Drug interactions
Cholic acid + Simvastatin
Severity: Moderate
Cholic acid 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
Simvastatin may inhibit the bile salt export pump and reduce clearance of bile acids from hepatocytes. Together with cholic acid this may cause accumulation of conjugated bile salts and liver injury.
What this interaction means in plain words
Cholic acid 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.
Cholic acid belongs to Gastrointestinal Tract; Simvastatin belongs to Cardiovascular.
Why it happens
Inhibition of the hepatic bile salt export pump (BSEP) by simvastatin reduces biliary elimination of bile acids.
What to do
Avoid the combination where possible. If used together, monitor serum transaminases and bilirubin regularly and stop cholic acid if liver injury develops.
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 Cholic acid
Frequently asked questions
Can I take Cholic acid with Simvastatin?
MediHelp rates the interaction as moderate. Cholic acid 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. Simvastatin may inhibit the bile salt export pump and reduce clearance of bile acids from hepatocytes. Together with cholic acid this may cause accumulation of conjugated bile salts and liver injury.
How serious is the interaction between Cholic acid 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: Avoid the combination where possible. If used together, monitor serum transaminases and bilirubin regularly and stop cholic acid if liver injury develops.
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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