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