MajorHMG-CoA reductase inhibitors (statins)×Non-dihydropyridine calcium channel blocker
Updated · Methodology
Mechanism
Verapamil inhibits CYP3A4 and P-glycoprotein. Simvastatin rises 2–3 fold with myopathy and rhabdomyolysis risk. FDA Zocor Section 7 caps simvastatin at 10 mg/day with verapamil.
Symptoms
Myalgia, weakness, rising CK within 1–3 weeks.
Management
Cap simvastatin at 10 mg/day. Alternative: pravastatin or rosuvastatin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Zocor (simvastatin) prescribing information (2012)
- AEMPS: Ficha técnica: Simvastatina (nº registro 65199), sección 4.5 (2026)– AEMPS, CIMA, nº registro 65199, revisión 03/2026, sección 4.5