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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.

Check with your doctor immediately if any of the following side effects occur while taking ezetimibesimvastatin:

Grapefruit may interact with ezetimibe and simvastatin and lead to unwanted side effectsAvoid the use of grapefruit products.

The risk of myopathy is increased by reducing the elimination of the simvastatin component of VYTORINHence when VYTORIN is used with an inhibitor of CYP3A4e.gas listed belowelevated plasma levels of HMG-CoA reductase inhibitory activity increases the risk of myopathy and rhabdomyolysisparticularly with higher doses of VYTORINSee WARNINGS AND PRECAUTIONS and CLINICAL PHARMACOLOGYConcomitant use of drugs labeled as having a strong inhibitory effect on CYP3A4 is contraindicatedsee CONTRAINDICATIONSIf treatment with itraconazoleketoconazoleposaconazolevoriconazoleerythromycinclarithromycin or telithromycin is unavoidabletherapy with VYTORIN must be suspended during the course of treatment.

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