Simvastatin

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Simvastatin is a hypolipidemic drug belonging to the class of pharmaceuticals called “statins” or (or HMG-CoA reductase inhibitors). Introduced in 1989 simvastatin is a lipid-lowering drug used to block the action of enzyme that is needed for cholesterol to be manufactured in the liver this allows the blood levels of cholesterol and triglyceride (fatty substances) to be lowered. It is used in doses of 5 mg up to 80 mg. Higher doses (160 mg) have been found to be too toxic. Its main use is for people who have not responded well to other forms of therapy and reduce the risk of developing coronary heart disease in people who have already had a heart attack, as well as those who suffer from diabetes or angina. Simvastatin is used only for patients who have high cholesterol levels not caused by another disease. (hereditary). Side effects are reported mild and wear off after a few weeks. Found mainly in the liver simvastatin may raise levels of various enzymes. however, this does not usually indicate serious liver damage, but long term use can adversely effect liver function.

Simvastatin can also be used to reduce the risk of coronary heart disease in people who have already had a heart attack, or who suffer from angina or diabetes. In these people simvastatin slows down hardening of the arteries

Our liver makes almost all of the cholesterol found in our body. The body produces most of its cholesterol at night and it is for this reason simvastatin is best taken in the evening or just before going to bed for the night.

Statins, the most potent cholesterol-lowering agents available, lower LDL cholesterol (so-called “bad cholesterol”) by 1.8 mmol/l. This translates in a 60% decrease in the number of cardiac events (heart attack, sudden cardiac death), and a 17% reduced risk of stroke. They have less effect than the fibrates or niacin in reducing triglycerides and raising HDL-cholesterol (“good cholesterol”). See this link for a more detailed indication of use

Detailed Information

Quick Guide

• Lipid-Lowering drug overdose danger – MEDIUM.
• Dependency is said to be – LOW.
• Prescription only drug – YES.
• Available as generic – NO.
• Alcohol Avoidance – YES.
• There is a risk of developing liver disease when drinking alcohol excessively.
• Simvastatin may also be of benefit to diabetes and angina sufferers.

Side Effects

You may if on this medication suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all, as it does not follow that being on this medication will cause unwanted adverse effects.

Common: Indigestion, and a general feeling of weakness
Rare: Anaemia causing unusual tiredness and weakness, Abdominal Pains, Constipation, Diarrhoea, Headaches, Muscle Stiffness and Pain, Nausea, Rash, Flatulence, Numbness or loss of sensation in the arms and legs, Hair Loss, Liver Disease.

It is possible to suffer a very rare allergic reaction which could include: swelling of the face or/and neck, muscle and joint pain, muscle tenderness, hives, fever, flushing and a shortness of breath. You should inform you doctor immediately as you may need urgent medical attention.

The side effects listed here are the most common and rare problems reported by patients using simvastatin. It does not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or pharmacist (chemist).

Prolonged Use

Prolonged treatment of this drug can cause adverse effects on the liver. Regular monitoring on blood tests to assess liver function and muscle strength would be recommended.

Driving, Hazardous Work & Alcohol

There is an increased risk of developing liver disease when drinking excessive amounts of alcohol. There would be no special problems with driving or hazardous work.

Pregnancy and Breast-Feeding

Simvastatin would not usually be prescribed in pregnancy. If you are a woman who could become pregnant unless you are using a reliable form of contraception other than the pill you should not take this simvastatin. If you become pregnant while taking simvastatin you should see your doctor immediately and stop taking this drug. If you breast feed safety in this area has not been established. You should consult with your doctor on all issues of pregnancy.

Simvastatin is classified as a pregnancy Category X medicine by the U.S. Food and Drug Administration (FDA)… Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Tell Your Doctor

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary / alternative preparations.

Over 60′s & Children

There would be no special problems for the over sixties. Simvastatin is not recommended for infants, children or adolescents under the age of 18yrs.

Overdose

You should notify your doctor or go to your nearest accident and emergency department taking the container with you, even if it is empty, if large overdose has been taken it may cause liver damage. However, having said that if at some time you happen to take an unintentional extra dose it would be unlikely to give reason for concern.

Other Medication Reactions

The effects of anticoagulants may be increased by simvastatin, an adjusted dose may be necessary and prothrombin should be monitored. Ciclosporin and other immunosuppressant drugs as well as antiviral drugs are not usually prescribed alongside simvastatin because of the risk of muscle toxicity. The use of other lipid lowering drugs with simvastatin may increase the risk of muscle toxicity. Itraconazole, ketoconazole, telithromycin and erythromcin may also increase the risk of muscle toxicity.

Due to the risk of toxicity patients taking simvastatin should restrict their intake of grapefruit and grapefruit-containing products. Grapefruit contains furanocoumarins, notably bergamottin and 6′,7′-dihydroxybergamottin, which inhibit the intestinal cytochrome P450 3A4 isoform. This in turn slows metabolization of simvastatin and a large number of other drugs resulting in higher plasma levels of the drug.An in-depth look at simvastatin.

Missed A Dose

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue the regular dosing schedule. Do not take a double dose to make up for a missed one.

Reducing or Stopping Medication

It is important that you do not stop taking your simvastatin without consulting your doctor. It is possible that the symptoms will recur.

Effect Of Medication

The effects of this drug can be felt within 2 weeks, However, full benefits may take 4 to 6 weeks. The duration of this drug can be felt for up to 24 hours.

• Keep simvastatin in its original container, in a cool dry place, away from the reach and eye sight of children.
• Do not store simvastatin above a temperature of 25°C.
• Never take more or less than the original dosage prescribed by your doctor.
• Never take preparations that has past the expiry date shown on the box or container.
• Do not discard old or unwanted drugs into your trash, sink or toilet.
• Return all unused or old medicines to your pharmacist, who will dispose of them safely.

If this medication has been prescribed for you never allow anyone else to use it, even if you know or they feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.