Statins Fusidate

Rhabdomyolysis has been attributed to the combination of fusidic acid with statins. 

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... 

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. 

CoUidge TA, Razvi S, Nolan C, Whittle M, Stirling C, Russell AJ, Mann AC, Deighan CJ. Severe statin-induced rhabdomyolysis mimicking Guillain-Barr6 syndrome in four patients with diabetes mellitus treated with fusidic acid. Diabet Med 2010 27(6) 696-700. 

A case report of severe rhabdomyolysis leading to death highlighted the risks of combining statins with fusidic acid. In this case, rifampicin was administered with fusidic acid in an elderly man following total hip revision surgery [153 ]. 

Cowan R, Johnson PD, Urbancic K, Grayson ML. A timely reminder about the concomitant use of fusidic acid with statins. Clin Infect Dis 2013 57(2) 329-30. 

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