Simvastatin

Brand names of simvastatin

  • Zocor

Simvastatin belongs to the class of medications known as HMG-CoA reductase inhibitors and is used for lowering blood cholesterol. Commonly known as 'statins', this class of drugs also include atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor) and fluvastatin (Lescol). Statins work by lowering the blood cholesterol level by means of slowing down the formation of an enzyme called HMG-CoA reductase in the liver. This enzyme is essential for producing cholesterol. When statins enter the bloodstream, they reduce the level of total and low-density lipoprotein (LDL) cholesterol, also called 'bad' cholesterol, and triglycerides. It is believed that LDL cholesterol is the primary reason for development of coronary artery disease. When the level of LDL cholesterol is reduced, it not only slows, but may also reverse the development of coronary artery disease. In addition, the use of statins also helps to augment the level of high-density lipoprotein (HDL) cholesterol, also called 'good' cholesterol, in the bloodstream. Like lowering the LDL, augmentation in the level of HDL also helps to retard the development of coronary artery disease. Simvastatin was approved for sale and use by the Food and Drug Administration (FDA) in December 1991.

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Things you need to tell your physician before taking simvastatin

As in the instance of beginning treatment with any new prescription drug, before you start taking simvastatin, you should essentially tell your physician or pharmacist whether you have allergic reactions to it, any of its ingredients or you have any different type of allergy. This drug may enclose a number of inactive elements that may result in allergies or additional problems. Therefore, if you are not certain about the components of simvastatin, ask your pharmacist for a list of the same.

In addition, before you start using simvastatin, inform your physician or pharmacist about your entire medical history, particularly if you have or have ever had any liver or kidney ailment or if you use alcohol. While undergoing treatment with this medication, it is essential to restrict your consumption of alcoholic beverages. Remember, drinking alcoholic beverages every day is likely to augment the chances of developing liver diseases, particularly when you are taking simvastatin. It is advisable that you talk to your physician or pharmacist for further details regarding this.

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In case you require undergoing a surgery, including a dental operation, you should tell your surgeon/ dentist that you are already taking simvastatin. In addition, before taking his medication, you need to tell your physician about all the prescription and over-the-counter drugs, vitamins, herbal products and dietary supplements you are already taking.

It may be noted that the elderly people taking simvastatin are likely to be more susceptible to the side effects of this medication, particularly the problems related to the muscles.

Pregnant women should keep away from using simvastatin, as it may cause harm to the fetus. Hence, it is important that women taking this medication should be careful in putting off pregnancy during their treatment. In case any woman becomes pregnant while undergoing treatment with simvastatin, she should right away call her physician to know what she ought to do next. It is advisable that in order to prevent pregnancy, such women should use no less than two dependable forms of contraceptive, for instance, condoms as well as oral contraceptive pills.

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While it is yet to be ascertained whether simvastatin passes onto the breast milk, new mothers taking this medication should consult their physician before breast feeding with a view to avoid any potential harm to the infant. Generally, breast feeding is not advisable for women taking this medication.

Usage

Simvastatin is a drug called HMG-CoA reductase inhibitor and it is used for treating high levels of blood cholesterol. In addition, this medication is also employed to lower the chances of having a stroke or a 'mini-stroke' (transient ischemic attack) in people who are suffering from high cholesterol levels as well as coronary artery disease. Usually, simvastatin is prescribed when the first line of treatment for high cholesterol, which includes weight loss, diet and work-outs, fails to lower total as well as LDL or low-density lipoprotein cholesterol to the desired levels. This medication acts by lowering the volume of cholesterol manufactured by the liver. Like lowering 'bad' or LDL cholesterol and triglycerides, raising the level of HDL or high-density lipoprotein also helps in reducing the chances of developing any heart ailment and, at the same time, prevents the occurrence of heart attacks and strokes.

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How to use simvastatin

Simvastatin should be taken orally either with or without food as per the instructions of your physician. Usually, this medication is taken once every day in the evening. The dosage of simvastatin is dependent on the patient's medication condition, age, reaction to the therapy and the other medications used by him/ her. Prior to beginning treatment with simvastatin, it is important to inform your physician as well as pharmacist regarding all the prescription and over-the-counter drugs, dietary supplements and herbal products that you may be taking. The standard highest dose for simvastatin is 40 mg taken once daily. However, if your physician has prescribed a higher dose for you, continue with that dose. Nevertheless, you should also talk to your physician about the benefits and risks of taking this medication in a dosage above 40 mg per day. Never raise the dose of the medication or take simvastatin more frequently than what has been prescribed by your physician. Taking an over-dose of the medication will not help in improving your condition faster. On the contrary, it may worsen the side effects of using this medication.

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It is advisable that unless you have been instructed otherwise by your physician, you should keep away from consuming grapefruit or drinking grapefruit juice while undergoing treatment with simvastatin. Remember, when grapefruit is used in combination with simvastatin, it may possibly raise the amount of the medication in the bloodstream. It is advisable that you talk to your physician for further information in this regard. In order to obtain the maximum benefits of using simvastatin, you should use the medication on a regular basis and also take it at the same time every day, as it will help you to remember that you have to take this medication. Even if you start feeling better after some weeks' of treatment with simvastatin, it is extremely vital for you to continue using this medication. It is worth mentioning here that usually the majority of the patients having high levels of blood cholesterol or triglycerides do not feel unwell. The complete benefits of using this drug cannot be felt immediately, but you should take simvastatin for no less than four weeks before you avail the full benefits of using it.

How simvastatin works

Belonging to the class of drugs called HMG-CoA reductase inhibitors, simvastatin works by obstructing the action of an enzyme formed in the liver (HMG-CoA reductase) that is necessary for producing cholesterol, thus, inhibiting its formation. As simvastatin reduces the level of cholesterol in the liver, it helps to augment the formation of LDL receptors. This way, this medication lowers the level of total as well as LDL cholesterol in the bloodstream. Besides reducing the amount of LDL cholesterol, this medication also moderately lowers the levels of triglycerides, while raising the levels of HDL or 'good' cholesterol in the blood.

Side effects

Serious:
Common:
Less common:

Possible interactions

Herbal medicines or minerals:
Specific herbs and minerals interact with simvastatin and, hence, it is not advisable to use them in conjunction. For instance, garlic slows down the accumulation of forming blood clots (platelets). Therefore, if you are taking any platelet inhibitor from before, you need to think twice before using simvastatin. It is worth mentioning here that the sale of one supplement known as Cholestin has been approved by the FDA. Basically, this dietary supplement encloses lovastatin. As using two HMG-CoA reductase inhibitors is likely to augment the chances of developing myopathy or rhabdomyolysis, you should never use this combination. On the other hand, using the herb St. John's wort and simvastatin may enhance vulnerability to sunlight and, therefore, you should also not use this combination.
If you use plant stanol ester products (for example Benecol) in combination with simvastatin, it will result in further lowering the levels of total as well as LDL cholesterol. The fact that soy products like tofu, soy milk and others enclose phytoestrogens, it has prompted to a health claim, which has been approved by the FDA, that taking them lowers the risks of developing heart ailments, provided they contain soy protein in measures of a minimum of 6.25 grams in every serving. In addition, if your diet includes soy products rather than some types of meat, it may assist further in reducing the blood cholesterol levels. Simvastatin has the potential to exhaust co-enzyme Q10, you may require supplementation.
Beverages:
People undergoing treatment with simvastatin should never use grapefruit juice in conjunction. However, this medication may be taken along with water or milk. If you take simvastatin in combination with grapefruit juice, it may result in a significant rise in the levels of blood cholesterol, thereby augmenting the chances of damage to the muscles.

Discontinuation

You should never stop taking simvastatin all of a sudden or without the consent and guidance of your physician. If you discontinue using this medication suddenly, it may result in considerable rise in the cholesterol levels in the bloodstream.

Storage instructions

Simvastatin should always be stored at room temperature and in a place that is free from moisture and light. It is important to note that the ideal storage temperature of this medication may differ depending on the manufacturers. Hence, it is advisable that you talk to your pharmacist for further information regarding the right storage temperature for this medication. Never keep this medication in your bathroom, which is normally damp. In addition, keep all medications in a place that is beyond the reach of children and pets.

Unless you have been instructed otherwise, never discard your medications that have become outdated or are needed no more by flushing them down the toilet or pouring them into the drain. Always dispose of your medications in a safe and proper manner. If necessary, talk to your pharmacist or any neighbourhood waste disposal company regarding the safe and appropriate manner to dispose of the products.

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