Drug Interaction Report

Grapefruit juice can significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You should avoid the consumption of grapefruit or grapefruit juice during treatment with simvastatin. Drinking green tea or taking green tea extracts may also increase the blood levels of simvastatin in some patients. Talk to your doctor or pharmacist if you have any questions or concerns. It may be advisable to avoid excessive consumption of green tea and green tea products while on simvastatin. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MetFORMIN should be taken with meals, and excessive alcohol intake (either short-term binge drinking or frequent consumption) should be avoided during treatment. Taking metFORMIN with alcohol may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis, which is a buildup of lactic acid in the blood that can occasionally occur during treatment with metformin-containing products. Lactic acidosis is more likely to occur if you have kidney or liver disease, acute or unstable congestive heart failure, or dehydration. You should seek immediate medical attention if you develop potential signs and symptoms of lactic acidosis such as fatigue, weakness, muscle pain, increasing drowsiness, abdominal pain or discomfort, slow or irregular heartbeat, breathing difficulty, chills, and other unusual symptoms. Alcohol may also affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, you should limit your alcohol intake due to the risk of lactic acidosis with metformin. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. Talk to your doctor or pharmacist if you have any questions or concerns about metformin.

Simvastatin may cause liver problems and using it with substantial quantities of ethanol (alcohol) may increase that risk. You should limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.