CYP3A4 and myopathy: Simvastatin is mostly metabolised by CYP3A4, while some of it is metabolised by CYP2C8.33, 34 It has been known that the concomitant use of simvastatin and amlodipine increases the risk of myopathy.35, 36 In addition, the concomitant use of simvastatin and cyclosporine is contraindicated as cyclosporine inhibits CYP3A4.37 However, these drugs did not cause changes in the onset timing of MAEs.