Medicines That Increase the Risk for Muscle Pain
While serious muscle problems are more common when
simvastatin is first started or when the dosage is increased, problems can develop at any time. There are also certain medicines that, when taken with simvastatin, can increase the risk of serious muscle problems. These medicines include:
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Danazol (Danacrine®)
- Fibrates (Lopid®, Tricor®, Triglide®, Antara®, Lofibra®, Lipofen™)
- Niacin (nicotinic acid, Niacor®, Nicolar®)
- Erythromycin
- Clarithromycin
- Telithromycin
- HIV protease inhibitors
- Nefazodone (Serzone®)
- Amiodarone (Cordarone®)
- Verapamil (Calan®, Calan SR, Verelan®, Verelan PM, Isoptin®, Covera-HS®)
- Antifungals, such as ketoconazole (Nizoral®), fluconazole (Diflucan®), and itraconazole (Sporanox®).
You should also avoid grapefruit juice and grapefruit products (including grapefruit supplements) while taking simvastatin
(see Simvastatin and Grapefruit).
Simvastatin and Muscle Pain: A Summary
Muscle pain and aches are a common problem for people taking simvastatin, especially during the beginning phases of treatment or when the dosage is increased. Unfortunately, it is impossible for your healthcare provider to know whether you will develop these problems if you have never taken the drug before. Therefore, you should talk with your healthcare provider if muscle pain becomes a problem while taking simvastatin. He or she may be able to give you suggestions for dealing with this. If the muscle pain continues, your healthcare provider may recommend adjusting the simvastatin dosage or switching to another
cholesterol medication.
You should call your healthcare provider immediately if you experience muscle aches, weakness, pain, or tenderness along with a fever or feeling of sickness. These symptoms could indicate a serious problem.
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