Ciprofibrate 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
Ciprofibrate
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-lowering medicines, simvastatin (a statin) and ciprofibrate (a fibrate). Both of these medicines can, on their own, sometimes cause muscle problems. When they're taken together, that risk goes up, and in rare cases it can lead to a serious condition where muscle tissue breaks down.
The main thing to watch for is new muscle pain, tenderness, or weakness, especially if it comes with dark or cola-colored urine. This doesn't happen overnight, so it's something to keep an eye on over time. Please don't stop either medicine on your own. Talk with your pharmacist or doctor, who can decide the safest plan for you and keep a close watch.
Effect: Additive risk of myopathy, rhabdomyolysis, and myoglobinuria when ciprofibrate (a fibrate) is combined with simvastatin (an HMG-CoA reductase inhibitor).
- Mechanism: Unknown; likely pharmacodynamic additive muscle toxicity rather than a defined PK enzyme/transporter interaction.
- Direction: Increased myotoxicity risk (neither agent is metabolically activated in a way that reverses this).
- Onset: Delayed. Evidence: Probable. Severity: Major.
- Management: Combination not recommended. If required, monitor for muscle pain, tenderness, weakness; consider CK and renal function checks and weigh benefit versus risk.
What happens
An increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Combining ciprofibrate with HMG-CoA reductase inhibitors like atorvastatin and simvastatin should be avoided, since this pairing raises the likelihood of myopathy, rhabdomyolysis, and myoglobinuria2. When such combined treatment cannot be avoided, watch the patient for indications of myopathy or rhabdomyolysis, including muscle pain, tenderness, or weakness. A careful assessment of the therapeutic benefits against the potential risks is warranted 345167.
Why it happens (mechanism)
Unknown
How to manage this interaction
Your care team will weigh whether you truly need both of these together, since this combination is generally not recommended. If it is needed, they can manage it safely:
- Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise.
- Your team may monitor you more closely for muscle problems, and your dose may be adjusted and individualized to you.
- Report right away any muscle pain, tenderness, or weakness, or dark-colored urine.
Bring this up at your next visit or with your pharmacist so they can confirm the plan that's best for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ciprofibrate and Simvastatin together?
Combining simvastatin and ciprofibrate raises the risk of serious muscle damage and is generally not recommended; if you take both, watch for muscle pain or weakness and stay in close contact with your care team. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ciprofibrate 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 "delayed". Effects tend to build up gradually over days to weeks.
How is the Ciprofibrate and Simvastatin interaction managed?
Your care team will weigh whether you truly need both of these together, since this combination is generally not recommended. If it is needed, they can manage it safely: Keep taking both medicines exactly as prescribed unless your prescriber tells you otherwise. Your team may monitor you more closely for muscle problems, and your dose may be adjusted and individualized to you. Report right away an… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Ciprofibrate 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 (7)
- Product Information: ZOCOR(R) oral tablets, simvastatin oral tablets. Merck Sharp & Dohme Corp. (per FDA), Whitehouse Station, NJ, 2015. DailyMed
- Product Information: Ciprofibrate oral tablets, ciprofibrate oral tablets. Zentiva (per EMC), Guildford, United Kingdom, 2014.
- Product Information: CRESTOR(R) oral tablets, rosuvastatin calcium oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2023. DailyMed
- Product Information: LIVALO(R) oral film coated tablets, pitavastatin oral film coated tablets. Kowa Pharmaceuticals America, Inc. (per FDA), Montgomery, AL, 2013. DailyMed
- Product Information: MEVACOR(R) oral tablets, lovastatin oral tablets. Merck Sharp & Dohme Corp. (per FDA), Whitehouse Station, NJ, 2014. DailyMed
- Product Information: Lescol(R) XL oral extended-release tablets, fluvastatin sodium oral extended-release tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2012. DailyMed
- Product Information: LIPITOR(R) oral tablets, atorvastatin calcium oral tablets. Parke-Davis (Per FDA), New York, NY, 2014. DailyMed
Keep reading about Simvastatin
Keep reading about Ciprofibrate
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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