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However, since rifampin is a potent inhibitor of the primary first-pass hepatic statin uptake transporter, the organic anion transporting polypeptide 1B1 (OATP1B1), simultaneous administration has been shown to significantly increase statin exposure. We report a previously fluvastatin-tolerant 63-year-old woman with nonalcoholic steatohepatitis who developed statin-induced rhabdomyolysis four weeks after the initiation and co-administration of rifampin for tuberculosis. After both medications were stopped, the patient showed clinical and biochemical improvement. While this report is the first to describe a clinical outcome of this interaction, multiple pharmacokinetic studies have demonstrated opposing, time-dependent rifampin effects on statin concentrations. Safe management of this challenging interaction includes statin dose reduction and\/or separate administration upon rifampin initiation until the anticipated onset of CYP induction, followed by careful and gradual dose titration with monitoring of both effectiveness and toxicity.<\/jats:p>","DOI":"10.1093\/omcr\/omag144","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T11:41:17Z","timestamp":1784374877000},"source":"Crossref","is-referenced-by-count":0,"title":["Rifampin-induced fluvastatin toxicity: a case report and review of literature"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5688-8021","authenticated-orcid":false,"given":"Ahmed","family":"Farghali","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Hamad General Hospital , P.O. box 3050, Doha 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