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Drug Interactions With Simvastatin

More Information on Interactions With Simvastatin

The following sections explain in detail the potentially negative interactions that can occur if simvastatin is combined with any of the drugs listed above.
  
Amlodipine
Combining amlodipine with simvastatin may increase the risk of serious muscle problems (such as myopathy or rhabdomyolysis). If you are taking these medicines together, your healthcare provider may choose to monitor your progress closely and make necessary dosing adjustments. Your dosage of simvastatin should not exceed 20 mg.
 
Cobicistat
The risk of serious side effects (including myopathy or rhabdomyolysis) is increased by combining simvastatin with cobicistat-containing medications, such as Stribild. In general, these medications should not be taken together.
 
Cyclosporine
Taking cyclosporine and simvastatin together is not recommended. This can cause significant reactions, including increasing the risk of developing serious muscle problems like myopathy or rhabdomyolysis.
  
Danazol
Taking danazol and simvastatin together is not recommended. This can cause significant reactions. Among other things, it can increase the risk of developing serious muscle problems like myopathy or rhabdomyolysis.
 
Diltiazem
Combining diltiazem with simvastatin may increase the risk of serious muscle problems, such as myopathy or rhabdomyolysis. If you are taking these medicines together, your healthcare provider may choose to monitor your progress closely and make necessary dosing adjustments. Your dosage of simvastatin should not exceed 10 mg.
  
Warfarin
If you are taking both simvastatin and warfarin, your body may metabolize the medicines differently than intended. When starting simvastatin therapy and/or changing the dosage, your healthcare provider may choose to monitor your INR and prothrombin time more closely and make any necessary adjustments. Prothrombin time and INR are tests used to measure how well your blood is clotting.
 
Gemfibrozil
Taking gemfibrozil and simvastatin together is not recommended. This can cause significant reactions, including increasing the risk of developing serious muscle problems like myopathy or rhabdomyolysis.
 
Lomitapide
Lomitapide can increase the level of simvastatin in your bloodstream. If you are taking lomitapide, the recommended maximum simvastatin dosage is 20 mg a day, or 40 mg a day for people who were previously taking simvastatin 80 mg daily before starting lomitapide.
  
Niacin
Both niacin and simvastatin alone can increase the chances of developing serious muscle problems. Therefore, it is thought that combining these medicines may cause an even greater risk.
 
If you are taking both of these products, your healthcare provider may choose to monitor your progress closely and make necessary dosing adjustments (see Niacin and Zocor). 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.
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