Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
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), 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, danazol, daptomycin, 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).
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.