Drug interactions
Glecaprevir / pibrentasvir + Simvastatin
Severity: Major
Glecaprevir / pibrentasvir 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
Glecaprevir and pibrentasvir inhibit OATP1B1/1B3 and other transporters, increasing simvastatin exposure. This raises the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Glecaprevir / pibrentasvir 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
Inhibition of OATP1B1/1B3 (and BCRP/P-gp) by glecaprevir/pibrentasvir raises simvastatin plasma levels.
What to do
Avoid the combination; suspend simvastatin during HCV treatment or use an alternative statin at a reduced dose as per labeling.
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 Glecaprevir / pibrentasvir with Simvastatin?
MediHelp rates the interaction as major. Glecaprevir / pibrentasvir 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. Glecaprevir and pibrentasvir inhibit OATP1B1/1B3 and other transporters, increasing simvastatin exposure. This raises the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Glecaprevir / pibrentasvir 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: Avoid the combination; suspend simvastatin during HCV treatment or use an alternative statin at a reduced dose as per labeling.
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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