Simvastatin interactions with other drugs

Abstract

Introduction: Statins, the mainstay of lipid-lowering therapy, are among the most commonly used drugs due to their beneficial effects in cardiovascular morbidity and mortality. Simvastatin, one of the most well-studied statins, is available in several generic forms both as monotherapy and with ezetimibe and is frequently prescribed worldwide. Despite its overall favorable risk profile, several previously stated concerns regarding high-dose simvastatin were recently formalized by the Food and Drug Administration (FDA).

Areas covered: This paper discusses the interactions between simvastatin and other drugs and presents the latest FDA recommendations regarding the safe use of this statin. Relevant articles were identified through a PubMed search (up to December 2011). Furthermore, the latest FDA warning (June 2011) regarding simvastatin use was taken into account.

Expert opinion: Simvastatin may have serious side effects particularly when used in high doses and in combination with certain drugs. Physicians need to adjust the recent recommendations made by the FDA in clinical practice in order to prevent treatment complications.

Keywords::

• cytochrome P450
• interactions
• rhabdomyolysis
• simvastatin