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Other adverse reactions reported with simvastatin in placebo-controlled clinical studiesregardless of causality assessment:

All patients starting therapy with VYTORIN or whose dose of VYTORIN is being increased should be advised of the risk of myopathyincluding rhabdomyolysisand told to report promptly any unexplained muscle paintenderness or weakness particularly if accompanied by malaise or fever or if muscle signs and symptoms persist after discontinuing VYTORINVYTORIN therapy should be discontinued immediately if myopathyis diagnosed or suspectedIn most casesmuscle symptoms and CK increases resolved when simvastatin treatment was promptly discontinuedPeriodic CK determinations may be considered in patients starting therapy with VYTORIN or whose dose is being increasedbut there is no assurance that such monitoring will prevent myopathy.

Ezetimibe and simvastatin can cause the breakdown of muscle tissuewhich can lead to kidney failureThis happens more often in womenin older adultsor in people who have kidney disease or poorly controlled hypothyroidismunderactive thyroid

Other adverse reactions reported with simvastatin in placebo-controlled clinical studiesregardless of causality assessment:

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by using ultrasounds to examine the neck arteries of these patients from both groups, researchers hoped to determine if the combination drug, vytorin, had lowered the incidence of plaque buildup in their arteries.

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