Drug interactions
Fosaprepitant + Simvastatin
Severity: Moderate
Fosaprepitant 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
Fosaprepitant is converted to aprepitant, which is a moderate CYP3A4 inhibitor, and a single IV dose has a short-lived but real effect on CYP3A4 substrates. Simvastatin exposure may rise modestly, increasing the risk of myopathy. The effect is usually limited because fosaprepitant is given as a single dose or a short course.
What this interaction means in plain words
Fosaprepitant 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.
Fosaprepitant belongs to Gastrointestinal Tract; Simvastatin belongs to Cardiovascular.
Why it happens
Aprepitant, the active metabolite, moderately inhibits CYP3A4, reducing first-pass and systemic metabolism of simvastatin.
What to do
This is not a labeled contraindication, so simvastatin can usually continue. Counsel the patient to report muscle pain or weakness, and consider holding simvastatin around multi-day antiemetic regimens in high-risk patients.
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 Fosaprepitant
- Flibanserin + Fosaprepitant Contraindicated
- Fosaprepitant + Pimozide Contraindicated
- Alprazolam + Fosaprepitant Moderate
- Amiodarone + Fosaprepitant Moderate
- Amobarbital + Fosaprepitant Moderate
- Apalutamide + Fosaprepitant Moderate
Frequently asked questions
Can I take Fosaprepitant with Simvastatin?
MediHelp rates the interaction as moderate. Fosaprepitant 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. Fosaprepitant is converted to aprepitant, which is a moderate CYP3A4 inhibitor, and a single IV dose has a short-lived but real effect on CYP3A4 substrates. Simvastatin exposure may rise modestly, increasing the risk of myopathy. The effect is usually limited because fosaprepitant is given as a single dose or a short course.
How serious is the interaction between Fosaprepitant 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: This is not a labeled contraindication, so simvastatin can usually continue. Counsel the patient to report muscle pain or weakness, and consider holding simvastatin around multi-day antiemetic regimens in high-risk patients.
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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