Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

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Combining simvastatin with which agent increases the risk of myalgias?

Cholestyramine
Ezetimibe
Gemfibrozil
Omega-3 fish oil

The correct answer is: Gemfibrozil

The combination of simvastatin with gemfibrozil significantly increases the risk of myalgias, which are muscle pain and discomfort. Gemfibrozil is a fibrate that can inhibit the metabolism of statins like simvastatin, leading to higher statin levels in the bloodstream. This elevation in statin concentration can increase the likelihood of adverse muscle-related side effects. The potential for myopathy and rhabdomyolysis is particularly heightened when these two medications are used together, making it critical for healthcare professionals to monitor patients closely and consider alternative therapies or dosage adjustments when prescribing simvastatin to patients already taking gemfibrozil.