Amiodarone is prescribed for a patient who is also on simvastatin 40 mg daily. What is the most significant concern with this combination?

Amiodarone is prescribed for a patient who

Multiple choice — select the best answer

AAmiodarone reduces simvastatin efficacy by inducing CYP3A4
BAdditive QTc prolongation requiring ECG monitoring only
CRisk of serious myopathy or rhabdomyolysis because amiodarone inhibits CYP3A4, raising simvastatin levels
DAmiodarone chelates simvastatin in the GI tract, preventing absorption

✓ Correct answer: C. Risk of serious myopathy or rhabdomyolysis because amiodarone inhibits CYP3A4, raising simvastatin levels Amiodarone inhibits CYP3A4, the primary enzyme metabolizing simvastatin; elevated simvastatin concentrations dramatically increase the risk of skeletal muscle toxicity including rhabdomyolysis, and the FDA limits simvastatin doses when used with amiodarone.

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Amiodarone is prescribed for a patient who is also on simvastatin 40 mg daily. What is the most significant concern with this combination?

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