Drug interactions
Cyclosporine + Simvastatin
Severity: Contraindicated
Cyclosporine 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
Cyclosporine markedly raises simvastatin acid exposure, which greatly increases the risk of myopathy and rhabdomyolysis. Cases of severe muscle toxicity with renal failure have been described with statin and cyclosporine combinations.
What this interaction means in plain words
Cyclosporine 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.
Why it happens
Cyclosporine inhibits OATP1B1-mediated hepatic uptake and CYP3A4 metabolism of simvastatin, raising systemic statin concentrations.
What to do
Do not combine simvastatin with cyclosporine; choose a statin with a safer profile (such as low-dose pravastatin or fluvastatin, per labeling) and monitor for muscle symptoms and CK.
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
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin Contraindicated
Frequently asked questions
Can I take Cyclosporine with Simvastatin?
MediHelp rates the interaction as contraindicated. Cyclosporine 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. Cyclosporine markedly raises simvastatin acid exposure, which greatly increases the risk of myopathy and rhabdomyolysis. Cases of severe muscle toxicity with renal failure have been described with statin and cyclosporine combinations.
How serious is the interaction between Cyclosporine 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 simvastatin with cyclosporine; choose a statin with a safer profile (such as low-dose pravastatin or fluvastatin, per labeling) and monitor for muscle symptoms and CK.
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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