Which medication risk is increased when combining simvastatin with amlodipine?

Which medication risk is increased when combining simvastatin with amlodipine?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypoglycemia
• D. Myopathy

Answer: (D)

Combining a statin with a calcium channel blocker raises the risk of muscle toxicity, specifically myopathy. Simvastatin is mainly broken down by the liver via the enzyme CYP3A4. Amlodipine can modestly inhibit this enzyme, increasing the level of simvastatin in the blood. When statin exposure is higher, the likelihood of muscle-related side effects rises, from mild myalgia to more serious rhabdomyolysis. This risk is dose-related, so using higher doses of simvastatin with amlodipine is particularly cautioned, and clinicians often limit the simvastatin dose or choose an alternative plan. Hyperkalemia, hyponatremia, and hypoglycemia are not typical consequences of this combination.

Combining a statin with a calcium channel blocker raises the risk of muscle toxicity, specifically myopathy. Simvastatin is mainly broken down by the liver via the enzyme CYP3A4. Amlodipine can modestly inhibit this enzyme, increasing the level of simvastatin in the blood. When statin exposure is higher, the likelihood of muscle-related side effects rises, from mild myalgia to more serious rhabdomyolysis. This risk is dose-related, so using higher doses of simvastatin with amlodipine is particularly cautioned, and clinicians often limit the simvastatin dose or choose an alternative plan. Hyperkalemia, hyponatremia, and hypoglycemia are not typical consequences of this combination.