Moderate
amlodipine × atorvastatin
Calcium channel blockers (dihydropyridines)×HMG-CoA reductase inhibitors (statins)
Mechanism
Amlodipine weakly inhibits CYP3A4 – atorvastatin concentration rises by about 18 %. Clinically significant myopathy is rare but possible in patients with additional risk factors.
Management
Routine dose adjustment is not needed. If myalgia develops, check CK. If CK is above 4× ULN, temporarily withhold atorvastatin.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)— Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)— Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024