Cerivastatin, rhabdomyolysis caused

Fluvastatin may increase warfarin toxicity because both compete with P450 2C9 for metabolism. Cerivastatin can cause fatal rhabdomyolysis risk with other statins unclear. 

Symptomatic rises in creatine kinase activity to over 10 times the upper end of the reference range occurred in 0,1, and 0.9% of patients taking placebo, cerivastatin 0.4 mg, or cerivastatin 0.8 mg respectively (55), and rhabdomyolysis has been described in patients taking cerivastatin (56,57). However, in a review of the pharmacological properties and therapeutic efficacy of cerivastatin in hypercholesterolemia, it was stated that cerivastatin only infrequently causes rhabdomyolysis when given alone (58). 

For instance/ the interaction between cerivastatin and gemfibrozil/ which has resulted in cases of severe rhabdomyolysiS/ is likely due to the inhibition of cerivastatin metabolism by gemfibrozil (i.e./ pharmacokinetic interaction)/ in addition to the propensity of both drugs to cause skeletal muscle toxicity (i.e./ pharmacodynamic interaction) (13-15). 

Statins are now amongst the most widely used drugs worldwide. They are highly effective in lowering cholesterol levels, and have been shown to be effective in the primary and secondary prevention of ischaemic heart disease. Statins, however, can cause muscle toxicity, which most commonly manifests as an asymptomatic rise in CPK, and in the most severe cases, can cause rhabdomyolysis and death (Fig. 3) (Laaksonen 2006). Cerivastatin was withdrawn in 2001 because of its propensity to... 

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