Maple Syrup Urine Disease (MSUD) is a condition that results from improper metabolism of branched-chain amino acids. The aromatic in fenugreek, sotolon, may be used as a diagnostic criteria for MSUD as it exists in the urine of those persons with this metabolic defect and gives the characteristic sweet-scent.  It normally does not appear in healthy person's urine due to no dietary intake, but may appear in those who drink or consume fenugreek, leading to a false diagnosis.  Maternal consumption of sotolon can also transfer into the baby after birth, and cause trans-generational false diagnosis. 
Simvastatin 20-40 mg/day modestly potentiated the effect of coumarin anticoagulants: the prothrombin time , reported as International Normalized Ratio (INR), increased from a baseline of to and from to in a normal volunteer study and in a hypercholesterolemic patient study, respectively. With other statins, clinically evident bleeding and/or increased prothrombin time has been reported in a few patients taking coumarin anticoagulants concomitantly. In such patients, prothrombin time should be determined before starting VYTORIN and frequently enough during early therapy to ensure that no significant alteration of prothrombin time occurs. Once a stable prothrombin time has been documented, prothrombin times can be monitored at the intervals usually recommended for patients on coumarin anticoagulants. If the dose of VYTORIN is changed or discontinued, the same procedure should be repeated. Simvastatin therapy has not been associated with bleeding or with changes in prothrombin time in patients not taking anticoagulants.