Page 60 - PBA Medicine list - edition 5_SW_Neat

By Abdul Basit

Generic Name: Simvastatin

Brand names: APO-Ezetimibe/Simvastatin 10 mg/20 mg Tablets

Side effects/precautions:
Gastrointestinal disorders. Uncommon: abdominal pain; abdominal discomfort; abdominal pain upper;
dyspepsia; flatulence; nausea; vomiting. Constipation, pancreatitis.

General disorders and administration site conditions. Uncommon: asthenia; fatigue; malaise; oedema
peripheral.

Psychiatric disorders. Uncommon: sleep disorder.

Vascular disorders. Hot flush; hypertension.

Metabolism and nutrition disorders. Decreased appetite.

Interactions:
Calcium channel blockers, Cholestyramine, Fibrates, Antacids.

Reasons for interactions:
Amiodarone :The risk of myopathy/rhabdomyolysis is increased by concomitant administration of
amiodarone with ezetimibe/simvastatin
Calcium Chanel Blockers :The risk of myopathy/rhabdomyolysis is increased by concomitant
administration of verapamil, diltiazem, or amlodipine
Cholestyramine: Concomitant cholestyramine administration decreased the mean AUC of total
ezetimibe (ezetimibe + ezetimibe glucuronide) approximately 55%. The incremental LDL-C reduction
due to adding ezetimibe/simvastatin to cholestyramine may be lessened by this interaction.

Fibrates: Fibrates may increase cholesterol excretion into the bile, leading to cholelithiasis.
Concomitant antacid administration decreased the rate of absorption of ezetimibe but had no effect on
the bioavailability of ezetimibe.

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