Fluvoxamine 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
Fluvoxamine
No brand names on recordSimvastatin
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.
Let's talk about taking fluvoxamine (an antidepressant) together with simvastatin (a cholesterol medicine). Your body uses a liver enzyme to break down simvastatin. Fluvoxamine can slow that enzyme down, so more simvastatin may build up in your blood than usual.
When statin levels climb, the main thing to watch for is muscle problems, like unexplained muscle pain, soreness, tenderness, or weakness. This concern is based mostly on how these drugs work rather than strong real-world data, so try not to worry. Keep taking both as prescribed, and let your pharmacist or doctor know about any new muscle aches. Your care team can easily manage this by adjusting your dose or watching you a bit more closely.
Effect: Fluvoxamine may increase simvastatin plasma exposure, raising the risk of myopathy and rhabdomyolysis.
Mechanism: Fluvoxamine inhibits CYP3A4, which mediates simvastatin metabolism; reduced clearance increases statin AUC/Cmax. (Simvastatin is a lactone prodrug, but inhibiting its CYP3A4 elimination still yields net accumulation of active moiety.)
Direction: Increased simvastatin effect and toxicity risk.
- Onset: Unspecified
- Evidence: Theoretical
- Severity: Moderate
Management: Monitor for unexplained muscle pain, tenderness, weakness; check CK if symptomatic. Consider lowering the simvastatin dose, individualized to the patient.
What happens
Increased plasma concentrations of selected statins and increased risk for myopathy and rhabdomyolysis
Interaction Deep Dive
When fluvoxamine is given together with certain statins, the plasma concentrations of the statin may rise, which raises the likelihood of myopathy. Observe the patient closely and think about reducing the statin dose1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated statin metabolism
How to manage this interaction
Good news: this is very manageable with your care team's help.
- Keep taking both medicines as prescribed unless your prescriber tells you otherwise.
- Your team may lower your simvastatin dose, adjusted and individualized to you, and/or monitor you more closely.
- Watch for and promptly report unexplained muscle pain, tenderness, or weakness, especially if it comes with dark urine or feeling unusually tired.
Bring this combination up at your next pharmacy or doctor visit so they can confirm the best plan for you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Fluvoxamine and Simvastatin together?
Fluvoxamine can raise simvastatin levels and increase the small risk of muscle problems; keep taking both as prescribed, report any muscle pain, and ask your pharmacist or doctor whether a lower statin dose or closer monitoring makes sense. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Fluvoxamine and Simvastatin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Fluvoxamine and Simvastatin interaction managed?
Good news: this is very manageable with your care team's help. Keep taking both medicines as prescribed unless your prescriber tells you otherwise. Your team may lower your simvastatin dose, adjusted and individualized to you, and/or monitor you more closely. Watch for and promptly report unexplained muscle pain, tenderness, or weakness, especially if it comes with dark urine or feeling unusually… 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 Fluvoxamine 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 anything you'd monitor while I'm on both?
References (1)
- Andrade C: Selective serotonin reuptake inhibitor drug interactions in patients receiving statins. J Clin Psychiatry 2014; 75(2):e95-e99. PubMed
Keep reading about Fluvoxamine
Keep reading about Simvastatin
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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