Drug interaction between simvastatin and warfarin

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Fibrates The use of fibrates alone is occasionally associated with myopathy; use with statins may increase this risk.

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A year-old man receiving a stable maintenance dosage of warfarin experienced an increased international normalized ratio INR without bleeding when his atorvastatin therapy was switched to fluvastatin. Careful monitoring is therefore needed, and maximum daily dose of simvastatin is 10 mg daily when used with fibrates except fenofibrate. This tool may not cover all possible drug interactions. Shingrix Shingrix herpes zoster subunit vaccine is a non-live, recombinant subunit vaccine for the Caution is needed with ciclosporin, fluconazole, phenytoin, and glibenclamide—see product information for details.

Home Drug Safety Update. Substrate kinetics of warfarin and pure enantiomers were performed with human liver microsomes to determine the kinetic parameters Km and Vmax for the formation of all 6 hydroxywarfarin metabolites, inhibition of warfarin metabolism in the presence of statins, was determined.

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Caution is needed with ciclosporin, erythromycin, and clarithromycin. For rosuvastatin, start with 5 mg and do not exceed 20 mg during use with fibrates. Add to My Bibliography.

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The fluvastatin was switched back to atorvastatin, and the warfarin dosage was increased to maintain the patient's goal INR. Subscribe to receive email notifications whenever new articles are published. Ciclosporin is contraindicated with rosuvastatin Crestor. Monitor INR before starting treatment and regularly during treatment, especially with dose changes. It is unclear whether simvastatin interacts with warfarin, but it may increase INRs slightly or increase serum simvastatin levels.

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To view content sources and attributions, please refer to our editorial policy. The literature supports a drug interaction between warfarin and fluvastatin due to the strong affinity of fluvastatin for the cytochrome P enzyme 2D6. Women's Health Find out what women really need.

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Generate a file for use with external citation management software. This study investigated the etiology of the DDIs between warfarin and statins.

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