Simvastatin

Simvastatin belongs to a group of medicines known as HMG-CoA reductase inhibitors. HMG-CoA reductase is a liver enzyme, which is involved in the production of cholesterol. Medications such as simvastatin block the action of this enzyme, which means that less “bad” LDL cholesterol is produced. As a result, your blood cholesterol levels are lowered, which is thought to reduce dangerous complications such as stroke and heart attack. Simvastatin also reduces blood levels of other blood fats (for example a type of blood fat called triglycerides).

In addition to taking simvastatin, you must follow a low cholesterol diet. Your GP will advise you on how to plan your meals and reduce your intake of cholesterol and saturated fats.

Your GP will decide which Simvastatin dosage you need to take. The starting dose is usually 10mg Simvastatin a day. Your GP may need to adjust this dosage and increase it gradually. Once you have reached your cholesterol goal, your GP might decide to lower your dosage.

You may need to take Simvastatin 20mg, 40mg or 80mg, depending on your prescription. The exact dosage depends on how well you adjust to taking the statin and how effectively simvastatin lowers your cholesterol. The maximum daily dosage is 80mg. Patients who suffer from particular health conditions (for example kidney disease) or are taking other medications are often prescribed a low dosage to prevent side effects. Please note, product packaging may differ from the image above.

You must not stop taking Simvastatin tablets without consulting your doctor first. If you stop taking Simvastatin, your blood cholesterol levels are likely to increase. This puts you at risk of heart problems and stroke.

Simvastatin tablets need to be taken in the evening, as the medication works more effectively at night. Take your daily dose with a drink of water. Do not chew the tablet but swallow it whole. You can take Simvastatin with or without food.

If you forget to take a Simvastatin dose, take it as soon as you remember. If it is nearly time to take the next dose, skip the missed tablet and continue your treatment as usual.

Simvastatin and Grapefruit

Simvastatin and grapefruit are known to interact. Avoid grapefruit and grapefruit juice while taking Simvastatin. Grapefruit contains components which increase the level of Simvastatin in your blood. This increases your risk of side effects, such as muscle damage.

Simvastatin and alcohol

Alcohol can affect the action of simvastatin, and you should keep your alcohol intake to a minimum whilst you are on simvastatin. You must tell your doctor if you are consuming large amounts of alcohol on a regular basis. Drinking alcohol increases your risk of liver and kidney disease, which means Simvastatin may not be suitable for you.

Can I drive or operate machinery while taking Simvastatin tablets?

You can drive and work with machines during your treatment with Simvastatin. The statin should not have any impact on your ability to concentrate. However, a very small number of patients report feeling dizzy when taking Simvastatin. Speak to your doctor if this happens to you. Do not drive while feeling dizzy.

Do not take Simvastatin if:

• you are allergic to one of the ingredients in Simvastatin tablets
• you have liver problems
• you are pregnant
• you are breastfeeding
• you are taking any medication which interacts with Simvastatin
• you are allergic to lactose

Tell your doctor if:

• you have ever had muscle pain, cramps or weakness, or if any member of your family has a muscle disorder or a reaction to drugs for cholesterol
• you suffer from any medical condition other than high cholesterol
• you drink large quantities of alcohol
• you have had liver problems in the past
• you will have an operation in the near future
• you suffer from lung disease

Before prescribing Simvastatin tablets, your doctor will take a blood sample to test whether your liver function is normal. During treatment, you will need to attend regular check-ups during which your GP will make sure your treatment is working.

Simvastatin is usually tolerated well, but some patients experience side effects.

Rare Simvastatin Side Effects

• problems with the muscles, including aches and pains, weakness, or cramps. Occasionally this can be serious, causing muscle breakdown which in turn leads to kidney damage. If you have any unexplained symptoms in your muscles, you must stop taking the medication and seek urgent medical advice
• inflammation of the liver and altered liver function
• allergic reactions
• low red blood cell count
• stomach problems
• digestive problems
• inflammation of the pancreas (may cause abdominal and back pain)
• nausea and vomiting
• kidney damage

The risk of muscle breakdown is higher in:

• patients over the age of 65
• patients suffering from kidney or thyroid problems
• patients suffering from a muscle disorder
• women
• patients who consume large quantities of alcohol

Stop taking Simvastatin and seek medical help if you experience:

• muscle pains
• cramps
• symptoms of an allergic reaction, such as wheezing, swelling of the face or throat and difficulty breathing
• weakness
• rash and bruising
• joint pain
• yellowing of skin and eyes
• dark urine
• severe abdominal pain

For all risks and side effects associated with Simvastatin, read the patient leaflet provided with your medication.

Tell your doctor if you are taking any other medications. It is particularly important that you mention if you are taking:

• fibrates (taken to lower cholesterol)
• cyclosporin (a drug which suppresses your immune system)
• antifungal medications such as itraconazole, ketoconazole, fluconazole and posaconazole
• certain antibiotics, such as Erythromycin, clarithromycin and telithromycin
• certain medications used to treat HIV
• danazol (a drug that alters hormone levels)
• certain antidepressant, for example Nefazodone
• some medication used to treat an irregular heartbeat
• some medications used to treat hypertension and heart conditions
• certain medications used to treat bacterial infections
• the gout medication Colchicine