Can You Take Progesterone and Simvastatin Together?
Yes, you can safely take micronized oral progesterone and simvastatin together—there is no clinically significant drug-drug interaction between these two medications.
Why This Combination Is Safe
Different Metabolic Pathways
- Simvastatin is metabolized primarily by CYP3A4 in the liver 1
- Progesterone does not inhibit or induce CYP3A4 to any clinically meaningful degree
- The evidence base for statin interactions focuses on CYP3A4 inhibitors (like amiodarone, diltiazem, verapamil) and fibrates, not on hormonal therapies 1
No Evidence of Interaction
- Comprehensive guidelines from the American Heart Association on statin drug interactions do not list progesterone or any progestins as interacting agents 1
- The major concerns with simvastatin involve strong CYP3A4 inhibitors that increase simvastatin blood levels by 75% or more, leading to myopathy risk 1
- Progesterone does not affect simvastatin pharmacokinetics in this manner
What You Should Monitor
Standard Statin Monitoring Applies
- Watch for muscle pain, tenderness, or weakness at any time during therapy 2
- Report any unexplained muscle symptoms to your physician immediately
- No additional monitoring is required specifically for the progesterone-simvastatin combination
Important Caveat About Simvastatin Interactions
While progesterone is safe with simvastatin, be aware that simvastatin does interact dangerously with:
- Amiodarone (limit simvastatin to 20 mg daily) 1
- Diltiazem or dronedarone (limit simvastatin to 10 mg daily) 1, 2
- Verapamil (limit simvastatin to 10 mg daily) 1
- Amlodipine or ranolazine (limit simvastatin to 20 mg daily) 1
- Gemfibrozil (avoid this combination entirely) 1
Clinical Bottom Line
Proceed with your prescribed regimen of progesterone and simvastatin without concern for drug interaction. The combination has no pharmacokinetic or pharmacodynamic interaction that would increase your risk of adverse effects. Focus instead on ensuring you're not taking any of the actual CYP3A4 inhibitors listed above, which would require simvastatin dose adjustment 1, 2.