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• Interactions

Many drugs can interact with simvastatin. Below is just a partial list. Tell your doctor if you are using:

• danazol (Danocrine);

• gemfibrozil (Lopid), clofibrate (Atromid-S), or fenofibrate (Tricor);

• niacin (Nicolar, Nicobid, Slo-Niacin, others);

• nefazodone (Serzone);

• cholestyramine (Questran) or colestipol (Colestid);

• a blood thinner such as warfarin (Coumadin); or

• amiodarone (Cordarone), diltiazem (Cartia, Cardizem, Dilacor, Tiazac), or verapamil (Verelan, Calan, Isoptin);

• erythromycin (E-Mycin, Ery-Tab, others), clarithromycin (Biaxin), or telithromycin (Ketek);

• an antifungal medication such as itraconazole (Sporanox), fluconazole (Diflucan), or ketoconazole (Nizoral);

• drugs that weaken your immune system such as cancer medicine or steroids, cyclosporine (Neoral, Sandimmune, Gengraf), sirolimus (Rapamune), tacrolimus (Prograf), and others;

• HIV or AIDS medication such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), lopinavir-ritonavir (Kaletra), or saquinavir (Invirase, Fortovase).

This list is not complete and there may be other drugs that can interact with simvastatin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using simvastatin and call your doctor at once if you have any of these serious side effects:

• muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine.

Less serious side effects may include:

• mild stomach pain, gas, bloating, stomach upset, heartburn;

• nausea;

• constipation; or

• diarrhea.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.