Moderate
Amlodipine × Atorvastatin
Calcium channel blockers (dihydropyridines)×HMG-CoA reductase inhibitors (statins)
Mechanism
Amlodipine weakly inhibits CYP3A4 – a partial atorvastatin metabolic route. Atorvastatin plasma levels rise by about 18%. Clinically significant myopathy is rare.
Symptoms
Usually no additional symptoms. In patients with risk factors (older age, chronic kidney disease, hypothyroidism): muscle pain and weakness are possible.
Management
The combination is acceptable without dose change. Cap atorvastatin at 40 mg/day if needed. Check creatine kinase on muscle symptoms.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)– Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)– Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024