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SARAH DEHONEY, PHARM.D., is Emergency Department Clinical Pharmacist, Department of Pharmacy Services, University of Utah, Salt Lake City; at the time of writing she was Pharmacotherapy Resident, Medical Center and College of Pharmacy Residency Program, Medical University of South Carolina, Charleston. MARLEA WELLEIN, PHARM.D., BCPS, is Clinical Pharmacist, Trident Medical Center, Charleston; at the time of writing she was Assistant Professor, Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy, Charleston.

Address correspondence to Dr. Dehoney at the Department of Pharmacy Services, University of Utah, 50 North Medical Drive, Room A050, Salt Lake City, UT 84132 (sarah.dehoney{at}hsc.utah.edu).

Purpose. A case of rhabdomyolysis associated with the use of Hydroxycut is reported. Summary. An 18-year-old Caucasian man arrived at an urgent care center complaining of bilateral leg pain and weakness. His creatine kinase (CK) concentration was 13,220 IU/L. He was diagnosed with rhabdomyolysis and instructed to go to the emergency room. He admitted to decreased urine output for four to five days before hospital admission. He had no significant past medical history, and his medications before symptom onset included Hydroxycut four caplets by mouth daily, naproxen sodium 220 mg by mouth as needed for pain, dextroamphetamine saccharate–amphetamine salts (Adderall) 15 mg by mouth once five days prior for a school examination, and hydrocodone–acetaminophen and cyclobenzaprine for pain. His social history revealed a recent increase in his exercise regimen, and his last alcoholic beverage was consumed five days prior. Upon admission, laboratory tests revealed elevated concentrations of CK, serum creatinine (SCr), aspartate transaminase, alanine transaminase (ALT), and alkaline phosphatase. The patient was diagnosed with rhabdomyolysis and treated with intravenous hydration. The patient’s leg tenderness was reduced, and he was discharged with instructions to stop Hydroxycut, increase fluid intake, avoid alcohol consumption, and limit physical activity for the next week. Two weeks after hospital discharge, the patient’s CK and liver enzyme values returned to normal, excluding ALT and SCr, which remained slightly elevated, and his lower-extremity tenderness fully resolved. Conclusion. An 18-year-old Caucasian man with no significant medical history developed rhabdomyolysis possibly associated with the ingestion of Hydroxycut in addition to his increased exercise regimen. Index terms: Acetaminophen; Amphetamines; Cyclobenzaprine; Dextroamphetamine saccharate; Dietary supplements; Hydrocodone; Naproxen sodium; Rhabdomyolysis; Toxicity