Table 2 Presentation, treatment and recovery of ADRs in case reports of statin-quinolone interactions
From: A systematic review of the drug-drug interaction between Statins and Quinolones
Author (year) | Time from quinolones initiation to onset of ADR | Hospitalization | ADR developed | Tests for diagnostic purposes | Laboratory examination | Presentation of ADR | Treatment of ADR | Regression of ADR | Time to improvement of symptoms | Time to normalization of laboratory indicators | Outcomes of patients | Mortality after adverse drug event |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Andrea (2013) [9] | 7 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:33,687 U/L | (1) CK level increased; (2) Renal function decreased | (1) Discontinuation of atorvastatin and ciprofloxacin; (2) Dialysis | (1) CK level declined; (2) Renal function increased | 5 days | Unspecified | Improved | No |
Ankur (2012) [10] | 2 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:7557 U/L | (1) Increasing myalgias and fatigu; (2) Diffuse musculartenderness; (3) CK level increased | Discontinuation of levofloxacin | (1) Clinical symptoms resolved; (2) CK was normalized | 3–5 days | 7 days | Improved | No |
Asher (2006) [11] | 10 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:6200 U/L | (1) Worsening myalgia and difficulty in walking; (2) Myoglobinuria was present; (3) CK level increased | (1) Discontinuation of levofloxacin and simvastatin; (2) Intravenous hydration was maintained for 5 days | (1) Muscle pain and tenderness disappeared; (2) CK level return to normal | 14 days | Unspecified | Improved | No |
Corrine (2012) [12] | 10 days | Yes | Tendinopathy of the hip | Computed tomography | None | New-onset left lateral hip pain | Discontinuation of simvastatin | (1) Pain was improved at a 10-day recheck; (2) Reintroduction of simvastatin in 6 weeks later | 10 days | Not mentioned | Improved | No |
Darnis (2011) [13] | 3 days | Yes | Muscular deficit and major rhabdomyolysis | (1) Creatine phosphokinase level: (2) Muscle biopsy | None | Muscular necrosis | Discontinuation of simvastatin | Not mentioned | Unspecified | Unspecified | Improved | No |
Dorothee (2008) [14] | 3 months | Yes | Myopathy | Electromyography | CK:2976 U/L | (1) Subacute bilateral proximal paraparesis; (2) CK level increased; (3) Decreased creatinine clearance(30 ml/min) | Discontinuation of simvastatin | (1) Muscle strength improved; (2) CK level returned to normal within 1 week; (3) Creatinine clearance increased(44 ml/min) | 7 days | 7 days | Improved | No |
Emily (2020) [15] | 4 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:48,644 U/L; LD:1382 U/L | (1) The urine was dark amber in colour; (2) CK level increased | Conversion of atorvastatin to pravastatin 10 mg daily | CK level returned to normal | Not mentioned | 2 days | Improved | No |
Farhana (2020) [16] | 1 day | Yes | Muscle weakness | Routine laboratory exams | CK:183 U/L | (1) Extreme fatigue; (2) Progressing muscle weakness; (3) Agitation and insomnia; (4) CK level increased | Discontinuation of atorvastatin and ciprofloxacin | (1) Muscle weakness resolved; (2) CK level returned to normal in two weeks; (3) Atorvastatin was restarted after a month | 21 days | Unspecified | Improved | No |
Figueira (2010) [17] | 7 days | Yes | Acute hepatitis | Routine laboratory exams | AST: 329 U/L, ALT:953 U/L | Elevation of transaminases | Discontinuation of levofloxacin | (1) Transaminase values in progressive decline; (2) Reintroduction of simvastatin 20 mg in 6 months later | 28 days | 28days | Improved | No |
Fraser (2016) [18] | 4 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:24,514 U/L; AST:870 U/L, ALT:240 U/L | (1) A 15-dayhistory of slowly progressing muscle weakness; (2) A 10-day history of dark brown, frothy urine; (3) Liver function disorders; (4) CK level increased | (1) Discontinuation of simvastatin; (2) Management with intravenous crystalloid fluids and urinary catheterisation | (1) Muscle weakness improve; (2) Liver function improved; (3) CK level improved | 7 days | 7 days | Improved | No |
Jeannette (2019) [19] | 19 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:11,609 U/L; AST:1613 IU/L | (1) Muscle pain and weakness; (2) CK level increased | (1) Discontinuation of levofloxacin and atorvastatin; (2) Intravenous saline injection at 150 ml/h | (1) Relevant laboratory values were back to baseline 1 week following hospital discharge; (2) Atorvastatin was resumed several months later | Unspecified | Unspecified | Improved | No |
Klinik (2016) [20] | Several days (Not specified) | Yes | Rhabdomyolysis | Routine laboratory exams | CK:10,137 U/L; AST:279 U/L; ALT:87 U/L; Tn:1301 ng/L; LD:525 U/L; SCR:164 µmol/L; CK-MB:137U/L; MB:16,228 µg/L | (1) Muscle weakness of upper and lower limbs; (2) CK level increased | (1) No mention of discontinuing the medication; (2) Force diuresis with 3–4 L NaCl 0.9% daily and start intravenous furosemide Alkalinize the urine with sodium bicarbonate | (1) Increased muscle strength; (2) CK returned to normal after one week | 7 days | 7 days | Improved | No |
Maria (2014) [21] | 5 days | Yes | Rhabdomyolysis | (1) Routine laboratory exams; (2) Physical examination | CK:159,450 U/L; AST:1408 U/L | (1) Increased bilateral legs and arms weakness; (2) CK level increased | (1) Discontinuation of levofloxacin and simvastatin; (2) Treated with intravenous crystalloid hypotonic solution (100mL/h); (3) Urine alkalinization; (4) Physical therapy | (1) Symptoms improved significantly and muscle and liver enzymes normalized; (2) Normal laboratory parameters; (3) Resumption of simvastatin at 40 mg/day | A few days | A few days | Improved | No |
Mário Bibi (2021) [22] | 7 days | Yes | Rhabdomyolysis | (1) Routine laboratory exams; (2) Electromyography | CK:17,830 U/L | (1) Generalized muscular weakness; (2) CK level increased | (1) Discontinuation of levofloxacin and ciprofloxacin; (2) Fluid infusion | (1) Muscle strength and electromyography showed a return to normal after 6 months; (2) CK returned to normal; (3) Restarted antibiotic therapy with 400 mg moxifloxacin daily one month after admission; (4) Statins were reintroduced after antibiotic discontinuation | 21 days | 21 days | Improved | No |
Nicolas (2015) [23] | 9 days | Yes | Rhabdomyolysis | Routine laboratory exams | CK:816,000 IU/L; LD:19,200 IU/L | (1) Diffuse severe muscle pain with intense weakness; (2) The peritoneal dialysis effluent color appeared reddish; (3) Progressively anuric; (4) Severe electrolyte disorder | (1) No mention of discontinuing the medication; (2) Maintenance peritoneal dialysis treatment (3 times/day); (3) Refining the genetic analysis of statins | (1) The peritoneal dialysis effluent progressively cleared; (2) Renal function recovered; (3) Normalization of serum creatinine; (4) Correction of electrolyte disorders | Unspecified | 3 days | Improved | No |
Sawant (2009) [24] | 1 day | Yes | Rhabdomyolysis | Routine laboratory exams | CK:28,980 U/L | (1) Severe muscle weakness and generalised muscle aches for 4 days; (2) Dark discoloration of urine; (3) CK level increased | (1) Discontinuation of ciprofloxacin and simvastatin; (2) Fluid infusion | (1) Able to walk with a Zimmer frame; (2) CK levels returned to normal | 23 days | 14 days | Improved | No |