| Drugs that inhibit CYP3A4 should not be taken with simvastatin because
they increase the chances of developing these muscle disorders. Some of
these drugs include Itraconazole, Ketoconazole, Clarithromycin, Erythromycin,
Telithromycin, HIV protease inhibitors, Nefazodone, Cyclosporine, and large
quantities of grapefruit juice (2). Cytochrome P-450 enzymes are responsible
for metabolizing simvastatin. When these enzymes are inhibited they cause
an increase concentration of the drug and can lead to the destruction of
muscle fibers |
