Ketoconazole and Simvastatin: Drug Interaction Guide

Quick answer: This is a major interaction — avoid combining Ketoconazole and Simvastatin unless specifically directed by your doctor.

Interaction severity: Major — avoid combination

How Ketoconazole interacts with Simvastatin

Ketoconazole strongly inhibits CYP3A4, increasing simvastatin exposure more than 10-fold with a high risk of rhabdomyolysis.

What you should do

Combination is contraindicated. Withhold simvastatin during ketoconazole treatment or switch to pravastatin/rosuvastatin.

Key facts

Severity

Major — avoid combination

Mechanism

Ketoconazole strongly inhibits CYP3A4, increasing simvastatin exposure more than 10-fold with a high risk of rhabdomyoly...

Action

Combination is contraindicated. Withhold simvastatin during ketoconazole treatment or switch to pravastatin/rosuvastatin...

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Ketoconazole and Simvastatin together?

No — this combination should generally be avoided. Combination is contraindicated. Withhold simvastatin during ketoconazole treatment or switch to pravastatin/rosuvastatin.

What is the severity of this interaction?

The interaction between Ketoconazole and Simvastatin is classified as Major — avoid combination. Ketoconazole strongly inhibits CYP3A4, increasing simvastatin exposure more than 10-fold with a high risk of rhabdomyolysis.

What should I do if I'm prescribed both?

Combination is contraindicated. Withhold simvastatin during ketoconazole treatment or switch to pravastatin/rosuvastatin. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.