7 Interactions found for:
Drug Interactions
No drug interactions were found for selected drugs: Lantus, simvastatin.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Drug and Food Interactions
Major
Simvastatin
+ Food
The following applies to the ingredients: Simvastatin
Grapefruit juice can significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You should avoid the consumption of grapefruit or grapefruit juice during treatment with simvastatin. Drinking green tea or taking green tea extracts may also increase the blood levels of simvastatin in some patients. Talk to your doctor or pharmacist if you have any questions or concerns. It may be advisable to avoid excessive consumption of green tea and green tea products while on simvastatin. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate
Lantus
+ Food
The following applies to the ingredients: Insulin Glargine (found in Lantus)
Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate
Simvastatin
+ Food
The following applies to the ingredients: Simvastatin
Simvastatin may cause liver problems and using it with substantial quantities of ethanol may increase that risk. You should limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Pregnancy Interactions
Major
Simvastatin
+ Pregnancy
The following applies to the ingredients: Simvastatin
Professional Content
Use is contraindicated
AU TGA pregnancy category: D
US FDA pregnancy category: X
Comments:
-This drug is contraindicated in women who are or who may become pregnant; women of childbearing potential should be advised to use effective contraception.
-If pregnancy occurs, this drug should be immediately discontinued.
Lipid lowering drugs offer no benefit during pregnancy. Cholesterol and cholesterol derivatives are needed for normal fetal development and HMG-CoA reductase inhibitors are known to inhibit these biosynthetic processes. Studies in rats and rabbits have not shown teratogenicity at doses about 3 times the human exposure, however, studies with a structurally-related statin found skeletal malformations in rats and mice. There are rare reports of congenital anomalies following intrauterine exposure. Two series of pregnant women who took an HMG-CoA reductase inhibitor (n=178 and n=134) during the first trimester of pregnancy, found serious fetal abnormalities in several cases including limb and neurological defects, spontaneous abortions, and fetal deaths. There are no controlled data in human pregnancy.
Atherosclerosis is a chronic process and the discontinuation of lipid-lowering drugs during pregnancy should have little impact on the outcome of long-term therapy of primary hypercholesterolemia.
AU TGA pregnancy category D: Drugs which have caused are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.
US FDA pregnancy category X: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
References
- "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
- Cerner Multum, Inc. "Australian Product Information." O 0
Minor
Lantus
+ Pregnancy
The following applies to the ingredients: Insulin Glargine (found in Lantus)
Professional Content
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus
AU TGA pregnancy category: B3
US FDA pregnancy category: Not assigned
Risk Summary: Published studies of insulin glargine use during pregnancy have not reported a clear association with adverse developmental outcomes; there are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy.
Comments:
-Patients with diabetes or a history of gestational diabetes should maintain good metabolic control before conception and during pregnancy. Insulin requirements may decrease during the first trimester; generally increase during the second and third trimesters, and rapidly decline after delivery. Careful monitoring of glucose control is essential.
For rats and rabbits, dosed at 50 and 10 times the human subcutaneous dose during organogenesis, respectively, the effects of insulin glargine did not differ greatly from those observed with regular human insulin. In rabbits, 5 fetuses from 2 high-dosed litters exhibited dilation of the cerebral ventricles. Fertility and early embryonic development appeared normal. In published human pregnancy reports, no specific adverse effects of insulin glargine on pregnancy and no specific malformations nor fetal or neonatal toxicity has been reported. These studies are not definitive in ruling out the absence of risk due to methodological limitations. The estimated background risk of major birth defects in women with pregestational diabetes with an HbA1c greater than 7 is 6% to 10%; in women with a HbA1c greater than 10, it has been reported to be as high as 20% to 25%. There are no controlled data in human pregnancy.
Clinical Considerations:
-Poorly controlled diabetes during pregnancy increases the maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications.
-Poorly controlled diabetes during pregnancy increases the fetal risk for major birth defects, stillbirth, and macrosomia related morbidity.
AU TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Lantus (insulin glargine)." Aventis Pharmaceuticals PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Toujeo SoloStar (insulin glargine)." sanofi-aventis (2015):
- "Product Information. Basaglar (insulin glargine)." Eli Lilly Canada Inc (2018):
Drug and Breastfeeding Interactions
Major
Simvastatin
+ Breastfeeding
The following applies to the ingredients: Simvastatin
Professional Content
Use is contraindicated
Excreted into human milk: Unknown
Excreted into animal milk: Unknown
Comments: The effects in the nursing infant are unknown.
It is not known if this drug is excreted in human milk; a small amount of another statin drug has been observed in human milk. In animal studies, reduced weight gain was observed in rat offspring dosed with 12.5 to 25 mg/kg/day. Due to concerns with disrupting infant lipid metabolism, most experts agree that this drug should not be used during breastfeeding.
References
- "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
Minor
Lantus
+ Breastfeeding
The following applies to the ingredients: Insulin Glargine (found in Lantus)
Professional Content
Use is considered acceptable; caution is recommended.
Excreted into human milk: Yes
Comments: Women who are breastfeeding may require adjustments in insulin dose and diet.
Exogenous insulins, including the newer biosynthetic insulins (i.e. aspart, detemir, glargine, glulisine, lispro) appear to be excreted into breast milk. Insulin is a protein that is inactivated if taken by mouth. If absorbed, it would be destroyed in the digestive tract of the infant.
Lactation onset occurs later in women with type 1 diabetes, and there is an even greater delay in those with poor glucose control. However, once established lactation persists. Insulin requirements are generally lower in women who breastfeed, most likely due to glucose being used for milk production.
References
- "Product Information. Lantus (insulin glargine)." Aventis Pharmaceuticals PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
- "Product Information. Toujeo SoloStar (insulin glargine)." sanofi-aventis (2015):
- "Product Information. Basaglar (insulin glargine)." Eli Lilly Canada Inc (2018):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Professional Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
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