Bezafibrate and Simvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 4, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Simvastatin
Bezafibrate
No brand names on record
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.
You've been prescribed two cholesterol medicines, simvastatin (a statin) and bezafibrate (a fibrate). Both can, on their own, sometimes cause muscle problems. When taken together, that muscle risk can add up, meaning a higher chance of muscle aches, weakness, or tenderness. In rare cases, serious muscle breakdown can happen.
The good news is that this is very manageable. Your care team may lower your statin dose and keep a closer eye on you. The most important thing you can do is tell your doctor or pharmacist right away if you notice unexplained muscle pain, weakness, tenderness, or dark-colored urine. Please don't stop either medicine on your own first.
Effect: Additive risk of myopathy (potentially rhabdomyolysis) with concomitant simvastatin and bezafibrate. This is a pharmacodynamic, additive muscle-toxicity interaction, not a prodrug or CYP-driven effect.
- Direction/magnitude: Increased incidence and severity of myopathy; magnitude unspecified.
- Onset: Unspecified. Evidence: Theoretical.
- Contraindicated in patients with predisposing factors (renal impairment, age >65, hereditary muscular disorders, prior fibrate/lipid-lowering muscle toxicity, hypothyroidism, severe infection, trauma, surgery, electrolyte/hormone disturbance, high alcohol intake).
- Management: If coadministration necessary, consider simvastatin dose reduction. Monitor for myopathy signs/symptoms and CK. Discontinue if myopathy develops.
What happens
Increased incidence and severity of myopathy
Interaction Deep Dive
When bezafibrate is taken together with an HMG-CoA reductase inhibitor, both the frequency and the severity of myopathy rise. This combination is contraindicated in individuals who have factors that predispose them to myopathy, such as renal impairment, being older than 65 years, a personal or family history of inherited muscular disorders, a prior episode of muscle toxicity from a fibrate or another lipid lowering agent, hypothyroidism, severe infection, trauma, surgery, imbalances involving hormones or electrolytes, and heavy alcohol consumption. Should the two drugs need to be given together, it may be necessary to lower the dose of the HMG-CoA reductase inhibitor. Watch for signs and symptoms of myopathy along with rising creatine kinase levels, and stop the combined therapy if any indication of myopathy develops1.
Why it happens (mechanism)
Additive myopathy effect
How to manage this interaction
Both drugs can affect muscle, so your care team takes a few practical steps when they are used together:
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your statin dose may be reduced and individualized by your care team to lower the muscle risk.
- Your team may monitor you more closely, including checking a blood test called creatine kinase (CK).
- Combining these is not recommended if you have added risk factors (for example kidney problems, age over 65, thyroid problems, or heavy alcohol use), so share your full history.
Contact your pharmacist or prescriber promptly if you get unexplained muscle pain, weakness, tenderness, or dark urine.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Bezafibrate and Simvastatin together?
Taking simvastatin with bezafibrate adds up the risk of muscle injury, so your care team may lower your statin dose and monitor your muscle enzymes. Report any unexplained muscle pain, weakness, or dark urine right away, and do not stop either drug on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Bezafibrate 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 Bezafibrate and Simvastatin interaction managed?
Both drugs can affect muscle, so your care team takes a few practical steps when they are used together: Keep taking both as prescribed unless your doctor tells you otherwise. Your statin dose may be reduced and individualized by your care team to lower the muscle risk. Your team may monitor you more closely, including checking a blood test called creatine kinase (CK). Combining these is not recom… 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 Bezafibrate 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: Bezalip Mono oral modified-release tablets, bezafibrate oral modified-release tablets. Actavis Group PTC ehf (per eMC+), Hafnarfjordur, Iceland, 2015. DailyMed
Keep reading about Simvastatin
Keep reading about Bezafibrate
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