Simvastatin and drug interactions

We have recently received updated advice from the Medical Health Regulatory Authority about the increased risk of myopathy associated with other medication being taken at the same time. Muscle aches with simvastatin are a fairly common side effect but myopathy is more serious when muscles become inflamed and then weak. The full advice can be read here on the MHRA website.

The commonest drug that will be affected is amlodipine. Amlodipine is a drug that we commonly use to treat patients with raised blood pressure and the new advice says that the maximum dose of simvastatin that should be used is 20mg.

We have decided that the easiest way to manage this situation is actually to swap patients to a different statin that does not have an interaction with amlodipine. Our thinking is that if patients are taking simvastatin in a dose of 40mg cutting the dose down to 20mg will have an adverse effect on their cholesterol control. Advice from Wakefield PCT Medicines Management departments is that switching patients from simvastatin 40mg to atrovastatin 10mg will have a similar effect on their cholesterol with none of the intereactions that simvastatin 40mg has.

So that is what we have done!





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