Minor
Established
Descripción
Amlodipine weakly inhibits CYP3A4-mediated atorvastatin metabolism, leading to a modest increase in atorvastatin exposure; the combination is generally used safely in clinical practice.
Mecanismo
Amlodipine is a weak CYP3A4 inhibitor; atorvastatin is a CYP3A4 substrate. The increased atorvastatin exposure (~20%) is substantially smaller than with simvastatin.
Relevancia clínica
The modest increase in atorvastatin AUC rarely causes clinically significant myopathy at standard doses; the combination appears safe in cardiovascular outcome trials.
Manejo clínico
No dose adjustment is generally required; monitor for myalgia. At very high atorvastatin doses (80 mg), some clinicians prefer pravastatin or rosuvastatin.