Amiodarone Injection Solution and Simcor

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using simvastatin together with amiodarone. Combining these medications may significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications, or your doctor may prescribe alternative medications that do not interact. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with simvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: The use of amiodarone with higher dosages of simvastatin or lovastatin may be associated with an increased risk of myopathy. In an ongoing clinical trial, myopathy was reported in 6% of patients receiving simvastatin 80 mg and amiodarone. There is also a reported case of rhabdomyolysis in a patient who received simvastatin 40 mg with amiodarone for 2 weeks. The proposed mechanism is inhibition by amiodarone of intestinal and hepatic CYP450 3A4, resulting in enhanced bioavailability as well as reduced clearance of simvastatin and its active metabolite, simvastatin acid. Although not studied, the interaction is also expected to occur with lovastatin due to its similar metabolic profile to simvastatin. In general, the risk of myopathy associated with the statin class of drugs is thought to be dose-related and increased by high levels of HMG-CoA reductase inhibitory activity in plasma. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: Simvastatin dosage should not exceed 20 mg daily and lovastatin dosage not exceed 40 mg daily when used in combination with amiodarone. The benefits of this combination should be carefully weighed against the potentially increased risk of myopathy including rhabdomyolysis. Fluvastatin, pravastatin, and rosuvastatin are probably safer alternatives in patients receiving amiodarone, since they are not metabolized by CYP450 3A4. All patients treated with HMG-CoA reductase inhibitors should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Amiodarone Injection Solution

Generic Name: amiodarone

Brand name: Pacerone, Cordarone, Nexterone

Synonyms: Amiodarone

What is Amiodarone Injection Solution?

Simcor

Generic Name: niacin / simvastatin

Brand name: Simcor

Synonyms: n.a.

What is Simcor?