Inappropriate concomitant use of amlodipine and simvastatin: A report on its incidence in a primary care unit

Abstract

Sir, Metabolic syndrome (diabetes mellitus, dyslipidemia, hypertension and obesity) is a common metabolic disorder that can be seen around the world. Polypharmacy can be expected in patients with this syndrome and it sometimes causes adverse effects due to drug interaction. An important concern is the inappropriate concomitant use of amlodipine and simvastatin. It is reported that concomitant use can result in double dosing of simvastatin due to common passing of the CYP3A4,[1] and this can be a risk factor for myopathy. Here, the authors report on incidence of inappropriate concomitant use of amlodipine and simvastatin in a primary care unit of a tertiary hospital (the name is blinded due to privacy). Based on the data of 600 dyslipidemic cases in this setting, 120 (20%) cases were administered high-dose simvastatin (40 mg/day). Of interest, 30 (5%) had inappropriate concomitant use of amlodipine and simvastatin. This implies that general practitioners might not know the fact that concomitant use of amlodipine and high dosage of simvastatin can be a risk factor for myopathy.