Atorvastatin; Lovastatin (<= 20 mg); Simvastatin (<= 10 mg)/Verapamil
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
If you are taking verapamil with lovastatin or simvastatin, your body may not process your cholesterol medicine correctly.If you are taking atorvastatin and verapamil, your body may not process verapamil correctly.
What might happen:
If you are taking verapamil with lovastatin or simvastatin, the amount of cholesterol medicine in your blood may increase and cause muscle problems.If you are taking atorvastatin and verapamil, the amount of verapamil in your blood may increase and cause more side effects than normal.
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.
1.Kantola T, Kivisto KT, Neuvonen PJ. Erythromycin and verapamil considerably increase serum simvastatin and simvastatin acid concentrations. Clin Pharmacol Ther 1998 Aug;64(2):177-82.
2.Mevacor (lovastatin) US prescribing information. Merck & Co., Inc. February, 2012.
3.Zocor (simvastatin) US prescribing information. Merck & Co., Inc. October, 2011.
4.Vytorin (ezetimibe/simvastatin) US prescribing information. Merck/Schering-Plough Pharmaceuticals October, 2012.
5.USFood and Drug Administration. 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.
6.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.
7.Choi DH, Shin WG, Choi JS. Drug interaction between oral atorvastatin and verapamil in healthy subjects: effects of atorvastatin on the pharmacokinetics of verapamil and norverapamil. Eur J Clin Pharmacol 2008 May;64(5):445-9.
8.Calan (verapamil hydrochloride) US prescribing information. Pfizer, Inc. November, 2011.