Drug interactions
Atazanavir + Simvastatin
Severity: Contraindicated
Atazanavir and Simvastatin: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir, usually boosted with ritonavir or cobicistat, strongly inhibits CYP3A4 and greatly increases simvastatin exposure. This raises the risk of myopathy and rhabdomyolysis, and simvastatin labeling contraindicates it.
What this interaction means in plain words
Atazanavir and Simvastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Atazanavir belongs to Anti Virals; Simvastatin belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated simvastatin metabolism raises simvastatin and its active acid levels.
What to do
Do not combine; switch to a statin with less CYP3A4 dependence such as pravastatin or rosuvastatin, with dose limits as appropriate.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Simvastatin
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Simvastatin?
MediHelp rates the interaction as contraindicated. Atazanavir and Simvastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Atazanavir, usually boosted with ritonavir or cobicistat, strongly inhibits CYP3A4 and greatly increases simvastatin exposure. This raises the risk of myopathy and rhabdomyolysis, and simvastatin labeling contraindicates it.
How serious is the interaction between Atazanavir and Simvastatin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine; switch to a statin with less CYP3A4 dependence such as pravastatin or rosuvastatin, with dose limits as appropriate.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Clarithromycin, Cobicistat, Cyclosporine. The full list is on the Simvastatin page.
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