Prevymis and Zocor

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 letermovir is generally 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 if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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.

GENERALLY AVOID: Coadministration with letermovir may significantly increase the plasma concentrations of simvastatin and its active beta-hydroxyacid metabolite, simvastatin acid. The proposed mechanism is letermovir inhibition of intestinal and hepatic CYP450 3A4, the isoenzyme responsible for the metabolic clearance of simvastatin and simvastatin acid. In addition, simvastatin acid is a substrate of the hepatic uptake transporters, organic anion transporting polypeptide protein (OATP) 1B1 and 1B3, which are also inhibited by letermovir. Although the interaction has not been studied, substantial increases in statin exposure are expected based on known pharmacokinetics of the drugs. Additional use of cyclosporine is likely to further increase the magnitude of interaction, since it is an inhibitor of CYP450 3A4 and a strong inhibitor of OATP 1B1 and 1B3. 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.

MANAGEMENT: Concomitant use of simvastatin with letermovir should generally be avoided. The combination is considered contraindicated when coadministered with cyclosporine. Fluvastatin or pravastatin may be suitable alternatives, although lower dosages of the statin are recommended in combination with letermovir and/or cyclosporine. Please refer to the statin prescribing information for specific statin dosing recommendations. 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.

Prevymis

Generic Name: letermovir

Brand name: Prevymis

Synonyms: n.a.

What is Prevymis?

Zocor

Generic Name: simvastatin

Brand name: Zocor, Flolipid

Synonyms: n.a.

What is Zocor?