Drug interactions
Fexinidazole + Simvastatin
Severity: Major
Fexinidazole and Simvastatin: major 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
Fexinidazole inhibits CYP3A4 and may raise simvastatin concentrations, increasing the risk of myopathy and rhabdomyolysis. Fexinidazole is given only for a short course.
What this interaction means in plain words
Fexinidazole 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.
Why it happens
Fexinidazole inhibits CYP3A4, reducing simvastatin first-pass and systemic metabolism.
What to do
Withhold simvastatin during the fexinidazole course or switch temporarily to a statin not metabolised by CYP3A4. Monitor for muscle symptoms.
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?
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Other interactions of Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
Frequently asked questions
Can I take Fexinidazole with Simvastatin?
MediHelp rates the interaction as major. Fexinidazole 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. Fexinidazole inhibits CYP3A4 and may raise simvastatin concentrations, increasing the risk of myopathy and rhabdomyolysis. Fexinidazole is given only for a short course.
How serious is the interaction between Fexinidazole 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: Withhold simvastatin during the fexinidazole course or switch temporarily to a statin not metabolised by CYP3A4. Monitor for muscle symptoms.
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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