Ranolazine and Simvastatin: Drug Interaction Guide

Quick answer: This combination requires caution. Ranolazine and Simvastatin can be used together with adjustments and monitoring.

Interaction severity: Moderate — caution required

How Ranolazine interacts with Simvastatin

Ranolazine inhibits CYP3A4 and P-glycoprotein, increasing simvastatin exposure and the risk of myopathy.

What you should do

Limit simvastatin to 20 mg daily when co-administered with ranolazine, or switch to pravastatin or rosuvastatin which are not CYP3A4 substrates.

Key facts

Severity

Moderate — caution required

Mechanism

Ranolazine inhibits CYP3A4 and P-glycoprotein, increasing simvastatin exposure and the risk of myopathy.

Action

Limit simvastatin to 20 mg daily when co-administered with ranolazine, or switch to pravastatin or rosuvastatin which ar...

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 Ranolazine and Simvastatin together?

With caution. Limit simvastatin to 20 mg daily when co-administered with ranolazine, or switch to pravastatin or rosuvastatin which are not CYP3A4 substrates.

What is the severity of this interaction?

The interaction between Ranolazine and Simvastatin is classified as Moderate — caution required. Ranolazine inhibits CYP3A4 and P-glycoprotein, increasing simvastatin exposure and the risk of myopathy.

What should I do if I'm prescribed both?

Limit simvastatin to 20 mg daily when co-administered with ranolazine, or switch to pravastatin or rosuvastatin which are not CYP3A4 substrates. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

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