Related Experiment Video
Updated: Aug 7, 2026
11:06
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Rhabdomyolysis and renal failure associated with gemfibrozil monotherapy
Richard D Layne1, Aasim S Sehbai, Linda J Stark
1School of Medicine, West Virginia University, Morgantown, WV 26506-9160, USA. rlayne@hsc.wvu.edu
The Annals of Pharmacotherapy
|January 27, 2004
Summary
Gemfibrozil monotherapy for hyperlipidemia can lead to rhabdomyolysis and acute kidney injury. Patients should be aware of the risks associated with strenuous activity and dehydration while taking this medication.
Area of Science:
- Pharmacology
- Nephrology
- Toxicology
Background:
- Hyperlipidemia is a common condition requiring management.
- Gemfibrozil is a lipid-lowering agent.
- Rhabdomyolysis and acute kidney injury are serious potential adverse events.
Observation:
- A 30-year-old man developed rhabdomyolysis and acute renal failure after starting gemfibrozil.
- The patient also engaged in strenuous physical exertion (jackhammer operation) and had underlying conditions (hypertension, type 1 diabetes).
- Elevated creatine kinase and creatinine levels confirmed the diagnosis.
Findings:
- This case represents a rare instance of gemfibrozil monotherapy causing rhabdomyolysis and acute renal failure in a patient with normal baseline renal function.
- Potential contributing factors included strenuous exertion, hypovolemia, and concurrent lisinopril use.
- An adverse drug reaction to gemfibrozil was deemed a possible cause.
Implications:
- Gemfibrozil monotherapy may increase the risk of rhabdomyolysis and acute renal failure.
- Patients prescribed gemfibrozil should be counseled on the potential risks, especially concerning strenuous exertion and dehydration.
- Prompt medical evaluation of myalgia (muscle pain) is crucial for early detection of potential rhabdomyolysis.
More Related Videos
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
01:30Drug toxicity: Drug–Drug Interaction
Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...