Asciminib and Simvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Simvastatin
Asciminib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what's going on: Asciminib (Scemblix) is a cancer medicine that can block a transporter in your body called BCRP. This transporter normally helps pump certain drugs out. Simvastatin (Zocor) is one of the drugs that transporter handles.
When you take both, your body may hold onto more simvastatin than usual. That can raise the chance of statin side effects, like muscle aches or muscle weakness. This is based on how the drugs are expected to behave rather than strong real-world studies, so it's a caution, not a crisis. The good news is your care team can manage this easily by adjusting your dose and keeping an eye on how you feel.
Mechanism: Asciminib inhibits BCRP-mediated efflux. Simvastatin is a BCRP substrate, so co-administration is predicted to increase simvastatin systemic exposure (increased AUC/Cmax).
Direction/effect: Higher statin exposure raises the risk of dose-related adverse effects (myalgia, myopathy, rare rhabdomyolysis, transaminase elevation).
- Severity: Major
- Evidence: Theoretical
- Onset: Unspecified
Management: Monitor closely for statin-related adverse reactions at all recommended asciminib doses. Reduce the BCRP substrate (simvastatin) dose as recommended in labeling. Counsel patient to report muscle pain, tenderness, weakness, or dark urine; check CK if myopathy is suspected.
What happens
Increased BCRP substrate exposure and an increased risk of BCRP substrate-related adverse effects
Interaction Deep Dive
When asciminib, which inhibits BCRP, is taken together with substrates of BCRP, the exposure to those substrates may rise, potentially heightening the risk of adverse reactions associated with them. For patients receiving asciminib at any of the recommended doses alongside a BCRP substrate, watch carefully for adverse reactions. In this setting, at all recommended asciminib doses, lower the dose of the BCRP substrate as advised1.
Why it happens (mechanism)
Inhibition of BCRP-mediated efflux transport by asciminib
How to manage this interaction
What your care team may do:
- Consider lowering your simvastatin dose while you are on asciminib, as recommended by the labeling.
- Watch you more closely for statin side effects such as muscle aches or weakness.
What you can do:
- Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Report any new or unusual muscle pain, tenderness, weakness, or dark-colored urine right away.
- Ask your pharmacist or doctor whether your simvastatin dose should be adjusted. Your dose can be individualized and managed by your team.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Asciminib and Simvastatin together?
Asciminib can raise simvastatin levels and increase the risk of muscle-related statin side effects, so your team may lower your simvastatin dose and watch you more closely. Report any muscle pain or weakness and ask your pharmacist before making changes. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Asciminib and Simvastatin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Asciminib and Simvastatin interaction managed?
What your care team may do: Consider lowering your simvastatin dose while you are on asciminib, as recommended by the labeling. Watch you more closely for statin side effects such as muscle aches or weakness. What you can do: Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Report any new or unusual muscle pain, tenderness, weakness, or dark-colored urin… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Asciminib or Simvastatin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: SCEMBLIX® oral tablets, asciminib oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2025. DailyMed
Keep reading about Simvastatin
Keep reading about Asciminib
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