Flolipid and Serzone

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using nefazodone together with simvastatin is not recommended. Combining these medications may significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Your doctor may be able to prescribe alternatives that do not interact, or interact to a lesser extent. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with simvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

CONTRAINDICATED: Coadministration with potent inhibitors of CYP450 3A4 such as nefazodone may significantly increase the plasma concentrations of simvastatin and lovastatin and their active acid metabolites, all of which are primarily metabolized by the isoenzyme. Nefazodone has been reported to increase systemic exposure (AUC) to simvastatin and its pharmacologically active acid metabolite by 20-fold. Although not studied, the interaction is also expected to occur with lovastatin due to its similar metabolic profile to simvastatin. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death. There have been case reports of patients treated with simvastatin who developed severe myopathy or rhabdomyolysis during coadministration of nefazodone.

MANAGEMENT: Due to the potential for severe interaction, concomitant use of simvastatin or lovastatin with potent CYP450 3A4 inhibitors such as nefazodone is considered contraindicated. Fluvastatin, pravastatin, pitavastatin, and rosuvastatin are probably safer alternatives, since they are not metabolized by CYP450 3A4, although pravastatin was cited in a case report of suspected interaction that resulted in asymptomatic increases in creatine kinase levels. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Flolipid

Generic Name: simvastatin

Brand name: Flolipid, Zocor

Synonyms: n.a.

What is Flolipid?

Serzone

Generic Name: nefazodone

Brand name: Serzone

Synonyms: n.a.

What is Serzone?