Rhabdomyolysis in the Setting of Concomitant Use of Tafamidis, Atorvastatin, and Amiodarone

Jessica Laird; Rodney H Falk; Melissa Coyle; Sarah A M Cuddy

doi:10.1016/j.jaccas.2020.09.037

Rhabdomyolysis in the Setting of Concomitant Use of Tafamidis, Atorvastatin, and Amiodarone

JACC Case Rep. 2020 Dec 2;2(15):2372-2375. doi: 10.1016/j.jaccas.2020.09.037. eCollection 2020 Dec.

Authors

Jessica Laird¹, Rodney H Falk^{1

2}, Melissa Coyle³, Sarah A M Cuddy^{1

2

4}

Affiliations

¹ Harvard Medical School, Boston, Massachusetts, USA.
² Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
³ Partners HealthCare Specialty Pharmacy, Burlington, Massachusetts, USA.
⁴ CV Imaging Program, Cardiovascular Division, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Abstract

An 85-year-old women with transthyretin cardiac amyloidosis presented with generalized weakness, elevated liver function test levels, and creatinine kinase consistent with rhabdomyolysis 1 week after starting tafamidis. She was already taking atorvastatin and amiodarone, raising the possibility of a drug-drug interaction inhibiting the breakdown and excretion of atorvastatin, causing drug-induced rhabdomyolysis. (Level of Difficulty: Intermediate.).

Keywords: ALT, alanine aminotransferase; AST, aspartate aminotransferase; ATTR, transthyretin amyloidosis; BCRP, breast cancer receptor protein; CK, creatinine kinase; CYP3A4, cytochrome P-450 3A4 pathway; LFT, liver function test; atherosclerosis; cardiomyopathy; restrictive.

Publication types

Case Reports