Amlodipine Simvastatin Interaction Med List

Amlodipine Simvastatin Interaction Med List2

1.  The interaction between amlodipine and simvastatin was the first thing I notice – Currently, FDA recommends a max dose of simvastatin 20 mg daily if on Norvasc – Also noted that amlodipine is listed twice which is the generic name of Norvasc.

2.  I can’t help but wonder why they are using the methotrexate injection in this case, and along with that what the indication is that it is being used for?  Also remember that Folic Acid supplementation is recommended with methotrexate which this patient is on.  I would be interested to know why they are on a daily dose of 2 mg (folic acid).

A few other points that I would look into – PRN analgesic for breakthrough pain, with Fosamax use would look into why we aren’t supplementing with vitamin D/calcium, 5 injections would maybe nice to get down to 4 if possible (6 with methotrexate weekly) – relatively low dose Lantus could maybe go to one injection depending upon history, frequency of triptan for migraine, and both gabapentin and amlodipine can contribute to edema issues and would look into Lasix timing/relationship.  Plenty of labs to be monitoring as well!

Please feel free to add anything else!

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15 Comments

  1. Pilar Ceballos

    I think thats very important that physicians we are upddate

    Reply
  2. Erica Johnson

    Additionally folic acid should not be taken with MTX. It should be taken on a separate day (to the best of my knowledge)

    Reply
    • Lila Harrison

      Seems like driving with one foot on the gas, the other on the brakes to me.

      Reply
  3. Brian Catton

    Had an amlodipine-simvastatin DDI I was able to remedy! Because if my intervention, the MD switched patient over to Lipitor. More than that, I prevented a potentially fatal DDI (if not complicated), prevented the patient from spending unnecessary healthcare dollars, and improved their overall quality of life!
    #WhyImAPharmacist
    #ThatsWhatIDo
    #ThatsHowIRoll

    Reply
    • dorothy

      What’s a DDI????

      Reply
      • Eric Christianson

        drug drug interaction

        Reply
  4. Tim Hames

    OxyContin prescribed tds not bd and no breakthrough pain medication.

    Reply
  5. Anes mejzini

    Folic acid should never be taken on the same day as Methotrexate because it will compromise it’s mechanism of action. Usually the two are prescribed so that the patient takes them both weekly, on separate days. For example: Methotrexate Monday, Folic acid (5mg) Friday.

    Reply
  6. Sw

    Lantus bid !!!!!!!!!

    Reply
  7. melanie baker pharmd

    Patient on prevacid – wouldn’t absorb enough oral Ca+ to make a difference. Curious as to age of patient and sex – makes a difference. ALSO Metoprolol should be taken at night so the effect will not cause drowsiness during the day and/or cause possibility of hypoglycemia from meal time insulin to be missed/covered up.

    Reply
  8. Pharmacist mahmood

    Why lantus bid ..it is long acting 24hrs..
    And folic acid twice aday… + methotrexate.. i think its enough once ..and during methot skip folic acid that day and take one day after

    Reply
  9. Carol Bell

    Taking calcium citrate instead of carbonate would increase calcium absorption when taken with PPIs or H2-antagonists.

    Reply
  10. saad alali

    Hello Eric
    I would like from you to sent to me ,the best Book name in PACT in pharmacy , and how much it cost I pay by the visa card to you.
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    Reply
    • Eric Christianson

      Hmm..not sure what you are asking…are you looking for PCAT material?

      Thanks,Eric

      Reply
  11. Jessica

    While there is an FDA recommendation for dose limitations with simvastatin and amlodipine, it is based on weak evidence with low clinical implication. So much so that the VA/DoD guidance does not consider it a reason for dose adjustment.

    Reply

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Written By Eric Christianson

July 13, 2014

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