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Posted on 24.08.2018 in the General category

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The risk of myopathyincluding rhabdomyolysisis greater in patients on simvastatin 80 mg compared with other statin therapies with similar or greater LDL-C-lowering efficacy and compared with lower doses of simvastatinThereforethe 10/80-mg dos e of VYTORIN should be used only in patients who have been taking VYTORIN 10/80 mg chronicallye.gfor 12 months or morewithout evidence of muscle toxicitysee DOSAGE AND ADMINISTRATIONRestricted Dosing for 10/80 mgIfhowevera patient who is currently tolerating the 10/80-mg dose of VYTORIN needs to be initiated on an interacting drug that is contraindicated or is associated with a dose cap for simvastatinthat patient should be switched to an alternative statin or statinbased regimen with less potential for the drug-drug interactionPatients should be advised of the increased risk of myopathyincluding rhabdomyolysisand to report promptly any unexplained muscle paintenderness or weaknessIf symptoms occurtreatment should be discontinued immediatelysee Liver Enzymes

The risk of myopathyincluding rhabdomyolysisis increased by concomitant administration of amiodaronedronedaroneranolazineor calcium channel blockers such as verapamildiltiazem or amlodipinesee DOSAGE AND ADMINISTRATION and WARNINGS AND PRECAUTIONS and Table 6 in CLINICAL PHARMACOLOGY

27Summaries for patientsMuscle abnormalities in four patients taking statins to treat unfavorable cholesterol levelsAnn Intern Med 1372002I45.

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