Simvastatin (>20 mg)/Amlodipine
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Amlodipine may slow down how quickly your liver processes simvastatin.
What might happen:
The levels of simvastatin may build up in your blood. This may cause damage to your muscles.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together. Your doctor may want to change the dose of your cholesterol medicine or you may need to take a different cholesterol medicine.Tell your doctor right away if you experience muscle pain, tenderness, or weakness; unexplained tiredness; or discolored urine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Anonymous. FDA Drug Safety Communication: New restrictions, contraindications, and dose limitations for Zocor (simvastatin) to reduce the risk of muscle injury. available at: http://www.fda.gov/Drugs/DrugSafety/ucm256581.htm June 8, 2011.
2.Zocor (simvastatin) US prescribing information. Merck & Co., Inc. October, 2011.
3.Vytorin (ezetimibe/simvastatin) US prescribing information. Merck/Schering-Plough Pharmaceuticals October, 2012.
4.Ede M. Dear Canadian Healthcare Professional: Subject: ZOCOR (simvastatin) - New Safety Recommendations on Dosage Associated with the Increased Risk of Myopathy/Rhabdomyolysis. Merck Canada Inc. November 7, 2012.
5.Park CG, Lee H, Choi JW, Lee SJ, Kim SH, Lim HE. Non-concurrent dosing attenuates the pharmacokinetic interaction between amlodipine and simvastatin. Int J Clin Pharmacol Ther 2010 Aug;48(8):497-503.
6.Nishio S, Watanabe H, Kosuge K, Uchida S, Hayashi H, Ohashi K. Interaction between amlodipine and simvastatin in patients with hypercholesterolemia and hypertension. Hypertens Res 2005 Mar;28(3):223-7.
7.Deme D, Al-Hadad A, Varga T, Szanto E, Sandor K, Rakonczai E. Maximal initial dose of simvastatin causing acute renal failure through rhabdomyolysis: risk factors, pathomechanism and therapy related to a case. Orv Hetil 2009 Feb 8;150(6):265-9.
