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Simvastatin + Amiodarone = Bad Combination

Posted Oct 03 2008 11:31am
New warning from USFDA on 080808 : When simvastatin is used with amiodarone, the patient will be exposed to higher risk of getting rhabdomyolysis.

Amiodarone is used to control a heart rhythm problem and simvastatin is used to lower cholesterol.

Cordarone (amiodarone) tab 200mg


RhabdomyolysisThe breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream. Some of these are harmful to the kidney and frequently result in kidney damage. (definition from Medlineplus )



This risk is dose-related and increases when a dose of simvastatin greater than 20 mg per day is given with amiodarone.

Before this, the warning on rhabdomyolysis caused by combination of simvastatin and amiodarone was already there. However, following the warning, serious reports of rhabdomyolysis were still keep coming in when amiodarone is used with simvastatin, especially when the doses of simvastatin greater than 20 mg daily.

Compared to other statins, the risk of rhabdomyolysis is more pronounced when simvastatin is administered with amiodarone.

In fact, all statins carry a potential risk of rhabdomyolysis, whether or not they are administered with amiodarone.

It's Statin again!


For healthcare professionals
  1. When prescribing simvastatin or simvastatin-containing medications, ASK whether the patient is taking amiodarone or not.
  2. If the patient is taking amiodarone, MAKE SURE the doses of simvastatin are NOT more than 20mg daily.
  3. TELL the patients to come back to you when they are experiencing any unexplained muscle pain, tenderness or weakness.
For the public
  1. TELL the doctors or pharmacists in charge about ALL the medications that you are currently taking (including over-the-counter, or herbal products)
  2. ASK about the medications that the doctors prescribed, or the pharmacist dispensed to you.
  3. BE AWARE of your own body, when you are experiencing any unexplained muscle pain, tenderness or weakness, please go back to the doctor!
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