Drug interactions
Atorvastatin + Simvastatin
Severity: Major
Atorvastatin and Simvastatin: major interaction.
Last updated Sources: Health Canada product monograph
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
These two statins have the same mechanism, so combining them adds no benefit and increases the risk of myopathy and rhabdomyolysis. The listed transporter effect is minor compared with the duplication.
What this interaction means in plain words
Atorvastatin and Simvastatin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atorvastatin belongs to Cardiovascular; Simvastatin belongs to Cardiovascular.
Why it happens
Therapeutic duplication with additive dose-related muscle toxicity.
What to do
Avoid combining statins and use one statin at the appropriate intensity. If both were taken, stop one and evaluate for muscle symptoms and CK.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Atorvastatin and Simvastatin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Atorvastatin
- Atorvastatin + Tipranavir Contraindicated
- Atazanavir + Atorvastatin Major
- Atorvastatin + Clarithromycin Major
- Atorvastatin + Cobicistat Major
- Atorvastatin + Cyclosporin Major
- Atorvastatin + Danazol Major
Other interactions of Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin Contraindicated
Frequently asked questions
Can I take Atorvastatin with Simvastatin?
MediHelp rates the interaction as major. Atorvastatin and Simvastatin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. These two statins have the same mechanism, so combining them adds no benefit and increases the risk of myopathy and rhabdomyolysis. The listed transporter effect is minor compared with the duplication.
How serious is the interaction between Atorvastatin and Simvastatin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining statins and use one statin at the appropriate intensity. If both were taken, stop one and evaluate for muscle symptoms and CK.
What other medicines interact with Atorvastatin?
MediHelp also lists interactions of Atorvastatin with, for example, Tipranavir, Atazanavir, Clarithromycin. The full list is on the Atorvastatin page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
