Nirmatrelvir/Ritonavir and Simvastatin Interaction

Drug interaction information between Nirmatrelvir/Ritonavir and Simvastatin.

Nirmatrelvir/Ritonavir and Simvastatin have a documented major interaction in FDA labeling.

FDA drug labeling documents a major-severity interaction between Nirmatrelvir/Ritonavir and Simvastatin. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.

Drug A

Nirmatrelvir/Ritonavir

Antiviral (Protease Inhibitor Combination)

Drug B

Simvastatin

HMG-CoA Reductase Inhibitor (Statin)

How They Interact

This medicine stops your body from breaking down simvastatin, which can lead to high levels that cause serious muscle damage.

FDA Label Information

HMG-CoA reductase inhibitors lovastatin, simvastatin ↑ lovastatin ↑ simvastatin Co-administration contraindicated due to potential for myopathy including rhabdomyolysis [see Contraindications (4) ] . If treatment with PAXLOVID is considered medically necessary, discontinue use of lovastatin and simvastatin at least 12 hours prior to initiation of PAXLOVID, during the 5 days of PAXLOVID treatment, and for 5 days after completing PAXLOVID.

Frequently Asked Questions

What SPL severity band is on file for Nirmatrelvir/Ritonavir + Simvastatin?

Compiled FDA labeling labels this pair major. That is a source-record field, not an individual medication-combination decision.

Which drug in this pair has the larger labeled-interaction portfolio?

Nirmatrelvir/Ritonavir has 86 labeled pairs on file vs Simvastatin's 41. In the major band specifically: Nirmatrelvir/Ritonavir has 23 (also Lovastatin, Sildenafil, Carbamazepine, Rifampin); Simvastatin has 11 (also Diltiazem, Verapamil, Cyclosporine, Amiodarone).

What mechanism field is on file for Nirmatrelvir/Ritonavir and Simvastatin?

This medicine stops your body from breaking down simvastatin, which can lead to high levels that cause serious muscle damage.

Nirmatrelvir/Ritonavir carries more major-labeled pairs than Simvastatin

SPL source-record counts only. This page's band is major · classes on file: Nirmatrelvir/Ritonavir (Antiviral (Protease Inhibitor Combination)); Simvastatin (HMG-CoA Reductase Inhibitor (Statin)).

Nirmatrelvir/Ritonavir has 23 major-labeled pairs vs Simvastatin's 11.

Nirmatrelvir/Ritonavir

23 major · 30 moderate · 33 minor · 86 total

Simvastatin

11 major · 9 moderate · 21 minor · 41 total

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.