Rhabdomyolysis after co-prescription of statin and fusidic acidBMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6562 (Published 09 October 2012) Cite this as: BMJ 2012;345:e6562
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This issue was highlighted by the MHRA in the September 2011 issue of Drug Safety Update - see their website:
Competing interests: No competing interests
This timely reminder of the interaction between Fucidic Acid and Statins serves also to re-inforce the oft repeated message of some of us in the drug databsse business that linkage of knowledge about drugs including their interactions should be presented at the point of prescribing to prescribers who may be ignorant of the dangers in their co-prescribing. This can be done using Electronic Medical Records (EMR) with integrated intelligent drug databases. In the absence of these surely it behoves prescribers of such drugs as Fucidic acid (aside from the topical ones, I presume), as a systemic antibiotic to be aware of these dangers especially as they are almost always prescribed in a hospital setting where they have pharmacists to check and warn against such dangers.
The BNF and the Fucidin 'Specification of Product Characteristics (SPC)' clearly show these interactions :-
The risk of myopathy (also a side effect) including rhabdomyolysis(also a side effect) may be increased by the concomitant administration of systemic Fucidin® with statins. Co-administration of this combination may cause increased plasma concentrations of both agents. The mechanism of this interaction (whether it is pharmacodynamics or pharmacokinetic, or both) is yet unknown. There have been reports of rhabdomyolysis (including some fatalities) in patients receiving this combination. If treatment with Fucidin® is necessary, statin treatment should be discontinued throughout the duration of the Fucidin® treatment.'
This and comprehensive drug information can be checked on our browser at www.safescript.com which is freely accessible to all.
Competing interests: Roger Weeks and Colin Duncton produce the World Standard Drug Database.