Drug interactions
Lomitapide + Simvastatin
Severity: Major
Lomitapide 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
Lomitapide is a weak CYP3A4 inhibitor and increases simvastatin exposure. This raises the risk of myopathy, and both drugs can also raise liver enzymes.
What this interaction means in plain words
Lomitapide 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.
Lomitapide belongs to Cardiovascular; Simvastatin belongs to Cardiovascular.
Why it happens
Lomitapide inhibits CYP3A4, reducing simvastatin metabolism.
What to do
Reduce the simvastatin dose by half when starting lomitapide, and do not exceed the labeled maximum simvastatin dose. Monitor for muscle symptoms and liver enzymes.
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 Lomitapide
- Aprepitant + Lomitapide Contraindicated
- Clarithromycin + Lomitapide Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Efavirenz + Lomitapide Contraindicated
- Ensitrelvir + Lomitapide Contraindicated
Frequently asked questions
Can I take Lomitapide with Simvastatin?
MediHelp rates the interaction as major. Lomitapide 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. Lomitapide is a weak CYP3A4 inhibitor and increases simvastatin exposure. This raises the risk of myopathy, and both drugs can also raise liver enzymes.
How serious is the interaction between Lomitapide 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: Reduce the simvastatin dose by half when starting lomitapide, and do not exceed the labeled maximum simvastatin dose. Monitor for muscle symptoms and liver enzymes.
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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