Moderate
Amiodarone × Rosuvastatin
Class III antiarrhythmics (Vaughan Williams)×HMG-CoA reductase inhibitors (statins)
Mechanism
Rosuvastatin is minimally metabolised by CYP3A4, so amiodarone's CYP3A4 inhibition has limited effect. A slight AUC rise is possible via OATP1B1 transport. Additive myopathy risk is modest.
Symptoms
Muscle pain, weakness, dark urine. Rhabdomyolysis with rosuvastatin and amiodarone is rare.
Management
No dose adjustment needed. Cap rosuvastatin at 20 mg/day with amiodarone. Check CK if muscle pain develops. Alternative: pravastatin (minimal interaction).