Drug interactions
Simvastatin + Verapamil
Severity: Major
Simvastatin and Verapamil: 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
Verapamil markedly increases simvastatin acid exposure, raising the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Simvastatin and Verapamil 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.
Simvastatin belongs to Cardiovascular; Verapamil belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated metabolism of simvastatin.
What to do
Do not exceed the labeled simvastatin dose limit with verapamil, or switch to rosuvastatin, pravastatin or pitavastatin. Counsel patients to report unexplained muscle symptoms and check CK if they occur.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil 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 Verapamil?
MediHelp rates the interaction as major. Simvastatin and Verapamil 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. Verapamil markedly increases simvastatin acid exposure, raising the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Simvastatin and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not exceed the labeled simvastatin dose limit with verapamil, or switch to rosuvastatin, pravastatin or pitavastatin. Counsel patients to report unexplained muscle symptoms and check CK if they occur.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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