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A study of 252, 460 patients taking lipid-lowering medications (ie, atorvastatin, pravastatin, and simvastatin) for cholesterol showed a moderately low risk of developing rhabdomyolysisa disorder that results in the breakdown of muscle. Reporting in the Journal of the American Medical Association (December 1, 2004), the researchers discovered, however, that older patients with diabetes mellitus taking combined statin-fibrate therapy seemed at greater risk for rhabdomyolysis. Furthermore, the patients who were taking cerivastatin combined with fibrates had an even higher riskabout 1 in 10 treated patients a year.
Of all the patients being treated with cholesterol-lowering drugs, only 24 cases of hospitalized rhabdomyolysis happened during treatment. All of the patients with rhabdomyolysis were taking daily dosages of statins within the dose range suggested in product labeling. "Compared with statin monotherapy, fibrate use was associated with a 5.5-fold increase in risk, and the combined use of a statin and fibrate increased risk by an additional 2-fold versus fibrate alone,"said the study authors. "The risk of rhabdomyolysis with cerivastatin monotherapy was 10-fold greater than with other statins and, in combination with a fibrate, was increased more than 1400-fold."