When two or more
medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a
Drug Interaction.
Simvastatin interacts with HIV-protease inhibitors e.g.nelfinavir,
boceprevir,
telaprevir, and
cobicistat which are used to treat viral diseases. The patients using CYP3A4 inhibitors with
Simvastatin may increase the risk of muscle diseases and breakdown of damaged skeletal muscles (
rhabdomyolysis) by increasing the inhibitory activity of HMG-CoA reductase
enzyme in the blood. The combined use of Simvastatin with
protease inhibitors is not recommended.
There may be an interaction of
Simvastatin with
Strong CYP3A4 inhibitors such as (
erythromycin,
clarithromycin,
telithromycin), which are used to treat bacterial infections in the lungs, throat, and ear. When these strong
cytochrome inhibitors are used with
Simvastatin may lead to an increase in the risk of breakdown of damaged skeletal muscles by increasing the inhibitory activity of HMG-CoA reductase
enzyme in the blood. The combined use of
Simvastatin with cytochrome inhibitors is not recommended. In case, if this combination is unavoidable, then follow the use of other alternative
statins.
Simvastatin may interact with
Strong CYP3A4 inhibitors such as (
itraconazole,
ketoconazole,
posaconazole,
voriconazole,
fluconazole), which are used to treat fungal infections. The patients using CYP3A4 inhibitors with
Simvastatin may increase the risk of muscle diseases and breakdown of damaged skeletal muscles (
rhabdomyolysis) by increasing the inhibitory activity of HMG-CoA reductase
enzyme in the blood. Use of voriconazole with
Simvastatin may lead to inhibition of metabolism of #NAME, so in that case, proper adjustment of the Simvastatin dose may be needed to reduce the risk of muscle diseases, including the breakdown of damaged skeletal muscles (rhabdomyolysis).
Your doctor's guidelines may need to be followed while taking this medicine along with
Nefazodone, which is used to treat
depression, aggressive behavior, and panic disorders. Nefazodone prevents the metabolic pathway of
cytochrome P450 isoform 3A4 which can raise the levels of
Simvastatin in the blood and may increase the risk of muscle diseases. The combined use of
Simvastatin with nefazodone should be avoided.
Special instructions need to be followed while taking this medicine along with CYP3A4 inhibitors such as (
cyclosporine and
danazol) which is used to prevent organ transplant rejection and to treat the hormonal disturbances in the body. The risk of muscle diseases, including muscular weakness and breakdown of damaged skeletal muscles (
rhabdomyolysis), is increased when
Simvastatin is taken with
cyclosporine or danazol. The combined use of
Simvastatin with
gemfibrozil,
cyclosporine, or danazol is not recommended.
Your doctor's guidelines may need to be followed while taking this medicine along with
Coumarin anticoagulants, which are used to prevent blood clot
formation. When
Simvastatin is used in combination with coumarin anticoagulants, may lead to an increase in prothrombin time. Before starting the treatment with
Simvastatin, the prothrombin time should be monitored carefully.
Special instructions need to be followed while taking this medicine along with
Colchicine, which is used to treat
gout. When
Simvastatin is taken with colchicine, cases of
myopathy, including
rhabdomyolysis have been reported.
Close clinical monitoring of such patients is advisable in this combination of
Simvastatin with colchicine.
Simvastatin interacts with
Niacin, which is used to fulfill
vitamin B3 deficiency and to treat high
cholesterol levels. Rare cases of muscle diseases have been found to be increased when the dose of niacin should be given more than 1 g per day. Take necessary precautions while treating Chinese patients with the exceeding dose (20 mg per day) of
Simvastatin when used in combination with niacin-containing products.
There may be an interaction of
Simvastatin with Lipid-lowering drugs such as fibrates,
Lomitapide, and
gemfibrozil. Use of gemfibrozil with
Simvastatin may lead to an increase in the metabolism of
Simvastatin by 1.9-fold, possibly due to inhibition of the drug metabolism (glucuronidation) pathway. The combined use of lipid-lowering drugs with Simvastatin should be avoided.
Simvastatin interacts with Fusidic acid, which is used as
topical medicine to treat skin infections. When fusidic acid is used in combination with
Simvastatin may increase the risk of
myopathy and
rhabdomyolysis. Discontinue the use of Simvastatin throughout the treatment procedure of fusidic acid.
There may be an interaction of
Simvastatin with
Grapefruit juice, which is used for weight loss,
asthma, high
cholesterol. When grapefruit juice and
Simvastatin (over 1 litre daily) is taken together, it resulted in a 7-fold increase in the absorption of
Simvastatin. Avoid the consumption of grapefruit juice during the treatment period of Simvastatin.
This page does not contain all the possible interactions of Simvastatin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any
medicines without the approval of your doctor.