Simvastatin 4- Rosiglitazone

No clinically relevant adverse interactions appear to have been reported between the statins and the sulphonylureas. One study reported an increased incidence of adverse effects with repaglinide and simvastatin, the clinical relevance of which is unclear. Most studies have shown no pharmacokinetic interaction or increased incidence of adverse effects when pioglitazone or rosiglitazone were used with atorvastatin or simvastatin. Subcutaneous exenatide modestly decreased the AUC of lovastatin, but no clear pattern of altered efficacy of statins was noted in exenatide clinical trials. 

However, in a study in healthy subjects, pioglitazone 45 mg daily did not significantly affect the pharmacokinetics of simvastatin 80 mg daily and concurrent use was well tolerated. Similarly, there was no pharmacokinetic interaction between pioglitazone 45 mg daily and atorvastatin 80 mg daily Moreover, clinical use of rosiglitazone with atorvastatin in patients with type 2 diabetes for 16 weeks was well tolerated, as was the clinical use of rosiglitazone or pioglitazone with simvastatin."... 

A 64-year-old woman with type 2 diabetes taking metoprolol aspirin, niacin, warfarin, simvastatin, rosiglitazone, and metformin was given fenofibrate. The HDL cholesterol fell from 1.09 to 0.44 mmol/1. The fenofibrate was withdrawn and the HDL rose to 1.09 mmol/1. 

---