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Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription herbal products you may use, especially aldesleukin, digoxin, drugs that can cause bleeding bruising including antiplatelet drugs such as clopidogrel, blood thinners such as dabigatran warfarin, nsaids such as aspirin celecoxib ibuprofen , hormones e.

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Myopathy rhabodomyolysis with acute renal failure and or myopathy reported; monitor patient closely dose adjustment required when coadministered with niacin, amiodarone, verapamil, diltiazem, amlodipine, and ranolazine predisposing factors for myopathy include advanced age 65 years , uncontrolled hypothyroidism, and renal impairment increased risk for myopathy in chinese patients coadministered niacin 1 g day; they should not receive simvastatin 80 mg coadministered with lipid-modifying doses of niacin-containing products withhold or discontinue if myopathy, renal failure, or transaminase levels 3x uln develop risk of myopathy is greater in patients taking simvastatin 80 mg day, especially in the 1st year of treatment rare reports of immune-mediated necrotizing myopathy imnm , characterized by increased serum creatine kinase that persists despite discontinuing statin risk for myopathy increased when coadministered with other lipid-lowering drugs other fibrates, 1 g day of niacin, or, for patients with hofh, lomitapide , colchicine, amiodarone, dronedarone, verapamil, diltiazem, amlodipine, or ranolazine see contraindications for list of drugs contraindicated because of increased risk for myopathy when coadministered with simvastatin see adult dosing for dose limitations and modifications.