Statins: How the drug prevents heart attacks and strokes
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The aim of statins is to lower the baseline levels of cholesterol and remove plaque from the arteries. In doing so, the drug is believed to help hundreds of thousands dodge major cardiac events each year. Concerns remain over the pill’s side effects, however, which in some cases carry a strong mortality risk. According to previous case reports, rhabdomyolysis has been more commonly reported in statin users being treated with fusidic acid.
An entry on the Government’s website read: “Fusidic acid and its salts are an anti-staphylococcal agent which is used for the treatment of serious or deep-seated infections requiring good tissue or bone penetration, such as osteomyelitis.”
Systemic formulations of fusidic acid tablets, suspension, and intravenous infusion, but the drug can also be applied topically as a cream or ointment.
Gov.co.uk continues: “We have previously highlighted in Drug Safety Update that consideration of any potential drug interactions is important because comorbidity is common in statin users.
“It has been known for some time that there is an increased risk of rhabdomyolysis when systemic fusidic acid is used at the same time as some statins.
READ MORE: Statins side effects: Experiencing pain in three areas of the body? Speak to your doctor
“The product information for systemic fusidic acid and for simvastatin and atorvastatin lists this interaction and warns of the associated risk.”
The website states that in patients for whom the use of systemic fusidic acid is essential, statins treatment should be temporarily discontinued throughout the duration of fusidic acid treatment.
Because the exact mechanisms of the drug interaction remain unknown, they are suspected to occur with some, or all statins.
Rhabdomyolysis occurs when the muscle tissue breaks down, resulting in the release of muscle fibre into the blood.
This is typically characterised by a triad of symptoms which include pain in the shoulders, thighs, or lower back.
Muscle weakness is another common sign, which could cause trouble moving the arms or legs, but half of those with the condition experience no muscle-related symptoms at all.
Occasionally, patients will notice changes to the colour of their urine, which may become dark red or brown.
The condition can kill unless treated swiftly, making it one of the deadliest side effects of statins.
Treatment often involves the intravenous administration of fluids and electrolytes, which helps flush out toxins from the system.
Although rhabdomyolysis is a well-documented side of the cholesterol-lowering drug, data shows the risk remains relatively low.
In fact, the Mayo Clinic states that the risk of rhabdomyolysis is around 1.5 for every 100,000 people taking the pill.
But a number of cases have highlighted the need for awareness of common drug interactions with statins.
Patients with additional risk factors, such as diabetes, hypothyroidism, and liver or renal disease, merit close monitoring as they may be at higher risk of rhabdomyolysis.
To minimise the likelihood of interactions, it is advisable to consult a doctor about minimising or discontinuing statin treatment to avoid concomitant use with other drugs.
Close monitoring of symptoms suggestive of rhabdomyolysis is also recommended to prevent further complications.
“To ensure clearance of systemic fusidic acid, statin therapy may be reintroduced seven days after the last dose of systemic fusidic acid,” states the Government’s website.
It continues: “In exceptional cases where prolonged systemic fusidic acid treatment is necessary, the need for co-administration of a statin should be considered individually and only under close medical supervision.”
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