It works by relaxing the muscles of your heart and blood vessels. It may be used alone or in combination with other high blood pressure medications.
Fifty-two patients (0.9%) in the 80-mg group versus one patient (0.02%) in the 20-mg group developed myopathy (defined as unexplained muscle weakness or pain with a serum CK >10 times the upper limit of normal [ULN]).
This risk appears to be higher during the first year of treatment, is often the result of interactions with certain medicines, and is frequently associated with a genetic predisposition toward simvastatin-related myopathy. In addition, clinical trial data from other long-term statin trials show higher overall rates of myopathy and rhabdomyolysis in patients treated with simvastatin 80 mg versus lower doses of simvastatin or other statins.When used with simvastatin, the following medications can raise the levels of simvastatin in the body and increase the risk of myopathy.
The most serious form of myopathy, called rhabdomyolysis, can damage the kidneys and lead to kidney failure which can be fatal.
)Atorva=Atorvastatin; Fluva=Fluvastatin; Pitava=Pitavastatin; Lova=Lovastatin; Prava=Pravastatin; Rosuva=Rosuvastatin; Simva=Simvastatin. N Engl J Med 1988; 319:385. An official website of the United States government: Cardizem (diltiazem) is a calcium channel blocker. Rhabdomyolysis is rare; hospitalized rhabdomyolysis occurs in 4.9 people out of every 100,000 people exposed to simvastatin for one full year (the average incidence for hospitalized rhabdomyolysis for atorvastatin, pravastatin, or simvastatin is 4.4 people out of every 100,000 people exposed to the drugs for one full year).FDA has revised the drug labels for simvastatin and Vytorin to include the new dosing restriction for the 80-mg dose. There were no fatalities related to rhabdomyolysis. Diltiazem (Note: These drugs are contraindicated with Simcor as Simcor is only available with 20 mg or 40 mg of simvastatin.) 1988; 2(2): pp. Lactation: Drug enters breast milk; because of risk for serious adverse reactions in nursing infants from diltiazem, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Pregnancy Rating: C; Lactation: Renal Dosing: Not studied, use caution; Hepatic Dosing: Not studied, use caution; Contraindications. 21. Multicenter Diltiazem Postinfarction Trial Research Group.
This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.Things to remember when you fill your prescription.WebMD does not provide medical advice, diagnosis or treatment. The therapeutic effects of diltiazem are related to its ability to inhibit the influx of calcium ions during membrane depolarization of cardiac and vascular smooth muscle.
Cardiovasc Drugs Ther . The labels for simvastatin, Vytorin, and Simcor were also revised to include new dosing recommendations when these drugs are used with certain medicines that interact with simvastatin to increase the level of simvastatin in the body. Diltiazem is a calcium ion cellular influx inhibitor, slow channel blocker or calcium antagonist. Patients with myopathy generally have muscle pain, tenderness or weakness, and an elevation of a muscle enzyme in the blood (creatine kinase, or CK). Drug Safety and Availability 177–189. Kostis JB, Lacy CR, Cosgrove NM, Wilson AC. WPW) Do not exceed 20 mg simvastatin daily with: These medications are not usually taken together. Allergy to drug/class; Infants <1yo; Wide-complex tachycardia due to bypass tract (e.g. Contraindicated in pediatric patients <1yo; See critical care quick reference for drug doses by weight; Special Populations. These medications may interact and cause very harmful effects. Cardizem is used to treat hypertension (high blood pressure). Approximately 60% of the cases of myopathy were associated with a genetic variant which affects the coding of the transporter responsible for simvastatin uptake into the liver. This information has been updated in the December 15, 2011, FDA Drug Safety Communication: Pregnancy Categories. The findings from the SEARCH trial are supported by analyses of the FDA's Adverse Event Reporting System (AERS) database, which show that the level of reporting of fatal rhabdomyolysis associated with the 80-mg dose of simvastatin has been higher in comparison with lower doses of simvastatin or lower doses of most other statins.
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