Drug interactions
Letermovir + Simvastatin
Severity: Major
Letermovir 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
Letermovir increases exposure to statins, and simvastatin levels can rise enough to cause myopathy or rhabdomyolysis. The effect is greater when cyclosporine is also given.
What this interaction means in plain words
Letermovir 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.
Letermovir belongs to Anti Virals; Simvastatin belongs to Cardiovascular.
Why it happens
Letermovir inhibits OATP1B1/3 and CYP3A, which reduces hepatic uptake and metabolism of simvastatin.
What to do
Avoid simvastatin during letermovir therapy, and never combine them if cyclosporine is also given; use an alternative statin at a reduced dose with monitoring 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
Other interactions of Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Letermovir with Simvastatin?
MediHelp rates the interaction as major. Letermovir 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. Letermovir increases exposure to statins, and simvastatin levels can rise enough to cause myopathy or rhabdomyolysis. The effect is greater when cyclosporine is also given.
How serious is the interaction between Letermovir 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 simvastatin during letermovir therapy, and never combine them if cyclosporine is also given; use an alternative statin at a reduced dose with monitoring 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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