Rhabdomyolysis from the Coadministration of Lovastatin and the Antifungal Agent Itraconazole

Abstract

To the Editor: Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, widely prescribed to treat hypercholesterolemia, are clearly effective and are associated with reductions in mortality from coronary disease and overall mortality.1 Toxic effects on skeletal muscle, which may range from diffuse myalgia to severe rhabdomyolysis, are a known side effect of these drugs.2 Interactions of HMG-CoA reductase inhibitors with cyclosporine, and less often with gemfibrozil and niacin, increase the risk of rhabdomyolysis.2 We report a case of severe rhabdomyolysis from the coadministration of lovastatin, niacin, and itraconazole. A 63-year-old woman with familial hypercholesterolemia and a previous myocardial infarction who had. © 1995, Massachusetts Medical Society. All rights reserved.