Fusidate Atorvastatin

STATINS FUSIDIC ACID Cases of rhabdomyolysis reported when fusidic acid was co-adminis-tered with atorvastatin or simvastatin Uncertain at present Monitor LFTs and CK closely warn patients to report any features of rhabdomyolysis... 

A 66-year-old kidney transplant recipient developed a gangrenous lesion on the left foot infected with S. aureus and Escherichia coli. He was given ciprofloxacin and chndamycin for 6 weeks and then fusidic acid 1500 mg/day for 2 weeks. He became Ul, with myalgia and no active movement of his legs, and rhabdomyolysis was established by laboratory tests. He had also taken atorvastatin 10 mg/day and he slowly recovered after withdrawal of both atorvastatin and fusidic acid. 

Wenisch C, Krause R, Fladerer P, El Menjawi I, Pohanka E. Acute rhabdomyolysis after atorvastatin and fusidic acid therapy. Am J Med 2000 109(1) 78. 

Rhabdomyolysis has been described in patients given atorvastatin or simvastatin with fusidic acid. 

The clinical significance of this possible interaction is unclear, but it would seem wise to remind patients taking either atorvastatin or simvastatin with fusidic acid to be on the look out for the symptoms of myopathy and rhabdomyolysis (i.e. otherwise unexplained muscle pain, tenderness or weakness or dark coloured urine). If myopathy does occur, the statin should be stopped immediately. See also muscle toxicity , (p.l086), for further guidance on monitoring, and risk factors for muscle toxicity. 

Magee CN, Medani SA, Leavey SF, Conlon PJ, Clarkson MR. Severe rhabdomyolysis as a consequence of the interaction of fusidic acid and atorvastatin. Am J Kidney Dis 2010 56(5) ell-5. 

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