Simvastatin Interactions

492 known interactions for Simvastatin. Click any interaction for the full evidence-based breakdown.

🛑 Contraindicated (2)

Simvastatin + ClarithromycinFDA contraindication. Temporarily discontinue simvastatin during clarithromycin treatment.
Simvastatin + ErythromycinFDA contraindication. Suspend simvastatin during erythromycin course or use alternative antibiotic.

⚠️ Major (7)

Simvastatin + Activated CharcoalTIMING CRITICAL — separate by 2-4 hours
Simvastatin + AmiodaroneFDA simvastatin label mandates maximum dose of 20mg/day with amiodarone. Higher doses increase rhabdomyolysis risk.
Simvastatin + DiltiazemFDA simvastatin label mandates maximum dose of 10mg/day with diltiazem. Higher doses significantly increase rhabdomyolysis risk.
Simvastatin + FluconazoleFDA-documented interaction. Consider temporary statin discontinuation or dose reduction during fluconazole treatment.
Simvastatin + Grapefruit🔴 MAJOR — Do NOT combine grapefruit with Simvastatin. Switch to pravastatin or rosuvastatin if you eat grapefruit regularly.
Simvastatin + RifampinFDA-documented interaction. Chronic rifampin reduces simvastatin exposure by up to 87%. Statin therapy may be ineffective during rifampin treatment.
Simvastatin + St. Johns Wort🔴 CAUTION — Major interaction between St. Johns Wort and Simvastatin. Avoid unless under direct medical supervision.

⚡ Moderate (3)

ℹ️ Minor (1)

Simvastatin + CoQ10🟡 LOW RISK — CoQ10 and Simvastatin have a minor interaction. Generally safe with awareness.

✅ Safe (479)