The Medical Letter on Drugs and Therapeutics
Drug Interactions with Simvastatin
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A recent letter to the editor of the Annals of Internal Medicine documented a single case of myopathy apparently due to an interaction between simvastatin (Zocor, and others) and green tea.1 Since it became available generically, simvastatin has surpassed atorvastatin (Lipitor) as the best selling statin. As such, it is probably the most common cause of statin-induced myopathy, which is often a result of drug interactions.

STATIN-INDUCED MYOPATHY — Statin-induced myopathy can range from myalgia to myositis (creatinine kinase ≥10x normal) to rhabdomyolysis. The risk of myopathy is closely related to the dose of the drug and even more closely to its concentration in serum. The incidence of myopathy with simvastatin, according to the manufacturer, is about 25 times higher with the maximum FDA-approved dose of 80 mg (0.53%) than with the usual starting dose of 20 ... more      

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Title: Drug Interactions with Simvastatin
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