Search Query (DRUGGENERICNAME = Avandia ) AND (RECORDTYPE = Case Report ) 1 Documents Exported 1. Fenofibrate interaction First report of an interaction with concomitant rosiglitazone leading to muscular disorders in an elderly patient: case report (801030252) Fenofibrate interaction First report of an interaction with concomitant rosiglitazone leading to muscular disorders in an elderly patient: case report Release Date: 20/01/2006 801030252 NARRATIVE A 75-year-old man, who had a history of hypertension, diabetic neuropathy, mild asymptomatic creatine kinase (CK) elevation and hepatic steatosis, developed acute muscular disorders while receiving fenofibrate for hyperlipidaemia and rosiglitazone for diabetes mellitus. Twelve weeks after switching from simvastatin to fenofibrate 200 mg/day, the man started treatment with rosiglitazone 2mg twice daily. He was hospitalised 23 days later with acute-onset pain and cramps in his calf muscles. Laboratory investigations revealed a CK level of 6897 U/L, a myoglobin level of 902 ng/ml, a lactate dehydrogenase level of 285 U/L, serum creatinine and blood urea nitrogen levels of 0.116 and 2.3 mmol/l, respectively, and elevated liver enzyme levels. Electromyography demonstrated no spontaneous muscular activity of the right rectus femoris muscle, and nerve conduction studies were consistent with polyneuropathy. A muscle biopsy showed disruption of the myofibrillar architecture and scattered defects of oxidative enzyme activity. Fenofibrate and rosiglitazone was discontinued, as was concomitant metformin. The man received IV fluids and mannitol over the next 13 days, and his CK, myoglobin and creatinine levels returned to pre-treatment levels, with resolution of his symptoms. Author Comment "The present case indicates that simultaneous treatment with fenofibrate and rosiglitazone might lead to severe myopathy in diabetic patients who are already at increased risk because of pre-existing polyneuropathy and impaired renal function." Editorial Comment A search of AdisBase and Medline did not reveal any previous case reports of an interaction between fenofibrate and rosiglitazone. The WHO Adverse Drug Reactions database contained 623 reports involving the concomitant use of fenofibrate and rosiglitazone. REFERENCE COUNTRY Austria CITATION DETAILS Ledl M, Hohenecker J, Francesconi C, Roots I, Bauer MF, Roden M. Acute myopathy in a type 2 diabetic patient on combination therapy with metformin, fenofibrate and rosiglitazone. Diabetologia 48: 1996-1998, No. 10, Oct 2005 (English)
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