Drug interactions
Carbamazepine + Simvastatin
Severity: Moderate
Carbamazepine and Simvastatin: moderate 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
Carbamazepine is a strong CYP3A4 inducer and substantially reduces simvastatin and its active acid concentrations. Cholesterol lowering may be significantly impaired.
What this interaction means in plain words
Carbamazepine and Simvastatin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Simvastatin belongs to Cardiovascular.
Why it happens
Carbamazepine induces CYP3A4, increasing simvastatin first-pass and systemic metabolism.
What to do
Monitor LDL cholesterol and titrate simvastatin upward, or choose a statin not dependent on CYP3A4 such as pravastatin or rosuvastatin.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin Contraindicated
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Simvastatin?
MediHelp rates the interaction as moderate. Carbamazepine and Simvastatin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine is a strong CYP3A4 inducer and substantially reduces simvastatin and its active acid concentrations. Cholesterol lowering may be significantly impaired.
How serious is the interaction between Carbamazepine and Simvastatin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor LDL cholesterol and titrate simvastatin upward, or choose a statin not dependent on CYP3A4 such as pravastatin or rosuvastatin.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Simvastatin page.
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