Amiodarone (also prescribed under the brand names Cordarone and Pacerone) is a medication designed to control abnormal heart rhythms. It can be a lifesaving drug, but it is especially prone to interacting with other medicines, especially those metabolized by an enzyme called CYP-3A4. Several of the cholesterol-lowering drugs, particularly simvastatin (also prescribed by brand name Zocor or in combination medicines called Vytorin and Simcor), are also metabolized by this enzyme. So are lovastatin (Mevacor) and atorvastatin (Lipitor). We suspect that these drugs would also interact with amiodarone. Red yeast rice might also be dangerous in combination with amiodarone.
According to a new warning from the FDA, patients on amiodarone should not take any more than 20 mg of simvastatin daily or they may be risking a serious complication called rhabdomyolysis. In this situation, muscle begins to break down and the muscle breakdown by-products overwhelm the kidneys, which can fail. This is an extremely dangerous interaction that can lead to disability or death.
Anyone who experiences muscle pain, weakness, spasm, stiffness or tenderness while taking this combination of drugs should notify the prescribing doctor immediately. Safety monitoring may require a urine test. Some doctors will prescribe a different cholesterol-lowering medicine for their heart patients on amiodarone to reduce the likelihood of such an interaction.
