SIMVASTATIN-ORAL (cont.)
DRUG INTERACTIONS: See also the How To Use section. This drug should not be used with the following medications because very serious, possibly fatal interactions may occur: certain azole antifungals (e.g., itraconazole, ketoconazole), delavirdine, HIV protease inhibitors (e.g., ritonavir, amprenavir, lopinavir), certain macrolide antibiotics (e.g., erythromycin, clarithromycin, troleandomycin), mibefradil, nefazodone, telithromycin. If you are currently using any of these medications, tell your doctor or pharmacist before starting simvastatin. Use caution if the following drugs are combined with simvastatin because serious side effects such as muscle injury (myopathy) infrequently could occur: fibrates (e.g., gemfibrozil, fenofibrate), high-dose niacin (1 gram or more per day). Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners" (e.g., warfarin), cholestyramine, colestipol, digoxin, other drugs which affect certain liver enzymes (CYP 3A4 substrates, inhibitors, and inducers such as amiodarone, cyclosporine, diltiazem, verapamil, rifampin, St. John's wort, carbamazepine). Do not start or stop any medicine without doctor or pharmacist approval.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.
NOTES: Do not share this medication with others. Laboratory and/or medical tests (e.g., blood cholesterol levels, liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. For best results, this medication should be used along with exercise, a low-cholesterol/low-fat diet, and a weight loss program if you are overweight. Also to help reduce your risk of heart attacks and strokes, check your blood pressure regularly, seek medical treatment if your blood pressure is high, and stop smoking. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store between 41 and 86 degrees F (5 and 30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.
Last Editorial Review: 3/2/2005
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