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Vytorin 10-20

Interactions

Fluvastatin (> 20 mg BID); Pitavastatin; Pravastatin (> 20 mg); Rosuvastatin (> 5 mg); Simvastatin/Cyclosporine

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known.

What might happen:

You may experience muscle aches, tenderness, or weakness.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together. You may need to take a different cholesterol medicine.Tell your doctor right away if you experience muscle pain, tenderness, or weakness; unexplained tiredness; or discolored urine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Lescol (fluvastatin sodium) US prescribing information. Novartis Pharmaceuticals Corporation October, 2012.

2.Livalo (pitavastatin) US prescribing information. Kowa Pharmaceuticals America, Inc. October, 2013.

3.Pravachol (pravastatin sodium) US prescribing information. Bristol-Myers Squibb Company October, 2012.

4.Crestor (rosuvastatin calcium) US prescribing information. AstraZeneca Pharmaceuticals LP July, 2014.

5.Zocor (simvastatin) US prescribing information. Merck & Co., Inc. February, 2014.

6.Vytorin (ezetimibe/simvastatin) US prescribing information. Merck/Schering-Plough Pharmaceuticals February, 2014.

7.USFood and Drug Administration. FDA Drug Safety Communication: New restrictions, contraindications, and dose limitations for Zocor (simvastatin) to reduce the risk of muscle injury. available at: http://www.fda.gov/Drugs/DrugSafety/ucm256581.htm June 8, 2011.

8.Park JW, Siekmeier R, Merz M, Krell B, Harder S, Marz W, Seidel D, Schuler S, Gross W. Pharmacokinetics of pravastatin in heart-transplant patients taking cyclosporin A. Int J Clin Pharmacol Ther 2002 Oct;40(10):439-50.

9.Olbricht C, Wanner C, Eisenhauer T, Kliem V, Doll R, Boddaert M, O'Grady P, Krekler M, Mangold B, Christians U. Accumulation of lovastatin, but not pravastatin, in the blood of cyclosporine-treated kidney graft patients after multiple doses. Clin Pharmacol Ther 1997 Sep;62(3):311-21.

10.Capone D, Stanziale P, Gentile A, Imperatore P, Pellegrino T, Basile V. Effects of simvastatin and pravastatin on hyperlipidemia and cyclosporin blood levels in renal transplant recipients. Am J Nephrol 1999; 19(3):411-5.

11.Akhlaghi F, McLachlan AJ, Keogh AM, Brown KF. Effect of simvastatin on cyclosporine unbound fraction and apparent blood clearance in heart transplant recipients. Br J Clin Pharmacol 1997 Dec;44(6):537-42.

12.Holdaas H, Hagen E, Asberg A, Lund K, Hartman A, Vaidyanathan S, Prasad P, He YL, Yeh CM, Bigler H, Rouilly M, Denouel J. Evaluation of the pharmacokinetic interaction between fluvastatin XL and cyclosporine in renal transplant recipients. Int J Clin Pharmacol Ther 2006 Apr; 44(4):163-71.

13.Locsey L, Asztalos L, Kincses Z, Balazs G. Fluvastatin (Lescol) treatment of hyperlipidaemia in patients with renal transplants. Int Urol Nephrol 1997;29(1):95-106.

14.Li PK, Mak TW, Chan TH, Wang A, Lam CW, Lai KN. Effect of fluvastatin on lipoprotein profiles in treating renal transplant recipients with dyslipoproteinemia. Transplantation 1995 Oct 15;60(7):652-6.

15.Holdaas H, Hartmann A, Stenstrom J, Dahl KJ, Borge M, Pfister P. Effect of fluvastatin for safely lowering atherogenic lipids in renal transplant patients receiving cyclosporine. Am J Cardiol 1995 Jul 13; 76(2):102A-106A.

16.Li PK, Mak TW, Wang AY, Lee YT, Leung CB, Lui SF, Lam CW, Lai KN. The interaction of fluvastatin and cyclosporin A in renal transplant patients. Int J Clin Pharmacol Ther 1995 Apr;33(4):246-8.

17.Park JW, Siekmeier R, Lattke P, Merz M, Mix C, Schuler S, Jaross W. Pharmacokinetics and pharmacodynamics of fluvastatin in heart transplant recipients taking cyclosporine A. J Cardiovasc Pharmacol Ther 2001 Oct; 6(4):351-61.

18.Simonson SG, Raza A, Martin PD, Mitchell PD, Jarcho JA, Brown CD, Windass AS, Schneck DW. Rosuvastatin pharmacokinetics in heart transplant recipients administered an antirejection regimen including cyclosporine. Clin Pharmacol Ther 2004 Aug;76(2):167-77.

19.Alejandro DS, Petersen J. Myoglobinuric acute renal failure in a cardiac transplant patient taking lovastatin and cyclosporine. J Am Soc Nephrol 1994 Aug;5(2):153-60.

20.Norman DJ, Illingworth DR, Munson J, Hosenpud J. Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin. N Engl J Med 1988 Jan 7;318(1):46-7.

21.East C, Alivizatos PA, Grundy SM, Jones PH, Farmer JA. Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation. N Engl J Med 1988 Jan 7;318(1):47-8.

22.Tobert JA. Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation (reply). N Engl J Med 1988 Jan 7;318(1):48.

23.Corpier CL, Jones PH, Suki WN, Lederer ED, Quinones MA, Schmidt SW, Young JB. Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients. JAMA 1988 Jul 8;260(2):239-41.

24.Tong J, Laport G, Lowsky R. Rhabdomyolysis after concomitant use of cyclosporine and simvastatin in a patient transplanted for multiple myeloma. Bone Marrow Transplant 2005 Oct;36(8):739-40.

25.Sochman J, Podzimkova M. Not all statins are alike: induced rhabdomyolysis on changing from one statin to another one. Int J Cardiol 2005 Mar 10;99(1):145-6.

26.Gumprecht J, Zychma M, Grzeszczak W, Kuzniewicz R, Burak W, Zywiec J, Karasek D, Otulski I, Mosur M. Simvastatin-induced rhabdomyolysis in a CsA-treated renal transplant recipient. Med Sci Monit 2003 Sep; 9(9):CS89-91.

27.Weise WJ, Possidente CJ. Fatal rhabdomyolysis associated with simvastatin in a renal transplant patient. Am J Med 2000 Mar;108(4):351-2.

28.Meier C, Stey C, Brack T, Maggiorini M, Risti B, Krahenbuhl S. Rhabdomyolysis in patients treated with simvastatin and cyclosporin: role of the hepatic cytochrome P450 enzyme system activity. Schweiz Med Wochenschr 1995 Jul 11;125(27-28):1342-6.

29.Blaison G, Weber JC, Sachs D, Korganow AS, Martin T, Kretz JG, Pasquali JL. Rhabdomyolysis caused by simvastatinin a patient following heart transplantation and cyclosporine therapy. Rev Med Interne 1992 Jan-Feb; 13(1):61-3.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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