Creatine kinase elevation caused by a combination of fluvastatin and telmisartan in a patient heterozygous for the CYP2C9*3 and ABCC2 -24C > T variants: a case report

BMC Res Notes. 2014 Oct 3;7:688. doi: 10.1186/1756-0500-7-688.

Abstract

Background: Genetic factors as predictor of the individual outcome of drug therapy is one aim of personalized medicine approaches.

Case presentation: We report a drug metabolism based analysis of genetic polymorphisms in a Caucasian patient receiving fluvastatin and telmisartan experiencing myotoxicity (myalgia and moderate creatine kinase elevation).

Conclusions: The obtained findings suggest that heterocygocity of cytochrome P450 CYP2C9*3 variant in combination with multidrug resistance-associated protein MRP2-24C > T functions as risk factor predisposing to experience drug-drug interaction combing those drugs.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angiotensin II Type 1 Receptor Blockers / administration & dosage
  • Angiotensin II Type 1 Receptor Blockers / adverse effects
  • Base Sequence
  • Benzimidazoles / administration & dosage
  • Benzimidazoles / adverse effects*
  • Benzoates / administration & dosage
  • Benzoates / adverse effects*
  • Creatine Kinase / blood*
  • Cytochrome P-450 CYP2C9 / genetics*
  • DNA Primers
  • Drug Therapy, Combination
  • Fatty Acids, Monounsaturated / administration & dosage
  • Fatty Acids, Monounsaturated / adverse effects*
  • Fluvastatin
  • Heterozygote*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Indoles / administration & dosage
  • Indoles / adverse effects*
  • Male
  • Multidrug Resistance-Associated Proteins / genetics*
  • Telmisartan

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Benzimidazoles
  • Benzoates
  • DNA Primers
  • Fatty Acids, Monounsaturated
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Indoles
  • Multidrug Resistance-Associated Proteins
  • multidrug resistance-associated protein 2
  • Fluvastatin
  • Cytochrome P-450 CYP2C9
  • Creatine Kinase
  • Telmisartan