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Coumadin and Zocor

Determining the interaction of Coumadin and Zocor and the possibility of their joint administration.

Check result:

Coumadin <> Zocor

Relevance: 01.06.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Simvastatin may slightly increase the anticoagulant response to warfarin. The mechanism may be warfarin displacement from protein binding sites. The clinical significance of this interaction has not been established, however, clinical monitoring of patient warfarin response and tolerance is recommended. Simvastatin may interact in a similar way with other oral anticoagulants. In addition, a case study has reported reversible rhabdomyolysis and acute renal failure 7 days following initiation of warfarin in a patient stabilized on simvastatin. Pravastatin, another HMG-CoA reductase inhibitor, does not appear to affect anticoagulation. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References

Lin JC, Ito MK, Stolley SN, Morreale AP, Marcus DB "The effect of converting from pravastatin to simvastatin on the pharmacodynamics of warfarin." J Clin Pharmacol 39 (1999): 86-90
Gaw A, Wosornu D "Simvastatin during warfarin therapy in hyperlipoproteinaemia." Lancet 340 (1992): 979-80
Mauro VF "Clinical pharmacokinetics and practical applications of simvastatin." Clin Pharmacokinet 24 (1993): 195-202
Pan HY "Clinical pharmacology of pravastatin, a selective inhibitor of HMg-CoA reductase." Eur J Clin Pharmacol 40 Suppl 1 (1991): s15-8
"Product Information. Zocor (simvastatin)." Merck & Co, Inc, West Point, PA.
Wells PS, Holbrook AM, Crowther NR, Hirsh J "Interactions of warfarin with drugs and food." Ann Intern Med 121 (1994): 676-83
Mogyorosi A, Bradley B, Showalter A, Schubert ML "Rhabdomyolysis and acute renal failure due to combination therapy with simvastatin and warfarin." J Intern Med 246 (1999): 599-602
Walker JF "Simvastatin: the clinical profile." Am J Med 87 (1989): s44-6

Coumadin

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Coumadin?

Zocor

Generic Name: simvastatin

Brand name: Zocor, Flolipid

Synonyms: n.a.

What is Zocor?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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