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All patients starting therapy with VYTORIN or whose dose of VYTORIN is being increased should be advised of the risk of myopathyincluding rhabdomyolysisand told to report promptly any unexplained muscle paintenderness or weakness particularly if accompanied by malaise or fever or if muscle signs and symptoms persist after discontinuing VYTORINVYTORIN therapy should be discontinued immediately if myopathyis diagnosed or suspectedIn most casesmuscle symptoms and CK increases resolved when simvastatin treatment was promptly discontinuedPeriodic CK determinations may be considered in patients starting therapy with VYTORIN or whose dose is being increasedbut there is no assurance that such monitoring will prevent myopathy.
Contraindicated with VYTORINsee CONTRAINDICATIONS and WARNINGS AND PRECAUTIONS
This list is not complete and many other drugs may interact with ezetimibe and simvastatinThis includes prescription and over-the-counter medicinesvitaminsand herbal productsNot all possible drug interactions are listed here.
Because the below reactions are reported voluntarily from a population of uncertain sizeit is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
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merck nyse mrk , known as msd outside the united states and canada, today announced that the new england journal of medicine published the results of the improve-it trial, an investigational study comparing treatment with vytorin ezetimibe and simvastatin to treatment with simvastatin alone in more than 18,000 patients presenting with acute coronary syndromes.