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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2015

Open Access 01-12-2015 | Case report

A 68-year old male presenting with rhabdomyolysis-associated acute kidney injury following concomitant use of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate and pravastatin/fenofibrate: a case report

Authors: Veronique Suttels, Eric Florence, John Leys, Marc Vekemans, Jef Van den Ende, Erika Vlieghe, Chris Kenyon

Published in: Journal of Medical Case Reports | Issue 1/2015

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Abstract

Introduction

We present what we believe to be the first case in the literature of rhabdomyolysis-induced renal failure caused by a probable drug interaction between elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) and pravastatin/fenofibrate.

Case presentation

A 68-year old Caucasian man presented with progressive pain in both legs two weeks after commencing treatment with EVG/COBI/FTC/TDF. He was found to have biochemical evidence of rhabdomyolysis and acute renal failure.

Conclusion

We emphasize the need for post marketing surveillance of adverse effects of new products. Pharmacokinetic studies are necessary to investigate the levels of pravastatin in patients taking COBI and fenofibrate with and without other comorbidities. Meanwhile, we suggest that creatine kinase levels should be monitored and patients advised to report myalgias when using concomitant EVG/COBI/FTC/TDF and pravastatin/fenofibrate. This case serves as an important reminder to use estimated glomerular filtration rates rather than serum creatinine levels when choosing new medications. If potentially nephrotoxic combinations are started in patients with borderline estimated glomerular filtration rates, it may be prudent to check these filtration rates more frequently than usual. In patients with reduced estimated glomerular filtration rates, potentially nephrotoxic combinations should be avoided wherever possible.
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Metadata
Title
A 68-year old male presenting with rhabdomyolysis-associated acute kidney injury following concomitant use of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate and pravastatin/fenofibrate: a case report
Authors
Veronique Suttels
Eric Florence
John Leys
Marc Vekemans
Jef Van den Ende
Erika Vlieghe
Chris Kenyon
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2015
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-015-0671-z

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