathy and various degrees of rhabdomyolysis. Lipophilic statins and colchicine are biotransformed in the liver, primarily via CYP3A4 enzyme system leading to elevated blood levels of both agents and resulting in increased potential for combined myotoxicity. Hence, it would be of great clinical importance not only the awareness of this devastating complication but also the more advantageous type of statin that we should choose to achieve the recommended therapeutic goals regarding LDL levels with minimal myopathy risk. Therefore, once colchicine’s use is commenced, a hydrophilic statin selection, such as rosuvastatin, seems favorable regarding the risk of myotoxicity. Herein, we aim to describe a patient with chronic kidney disease stage III and nephrotic syndrome that developed acute rhabdomyolysis soon after the administration of rosuvastatin while receiving colchicine. To the best of our knowledge, this is the first report of the combined effect of rosuvastatin and colchicine in the setting of chronic kidney disease leading to myotoxicity.

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Authors and Affiliations

  1. Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece

    Nikolaos Sabanis, Panagiota Papanikolaou & Georgios Zagkotsis

  2. Medical Unit of St Georgios, Department of General Practice & Family Medicine, Livadeia, Greece

    Eleni Paschou

  3. Medical School, National & Kapodistrian University of Athens, Athens, Greece

    Aikaterini Drylli

Authors
  1. Nikolaos Sabanis
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  2. Eleni Paschou
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  3. Aikaterini Drylli
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  4. Panagiota Papanikolaou
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  5. Georgios Zagkotsis
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Correspondence to Nikolaos Sabanis.

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Sabanis, N., Paschou, E., Drylli, A. et al. Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt. CEN Case Rep 10, 570–575 (2021). https://doi.org/10.1007/s13730-021-00598-7

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  • DOI: https://doi.org/10.1007/s13730-021-00598-7

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