Discontinue immediately if myopathy is suspected based on muscle symptoms or is confirmed by creatine phosphokinase level >10x ULN; in suspected cholelithiasis in combination w/ fenofibrate. Myopathy & rhabdomyolysis. Perform LFTs at initiation of therapy & according to recommendations of the statin. Monitor INR if used concomitantly w/ warfarin, another coumarin anticoagulant, or fluindione. Concomitant use w/ ciclosporin. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May affect ability to drive or operate machinery. Not recommended in moderate (Child Pugh score 7-9) to severe (Child Pugh score >9) hepatic impairment. Pregnancy. Not to be used during lactation. Paed patients <6 yr; 10-17 yr w/ simvastatin dose >40 mg daily; <10 yr w/ simvastatin.
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