Rosuvastatin Myotoxicity After Starting Canagliflozin Treatment
Authors: Ahmad Alamer, Charisse Te, Maryam T. Fazel
Journal: Annals of Internal Medicine (2021)

LettersMarch 2021Rosuvastatin Myotoxicity After Starting Canagliflozin TreatmentAhmad Alamer, PharmD, Charisse Te, MD, Maryam T. Fazel, PharmDAhmad Alamer, PharmDUniversity of Arizona, Tucson, Arizona, and Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi ArabiaSearch for more papers by this author, Charisse Te, MDBanner – University Medicine and University of Arizona, Tucson, ArizonaSearch for more papers by this author, Maryam T. Fazel, PharmDBanner – University Medicine and University of Arizona, Tucson, ArizonaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-1454 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Brailovski and colleagues (1) attributed their patient's rosuvastatin-induced myotoxicity to a possible rosuvastatin–canagliflozin interaction. The assumed interaction was based on known and speculated factors. The known factors include the roles of organic anion-transporting polypeptides (OATPs) 1B1 and 1B3 in facilitating rosuvastatin uptake into hepatocytes and breast cancer resistance protein (BCRP) in facilitating its intestinal absorption and biliary/renal elimination. Subsequent speculation was that rosuvastatin accumulation resulted from inhibition of the OATPs and BCRP by canagliflozin. However, this speculation is not supported by the cited study. Canagliflozin had less than 50% in vitro inhibition of OATP1B1 and OATP1B3, and ...References1. Brailovski E, Kim RB, Juurlink D. Rosuvastatin myotoxicity after starting canagliflozin treatment: a case report [Letter]. Ann Intern Med. 2020;173:585-7. doi:10.7326/L20-0549 LinkGoogle Scholar2. Mamidi RNVS, Dallas S, Sensenhauser C, et al. In vitro and physiologically-based pharmacokinetic based assessment of drug-drug interaction potential of canagliflozin. Br J Clin Pharmacol. 2017;83:1082-96. [PMID: 27862160] doi:10.1111/bcp.13186 CrossrefMedlineGoogle Scholar3. Product monograph: CRESTOR rosuvastatin calcium tablets, 5, 10, 20 and 40 mg. AstraZeneca Canada; 2020. Google Scholar4. DeGorter MK, Tirona RG, Schwarz UI, et al. Clinical and pharmacogenetic predictors of circulating atorvastatin and rosuvastatin concentrations in routine clinical care. Circ Cardiovasc Genet. 2013;6:400-8. [PMID: 23876492] doi:10.1161/CIRCGENETICS.113.000099 CrossrefMedlineGoogle Scholar5. Perkovic V, Jardine MJ, Neal B, et al; CREDENCE Trial Investigators. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019;380:2295-306. [PMID: 30990260] doi:10.1056/NEJMoa1811744 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Arizona, Tucson, Arizona, and Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi ArabiaBanner – University Medicine and University of Arizona, Tucson, ArizonaDisclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-1454. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRosuvastatin Myotoxicity After Starting Canagliflozin Treatment: A Case Report Eugene Brailovski , Richard B. Kim , and David Juurlink Rosuvastatin Myotoxicity After Starting Canagliflozin Treatment Rao N.V.S. Mamidi , Damayanthi Devineni , Don Sun , Yshai Yavin , and Norman Rosenthal Rosuvastatin Myotoxicity After Starting Canagliflozin Treatment Eugene Brailovski , Richard B. Kim , and David Juurlink Metrics March 2021Volume 174, Issue 3Page: 431 ePublished: 16 March 2021 Issue Published: March 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...