Discussions that mention simvastatin

Drug Interactions / Side Effects board


Anyone? I would like to take Luvox and Indocin (indomethacin) off that list, but I still need help with these two:

- Flexeril (cyclobenzaprine)
- Provigil (modafinil)

After reading this forum for a while, I found which site people use to check interactions and it returned the following interaction between those two (but I still don't have a clue what that means to me):


Moderate Drug-Drug Interaction: cyclobenzaprine (cyclobenzaprine) and modafinil (modafinil)

Coadministration with modafinil may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. Modafinil is a modest inducer of CYP450 3A4 in vitro, and pharmacokinetic studies suggest that its effects may be primarily intestinal rather than hepatic. Thus, clinically significant interactions would most likely be expected with drugs that have low oral bioavailability due to significant intestinal CYP450 3A4-mediated first-pass metabolism (e.g., buspirone, cyclosporine, felodipine, lovastatin, midazolam, nifedipine, nisoldipine, saquinavir, simvastatin, sirolimus, tacrolimus, triazolam, verapamil). However, the potential for interaction should be considered with any drug metabolized by CYP450 3A4, especially given the high degree of interpatient variability with respect to CYP450-mediated metabolism. Pharmacologic response to these drugs may be altered and should be monitored more closely whenever modafinil is added to or withdrawn from therapy. Dosage adjustments may be required if an interaction is suspected.


Help please!