Simvastatin belong to a class of drug known as HMG CoA reductase inhibitor. This is an anti-hypercholesterolemic drug that works by blocking the production of cholesterol (a type of fat) in the body. Simvastatin is used to reduce the total amounts of cholesterol, low density lipoprotein (LDL) or the bad cholesterol, triglycerides (another type of fat), and apolipoprotein B (a protein needed to make cholesterol) in your blood. Simvastatin (Zocor) is also used to increase the level of high density lipoprotein (HDL) or the good cholesterol in your blood. These actions may reduce the risk of hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease.
Do not take simvastatin if you have liver disease. Avoid alcohol use because along with simvastatin, it can both damage the liver. If you are pregnant, could become pregnant during treatment, or if you are breast-feeding a baby do not take simvastatin. There is also a dangerous interaction if simvastatin is taken with grapefruit and grapefruit juice. It could lead to potentially serious side effects.
Prior to taking simvastatin, tell your doctor if you have kidney disease; drink alcoholic beverages; have a chronic muscular disease or have a blood disorder.
You may not be able to take simvastatin, or may require a dosage adjustment or special monitoring during treatment if you have any of the above conditions.
Liver function tests may be requested and every six months after both the start of your treatment and in any dose increase. To get the most beneficial effects from simvastatin, avoid high fat and high-cholesterol foods. It is important to take simvastatin regularly and as directed by your doctor. Simvastatin may need to be taken on a long-term basis for the treatment of high cholesterol. Proper monitoring for progress and occurrence of side effects from simvastatin may be warranted such as blood tests or other medical evaluations while undergoing treatment.
Symptoms of a simvastatin overdose include nausea, diarrhea, stomach distress, and indigestion. Consult a doctor immediately if you experience any of the suspected overdose symptoms.
Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if accompanied by a fever or flu-like symptoms, yellowish discoloration of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools. These may be early symptoms of muscle or liver problems which are rare complications of simvastatin intake.
Discontinue taking simvastatin and seek emergency medical attention if you have these serious side effects: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); decreased urine or rust-colored urine; or blurred vision. Less serious side effects of simvastatin may be more likely to occur such as: gas, bloating, nausea, stomach upset, heartburn, abdominal pain, constipation, or diarrhea; cough; headache; or insomnia. Talk to your doctor about any other unusual side effects not listed here.
Discuss with your doctor if you are taking any of the following drugs which may interact with simvastatin: cyclosporine (Sandimmune, Neoral);
gemfibrozil (Lopid), clofibrate (Atromid-S), or fenofibrate (Tricor); niacin (Nicolar, Nicobid, Slo-Niacin, others); erythromycin (E-Mycin, E.E.S., Ery-Tab, others) or clarithromycin (Biaxin); cholestyramine (Questran) or colestipol (Colestid); an antifungal medication such as itraconazole (Sporanox), fluconazole (Diflucan), or ketoconazole (Nizoral); nefazodone (Serzone); digoxin (Lanoxin, Lanoxicaps); warfarin (Coumadin); a protease inhibitor such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), lopinavir-ritonavir (Kaletra), or saquinavir (Invirase, Fortovase); amiodarone (Cordarone, Pacer one); or verapamil (Calan, Covera-HS, Isoptin, Verelan). Drugs other than those listed above may affect simvastatin so always inform your doctor before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.
Simvastatin is a white to off-white, nonhygroscopic, crystalline powder that is practically insoluble in water, and freely soluble in chloroform, methanol and ethanol. Tablets Simvastatin for oral administration contain either 5 mg, 10 mg, 20 mg, 40 mg or 80 mg of simvastatin and the following inactive ingredients: cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, iron oxides, lactose, magnesium stearate, starch, talc, titanium dioxide and other ingredients. Butylated hydroxyanisole is added as a preservative.
Simvastatin has the following structural formula: