There is some evidence of a high incidence
of myopathy when amiodarone
is given with high doses of simvastatin
. Rarely, cases of myopathy and rhabdomyolysis have been reported in patients taking this combination.
It is generally recommended that the dose of simvastatin
should not exceed 20 mg daily in patients taking amiodarone
unless the clinical
benefit is likely to
outweigh the increased risk of myopathy and rhabdomyolysis. However, one manufacturer contraindicates the combination.