Simvastatin is a type of drug called a statin, which is a group of drugs that all work in a similar way to control the level of cholesterol in your blood. It works by blocking an enzyme in the body that is needed to produce cholesterol, reducing the amount of cholesterol inside your body, which is thought to help protect you from cardiovascular events such as a heart attack or stroke.
Brand Names and Doses
Simvastatin is the generic name of the drug, which is the active component that has an effect on your body. You may also know it by a brand name, the name given by the drug manufacturing company, such as:
- Zocor
- Simvahexal
- Simvasyn
- Zimstat
- Ransim
- Lipex
- Simvar
Each of these brand names contains the same active component – simvastatin – and works in the same way in the body. It is simply sold under different names according to which company produces the medication.
There are several different doses of simvastatin available including 5mg, 10 mg, 20 mg, 40 mg and 80 mg.
Most people who begin with a low dose such as 5 mg or 10 mg once a day, which can gradually be increased until the cholesterol in your blood reaches a safer level. Your doctor will usually schedule a follow-up appointment about a month after starting to take simvastatin to monitor the effects of the drug and make changes if needed. This allows your body time to adjust to the drug and reduces the risk of side effects, rather than starting with a dose that is too high.
What type of drug is it?
Simvastatin is a type of drug called a statin. Other several drugs that in this class include:
Simvastatin is one of the most effective statin drugs to reduce the level of cholesterol in the blood, particularly LDL cholesterol. Simvastatin is processed in the liver to be excreted from the body and can sometimes interact with other medications that your may be taking, so it is a good idea for your doctor to know which medications you are taking before prescribing simvastatin.
What is simvastatin used for?
Simvastatin helps to lower the LDL cholesterol and triglycerides concentration in your blood and increase HDL cholesterol concentration. Each of these factors can be helpful to prevent cardiovascular events because plaque is less likely to build up in your blood vessels (called atherosclerosis) that can block the flow of blood.
If you have a high risk of cardiovascular disease, simvastatin can reduce your risk of suffering from a myocardial infarction, stroke, revascularization procedures, and death. Your doctor may recommend simvastatin if you have:
- High levels of cholesterol in your blood (hypercholesteremia)
- Hypertension and other risk factors for heart disease
- High levels of triglycerides and cholesterol in your blood (mixed hyperlipidemia)
- High risk of coronary heart disease
- Heterozygous familial hypercholesteremia (in children)
Simvastatin should only be used in combination with diet and lifestyle alterations and not as a substitute for healthy living choices.
How does simvastatin work?
Like other statin drugs, Simvastatin changes the way that cholesterol is produced in your body to reduce the level of LDL cholesterol in your blood. This helps to stop the build-up of plaque in your blood vessels and prevent atherosclerosis and related cardiac events.
An enzyme called 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase is needed to synthesize cholesterol in the body. When you take simvastatin, it blocks this enzyme and reduces the rate that cholesterol can be produced so that the concentration of cholesterol in the blood decreases.
Simvastatin can also increase the uptake of cholesterol from the blood in the liver so that more cholesterol is taken out of the blood and broken down in the liver, reducing the LDL cholesterol even further. Additionally, it can increase the concentration of triglycerides and increase HDL cholesterol. HDL cholesterol is sometimes known as “good cholesterol” because it is believed to help prevent cardiovascular events.
Side Effects
Most patients can take simvastatin without any noticeable side effects. However, you may experience:
- Muscle pain (myopathy)
- Nausea, diarrhea or vomiting
- Headache
- Insomnia
- Dizziness
- Elevated levels of aminotransferase in the body
Rarely, severe muscle pain called myopathy or rhabdomyolysis may present. This usually happens when the dose is too high, such as if there is an interaction with another drug or another related health condition increases sensitivity to the drug. In most cases, the effects will improve if the dose of the drug is reduced.
You should be aware of the possible side effects of simvastatin so that you can recognize the signs and talk to your doctor about decreasing the dose if needed.
Precautions
If you have severe trauma, infection or metabolic disease, there is an increased risk of side effects and complications such as myopathy, rhabdomyolysis, and renal failure. Your doctor may advise you to temporarily stop taking rosuvastatin until you recover to prevent this.
These side effects are also more likely if you have poor renal function, which is often a natural part of aging. If you know that your kidneys aren’t working to their full capacity, make sure that your doctor knows so that they can prescribe the right dose for you.
Drug Interactions
Simvastatin can interact with many other drugs that you may take including:
- Amiodarone
- Bosentan
- Carbamazepine
- Clarithromycin
- Diltiazem
- Erythromycin
- Imatinib
- Itraconazole
- Ketoconazole
- Posaconazole
- Protease inhibitors
- St John’s wort
- Tacrolimus
- Ticagrelor
- Verapamil
If you are taking any of these drugs with simvastatin, it is important that your doctor knows so that the dose can be adjusted if needed. This is particularly important for herbal medications that you can buy over-the-counter without a presciption, such as St. John’s wort, which your doctor may not realise you are taking.
Pregnancy and Breastfeeding
Simvastatin should not be used during pregnancy because it can increase the risk of fetal malformation during the first trimester and other stages of pregnancy. If you are a woman of childbearing age, you should use contraceptive methods while taking simvastatin to avoid an unexpected pregnancy. If you are trying to conceive, you should talk to your doctor about your medications fist.
Simvastatin is not recommended for women who are breastfeeding due to the effect it could have on the baby if excreted in breast milk.
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