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No incremental benefit of VYTORIN on cardiovascular morbidity and mortality over and above that demonstrated for simvastatin has been established.
The risk of myopathy is increased by reducing the elimination of the simvastatin component of VYTORINHence when VYTORIN is used with an inhibitor of CYP3A4e.gas listed belowelevated plasma levels of HMG-CoA reductase inhibitory activity increases the risk of myopathy and rhabdomyolysisparticularly with higher doses of VYTORINSee WARNINGS AND PRECAUTIONS and CLINICAL PHARMACOLOGYConcomitant use of drugs labeled as having a strong inhibitory effect on CYP3A4 is contraindicatedsee CONTRAINDICATIONSIf treatment with itraconazoleketoconazoleposaconazolevoriconazoleerythromycinclarithromycin or telithromycin is unavoidabletherapy with VYTORIN must be suspended during the course of treatment.
Concomitant cholestyramine administration decreased the mean AUC of total ezetimibe approximately 55The incremental LDL-C reduction due to adding VYTORIN to cholestyramine may be reduced by this interaction.
Gastrointestinal disordersabdominal painconstipationdyspepsiaflatulencegastritis;
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john s wort, lovastatin or a product that contains lovastatin altoprev , advicor , mevacor , simvastatin or a product that contains simvastatin simcor , vytorin , zocor , rifampin or a product that contains rifampin rifadin , rifater , rifamate , rimactane , sildenafil revatio , when used for the treatment of pulmonary arterial hypertension pah , or triazolam halcion .