Drug interactions between Nizoral and Zocor
| Results for the following 2 drugs: |
|---|
| Nizoral (ketoconazole) |
| Zocor (simvastatin) |
Interactions between your selected drugs
ketoconazole ↔ simvastatin
Applies to:Nizoral (ketoconazole) and Zocor (simvastatin)
CONTRAINDICATED: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of lovastatin and simvastatin as well as their pharmacologically active metabolites, all of which are primarily metabolized by the isoenzyme. The interaction has been reported with potent CYP450 3A4 inhibitors such as azole antifungal agents, macrolide antibiotics, HIV protease inhibitors, and nefazodone. Clinically, high levels of HMG-CoA reductase inhibitory activity in plasma may be 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: Due to the potential for severe interaction, concomitant use of lovastatin or simvastatin with potent CYP450 3A4 inhibitors is considered contraindicated. Red yeast rice, which contains lovastatin, should also be avoided during treatment with a potent CYP450 3A4 inhibitor. Fluvastatin, pravastatin, pitavastatin, and rosuvastatin are probably safer alternatives, since they are not metabolized by CYP450 3A4. All patients treated with HMG-CoA reductase inhibitors should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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