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Drug Interactions With Ezetimibe/Simvastatin

Grapefruit
People on ezetimibe/simvastatin should avoid consuming grapefruit juice, grapefruit, or grapefruit supplements because doing so can increase the levels of ezetimibe/simvastatin in the blood. This can increase the chances of developing a serious muscle problem (for example, myopathy or rhabdomyolysis), which can cause the kidneys to stop working (see Vytorin and Muscle Pain).
 
If you are currently taking ezetimibe/simvastatin, do not increase or decrease your grapefruit consumption without consulting with your healthcare provider (see Grapefruit Juice and Vytorin for more information).
 
Lomitapide
Lomitapide can increase the level of simvastatin in your bloodstream. If you are taking lomitapide, the recommended maximum ezetimibe/simvastatin dosage is 10/20 mg a day, or 10/40 mg a day for people who were previously taking simvastatin 80 mg daily before starting lomitapide.
 
Niacin
Both niacin and ezetimibe/simvastatin alone can increase the chances of developing serious muscle problems. Therefore, combining these medicines may cause an even greater risk. If you are taking both ezetimibe/simvastatin and niacin, your healthcare provider may choose to monitor your progress closely and make necessary dosing adjustments (see Niacin and Vytorin).
 
This is particularly important for people of Chinese descent, as studies have suggested that Chinese people may be at a higher risk for problems when combining niacin and simvastatin.
 
Protease Inhibitors
Ezetimibe/simvastatin should not be combined with an HIV protease inhibitor, as your body may metabolize the medicines differently than intended. This can cause significant reactions, including increasing the risk of developing serious muscle problems like myopathy or rhabdomyolysis.
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Ezetimibe and Simvastatin Drug Information

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