title: Simvastatin interactions with other drugs.
abstract: BACKGROUND
  Statins, the mainstay of lipid-lowering therapy, are among the most commonly used drugs due to their beneficial effects in cardiovascular morbidity and mortality. Simvastatin, one of the most well-studied statins, is available in several generic forms both as monotherapy and with ezetimibe and is frequently prescribed worldwide. Despite its overall favorable risk profile, several previously stated concerns regarding high-dose simvastatin were recently formalized by the Food and Drug Administration (FDA).
  
  
  METHODS
  This paper discusses the interactions between simvastatin and other drugs and presents the latest FDA recommendations regarding the safe use of this statin. Relevant articles were identified through a PubMed search (up to December 2011). Furthermore, the latest FDA warning (June 2011) regarding simvastatin use was taken into account.
  
  
  CONCLUSIONS
  Simvastatin may have serious side effects particularly when used in high doses and in combination with certain drugs. Physicians need to adjust the recent recommendations made by the FDA in clinical practice in order to prevent treatment complications.
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Matilda
authors.initials: M
authors.lastname: Florentin
authors.forename: Moses S
authors.initials: MS
authors.lastname: Elisaf
mesh_terms: D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000493:pharmacokinetics; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D019821:Simvastatin / Q000009:adverse effects* / Q000493:pharmacokinetics
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin