Drug interactions
Miconazole + Simvastatin
Severity: Major
Miconazole 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
Systemic miconazole can increase simvastatin exposure and the risk of myopathy and rhabdomyolysis. Vaginal absorption is limited, but caution is warranted given the narrow safety margin.
What this interaction means in plain words
Miconazole 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.
Miconazole belongs to Anti Fungals; Simvastatin belongs to Cardiovascular.
Why it happens
Miconazole inhibits CYP3A4 metabolism of simvastatin.
What to do
Avoid with oral or buccal miconazole; withhold simvastatin during therapy. With vaginal use, monitor for muscle symptoms or use a non-CYP3A4 statin temporarily.
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 Miconazole
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 Miconazole with Simvastatin?
MediHelp rates the interaction as major. Miconazole 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. Systemic miconazole can increase simvastatin exposure and the risk of myopathy and rhabdomyolysis. Vaginal absorption is limited, but caution is warranted given the narrow safety margin.
How serious is the interaction between Miconazole 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 with oral or buccal miconazole; withhold simvastatin during therapy. With vaginal use, monitor for muscle symptoms or use a non-CYP3A4 statin temporarily.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Miconazole page.
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