Drug interactions
Mitotane + Simvastatin
Severity: Moderate
Mitotane 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
Mitotane strongly induces CYP3A4 and can markedly lower simvastatin plasma concentrations. This may lead to loss of lipid-lowering efficacy, and the effect can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Mitotane 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.
Mitotane belongs to Oncology; Simvastatin belongs to Cardiovascular.
Why it happens
Mitotane induces CYP3A4, increasing simvastatin metabolism.
What to do
Monitor lipid levels and consider a higher simvastatin dose or a statin less reliant on CYP3A4, such as rosuvastatin. Reassess dosing after mitotane discontinuation.
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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Mitotane with Simvastatin?
MediHelp rates the interaction as moderate. Mitotane 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. Mitotane strongly induces CYP3A4 and can markedly lower simvastatin plasma concentrations. This may lead to loss of lipid-lowering efficacy, and the effect can persist for weeks after mitotane is stopped.
How serious is the interaction between Mitotane 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: Monitor lipid levels and consider a higher simvastatin dose or a statin less reliant on CYP3A4, such as rosuvastatin. Reassess dosing after mitotane discontinuation.
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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