Juvisync and Vfend

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 simvastatin together with voriconazole 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. Talk to your doctor or pharmacist if you have any questions or concerns. 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 voriconazole may significantly increase the plasma concentrations of simvastatin and lovastatin and their active acid metabolites. The mechanism is decreased clearance due to inhibition of CYP450 3A4 by voriconazole, which is generally considered a potent inhibitor of the isoenzyme. 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. The interaction has been reported with other potent CYP450 3A4 inhibitors such as itraconazole, ketoconazole, nefazodone, macrolide antibiotics, and protease inhibitors. Although not studied clinically, voriconazole has been shown to inhibit lovastatin metabolism in vitro in human liver microsomes.

MANAGEMENT: Concomitant use is considered contraindicated by the manufacturers of of the statins, and it is also recommended that if treatment with a potent CYP450 3A4 inhibitor is necessary, therapy with the statin should be interrupted. The manufacturers of voriconazole recommend that the statin dose be reduced (dose not specified). Pitavastatin, pravastatin, and rosuvastatin may be safer alternatives, since they are not metabolized by CYP450 3A4 or other isoenzymes inhibited by voriconazole. 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.

Juvisync

Generic Name: simvastatin / sitagliptin

Brand name: Juvisync

Synonyms: n.a.

What is Juvisync?

Vfend

Generic Name: voriconazole

Brand name: Vfend, Vfend

Synonyms: Vfend Injection

What is Vfend?