Drug interactions
Pretomanid + Simvastatin
Severity: Major
Pretomanid 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
The pretomanid regimen is associated with hepatotoxicity, and statins can also elevate transaminases. Concurrent use may increase the risk of liver injury, and the patients involved are often also taking other hepatotoxic antituberculosis drugs.
What this interaction means in plain words
Pretomanid 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.
Pretomanid belongs to Anti Bacterial; Simvastatin belongs to Cardiovascular.
Why it happens
Additive hepatotoxicity; no specific pharmacokinetic mechanism is established.
What to do
Consider withholding simvastatin during the pretomanid regimen if it is not essential. If continued, monitor liver enzymes frequently and stop the offending agents if liver injury develops.
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
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin Contraindicated
Other interactions of Pretomanid
Frequently asked questions
Can I take Pretomanid with Simvastatin?
MediHelp rates the interaction as major. Pretomanid 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. The pretomanid regimen is associated with hepatotoxicity, and statins can also elevate transaminases. Concurrent use may increase the risk of liver injury, and the patients involved are often also taking other hepatotoxic antituberculosis drugs.
How serious is the interaction between Pretomanid 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: Consider withholding simvastatin during the pretomanid regimen if it is not essential. If continued, monitor liver enzymes frequently and stop the offending agents if liver injury develops.
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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