Rapid onset of rhabdomyolysis after switching to a raltegravir-based antiretroviral regimen

J Microbiol Immunol Infect. 2016 Apr;49(2):286-8. doi: 10.1016/j.jmii.2013.02.008. Epub 2013 Apr 21.

Abstract

Raltegravir is the first integrase inhibitor antiretroviral agent that has been demonstrated to have antiviral efficacy and safety. However, the US Food and Drug Administration has recommended use with caution in patients with risk factors for rhabdomyolysis, based on four case reports of rhabdomyolysis in patients with identifiable risk factors. We present a 32-year-old Asian man with human immunodeficiency virus (HIV), but without other underlying diseases, who developed rapid-onset, raltegravir-associated rhabdomyolysis and hyperlactatemia. Our patient lacked predisposing factors for rhabdomyolysis, and the rapid onset time of 4 days was the shortest reported. Therefore, clinicians should exercise caution when using raltegravir and closely monitor all patients for the symptoms of muscle pain and weakness. This case has been reported to the National Adverse Drug Reactions Reporting System of the Department of Health in Taiwan.

Keywords: Antiretroviral agents; Hyperlactatemia; Raltegravir; Rhabdomyolysis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / adverse effects*
  • Asian People
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • Humans
  • Hyperlactatemia / chemically induced
  • Hyperlactatemia / pathology
  • Male
  • Raltegravir Potassium / administration & dosage
  • Raltegravir Potassium / adverse effects*
  • Rhabdomyolysis / chemically induced*
  • Rhabdomyolysis / complications
  • Rhabdomyolysis / pathology*
  • Taiwan
  • Time

Substances

  • Anti-Retroviral Agents
  • Raltegravir Potassium