Moderate
Probable
विवरण
Simvastatin modestly potentiates warfarin anticoagulation, leading to small but potentially clinically relevant INR increases.
तंत्र
Simvastatin may inhibit CYP2C9-mediated S-warfarin metabolism; the precise mechanism is not fully elucidated but has been observed across multiple statins.
नैदानिक महत्व
INR increases of ~10–20% have been observed; dose-dependent effect—higher simvastatin doses carry greater risk.
प्रबंधन
Monitor INR when starting, stopping, or changing the simvastatin dose; adjust warfarin if INR moves outside target range.