Cardiovascular medications
Dental Considerations for Patients Taking Statin (atorvastatin/simvastatin)
Routine care — note drug considerations (statin)
Record of statin. The points below cover relevant oral side-effects and drug interactions so prescribing and treatment remain safe and non-conflicting.
Emergency vs routine management
If EMERGENCY — what to do
- • Avoid clarithromycin/erythromycin and azole antifungals with simvastatin/atorvastatin (myopathy) — use amoxicillin or azithromycin.Ref: Stockley's Drug Interactions (current edition)
If ROUTINE — what to do
- • Routine care.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
Clinical precautions
- • Avoid prescribing azole antifungals/clarithromycin with simvastatin/atorvastatin (raises statin levels, myopathy risk).
- • Avoid prescribing drugs that interact; verify any new prescription against the patient's full medication list.
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | ROUTINE Routine care — note drug considerations (statin) |
| Supragingival scaling / polish | ROUTINE Routine care — note drug considerations (statin) |
| Deep scaling / subgingival RSD (subgingival calculus) | ROUTINE Routine care — note drug considerations (statin) |
| Root canal treatment | ROUTINE Routine care — note drug considerations (statin) |
| Simple extraction (1–3 teeth) | ROUTINE Routine care — note drug considerations (statin) |
| Surgical / bony extraction | ROUTINE Routine care — note drug considerations (statin) |
| Implant placement | ROUTINE Routine care — note drug considerations (statin) |
References
- Drug considerations in dentistry (oral side-effects & interactions)
- Stockley's Drug Interactions (current edition)
- Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
Related guides
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.