Drug interactions
Amiodarone + Simvastatin
Severity: Major
Amiodarone and Simvastatin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amiodarone raises simvastatin exposure, increasing the risk of myopathy and rhabdomyolysis. The risk is dose related.
What this interaction means in plain words
Amiodarone and Simvastatin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Simvastatin belongs to Cardiovascular.
Why it happens
Amiodarone inhibits CYP3A4 metabolism of simvastatin, increasing simvastatin acid exposure.
What to do
Limit simvastatin to 20 mg daily with amiodarone, or switch to a statin less reliant on CYP3A4 such as rosuvastatin or pravastatin. Advise patients to report muscle pain and check CK if symptoms occur.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
Frequently asked questions
Can I take Amiodarone with Simvastatin?
MediHelp rates the interaction as major. Amiodarone and Simvastatin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Amiodarone raises simvastatin exposure, increasing the risk of myopathy and rhabdomyolysis. The risk is dose related.
How serious is the interaction between Amiodarone and Simvastatin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit simvastatin to 20 mg daily with amiodarone, or switch to a statin less reliant on CYP3A4 such as rosuvastatin or pravastatin. Advise patients to report muscle pain and check CK if symptoms occur.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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