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Amlodipine/atorvastatin Disease Interactions

There are 9 disease interactions with amlodipine / atorvastatin.

Major

CCBs (applies to amlodipine/atorvastatin) cardiogenic shock/hypotension

Major Potential Hazard, High plausibility. Applicable conditions: Aortic Stenosis

In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.

References

  1. Stehle G, Buss J, Eibach J, et al. (1990) "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet, 336, p. 1079
  2. (2002) "Product Information. Vascor (bepridil)." McNeil Pharmaceutical
  3. (2002) "Product Information. Cardizem (diltiazem)." Hoechst Marion Roussel
  4. (2001) "Product Information. Calan (verapamil)." Searle
  5. Kubota K, Pearce GL, Inman WHW (1995) "Vasodilation-related adverse events in diltiazem and dihydropyridine calcium antagonists studied by prescription-event monitoring." Eur J Clin Pharmacol, 48, p. 1-7
  6. Pahor M, Manto A, Pedone C, Carosella L, Guralnik JM, Carbonin P (1996) "Age and severe adverse drug reactions caused by nifedipine and verapamil." J Clin Epidemiol, 49, p. 921-8
View all 6 references
Major

CCBs (applies to amlodipine/atorvastatin) coronary artery disease

Major Potential Hazard, Low plausibility. Applicable conditions: Ischemic Heart Disease

Increased frequency, duration, and/or severity of angina, as well as acute myocardial infarction, have rarely developed during initiation or dosage increase of calcium channel blockers (CCBs), particularly in patients with severe obstructive coronary artery disease and those treated with immediate-release formulations. The mechanism of this effect is not established. Therapy with CCBs should be administered cautiously in patients with significant coronary artery disease.

References

  1. Schanzenbacher P, Deeg P, Liebau G, Kochsiek K (1984) "Paradoxical angina after nifedipine: angiographic documentation." Am J Cardiol, 53, p. 345-6
  2. Manga P, Vythilingum (1984) "Unstable angina precipitated by nifedipine." S Afr Med J, 66, p. 144
  3. Sia STB, MacDonald PS, Triester B, et al. (1985) "Aggravation of myocardial ischaemia by nifedipine." Med J Aust, 142, p. 48-50
  4. Myrhed M, Wiholm B-E (1986) "Nifedipine: a survey of adverse effects." Acta Pharmacol Toxicol (Copenh), 58, p. 133-6
  5. Lambert CR, Hill JA, Feldman RL, Pepine CJ (1985) "Myocardial ischemia during intravenous nicardipine administration." Am J Cardiol, 55, p. 844-5
  6. Thomassen AR, Bagger JP, Nielsen TT (1988) "Hemodynamic and cardiac metabolic changes during nicardipine-induced myocardial ischemia." Cathet Cardiovasc Diagn, 14, p. 41-3
  7. (2002) "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals
  8. (2002) "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc
  9. (2002) "Product Information. Procardia (nifedipine)." Pfizer U.S. Pharmaceuticals
  10. Furberg CD, Psaty BM, Meyer JV (1995) "Nifedipine: dose-related increase in mortality in patients with coronary heart disease." Circulation, 92, p. 1326-31
  11. Kloner RA (1995) "Nifedipine in ischemic heart disease." Circulation, 92, p. 1074-8
  12. Yusuf S (1995) "Calcium antagonists in coronary artery disease and hypertension: time for reevaluation?" Circulation, 92, p. 1079-82
  13. (2001) "Product Information. Sular (nisoldipine)." Astra-Zeneca Pharmaceuticals
  14. Oei SG, Oei SK, Brolmann HAM (1999) "Myocardial infarction during nifedipine therapy for preterm labor." N Engl J Med, 340, p. 154
  15. Abernathy DR, Schwrtz JB (1999) "Calcium-antagonist drugs." N Engl J Med, 341, p. 1447-57
View all 15 references
Major

CCBs (applies to amlodipine/atorvastatin) liver disease

Major Potential Hazard, High plausibility.

Calcium channel blockers (CCBs) are extensively metabolized by the liver. The half-lives of CCBs may be prolonged substantially in patients with severe hepatic impairment, with the potential for significant drug accumulation. In addition, the use of some CCBs has been associated with elevations in serum transaminases, both with and without concomitant elevations in alkaline phosphatase and bilirubin. While these effects may be transient and reversible, some patients have developed cholestasis or hepatocellular injury. Therapy with CCBs should be administered cautiously and often at reduced dosages in patients with significantly impaired hepatic function. Periodic monitoring of liver function is advised.

References

  1. Echizen H, Eichelbaum M (1986) "Clinical pharmacokinetics of verapamil, nifedipine and diltiazem." Clin Pharmacokinet, 11, p. 425-49
  2. Saracheck NS, London RL, Matulewicz TJ, et al. (1985) "Diltiazem and granulomatous hepatitis." Gastroenterology, 88, p. 1260-2
  3. Shallcross H, Padley SP, Glynn MJ, Gibbs DD (1987) "Fatal renal and hepatic toxicity after treatment with diltiazem." Br Med J, 295, p. 1256-7
  4. Colombo G, Zucchella G, Planca E, Grieco A (1987) "Intravenous diltiazem in the treatment of unstable angina: a study of efficacy and tolerance." Clin Ther, 9, p. 536-47
  5. Toft E, Vyberg M, Therkelsen K (1991) "Diltiazem-induced granulomatous hepatitis." Histopathology, 18, p. 474-5
  6. Abramson M, Littlejohn GO (1985) "Hepatic reactions to nifedipine." Med J Aust, 142, p. 47-8
  7. Toner M, White A, Moriarty J, Clancy L (1988) "Allergic urticarial eruption, leukocytosis and abnormal liver function tests following nifedipine administration." Chest, 93, p. 1320-1
  8. Babany G, Uzzan F, Larrey D, et al. (1989) "Alcoholic-like liver lesions induced by nifedipine." J Hepatol, 9, p. 252-5
  9. Brodsky SJ, Cutler SS, Weiner DA, Klein MD (1981) "Hepatotoxicity due to treatment with verapamil." Ann Intern Med, 94, p. 490-1
  10. Somogyi A, Albrecht M, Kliems G, et al. (1981) "Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis." Br J Clin Pharmacol, 12, p. 51-60
  11. Woodcock BG, Rietbrock I, Vohringer HF, Rietbrock N (1981) "Verapamil disposition in liver disease and intensive-care patients: kinetics, clearance, and apparent blood flow relationships." Clin Pharmacol Ther, 29, p. 27-34
  12. Woodcock BG, Rietbrock N (1982) "Verapamil bioavailability and dosage in liver disease." Br J Clin Pharmacol, 13, p. 240-1
  13. Stern EH, Pitchon R, King BD, Wiener I (1982) "Possible hepatitis from verapamil." N Engl J Med, 306, p. 612-3
  14. Stehle G, Buss J, Eibach J, et al. (1990) "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet, 336, p. 1079
  15. Hare DL, Horowitz JD (1986) "Verapamil hepatotoxicity: a hypersensitivity reaction." Am Heart J, 111, p. 610-11
  16. Guarascio P, D'Amato C, Sette P, et al. (1984) "Liver damage from verapamil." Br Med J, 288, p. 362-3
  17. Dow RJ, Graham DJM (1986) "A reveiw of the human metabolism and pharmacokinetics of nicardipine hydrochloride." Br J Clin Pharmacol, 22, s195-202
  18. McAllister RG Jr, Hamann SR, Blouin RA (1985) "Pharmacokinetics of calcium-entry blockers." Am J Cardiol, 55, b30-40
  19. Kates RE (1983) "Calcium antagonists: pharmacokinetic properties." Drugs, 25, p. 113-24
  20. Finucci GF, Padrini R, Piovan D, et al. (1988) "Verapamil pharmacokinetics and liver function in patients with cirrhosis." Int J Clin Pharmacol Res, 8, p. 123-6
  21. Giacomini KM, Massoud N, Wong FM, Giacomini JC (1984) "Decreased binding of verapamil to plasma proteins in patients with liver disease." J Cardiovasc Pharmacol, 6, p. 924-8
  22. Razak TA, McNeil JJ, Sewell RB, Drummer OH, Smallwood RA, Conway EL, Louis WJ (1990) "The effect of hepatic cirrhosis on the pharmacokinetics and blood pressure response to nicardipine." Clin Pharmacol Ther, 47, p. 463-9
  23. Rush WR, Alexander O, Hall DJ, Cairncross L, Dow RJ, Graham DJ (1986) "The metabolism of nicardipine hydrochloride in healthy male volunteers." Xenobiotica, 16, p. 341-9
  24. Benet LZ (1985) "Pharmacokinetics and metabolism of bepridil." Am J Cardiol, 55, c8-13
  25. Kurosawa S, Kurosawa N, Owada E, et al. (1990) "Pharmacokinetics of diltiazem in patients with liver cirrhosis." Int J Clin Pharmacol Res, 10, p. 311-8
  26. Elliott HL, Meredith PA (1991) "The clinical consequences of the absorption, distribution, metabolism and excretion of amlodipine." Postgrad Med J, 67, s20-3
  27. Stopher DA, Beresford AP, Macrae PV, Humphrey MJ (1988) "The metabolism and pharmacokinetics of amlodipine in humans and animals." J Cardiovasc Pharmacol, 12, s55-9
  28. Kleinbloesem CH, van Harten J, Wilson JP, et al. (1986) "Nifedipine: kinetics and hemodynamic effects in patients with liver cirrhosis after intravenous and oral administration." Clin Pharmacol Ther, 40, p. 21-8
  29. Raemsch KD, Sommer J (1983) "Pharmacokinetics and metabolism of nifedipine." Hypertension, 5, p. 18-24
  30. Ramsch KD, Graefe KH, Scherling D, et al. (1986) "Pharmacokinetics and metabolism of calcium-blocking agents nifedipine, nitrendipine, and nimodipine." Am J Nephrol, 6, p. 73-80
  31. Challenor VF, Waller DG, Renwick AG, et al. (1987) "The trans-hepatic extraction of nifedipine." Br J Clin Pharmacol, 24, p. 473-7
  32. Dunselman PH, Edgar B (1991) "Felodipine clinical pharmacokinetics." Clin Pharmacokinet, 21, p. 418-30
  33. Regardh CG, Edgar B, Olsson R, Kendall M, Collste P, Shansky C (1989) "Pharmacokinetics of felodipine in patients with liver disease." Eur J Clin Pharmacol, 36, p. 473-9
  34. Cotting J, Reichen J, Kutz K, Laplanche R, Nuesch E (1990) "Pharmacokinetics of isradipine in patients with chronic liver disease." Eur J Clin Pharmacol, 38, p. 599-603
  35. Tse FL, Jaffe JM (1987) "Pharmacokinetics of PN 200-110 (isradipine), a new calcium antagonist, after oral administration in man." Eur J Clin Pharmacol, 32, p. 361-5
  36. Graham D, Dow R, Hall D, Alexander O, Mroszczak E, Freedman A (1985) "The metabolism and pharmacokinetics of nicardipine hydrochloride in man." Br J Clin Pharmacol, 20, s23-8
  37. Gengo FM, Fagan SC, Krol G, Bernhard H (1987) "Nimodipine disposition and haemodynamic effects in patients with cirrhosis and age-matched controls." Br J Clin Pharmacol, 23, p. 47-53
  38. Meredith P, Elliott H (1992) "Clinical pharmacokinetics of amlodipine." Clin Pharmacokinet, 22, p. 22-31
  39. (2002) "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals
  40. (2002) "Product Information. Vascor (bepridil)." McNeil Pharmaceutical
  41. (2002) "Product Information. Cardizem (diltiazem)." Hoechst Marion Roussel
  42. (2002) "Product Information. Plendil (felodipine)." Merck & Co., Inc
  43. (2002) "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc
  44. (2002) "Product Information. Procardia (nifedipine)." Pfizer U.S. Pharmaceuticals
  45. (2002) "Product Information. Nimotop (nimodipine)." Bayer
  46. (2001) "Product Information. Calan (verapamil)." Searle
  47. Johnson KE, Balderston SM, Pieper JA, Mann DE, Reiter MJ (1991) "Electrophysiologic effects of verapamil metabolites in the isolated heart." J Cardiovasc Pharmacol, 17, p. 830-7
  48. "Product Information. Dynacirc (isradipine)." Sandoz Pharmaceuticals Corporation
  49. Kumar KL, Colley CA (1994) "Verapamil-induced hepatotoxicity." West J Med, 160, p. 485-6
  50. Traverse JH, Swenson LJ, Mcbride JW (1994) "Acute hepatic injury after treatment with diltiazem." Am Heart J, 127, p. 1636-9
  51. Scherling D, Karl W, Ahr G, Ahr HJ, Wehinger E (1988) "Pharmacokinetics of nisoldipine. III. Biotransformation of nisoldipine in rat, dog, monkey, and man." Arzneimittelforschung, 38, p. 1105-10
  52. (2001) "Product Information. Sular (nisoldipine)." Astra-Zeneca Pharmaceuticals
  53. Abernathy DR, Schwrtz JB (1999) "Calcium-antagonist drugs." N Engl J Med, 341, p. 1447-57
  54. (2020) "Product Information. Conjupri (levamlodipine)." CSPC Ouyi Pharmaceutical Co, Ltd
View all 54 references
Major

HMG-CoA reductase inhibitors (applies to amlodipine/atorvastatin) liver disease

Major Potential Hazard, High plausibility. Applicable conditions: Alcoholism

The use of HMG-CoA reductase inhibitors is contraindicated in patients with active liver disease or unexplained, persistent elevations of serum transaminases. HMG-CoA reductase inhibitors are extensively metabolized by the liver. Decreased drug metabolism may lead to accumulation and increased risk of toxicity, including biochemical abnormalities of liver function and, rarely, jaundice, hepatitis, cirrhosis, fatty change in the liver, and fulminant hepatic necrosis. Therapy with HMG-CoA reductase inhibitors should be administered cautiously in patients with a history of liver disease and/or heavy alcohol use. A lower initial dosage may be appropriate, and clinical monitoring of liver transaminase levels according to the individual product package labeling is recommended. Patients who develop elevated ALT or AST levels during therapy should be monitored until abnormalities resolve. If an increase above 3 times the upper limit of normal persists, consideration should be given to a reduction in dosage or withdrawal of therapy.

References

  1. Pan HY, DeValut AR, Wang-Iverson D, et al. (1990) "Comparative pharmacokinetics and pharmacodynamics of pravastatin and lovastatin." J Clin Pharmacol, 30, p. 1128-35
  2. Arnon R, Eisenberg S (1992) "Lovastatin-induced hepatitis." Isr J Med Sci, 28, p. 101-2
  3. Mauro VF (1993) "Clinical pharmacokinetics and practical applications of simvastatin." Clin Pharmacokinet, 24, p. 195-202
  4. Mauro VF, MacDonald JL (1991) "Simvastatin: a review of its pharmacology and clinical use." DICP, 25, p. 257-64
  5. Duggan DE, Chen IW, Bayne WF, Halpin RA, Duncan CA, Schwartz MS, Stubbs RJ, Vickers S (1989) "The physiological disposition of lovastatin." Drug Metab Dispos, 17, p. 166-73
  6. Pentikainen PJ, Saraheimo M, Schwartz JI, Amin RD, Schwartz MS, Brunner-Ferber F, Rogers JD (1992) "Comparative pharmacokinetics of lovastatin, simvastatin and pravastatin in humans." J Clin Pharmacol, 32, p. 136-40
  7. Everett DW, Chando TJ, Didonato GC, Singhvi SM, Pan HY, Weinstein SH (1991) "Biotransformation of pravastatin sodium in humans." Drug Metab Dispos, 19, p. 740-8
  8. Walker JF (1989) "Simvastatin: the clinical profile." Am J Med, 87, s44-6
  9. Simons LA (1993) "Simvastatin in severe primary hypercholesterolemia: efficacy, safety, and tolerability in 595 patients over 18 weeks. The Principal Investigators." Clin Cardiol, 16, p. 317-22
  10. McGovern ME, Mellies MJ (1993) "Long-term experience with pravastatin in clinical research trials." Clin Ther, 15, p. 57-64
  11. (1993) "Lovastatin 5-year safety and efficacy study. Lovastatin Study Groups I through IV." Arch Intern Med, 153, p. 1079-87
  12. Geddes JA (1990) "Cholestatic jaundice associated with lovastatin (mevacor) therapy." Can Med Assoc J, 143, p. 13-4
  13. McQueen MJ (1990) "Cholestatic jaundice associated with lovastatin (Mevacor) therapy." Can Med Assoc J, 142, p. 841-2
  14. Bilheimer DW (1990) "Long-term clinical tolerance of lovastatin and simvastatin." Cardiology, 77, p. 58-65
  15. Pan HY, Morrison RA, Singhvi SM, Frantz BM, Waclawski AP, Willard DA (1988) "Disposition of pravastatin sodium (SQ 31,000), a tissue-selective HMG-CoA reductase inhibitor, in healthy subjects." Clin Res, 36, a368
  16. (2002) "Product Information. Mevacor (lovastatin)." Merck & Co., Inc
  17. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  18. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  19. Levy RI, Troendle AJ, Fattu JM (1993) "A quarter century of drug treatment of dyslipoproteinemia, with a focus on the new HMG-CoA reductase inhibitor fluvastatin." Circulation, 87, i45-53
  20. Dain JG, Fu E, Gorski J, Nicoletti J, Scallen TJ (1993) "Biotransformation of fluvastatin sodium in humans." Drug Metab Dispos, 21, p. 567-72
  21. Tse FL, Jaffe JM, Troendle A (1992) "Pharmacokinetics of fluvastatin after single and multiple doses in normal volunteers." J Clin Pharmacol, 32, p. 630-8
  22. (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
  23. Halpin RA, Ulm EH, Till AE, Kari PH, Vyas KP, Hunninghake DB, Duggan DE (1993) "Biotransformation of lovastatin .5. species differences in invivo metabolite profiles of mouse, rat, dog, and human." Drug Metab Dispos, 21, p. 1003-11
  24. Jokubaitis LA (1994) "Updated clinical safety experience with fluvastatin." Am J Cardiol, 73, d18-24
  25. Davidson MH, on behalf of the FLUENT Investigators Group (1994) "Fluvastatin long-term extension trial (FLUENT): summary of efficacy and safety." Am J Med, 96 Suppl, 96 (suppl)
  26. Quion JAV, Jones PH (1994) "Clinical pharmacokinetics of pravastatin." Clin Pharmacokinet, 27, p. 94-103
  27. Grimbert S, Pessayre D, Degott C, Benhamou JP (1994) "Acute hepatitis induced by HMG-coa reductase inhibitor, lovastatin." Dig Dis Sci, 39, p. 2032-3
  28. Smit JW, Wijnne HJ, Schobben F, Sitsen A, Debruin TW, Erkelens DW (1995) "Effects of alcohol and fluvastatin on lipid metabolism and hepatic function." Ann Intern Med, 122, p. 678-80
  29. Smit JWA, Wijnne HJA, Schobben F, Sitsen A, Debruin TWA, Erkelens DW (1995) "Effects of alcohol consumption on pharmacokinetics, efficacy, and safety of fluvastatin." Am J Cardiol, 76, a89-96
  30. Bakker-Arkema RG, Davidson MH, Goldstein RJ, Davignon J, Isaacsohn JL, Weiss SR, Keilson LM, Brown WV, Miller VT, Shurzinske LJ, Black DM (1996) "Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia." JAMA, 275, p. 128-33
  31. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  32. Boberg M, Angerbauer R, Fey P, Kanhai WK, Karl W, Kern A, Ploschke J, Radtke M (1997) "Metabolism of cerivastatin by human liver microsomes in vitro. Characterization of primary metabolic pathways and of cytochrome P45 isozymes involved." Drug Metab Dispos, 25, p. 321-31
  33. (2001) "Product Information. Baycol (cerivastatin)." Bayer
  34. Cilla DD Jr, Whitfield LR, Gibson DM, Sedman AJ, Posvar EL (1996) "Multiple-dose pharmacokinetics, pharmacodynamics, and safety of atorvastatin, an inhibitor of HMG-CoA reductase, in healthy subjects." Clin Pharmacol Ther, 60, p. 687-95
  35. Lea AP, McTavish D (1997) "Atorvastatin. A review of its pharmacology and therapeutic potential in the management of hyperlipidaemias." Drugs, 53, p. 828-47
  36. Cilla DD Jr, Gibson DM, Whitfield LR, Sedman AJ (1996) "Pharmacodynamic effects and pharmacokinetics of atorvastatin after administration to normocholesterolemic subjects in the morning an evening." J Clin Pharmacol, 36, p. 604-9
  37. Posvar EL, Radulovic LL, Cilla DD Jr, Whitfield LR, Sedman AJ (1996) "Tolerance and pharmacokinetics of single-dose atorvastatin, a potent inhibitor of HMG-CoA reductase, in healthy subjects." J Clin Pharmacol, 36, p. 728-31
  38. Lennernas H, Fager G (1997) "Pharmacodynamics and pharmacokinetics of the HMG-CoA reductase inhibitors. Similarities and differences." Clin Pharmacokinet, 32, p. 403-25
  39. Muck W, Unger S, Kawano K, Ahr G (1998) "Inter-ethnic comparisons of the pharmacokinetics of the HMG-CoA reductase inhibitor cerivastatin." Br J Clin Pharmacol, 45, p. 583-90
  40. Hartleb M, Rymarczyk G, Januszewski K (1999) "Acute cholestatic hepatitis associated with pravastatin." Am J Gastroenterol, 94, p. 1388-90
  41. Nakad A, Bataille L, Hamoir V, Sempoux C, Horsmans Y (1999) "Atorvastatin-induced acute hepatitis with absence of cross-toxicity with simvastatin." Lancet, 353, p. 1763-4
  42. (2010) "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic)
View all 42 references
Major

HMG-CoA reductase inhibitors (applies to amlodipine/atorvastatin) rhabdomyolysis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Myopathy, Myoneural Disorder, Hypothyroidism, Renal Dysfunction

Severe myopathy, including rhabdomyolysis with acute renal failure secondary to myoglobinuria, has been reported rarely with the use of HMG-CoA reductase inhibitors. The myopathy may be dose-related and is characterized by muscle aches and/or weakness in conjunction with increases in creatine phosphokinase (CPK) values exceeding 10 times the upper limit of normal. Therapy with HMG-CoA reductase inhibitors should be administered cautiously in patients with preexisting myopathy, in those with predisposing factors for myopathy or with a history of myoneural disorder, since it may delay the recognition or confound the diagnosis of a drug-induced musculoskeletal effect. Patients should be advised to report promptly any unusual muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. Periodic CPK determinations may be considered in some patients, although the value of such monitoring is uncertain. HMG-CoA reductase inhibitor therapy should be withdrawn if markedly elevated CPK levels occur or if drug-related myopathy is diagnosed or suspected.

References

  1. Schalke BB, Schmidt B, Toyka K, Hartung H-P (1992) "Pravastatin-associated inflammatory myopathy." N Engl J Med, 327, p. 649-50
  2. Pierce LR, Wysowski DK, Gross TP (1990) "Myopathy and rhabdomyolysis associated with lovastatin-gemfibrozil combination therapy." JAMA, 264, p. 71-5
  3. Walker JF (1989) "Simvastatin: the clinical profile." Am J Med, 87, s44-6
  4. Simons LA (1993) "Simvastatin in severe primary hypercholesterolemia: efficacy, safety, and tolerability in 595 patients over 18 weeks. The Principal Investigators." Clin Cardiol, 16, p. 317-22
  5. McGovern ME, Mellies MJ (1993) "Long-term experience with pravastatin in clinical research trials." Clin Ther, 15, p. 57-64
  6. Reaven P, Witztum JL (1988) "Lovastatin, nicotinic acid, and rhabdomyolysis." Ann Intern Med, 109, p. 597-8
  7. (1993) "Lovastatin 5-year safety and efficacy study. Lovastatin Study Groups I through IV." Arch Intern Med, 153, p. 1079-87
  8. Corpier CL, Jones PH, Suki WN, et al. (1988) "Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients." JAMA, 260, p. 239-41
  9. East C, Alivizatos PA, Grundy SM, Jones PH, Farmer JA (1988) "Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation." N Engl J Med, 318, p. 47-8
  10. Norman DJ, Illingworth DR, Munson J, Hosenpud J (1988) "Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin." N Engl J Med, 318, p. 46-7
  11. Wallace CS, Mueller BA (1992) "Lovastatin-induced rhabdomyolysis in the absence of concomitant drugs." Ann Pharmacother, 26, p. 190-2
  12. Bilheimer DW (1990) "Long-term clinical tolerance of lovastatin and simvastatin." Cardiology, 77, p. 58-65
  13. (2002) "Product Information. Mevacor (lovastatin)." Merck & Co., Inc
  14. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  15. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  16. Chariot P, Abadia R, Agnus D, Danan C, Charpentier C, Gherardi RK (1993) "Simvastatin-induced rhabdomyolysis followed by a MELAS syndrome." Am J Med, 94, p. 109-10
  17. McDonagh J, Winocour P, Walker DJ (1993) "Musculoskeletal manifestations during simvastatin therapy." Br J Rheumatol, 32, p. 647-8
  18. Levy RI, Troendle AJ, Fattu JM (1993) "A quarter century of drug treatment of dyslipoproteinemia, with a focus on the new HMG-CoA reductase inhibitor fluvastatin." Circulation, 87, i45-53
  19. (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
  20. Fernandezzatarain G, Navarro V, Garcia H, Villatoro J, Calvo C (1994) "Rhabdomyolysis and acute renal failure associated with lovastatin." Nephron, 66, p. 483-4
  21. Jokubaitis LA (1994) "Updated clinical safety experience with fluvastatin." Am J Cardiol, 73, d18-24
  22. Lees RS, Lees AM (1995) "Rhabdomyolysis from the coadministration of lovastatin and the antifungal agent itraconazole." N Engl J Med, 333, p. 664-5
  23. Ahmand S (1995) "Lovastatin-induced myopathy in a hypothyroid patient." J Fam Pract, 41, p. 227-8
  24. Pedersen TR, Berg K, Cook TJ, Faergeman O, Haghfelt T, Kjekshus J, Miettinen T, Musliner TA, Olsson AG, Pyorala K, Thorgeirsso (1996) "Safety and tolerability of cholesterol lowering with simvastatin during 5 years in the scandinavian simvastatin survival study." Arch Intern Med, 156, p. 2085-92
  25. Bakker-Arkema RG, Davidson MH, Goldstein RJ, Davignon J, Isaacsohn JL, Weiss SR, Keilson LM, Brown WV, Miller VT, Shurzinske LJ, Black DM (1996) "Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia." JAMA, 275, p. 128-33
  26. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  27. Vanpuijenbroek EP, Dubufvereijken PWG, Spooren PFMJ, Vandoormaal JJ (1996) "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med, 240, p. 403-4
  28. (2001) "Product Information. Baycol (cerivastatin)." Bayer
  29. Grunden JW, Fisher KA (1997) "Lovastatin-induced rhabdomyolysis possibly associated with clarithromycin and azithromycin." Ann Pharmacother, 31, p. 859-63
  30. Iliadis EA, Rosenson RS (1999) "Long-term safety of pravastatin-gemfibrozil therapy in mixed hyperlipidemia." Clin Cardiol, 22, p. 25-8
  31. van Puijenbroek EP, Du Buf-Vereijken PW, Spooren PF, van Doormaal JJ (1996) "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med, 240, p. 403-4
  32. Alvarez JM, Rawdanowiz TJ, Goldstein J (1998) "Rhadbdomyolysis after coronary artery bypass grafting in a patient receiving simvastatin." J Thorac Cardiovasc Surg, 116, p. 654-5
  33. Pogson GW, Kindred LH, Carper BG (1999) "Rhabdomyolysis and renal failure associated with cerivastatin-gemfibrozil combination therapy." Am J Cardiol, 83, p. 1146
  34. (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
  35. (2010) "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic)
View all 35 references
Moderate

CCBs (applies to amlodipine/atorvastatin) CHF/AMI

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Congestive Heart Failure, Myocardial Infarction

Calcium channel blockers (CCBs) may have varying degrees of negative inotropic effect. Congestive heart failure (CHF), worsening of CHF, and pulmonary edema have occurred in some patients treated with a CCB, primarily verapamil. Some CCBs have also caused mild to moderate peripheral edema due to localized vasodilation of dependent arterioles and small blood vessels, which can be confused with the effects of increasing left ventricular dysfunction. Although some CCBs have been used in the treatment of CHF, therapy with CCBs should be administered cautiously in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, caution is advised in patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened by administration of a CCB.

References

  1. Gillmer DJ, Kark P (1980) "Pulmonary oedema precipitated by nifedipine." Br Med J, 280, p. 1420-1
  2. Batra AK, Segall PH, Ahmed T (1985) "Pulmonary edema with nifedipine in primary pulmonary hypertension." Respiration, 47, p. 161-3
  3. Myrhed M, Wiholm B-E (1986) "Nifedipine: a survey of adverse effects." Acta Pharmacol Toxicol (Copenh), 58, p. 133-6
  4. Prigogine T, Waterlot Y, Gottignies P, et al. (1991) "Acute nonhemodynamic pulmonary edema with nifedipine in primary pulmonary hypertension." Chest, 100, p. 563-4
  5. Batlouni M, Armaganijan D, Ghorayeb N, Magliano MF (1992) "Clinical efficacy and tolerability of isradipine in the treatment of mild-to-moderate hypertension in young and elderly patients." J Cardiovasc Pharmacol, 19, s53-7
  6. Walton T, Symes LR (1993) "Felodipine and isradipine: new calcium-channel-blocking agents for the treatment of hypertension." Clin Pharm, 12, p. 261-75
  7. Scheidt S, LeWinter MM, Hermanovich J, Venkataraman K, Freedman D (1986) "Efficacy and safety of nicardipine for chronic, stable angina pectoris: a multicenter randomized trial." Am J Cardiol, 58, p. 715-21
  8. Taylor SH, Frais MA, Lee P, Verma SP, Jackson N, Reynolds G, Silke B (1985) "A study of the long-term efficacy and tolerability of oral nicardipine in hypertensive patients." Br J Clin Pharmacol, 20, s139-42
  9. Dubois C, Blanchard D (1989) "Efficacy and safety of nicardipine in 29,104 patients with hypertension." Clin Ther, 11, p. 452-60
  10. Yedinak KC, Lopez LM (1991) "Felodipine: a new dihydropyridine calcium-channel antagonist." DICP, 25, p. 1193-206
  11. Lorimer AR, Pringle SD (1990) "The safety of felodipine." J Cardiovasc Pharmacol, 15, s85-9
  12. Sundstedt CD, Ruegg PC, Keller A, Waite R (1989) "A multicenter evaluation of the safety, tolerability, and efficacy of isradipine in the treatment of essential hypertension." Am J Med, 86, p. 98-102
  13. Ruegg PC, Nelson DJ (1989) "Safety and efficacy of isradipine, alone and in combination, in the treatment of angina pectoris." Am J Med, 86, p. 70-4
  14. (2002) "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals
  15. (2002) "Product Information. Plendil (felodipine)." Merck & Co., Inc
  16. (2002) "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc
  17. (2002) "Product Information. Procardia (nifedipine)." Pfizer U.S. Pharmaceuticals
  18. (2002) "Product Information. Nimotop (nimodipine)." Bayer
  19. "Product Information. Dynacirc (isradipine)." Sandoz Pharmaceuticals Corporation
  20. Fagan TC, Haggert BE, Liss C (1994) "Efficacy and tolerability of extended-release felodipine and extended-release nifedipine in patients with mild-to-moderate essential hypertension." Clin Ther, 16, p. 634-46
  21. Blecker D (1994) "Antihypertensive therapy with isradipine in patients with special safety concerns." Angiology, 45, p. 997-1008
  22. Brogden RN, Sorkin EM (1995) "Isradipine: an update of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the treatment of mild to moderate hypertension." Drugs, 49, p. 618-49
  23. Kubota K, Pearce GL, Inman WHW (1995) "Vasodilation-related adverse events in diltiazem and dihydropyridine calcium antagonists studied by prescription-event monitoring." Eur J Clin Pharmacol, 48, p. 1-7
  24. Johnson BF, Eisner GM, Mcmahon FG, Jain AK, Rudd P, Sowers JR (1995) "A multicenter comparison of adverse reaction profiles of isradipine and enalapril at equipotent doses in patients with essential hypertension." J Clin Pharmacol, 35, p. 484-92
  25. (2001) "Product Information. Sular (nisoldipine)." Astra-Zeneca Pharmaceuticals
  26. Sleight P (1996) "Calcium antagonists during and after myocardial infarction." Drugs, 51, p. 216-25
  27. Elkayam U (1998) "Calcium channel blockers in heart failure." Cardiology, 89, p. 38-46
  28. Schaefer RM, Aldons PM, Burgess ED, Tilvis R, Singh GP, Rehn L, Morgan TO (1998) "Improved tolerability of felodipine compared with amlodipine in elderly hypertensives: A randomised, double-blind study in 535 patients, focusing on vasodilatory adverse events." Int J Clin Pract, 52, p. 381
  29. Abernathy DR, Schwrtz JB (1999) "Calcium-antagonist drugs." N Engl J Med, 341, p. 1447-57
View all 29 references
Moderate

HMG-CoA reductase inhibitors (applies to amlodipine/atorvastatin) cognitive impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: CNS Disorder

Cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) have been observed in patients receiving statins. The reports are usually not serious, and reversible upon statin discontinuation. Caution is recommended when using these agents in patients with cognitive impairment.

References

  1. (2002) "Product Information. Mevacor (lovastatin)." Merck & Co., Inc
  2. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  3. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  4. (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  6. (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
View all 6 references
Moderate

HMG-CoA reductase inhibitors (applies to amlodipine/atorvastatin) diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus

Increases in HbA1c and fasting serum glucose levels have been reported with the use of certain HMG-CoA reductase inhibitors. Caution should be exercised when using these agents in diabetic patients and close monitoring is recommended.

References

  1. (2002) "Product Information. Mevacor (lovastatin)." Merck & Co., Inc
  2. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  3. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  4. (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  6. (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
  7. (2010) "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic)
View all 7 references
Moderate

HMG-CoA reductase inhibitors (applies to amlodipine/atorvastatin) renal disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Some HMG-CoA reductase inhibitors such as fluvastatin, have not been studied in patients with severe renal impairment or end-stage renal disease. Some others such as pitavastatin and simvastatin, require a dose reduction when used in this group of patients. Caution and close monitoring is advised when using these drugs in patients with renal impairment.

References

  1. (2002) "Product Information. Mevacor (lovastatin)." Merck & Co., Inc
  2. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  3. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  4. (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  6. (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
  7. (2010) "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic)
View all 7 references

Amlodipine/atorvastatin drug interactions

There are 720 drug interactions with amlodipine / atorvastatin.

Amlodipine/atorvastatin alcohol/food interactions

There are 4 alcohol/food interactions with amlodipine / atorvastatin.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.