Digoxin
Taking
digoxin and
Vytorin together appears to slightly increase the levels of digoxin in the blood. When starting Vytorin or increasing the dosage, your healthcare provider may choose to monitor you more closely.
Diltiazem
Combining
diltiazem with Vytorin may increase the risk of serious muscle problems, such as myopathy or rhabdomyolysis. If you are taking these medicines together, your healthcare provider may choose to monitor your progress closely and make necessary dosing adjustments. Your dosage of Vytorin should not exceed 10/10 mg once daily.
Fibrates
If you are taking Vytorin and a fibrate, you may have an increased risk for serious reactions, including serious muscle problems. Gallbladder problems could also occur. At this time, people are advised against combining
gemfibrozil with Vytorin. The other fibrates may be used with Vytorin, but only with great caution.
Grapefruit
People on Vytorin should not consume grapefruit juice, grapefruit, or grapefruit supplements because doing so can increase the levels of Vytorin in the blood. This can increase the chances of developing a serious muscle problem (for example, myopathy or rhabdomyolysis), which can cause the kidneys to stop working
(see Vytorin and Muscle Pain).
If you are currently taking Vytorin, do not increase or decrease your grapefruit consumption without consulting with your healthcare provider
(see Grapefruit Juice and Vytorin for more information).
Niacin
Both
niacin and Vytorin alone can increase the chances of developing serious muscle problems. Therefore, combining these medicines may cause an even greater risk. If you are taking both of these products, your healthcare provider may choose to monitor your progress closely and make necessary dosing adjustments
(see Niacin and Vytorin).
This is particularly important for people of Chinese descent, as studies have suggested that Chinese people may be at a higher risk for problems when combining niacin and
simvastatin (one of the components of Vytorin).
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