Table 1.

Summary of Published Case Reports Describing an Interaction Between Simvastatin and Miodarone

DetailsPatient 17Patient 28Patient 312Patient 416Patient 521Current Patient
Simvastatin dose*80 mg40 mg80 mg40 mg40 mg80 mg
Amiodarone dose*200 mg200 mg100 mgNot reported600 mg200 mg
Other risk factorsChronic renal insufficiency, age, diabetes, recent surgeryAge, diabetes, recent surgeryChronic renal insufficiency, age, hypo-thyroidismAge, verapamilRecent surgery, clarithromycinAge, atazanavir, delviradine
Reported adverse eventRhabdomyolysisRhabdomyolysisRhabdomyolysisMyopathyMyositisRhabdomyolysis
Time to adverse event39 days14 days21 days2 years1 to 9 days19 days
Peak creatine kinase (U/L)19,62040,39228,52348,000>20,000>70,000
Dialysis requiredNoNoNoNoNoYes
OutcomeResolvedResolvedResolvedResolvedResolvedResolved after 1 month of dialysis
  • * Dose at time of adverse event.

  • Other risk factors include advanced age, chronic renal insufficiency, metabolic disorders such as diabetes or hypothyroidism, major surgery, alcohol abuse, and the use of concomitant medications (azole antifungals, macrolide antibiotics, HIV protease inhibitors, nefazodone, cyclosporine, danazol, verapamil, and amiodarone).

  • Time to adverse event from the time that amiodarone and simvastatin were being administered concomitantly.