Rhabdomyolysis Associated With Pomegranate Juice Consumption

Am J Cardiol. 2006 Sep 1;98(5):705-6. doi: 10.1016/j.amjcard.2006.03.057. Epub 2006 Jul 14.

Abstract

This 48-year-old man with possible underlying myopathy was successfully treated with ezetimibe 10 mg/day and rosuvastatin 5 mg every other day for 17 months. Three weeks before presentation, he began drinking pomegranate juice (200 ml twice weekly). He presented urgently with thigh pain and an elevated serum creatine kinase level (138,030 U/L, normal < 200 U/L). In conclusion, because both grapefruit and pomegranate juice are known to inhibit intestinal cytochrome P450 3A4, this report suggests that pomegranate juice may increase the risk of rhabdomyolysis during rosuvastatin treatment, despite the fact that rosuvastatin is not known to be metabolized by hepatic P450 3A4.

Publication types

  • Case Reports

MeSH terms

  • Beverages*
  • Creatine Kinase / blood
  • Fluorobenzenes / therapeutic use
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hyperlipoproteinemia Type II / diet therapy
  • Hyperlipoproteinemia Type II / drug therapy
  • Lythraceae / adverse effects*
  • Male
  • Middle Aged
  • Pyrimidines / therapeutic use
  • Rhabdomyolysis / enzymology
  • Rhabdomyolysis / etiology*
  • Rosuvastatin Calcium
  • Sulfonamides / therapeutic use

Substances

  • Fluorobenzenes
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium
  • Creatine Kinase