Myopati hos en patient i behandling med simvastatin og fluconazol
Sammanfattning
A 69-year-old female was admitted due to progressive loss of muscle strength following addition of fluconazole to long-term simvastatin
treatment. Rhabdomyolysis was suspected and both drugs were discontinued. Forced diuresis was initiated together with a short course of
prednisolone. After 21 weeks the patient had regained normal muscle strength and endurance. The favourable course and the absence of
antibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase suggest that the condition was due to interaction between the two drugs,
which are both metabolized via the CYP3A4 pathway.