Описание
Simvastatin modestly potentiates warfarin anticoagulation, leading to small but potentially clinically relevant INR increases.
Механизм
Simvastatin may inhibit CYP2C9-mediated S-warfarin metabolism; the precise mechanism is not fully elucidated but has been observed across multiple statins.
Клиническое значение
INR increases of ~10–20% have been observed; dose-dependent effect—higher simvastatin doses carry greater risk.
Тактика ведения
Monitor INR when starting, stopping, or changing the simvastatin dose; adjust warfarin if INR moves outside target range.
Медицинский отказ от ответственности
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