Simvastatin (Less Than or Equal To 20 mg)/Azithromycin Interactions

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:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process your cholesterol medicine properly.

What might happen:

The blood levels of your cholesterol medicine may increase and cause toxic effects.

What you should do about this interaction:

If you experience unexplained muscle pain, tenderness, weakness, or discoloration of urine, contact your healthcare professional (e.g doctor or pharmacist). Your doctor may want to adjust the dose of your cholesterol medicine.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.

  • 1.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 2.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
  • 3.Mevacor (lovastatin) US prescribing information. Merck & Co., Inc. February, 2014.
  • 4.Zocor (simvastatin) US prescribing information. Merck & Co., Inc. March, 2023.
  • 5.Strandell J, Bate A, Hagg S, Edwards IR. Rhabdomyolysis a result of azithromycin and statins: an unrecognized interaction. Br J Clin Pharmacol 2009 Sep;68(3):427-34.
  • 6.Alreja G, Inayatullah S, Goel S, Braden G. Rhabdomyolysis caused by an unusual interaction between azithromycin and simvastatin. J Cardiovasc Dis Res 2012 Oct;3(4):319-22.
  • 7.Skrabal MZ, Stading JA, Cannella CA, Monaghan MS. Two cases of rhabdomyolysis associated with high-dose simvastatin. Am J Health Syst Pharm 2003 Mar 15;60(6):578-81.
  • 8.Grunden JW, Fisher KA. Lovastatin-induced rhabdomyolysis possibly associated with clarithromycin and azithromycin. Ann Pharmacother 1997 Jul-Aug;31(7-8):859-63.
  • 9.Ayanian JZ, Fuchs CS, Stone RM. Lovastatin and rhabdomyolysis. Ann Intern Med 1988 Oct 15;109(8):682-3.
  • 10.Lilley LL, Guanci R. Drug interaction triggers weakness. Am J Nurs 1998 Apr;98(4):10.

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, except 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.