Simvastatin

💊 What is Simvastatin used for?

• •Lowering the risk of death from heart disease, heart attacks, and strokes in adults with established coronary heart disease, cerebrovascular disease, peripheral vascular disease, and/or diabetes who are at high risk of heart disease events
• •Lowering LDL cholesterol ("bad" cholesterol) along with diet in adults with high levels of fat in the blood (hyperlipidemia)
• •Lowering LDL cholesterol along with diet in adults and children 10 years of age and older with heterozygous familial hypercholesterolemia, an inherited condition
• •Lowering LDL cholesterol in adults with homozygous familial hypercholesterolemia, used together with other cholesterol-lowering treatments
• •Treating adults with primary dysbetalipoproteinemia, a type of high cholesterol, along with diet
• •Lowering triglycerides (a type of fat in the blood) in adults, along with diet

How it works

The label says simvastatin decreases the body's production of cholesterol, and that it is a type of HMG-CoA reductase inhibitor.

How it is usually taken

• •The label says simvastatin is taken by mouth once a day, in the evening. It is used along with diet. Follow the instructions from your prescriber or pharmacist about how to take it.

Comes as

• •5 mg tan, round, film-coated tablets
• •10 mg peach, oval, film-coated tablets
• •20 mg tan, oval, film-coated tablets
• •40 mg brick red, round, film-coated tablets
• •80 mg brick red, capsule-shaped, film-coated tablets

⚠️ Simvastatin side effects

🛑 Who should not take Simvastatin, and who should be careful

The label says not to take it if

• 🚨You take certain strong CYP3A4 inhibitor medicines, such as some antifungal medicines (itraconazole, ketoconazole, posaconazole, voriconazole), certain antibiotics (erythromycin, clarithromycin), certain HIV protease inhibitors, certain hepatitis C protease inhibitors (boceprevir, telaprevir), cobicistat-containing products, or the antidepressant nefazodone. The label says these are contraindicated.
• 🚨You take cyclosporine, danazol, or gemfibrozil. The label says these are contraindicated.
• 🚨You have acute liver failure or decompensated cirrhosis. The label says these are contraindicated.
• 🚨You are allergic to simvastatin or any of its ingredients. The label notes that serious allergic reactions, including anaphylaxis, angioedema, and Stevens-Johnson syndrome, have been reported.

Tell your doctor before taking it if

• •Tell your prescriber about all your medical conditions, including unexplained muscle aches or weakness, myasthenia gravis or ocular myasthenia, kidney problems, liver problems, thyroid problems, and if you drink more than 2 glasses of alcohol daily.
• •Tell your prescriber if you are 65 years of age or older, or of Chinese descent. The label says these can affect the risk of muscle problems.
• •Tell your prescriber if you are pregnant or plan to become pregnant.
• •Tell every prescriber and pharmacist about all medicines you take, both prescription and over the counter. Tell other prescribers if you are taking simvastatin before they start or change a medicine.
• •The label says to read the Patient Information leaflet each time you get a refill, because there may be new information.

🔀 Simvastatin with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Grapefruit juice: The label says it can increase the risk of myopathy and rhabdomyolysis with simvastatin.
• •Other medicines that raise the risk of muscle problems: the label lists strong CYP3A4 inhibitors, cyclosporine, danazol, gemfibrozil, and says dosage changes are recommended with lomitapide, verapamil, diltiazem, dronedarone, amiodarone, amlodipine, or ranolazine.
• •Coumarin anticoagulants (blood thinners): The label says to obtain an INR before starting simvastatin and to monitor INR during starting or dose changes.
• •Digoxin: The label says digoxin levels should be monitored during the start of simvastatin.
• •Other lipid-lowering therapies: The label lists these as a factor that can increase the risk of myopathy.

Alcohol and food

The label says to tell your prescriber if you drink more than 2 glasses of alcohol daily, since this is listed as a condition to report. The label also says grapefruit juice can increase the risk of muscle problems with simvastatin.

🤰 Simvastatin in pregnancy and breastfeeding

Pregnancy

The label says simvastatin should be discontinued when pregnancy is recognized, and that it may cause fetal harm. It also says treatment of high cholesterol is generally not necessary during pregnancy. Pregnant people and people who can become pregnant should discuss the potential risk with their healthcare provider.

Breastfeeding

The label says breastfeeding is not recommended during treatment with simvastatin.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store between 20 and 25 degrees Celsius (68 to 77 degrees Fahrenheit) and to keep the tablets in a tight container.

If a dose is missed

The label says that if a dose is missed, take it as soon as possible. Do not double the next dose.

If too much is taken

The label says no specific antidote for simvastatin is known. Contact Poison Control at 1-800-222-1222 for the latest recommendations.

🗒️ Questions to ask about Simvastatin

• Which other medicines I take could increase my risk of muscle problems with simvastatin?
• Should I avoid grapefruit juice while taking simvastatin?
• How often should my liver and cholesterol levels be checked?
• What should I do if I have unexplained muscle pain or weakness?
• What should I do if I think I might be pregnant?
• What should I do if I miss a dose?

❓ Simvastatin: frequently asked questions