|Type of medicine||A lipid-regulating drug commonly known as a statin|
|Used for||Lowering cholesterol and other lipids (fats) in the blood
To reduce the risk of heart disease problems
|Also called||Simvador®, Zocor®
Inegy® (a combination of simvastatin with ezetimibe)
|Available as||Tablets and oral liquid|
Lipid is another word for fat. Lipids are easily stored in your body and serve as a source of energy. Cholesterol is a lipid. It is made naturally in your body from the food you eat. When the concentration of cholesterol in your blood is too high, it is called hypercholesterolaemia.
In hypercholesterolaemia, small fatty patches called atheroma develop within the inside lining of your blood vessels. Over time, these patches can make a blood vessel narrower and this is called atherosclerosis or 'hardening of the arteries'. This narrowing reduces the blood flow through the artery and increases the risk of a number of heart and blood vessel diseases, such as heart attack and stroke.
Simvastatin reduces the amount of lipids such as cholesterol made by your body. It does this by blocking the action of a certain enzyme which is needed to make cholesterol. This lowers your risk of heart and blood vessel disease. It can also reduce this risk (even if your cholesterol levels are normal) if you have an increased risk of heart disease.
Simvastatin is available on prescription, or you can buy it at a pharmacy without a prescription.
Before taking simvastatin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking simvastatin it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have any liver problems, or if you have ever had a disease which has affected your liver.
- If you have ever had muscle problems, or if you have repeated or unexplained muscle aches or pains.
- If you regularly drink large amounts of alcohol.
- If you have a thyroid disorder.
- If you have kidney problems.
- If you have porphyria (a rare inherited blood disorder).
- If you have ever had an allergic reaction to this or to any other medicine.
- If you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines. It is particularly important that your doctor knows if you are also taking a medicine called amlodipine or diltiazem, as taking these medicines will affect the dose of simvastatin that your doctor will prescribe for you.
How to take simvastatin
- Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about the brand of simvastatin you have been given and a full list of possible side-effects from taking it.
- Take simvastatin exactly as your doctor has told you. Unless you have been told otherwise, take your dose in the evening.
- You can take simvastatin before or after food.
- Do not drink grapefruit juice at any time while you are taking simvastatin. This is because a chemical in grapefruit juice increases the amount of simvastatin in your bloodstream. This makes side-effects more likely and increases the risk of them being serious.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have blood tests, particularly when you first start treatment. The tests will check that your liver has not been affected by taking simvastatin, and may also measure your cholesterol level.
- Your doctor will give you advice about eating a healthy diet, reducing the amount of salt in your diet, stopping smoking and taking regular exercise. Following this advice will also help you to reduce your risk of developing heart and blood vessel disease.
- Cut down on the amount of alcohol you normally drink. This is because alcohol can increase the risk of side-effects to your liver.
- Women who could become pregnant should not take simvastatin unless they are using an effective contraceptive. If this affects you, ask your doctor for advice about suitable contraception.
- If you buy any medicines, check with a pharmacist that they are suitable to take with simvastatin.
Can simvastatin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Possible simvastatin side-effects||What can I do if I experience this?|
|Muscle aches, cramps, pains, weakness, or tenderness||Although this may not be anything to be concerned about, you should tell your doctor about this. This is because there is a rare but serious side-effect of simvastatin which is a severe form of muscle inflammation|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Constipation||Try to eat a well-balanced diet and drink plenty of water each day|
|Diarrhoea||Drink plenty of water to replace any lost fluids|
|Feeling sick, indigestion, wind||Stick to bland foods - avoid rich or spicy food|
|Disturbed sleep, feeling dizzy or tired, forgetfulness, depression, sexual problems, itchy rash, hair thinning||Speak with your doctor if any of these become troublesome|
Important: if you experience any of the following rare but serious symptoms, stop taking simvastatin and contact your doctor for advice straightaway:
- Any unexplained shortness of breath or cough. This is because (in very rare cases), simvastatin may cause a disease called interstitial lung disease.
- Any swelling of your face or mouth, or a severe skin rash. These may be signs that you are allergic to simvastatin.
If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
How to store simvastatin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- The oral liquid may be stored for up to 12 months if it is unopened, but once the bottle has been opened you must not use it for more than one month.
Important information about all medicines
Further reading & references
- British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Manufacturer's PIL, Simvastatin 10 mg/20 mg/40 mg/80 mg Tablets; Manufacturer's PIL, Simvastatin 10 mg/20 mg/40 mg/80 mg Tablets, Aurobindo Pharma Ltd, electronic Medicines Compendium. Dated August 2010.
- Manufacturer's PIL, Simvastatin 20 mg/5 ml Oral Suspension; Manufacturer's PIL, Simvastatin 20 mg/5 ml Oral Suspension, Rosemont Pharmaceuticals Limited, electronic Medicines Compendium. Dated May 2010.
- Simvastatin patient information article; Medicines and Healthcare products Regulatory Agency (MHRA), October 2012
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox