simvastatin + ticagrelor

Simvastatin + ticagrelor is a combination of two pharmaceutical agents used together, typically in patients with cardiovascular disease who require both cholesterol lowering and antiplatelet therapy. Simvastatin is an HMG-CoA reductase inhibitor (statin) that lowers cholesterol by inhibiting the enzyme responsible for cholesterol synthesis in the liver. Ticagrelor is a P2Y12 receptor antagonist (antiplatelet agent) that prevents platelet aggregation by reversibly inhibiting the ADP receptor on platelets, reducing the risk of thrombotic events such as heart attack or stroke. When used together, there are important pharmacokinetic interactions—ticagrelor can increase plasma concentrations of simvastatin due to CYP3A4 inhibition and transporter effects, raising the risk of statin-related adverse effects such as myopathy and rhabdomyolysis. The combination should be used with caution; doses of simvastatin above 40 mg daily are not recommended when co-administered with ticagrelor[1][2][3][4][5][6].