Q. My mother-in-law is 86 years old and in reasonably good health. Several months ago, she started complaining about increased pain and seemed very weak and confused. Within a month, she could not walk and was forced to leave her home and move in with her granddaughter.
I looked her medications up and found a drug interaction between simvastatin (40 mg) and verapamil. We brought this to the attention of her doctor who said, “There is no interaction.”
On our own, we stopped the simvastatin and within 4 weeks she had improved dramatically. Two months later, she is now walking without a walker and feels pretty good.
She saw the doctor again the other day and her cholesterol was high, so he ordered Vytorin 10/80. I don’t get it: If she could not tolerate 40 mg of simvastatin what makes him think she can take 80 mg as part of a combination? How critical is it to lower cholesterol aggressively in a person her age? She has no history of heart disease.
A. The blood pressure drug verapamil can indeed boost blood levels of simvastatin (Clinical Pharmacology & Therapeutics, Aug.1998). Older people like your mother-in-law may be especially sensitive to the side effects, particularly muscle pain, weakness and mental confusion.
There is no convincing data showing that lowering cholesterol aggressively will extend life in an otherwise healthy person her age. If she can’t walk, the quality of her life and the risk of a fall could easily outweigh the drug benefits.
We’d like to send you our Guides to Drugs and Older People for an in-depth discussion of the pitfalls of medications for senior citizens.
