• Rhabdomyolysis is a serious but rare adverse effect of statins.• The mechanism of rhabdomyolysis with statins is poorly defined, but the occurrence is known to increase with dose/ concentration.• Some macrolides are known to interact with statins; however, azithromycin has not been described to interact with statins with the exception of two literature case reports.• A case series in the World Health Organization Adverse Drug Reaction (WHO‐ADR) database was suggestive of a possible drug interaction between statins and azithromycin with rhabdomyolysis.• A disproportionality measure, Omega, was shown to identify previously not recognized suspected drug interactions within the WHO‐ADR dataset.In a systematic screening of the World Health Organization Adverse Drug Reaction database, VigiBase, in July 2008, a measure of association used to detect interactions (Omega) highlighted azithromycin with the individual statins atorvastatin, lovastatin and simvastatin and rhabdomyolysis.
Although azithromycin remains the safest choice among macrolides in patients using statins, life-threatening complications may occur including severe rhabdomyolysis and acute kidney injury.
If clarithromycin is necessary, we recommend (a) avoiding co‐administration with simvastatin, lovastatin or atorvastatin; (b) withholding … Duplicate reports and follow‐up reports are present in VigiBase and are identified by an automatic In a systematic screening of VigiBase in July 2008 the associations of rhabdomyolysis with azithromycin–atorvastatin, lovastatin and simvastatin were quantitatively highlighted.
Macrolides have a diverse range of effects on numerous cell types.
Pharmacokinetic as well as pharmacodynamic interactions may be involved In conclusion, our study has demonstrated the usefulness of the newly developed disproportionality measure, Omega, in order to identify drug interactions in spontaneous reporting datasets. In six cases, two or more statins were co‐reported.
These findings prompted a more extensive analysis of azithromycin and all statins with rhabdomyolysis.
Atorvastatin, lovastatin and simvastatin were all reported more frequently than expected with azithromycin and rhabdomyolysis. Patients in both groups were well matched for demographics, comorbidities, statin dose, and concurrent medications. This is particularly important given the widespread use of statins, the desire on occasion to co‐prescribe macrolides, and the seriousness of rhabdomyolysis as an adverse reaction.Please check your email for instructions on resetting your password.
azithromycin in 23% of cases.
It isn't uncommon to take a short "break" on a "statin" drug like Lipitor if you were prescribed azithromycin but there are several factors to take into account. With the exception of one patient, the statin doses reported were within the recommended daily doses.Case reports in VigiBase are suggestive that interactions between azithromycin and statins resulting in rhabdomyolysis may occur. The case reports within the database originated from more than one country.
These reports are forwarded from national centres in 86 countries There are several measures of pairwise association used to screen collections of spontaneous reports for excessive reporting of single drug–single adverse reaction combinations.
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