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An elderly patient in my small 6000 size practice was admitted with rhabdomyolysis . I understood that this was said to a rare complication of statin prescribing use although at the time we had being persuaded to use cerivastatin rather than simvastatin for cost reasons by our NHS pharmaceutical advisors . I considered myself a cautious prescriber for the elderly having lived through the Opren story as a general medical practice registrar. Despite sticking to simvastatin and using it mainly for secondary prevention a patient in the practice had developed this rare statin muscle damage . My excellent MRCGP trained registar had attended the American Crestor (rovustatin) launch conference with her cardiologist husband and came back a statin evangelist . She had put this elderly patient with associated poor renal function on simvastatin . This patient developed a chest infection and as she was allergic to penicillin was given erythromycin . This interactive toxic cocktail produced the rhabdomyolysis from which the patient survived . At the practice critical incident review I decided to add the words avoid erthromycin on all practice statin prescriptions on the drug instructions to warn prescribers, pharmacists and patients to be wary of this drug combination .
No competing interests
21 March 2015
retired general medical practitioner / medical records compliance officer
Highfield Surgery , Highfield Way , Hazlemere . High Wycombe , Buckinghanshire , HP91TR