Drug interactions
Ritonavir + Simvastatin
Severity: Contraindicated
Ritonavir and Simvastatin: contraindicated 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
Ritonavir sharply increases simvastatin concentrations and has caused rhabdomyolysis in combination. The labeling contraindicates the pair.
What this interaction means in plain words
Ritonavir and Simvastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Ritonavir belongs to Anti Virals; Simvastatin belongs to Cardiovascular.
Why it happens
Ritonavir is a potent CYP3A4 inhibitor and also inhibits OATP1B1, reducing simvastatin clearance.
What to do
Avoid; use pravastatin or low-dose atorvastatin or rosuvastatin during ritonavir therapy and monitor for muscle symptoms.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Ritonavir with Simvastatin?
MediHelp rates the interaction as contraindicated. Ritonavir and Simvastatin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ritonavir sharply increases simvastatin concentrations and has caused rhabdomyolysis in combination. The labeling contraindicates the pair.
How serious is the interaction between Ritonavir and Simvastatin?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid; use pravastatin or low-dose atorvastatin or rosuvastatin during ritonavir therapy and monitor 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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