Drug interactions
Simvastatin + Ticagrelor
Severity: Moderate
Simvastatin and Ticagrelor: 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
Ticagrelor raises simvastatin and its acid metabolite exposure, increasing the risk of myopathy and rhabdomyolysis at higher doses.
What this interaction means in plain words
Simvastatin and Ticagrelor 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.
Simvastatin belongs to Cardiovascular; Ticagrelor belongs to Cardiovascular.
Why it happens
Ticagrelor inhibits CYP3A4-mediated simvastatin metabolism.
What to do
Limit simvastatin to 40 mg daily or switch to a statin not dependent on CYP3A4; counsel on muscle symptoms.
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
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 Simvastatin with Ticagrelor?
MediHelp rates the interaction as moderate. Simvastatin and Ticagrelor 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. Ticagrelor raises simvastatin and its acid metabolite exposure, increasing the risk of myopathy and rhabdomyolysis at higher doses.
How serious is the interaction between Simvastatin and Ticagrelor?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit simvastatin to 40 mg daily or switch to a statin not dependent on CYP3A4; counsel on muscle symptoms.
What other medicines interact with Ticagrelor?
MediHelp also lists interactions of Ticagrelor with, for example, Itraconazole, Ketoconazole, Levoketoconazole. The full list is on the Ticagrelor page.
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