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Mark R. Goldstein, MD
Crozer-Chester Medical Center Upland, Pa

JAMA. 1990;264(23):2991.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

The article by Pierce et al¹ on myopathy and rhabdomyolysis associated with the combination of lovastatin and gemfibrozil has several important messages. Most important, it provides firm evidence that the concomitant use of lovastatin and gemfibrozil should be avoided because of the apparent synergism of this combination in causing myopathy and rhabdomyolysis. This report is timely since other investigators have recently published data that support the efficacy of this combination in treating mixed hyperlipidemia.^2,3

Of the 12 cases reported, eight were in women 65 years of age and older. Although disturbing, this is not surprising, since prescribing practices in 1988 revealed that cholesterol-lowering drugs were given predominantly to women and the elderly.⁴ There have been no primary or secondary prevention trials of coronary heart disease using cholesterol-lowering drugs in women or the elderly to suggest their long-term safety and/or efficacy in decreasing end . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD, Senior Editor.

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