رجل عمره ٦٣ سنة بعد احتشاء، بدأ أتورفاستاتين ٨٠ ملغ قبل ٣ أسابيع، وأُضيف له مؤخراً كلاريثرومايسين لالتهاب صدري. يقول إن عضلات فخذيه تؤلمه وضعيفة، وبوله صار داكناً مثل الشاي. ما التصرف الصحيح؟

A 63-year-old man after an MI started atorvastatin 80 mg 3 weeks ago and recently also clarithromycin for a chest infection. He reports painful, weak thigh muscles and tea-coloured urine. What is the correct action?

1. Continue and take an analgesic, as muscle aches are common and settle
2. Take the dose in the morning instead of the evening to reduce pain
3. Hold the next dose and notify the prescriber for CK and renal tests
4. Drink two extra litres of water and continue the same dose

Answer: C) Hold the next dose and notify the prescriber for CK and renal tests. Muscle pain with dark urine on a statin suggests rhabdomyolysis, which can injure the kidneys. The drug is held and the prescriber notified for CK and kidney function.