Report muscle problems while on statin drugs

Back to Home > Wednesday, Apr 12, 2006 Life & Home Posted on Wed, Apr. 12, 2006 email this print this

An ENT doctor prescribed an antibiotic called Biaxin XL. After the fifth dose, I developed severe muscle problems in my shoulders and upper arms as well as my back and calves of my legs. Later, when I returned to the pharmacy, I consulted a pill book they had and was shocked to find the combination of Biaxin and a statin drug could interact to cause a severe and possibly fatal reaction with the same symptoms I had. I'm taking the statin drug Pravachol. Can you tell me what you know about this condition?

Biaxin "XL" is an extended-release form of Biaxin (clarithromycin).

Pravachol (pravastatin) is a cholesterol-lowering drug.

Indeed, there are reports of interactions between statin drugs and Biaxin that lead to the muscle symptoms you mention. Implicated statins are lovastatin (Mevacor), simvastatin (Zocor) and possibly atorvastatin (Lipitor).

The interaction involves Biaxin's capacity to hinder the body's breakdown of the statin drug. This allows the statin drug to build up to higher than expected levels in the blood.

Excessive statin levels can lead to a condition called myopathy, with such muscle symptoms as pain, soreness, weakness and tenderness.

However, your case is puzzling because the Pravachol you take is broken down a different way by the body and would not be expected to undergo this interaction. Other statins not expected to interact with Biaxin are fluvastatin (Lescol) and rosuvastatin (Crestor).

In extreme cases, myopathy can progress to a very serious condition called rhabdomyolysis in which muscle-breakdown products damage the kidneys. This is probably the condition you read about in the pill book.

Apart from such drug interactions, statin-related muscle symptoms usually are not serious and may improve over time. But you want to err on the side of caution. Individuals on statin therapy should immediately report any unexpected muscle symptoms. Blood levels of a muscle enzyme called CK can be measured to determine whether these symptoms might be serious.

No question, just some information for your readers: I take that same Viteyes vitamin formulation you mentioned in a recent column. My ophthalmologist also recommended it to help prevent the age-related macular degeneration.

Viteyes supplies 15 mg of beta carotene, along with zinc (40 mg), copper (2 mg), vitamin E (200 IU) and vitamin C (250 mg).

In that column, I mentioned eye doctors might wish to consider a product with lutein instead of beta carotene. Lutein is in the same family as beta carotene.

Some studies indicate a lutein-rich diet may reduce the risk of developing age-related macular degeneration and cataracts. Getting 6 mg daily through either diet or supplements has been suggested.

Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books. Write him at 1224 King Henry Drive, Ocean Springs, MS 39564; or rharkn@aol. com. Selected questions will be used in the column.

This is cache, read story here