ROSUVASTATIN COPRESCRIPTION WITH CANAGLIFLOZIN TIED TO STATIN TOXICITY
Good morning dear friends and fellow colleagues, Here is an update on coprescription of Rosuvastatin with Canagliflozin tied to statin toxicity. The first report of interaction of these two drugs is published in Annals of internal medicine. Researchers have found in a case study that coprescription of Rosuvastatin and Canagliflozin may lead to statin toxicity. The major reason for statin discontinuation is because of development of statin associated muscle symptoms ranging from severe muscle pain, liver damage,acute kidney failure, Rhabdomyolysis and death. Researchers from the University of Toronto described a case of Patient who was hospitalized with severe Rosuvastatin toxicity ( manifesting as muscle damage and inability to walk) 2 weeks after starting Canagliflozin. Although she had taken Rosuvastatin uneventfully for more than 5 years , her blood Rosuvastatin concentration when arrived at the hospital is 15 times higher than expected her dose. The authors speculate that Canagliflozin caused Rosuvastatin toxicity by Increasing rosuvastatin absorption and by reducing it's elimination by the liver and kidney. The authors encourage clinicians to remain vigilant for features of myotoxicity when Canagliflozin and Rosuvastatin are coprescribed. With regards, Dr Sepuri Tirumala Devi.
Clinical information is very very encouraging but two queries 1 does all Sglt2i has same effect with Rousavastatin or it is only canagliflozine 2 what about other statins like atorovastatin and simvastatin which used profoundaly
Do all sglt2 inhibitors have the same side effect when used with statins. We use in many pts this combination. Is this pt a special case.all statins cause myalgias in initial phase and they subside after few days
Do Resuvastatun gives more side effects then Atorvastatin? Remembering information is provided,sir! Thanks a lot!
Cases that would interest you
- Login to View the image
A 35-year-old man presented to the emergency department with a 2-day history of abdominal pain, headache, and brown urine. He was alert and oriented to time, place, and self. He had no purpura or petechiae. Laboratory evaluation revealed a hemoglobin level of 8.6 g per deciliter (normal range, 13.7 to 17.5) and a platelet count of 6000 per cubic millimeter (normal range, 140,000 to 370,000). Levels of indirect bilirubin and lactate dehydrogenase were elevated, haptoglobin was undetectable, and the serum creatinine level was 1 mg per deciliter (88 μmol per liter; normal range, 0.6 to 1.3 mg per deciliter [57 to 115 μmol per liter]). Test results for infection with the human immunodeficiency virus were negative. A peripheral-blood smear showed numerous schistocytes. What is the diagnosis? a) Idiopathic thrombocytopenic purpura b) Thrombotic thrombocytopenic purpura c) Pseudothrombocytopenia d) Hemolytic-uremic syndrome e) Excessive splenic platelet sequestration
Dr. Bindu Singh4 Likes17 Answers - Login to View the image
A 60 yr old female k/c/o T2DM, CAD (Post PTCA) Hypothyroidism presented with complaints of sudden onset breathlessness since 3 hrs....She went to some nearby doctor who gave her Loading dose in view of ACS...This history was not revealed in hospital...So in ED, the patient was agn given loading dose and was suspected of having acute LVF and was put on Bipap...In the morning, patient improved a little but strtd bleeding from angle of mouth....A history of small gastric ulcer was revealed (3 yrs back)...Vitals were 200/100 mmHg , PR- 90, at presentation....In morning, BP- 140/80 PR- 88/min....Discuss the treatment approach to this patient....
Dr. Hardik Ahuja2 Likes18 Answers - Login to View the image
A 7 yr male child have problem last 1 year vomit water after eating mainly at night time... aggravate his problem from sour things. ..desire milk ,potato,thirsty white coating tongue with dryness of mouth abdomen feel soft but looks bloated bowel movement are clear but flatus is offensive. patient not give any serious complaints. some time pain at epigatric region. suggest diagnosis? treatment plan?
Dr. Soni Dixit6 Likes20 Answers - Login to View the image
45 yrs female clo swelling in both legs K/C/O - RBS and HTN since 10yrs She is very obese Plz Dx the case and Advice the Rx
Dr. Papiya Roy4 Likes17 Answers - Login to View the image
M28 Asymptomatic with average built having following reports... BP 140/90... What these indicate...?
Dr. Chirag Barot1 Like10 Answers
3 Likes