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Rhabdomyolysis induced by darolutamide and rosuvastatin
E H Lee1, N E Gogolin2, M M Charpentier1,2
1South County Health, Wakefield, RI, USA.
Summary
Darolutamide, used for prostate cancer, can interact with rosuvastatin, causing rhabdomyolysis. Discontinuing or reducing rosuvastatin dosage is crucial to prevent this serious drug interaction.
Area of Science:
- Oncology
- Pharmacology
- Clinical Pharmacy
Background:
- Darolutamide is an androgen receptor antagonist for prostate cancer.
- Drug interactions involving darolutamide require careful management.
- Prostate cancer patients may be on multiple medications, increasing interaction risks.
Purpose of the Study:
- To report a case of rhabdomyolysis induced by the drug interaction between darolutamide and rosuvastatin.
- To highlight the importance of monitoring drug interactions in patients receiving darolutamide.
- To emphasize the clinical significance of darolutamide's effect on drug transporters.
Main Methods:
- A case report of a patient with castration-resistant prostate cancer treated with darolutamide.
- Pharmacist identified a potential drug interaction between darolutamide and rosuvastatin.
- Clinical assessment including creatine phosphokinase levels and patient-reported symptoms.
Main Results:
- The patient developed lower extremity weakness, myalgia, and elevated creatine phosphokinase.
- Rhabdomyolysis was diagnosed, attributed to the darolutamide-rosuvastatin interaction.
- Symptoms and creatine phosphokinase levels improved after discontinuing rosuvastatin.
Conclusions:
- Darolutamide's inhibition of BCRP and OATP transporters can increase rosuvastatin levels.
- This interaction elevates the risk of statin-associated muscle symptoms, including rhabdomyolysis.
- Careful medication review and dose adjustment are essential when co-administering darolutamide and rosuvastatin.
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