Zocor drug interactions

List of precautions
Amiodarone or Verapamil Propranolol Digoxin Warfarin Antifungal drugs Complete list of drug interactions

Amiodarone or Verapamil
The risk of myopathy / rhabdomyolysis is increased by concomitant administration of amiodarone or verapamil. Return to top

Propranolol
In healthy male volunteers there was a significant decrease in mean Cmax, but no change in AUC, for simvastatin total and active inhibitors with concomitant administration of single doses of ZOCOR and propranolol. The clinical relevance of this finding is unclear. The pharmacokinetics of the enantiomers of propranolol were not affected. Return to top

Digoxin
Concomitant administration of a single dose of digoxin in healthy male volunteers receiving simvastatin resulted in a slight elevation (less than 0.3 ng/mL) in digoxin concentrations in plasma (as measured by a radioimmunoassay) compared to concomitant administration of placebo and digoxin. Patients taking digoxin should be monitored appropriately when simvastatin is initiated. Return to top

Warfarin
In two clinical studies, one in normal volunteers and the other in hypercholesterolemic patients, simvastatin 20-40 mg/day modestly potentiated the effect of coumarin anticoagulants: the prothrombin time, reported as International Normalized Ratio (INR), increased from a baseline of 1.7 to 1.8 and from 2.6 to 3.4 in the volunteer and patient studies, respectively. With other reductase inhibitors, clinically evident bleeding and/or increased prothrombin time has been reported in a few patients taking coumarin anticoagulants concomitantly. In such patients, prothrombin time should be determined before starting simvastatin and frequently enough during early therapy to insure that no significant alteration of prothrombin time occurs. Once a stable prothrombin time has been documented, prothrombin times can be monitored at the intervals usually recommended for patients on coumarin anticoagulants. If the dose of simvastatin is changed or discontinued, the same procedure should be repeated. Simvastatin therapy has not been associated with bleeding or with changes in prothrombin time in patients not taking anticoagulants. Return to top

Antifungal drugs
Itraconazole increases the plasma concentrations of some HMG-CoA reductase inhibitors and may increase the risk of rhabdomyolysis. The mechanism has been reported to be inhibition of hepatic CYP450 3A4 enzymes responsible for HMG-CoA reductase inhibitor metabolism. Itraconazole greatly increases levels of lovastatin and its active metabolite, lovastatin acid and significantly increases simvastatin levels.

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Major Interactions

 * Agenerase
 * amiodarone
 * amprenavir
 * Antara
 * Aptivus
 * atazanavir
 * Atromid-S
 * B-3-50
 * B3-500-Gr
 * Biaxin
 * Biaxin XL
 * Biaxin XL-Pak
 * Calan
 * Calan SR
 * clarithromycin
 * clarithromycin extended release
 * clofibrate
 * clotrimazole
 * conivaptan
 * Cordarone
 * Cordarone I.V.
 * Covera-HS
 * Crixivan
 * cyclosporine
 * danazol
 * Danocrine
 * darunavir
 * delavirdine
 * Diflucan
 * Dom-Fenofibrate
 * E-Mycin
 * E.E.S. Granules
 * E.E.S.-200
 * E.E.S.-400
 * E.E.S.-400 Filmtab
 * Ery-Tab
 * Eryc
 * EryPed
 * EryPed 200
 * EryPed 400
 * Erythrocin Lactobionate
 * Erythrocin Stearate Filmtab
 * Erythrocot
 * erythromycin
 * erythromycin base
 * erythromycin estolate
 * erythromycin ethylsuccinate
 * erythromycin lactobionate
 * erythromycin stearate
 * fenofibrate
 * Fenoglide
 * fluconazole
 * Fortovase
 * fosamprenavir
 * gemfibrozil
 * Gengraf
 * Ilosone
 * Ilotycin Gluceptate
 * indinavir
 * Invirase
 * Isoptin
 * Isoptin I.V.
 * Isoptin SR
 * itraconazole
 * Ketek
 * Ketek Pak
 * ketoconazole
 * Lexiva
 * Lipidil EZ
 * Lipidil Micro
 * Lipidil Supra
 * Lipofen
 * Lofibra
 * Lopid
 * mibefradil
 * miconazole
 * Monistat I.V.
 * MY-E
 * Mycelex Troche
 * nefazodone
 * nelfinavir
 * Neoral
 * niacin
 * niacin extended release
 * Niacin SR
 * Niacor
 * Niacor B3
 * Niaspan ER
 * Niaspan ER Starter Pack
 * Nico-400
 * Nicobid Tempules
 * Nicolar
 * Nicotinex
 * Nicotinic Acid
 * Nizoral
 * Norvir
 * Norvir Soft Gelatin
 * Noxafil
 * Pacerone
 * PCE Dispertab
 * posaconazole
 * Posicor
 * Prezista
 * Rescriptor
 * Reyataz
 * ritonavir
 * Robimycin
 * Sandimmune
 * saquinavir
 * saquinavir mesylate
 * Serzone
 * Slo-Niacin
 * Sporanox
 * Tao
 * telithromycin
 * Telzir
 * tipranavir
 * TriCor
 * Triglide
 * troleandomycin
 * Vaprisol
 * verapamil
 * verapamil 24 hour extended release
 * verapamil extended release
 * Verelan
 * Verelan PM
 * Viracept
 * vitamin B3

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Moderate Interactions

 * 8-Mop
 * Abraxane
 * Accolate
 * Adalat
 * Adalat CC
 * Afeditab CR
 * aminolevulinic acid topical
 * Antabuse
 * aprepitant
 * Arava
 * armodafinil
 * Arranon
 * Avonex
 * Avonex Prefilled Syringe
 * azithromycin
 * Azithromycin 3 Day Dose Pack
 * Azithromycin 5 Day Dose Pack
 * azithromycin extended release
 * AZT
 * Betaseron
 * bortezomib
 * bosentan
 * bromocriptine
 * carbamazepine
 * carbamazepine extended release
 * Carbatrol
 * carboplatin
 * Carboplatin Novaplus
 * Cardizem
 * Cardizem CD
 * Cardizem LA
 * Cardizem Monovial
 * Cardizem SR
 * Cartia XT
 * Chloracol
 * chloramphenicol
 * Chloromycetin
 * Chloromycetin Sodium Succinate
 * cholestyramine
 * Cholestyramine Light
 * cisapride
 * cisplatin
 * clofarabine
 * Clolar
 * Colestid
 * Colestid Flavored
 * colestipol
 * Cubicin
 * D.H.E. 45
 * d4T
 * dalfopristin
 * daptomycin
 * dasatinib
 * ddC
 * ddI
 * didanosine
 * didanosine delayed release capsule
 * dihydroergotamine
 * dihydroergotamine nasal
 * Dilacor XR
 * Diltia XT
 * diltiazem
 * diltiazem 24 hour extended release
 * diltiazem extended release
 * Diltiazem Hydrochloride CD
 * Diltiazem Hydrochloride SR
 * Diltiazem Hydrochloride XR
 * Diltiazem Hydrochloride XT
 * Diquinol
 * disulfiram
 * docetaxel
 * echinacea
 * efavirenz
 * Eloxatin
 * Emend
 * Emend 3-Day
 * Emend for Injection
 * Epitol
 * Equetro
 * Ergomar
 * ergotamine
 * esomeprazole
 * etravirine
 * ezetimibe
 * Fasigyn
 * FK506
 * Flagyl
 * Flagyl 375
 * Flagyl ER
 * Flagyl I.V.
 * Flagyl I.V. RTU
 * fluvoxamine
 * fluvoxamine extended release
 * Folex PFS
 * fosaprepitant
 * Furadantin
 * Gleevec
 * goldenseal
 * grepafloxacin
 * Hivid
 * hypericum perforatum
 * imatinib
 * INH
 * Intelence
 * interferon beta-1a
 * interferon beta-1b
 * iodoquinol
 * isoniazid
 * ixabepilone
 * Ixempra
 * lanreotide
 * lansoprazole
 * lapatinib
 * leflunomide
 * Levulan Kerastick
 * Luvox
 * Luvox CR
 * Macrobid
 * Macrodantin
 * methotrexate
 * Methotrexate Sodium
 * Preservative Free
 * methoxsalen
 * Metro I.V.
 * metronidazole
 * metronidazole extended release
 * Metryl
 * Mifeprex
 * mifepristone
 * Migranal
 * modafinil
 * naltrexone
 * Navelbine
 * nelarabine
 * nevirapine
 * Nexium
 * Nexium I.V.
 * Nifediac CC
 * Nifedical XL
 * Nifedipine
 * Nifedipine extended release
 * nilotinib
 * Nitro Macro
 * nitrofurantoin
 * nitrofurantoin dual release
 * nitrofurantoin macrocrystals
 * nitrofurantoin regular release
 * Nuvigil
 * Nydrazid
 * octreotide
 * omeprazole
 * Oncovin
 * Onxol
 * oxaliplatin
 * oxcarbazepine
 * Oxsoralen-Ultra
 * paclitaxel
 * paclitaxel protein-bound
 * pantoprazole
 * Paraplatin
 * Parlodel
 * pectin
 * Platinol-AQ
 * Prevacid
 * Prevacid I.V.
 * Prevacid SoluTab
 * Prevalite
 * Priftin
 * Prilosec
 * Prilosec OTC
 * Procardia
 * Procardia XL
 * Prograf
 * Propulsid
 * Protonix
 * Protonix IV
 * Protostat
 * Provigil
 * Questran
 * Questran Light
 * Ranexa
 * ranolazine
 * Rapamune
 * Raxar
 * Rebif
 * Retrovir
 * ReVia
 * Rezulin
 * Rheumatrex Dose Pack
 * Rifadin
 * Rifadin IV
 * rifampin
 * rifapentine
 * Rimactane
 * RU-486
 * Sandostatin
 * Sandostatin LAR Depot
 * sirolimus
 * Somatuline Depot
 * Sprycel
 * St. John's wort
 * stavudine
 * stavudine extended release
 * Sustiva
 * tacrolimus
 * Tasigna
 * Taxol
 * Taxotere
 * Taztia XT
 * Tegretol
 * Tegretol XR
 * telbivudine
 * temsirolimus
 * thalidomide
 * Thalomid
 * thioguanine
 * Tiazac
 * Tindamax
 * tinidazole
 * Torisel
 * Tracleer
 * Trexall
 * Trileptal
 * troglitazone
 * Tykerb
 * Tyzeka
 * Uvadex
 * Velban
 * Velcade
 * verteporfin
 * VFEND
 * Videx
 * Videx EC
 * vinBLAStine
 * Vincasar PFS
 * vincristine
 * vinorelbine
 * Viramune
 * Visudyne
 * Vivitrol
 * voriconazole
 * Yodoxin
 * Z-Pak
 * zafirlukast
 * zalcitabine
 * Zegerid (Original Formulation)
 * Zerit
 * Zerit XR
 * Zetia
 * zidovudine
 * Zithromax
 * Zithromax IV
 * Zithromax TRI-PAK
 * Zithromax Z-Pak
 * Zmax

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Minor Interactions

 * anisindione
 * Armour Thyroid
 * bexarotene
 * Coumadin
 * Cytomel
 * dicumarol
 * Dynacirc
 * Dynacirc CR
 * Eltroxin
 * Euthyrox
 * Eutroxsig
 * Evotrox
 * isradipine
 * isradipine extended release
 * Jantoven
 * L Thyroxine Roche
 * l-thyroxine
 * Levo-T
 * Levotabs
 * Levotec
 * Levothroid
 * Levothyrox
 * levothyroxine
 * Levoxyl
 * liothyronine
 * liotrix
 * Miradon
 * Nature-Throid
 * Oroxine
 * Synthroid
 * Targretin
 * thyroid desiccated
 * Thyrolar-1
 * Thyrolar-1/2
 * Thyrolar-1/4
 * Thyrolar-2
 * Thyrolar-3
 * Tirosint
 * Triostat
 * Unithroid
 * warfarin
 * Westhroid

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