Ezetimibe and simvastatin and Heparin interaction
Ezetimibe and simvastatin and Heparin: the Ezetimibe and simvastatin prescribing label describes an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Ezetimibe and simvastatin (VYTORIN) label · effective 2026-01-21
Coumarin Anticoagulants: Obtain INR before VYTORIN initiation and monitor INR during VYTORIN dosage initiation or adjustment.
Table 4: VYTORIN Effects on Other Drugs Coumarin Anticoagulants Clinical Impact: VYTORIN may potentiate the effect of coumarin anticoagulants and increase the INR.
The concomitant use of simvastatin (20 to 40 mg) and coumarin anticoagulants increased the INR from a baseline of 1.7 to 1.8 in healthy subjects and from 2.6 to 3.4 in patients with hyperlipidemia.
There are postmarketing reports of clinically evident bleeding and/or increased INR in patients taking concomitant statins (with or without ezetimibe) and coumarin anticoagulants.
Intervention: In patients taking coumarin anticoagulants, obtain an INR before starting VYTORIN and frequently enough after initiation, dose titration, or discontinuation to ensure that no significant alteration in INR occurs.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.