| Title | Concurrent use of statins and amiodarone. | | Author(s) | Borders-Hemphill V | | Institution | Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology, Division of Epidemiology, Silver Spring, Maryland 20903, USA. | | Source | Consult Pharm 2009 May; 24(5):372-9. | | MeSH | Aged
Amiodarone
Anti-Arrhythmia Agents
Databases, Factual
Drug Interactions
Drug Monitoring
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Longitudinal Studies
Male
Middle Aged
Retrospective Studies
Rhabdomyolysis
| | Abstract | OBJECTIVE: To estimate the concurrent use between statins and amiodarone in context with published case reports of drug-interaction-induced rhabdomyolysis.
DESIGN: Retrospective analysis of a longitudinal prescription claims database for concurrent prescriptions of statins and amiodarone dispensed during 2006. PATIENTS,
PARTICIPANTS: The study population includes an unprojected annual number of patients who filled a prescription for an HMG CoA reductase inhibitor or simvastatin-containing products or lovastatin-containing products or Lipitor (atorvastatin) or Caduet (amlodipine/atorvastatin) concurrently with brand and generic forms of amiodarone during 2006. The concurrency analysis was used to provide context for published case reports of rhabdomyolysis/myopathy related to simvastatin and amiodarone concurrent use.
MAIN OUTCOME MEASURE: Episodes of concurrent use between statins and amiodarone.
RESULTS: Findings from this analysis indicate noteworthy amiodarone and statin concurrency (44%) when based on amiodarone patient volume. Atorvastatin had the greatest level of concurrency (23.5%) with amiodarone followed by simvastatin (13.3%). Proportionality based on amiodarone patient volume shows a greater level of concurrency with 20 mg (6%) and 40 mg (5.5%) simvastatin strengths compared with other simvastatin strengths.
CONCLUSION: Clinicians should be vigilant in monitoring the regimens of patients prescribed a statin with drugs that may increase the risk of myopathy. In particular, since nearly half of the patients prescribed amiodarone may also be prescribed a statin, then addition of amiodarone or changes in statin dose should trigger a drug regimen review and patient level monitoring. Clinicians should avoid simvastatin doses greater than 20 mg per day in patients taking amiodarone. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 19555146 |
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