Canagliflozin can lead to statin toxicity, case report finds
A case report describes a patient who had taken rosuvastatin for five years and had new muscle pain and difficulty ambulating two weeks after initiation of canagliflozin.
A patient with type 2 diabetes developed statin-induced myotoxicity after the initiation of canagliflozin, according to a case report published Aug. 4 by Annals of Internal Medicine.
The report describes a previously high-functioning 76-year-old woman who presented to the hospital with new-onset muscle pain and difficulty ambulating. She had taken rosuvastatin, 40 mg/d, for more than five years without a problem, but 15 days before presentation, she had begun treatment for her diabetes with canagliflozin, 100 mg/d. Three days after initiating canagliflozin, she had noticed bilateral thigh pain and weakness.
On admission, the patient's plasma rosuvastatin concentration was 176 ng/mL, which the report authors noted was more than 15-fold the mean value expected based on the dose. After discontinuation of rosuvastatin and canagliflozin and administration of an IV crystalloid, she recovered.
“To our knowledge, this is the first published report of a drug interaction between rosuvastatin and canagliflozin. The possibility of such an interaction is important because these drugs are taken by millions of patients worldwide and are increasingly prescribed together,” the authors wrote. “On the basis of our experience with this patient, we encourage clinicians to remain vigilant for features of myotoxicity when canagliflozin and rosuvastatin are coprescribed.”