Simvastatin

Simvastatin is a prescription medication that lowers cholesterol levels in your blood. It belongs to a group of drugs called statins. Doctors prescribe simvastatin to reduce your risk of heart attack, stroke, and other heart problems.

This medication works by blocking an enzyme your liver needs to make cholesterol. Lower cholesterol means less buildup in your arteries. Cleaner arteries help blood flow more easily to your heart and brain.

Simvastatin is available as a generic medication and was previously sold under the brand name Zocor. Your doctor will prescribe the dose that matches your cholesterol levels and health goals. You need a prescription to get this medication.

• Lowering LDL cholesterol, often called bad cholesterol
• Raising HDL cholesterol, often called good cholesterol
• Reducing triglycerides, another type of fat in your blood
• Preventing heart attack and stroke in people with heart disease
• Reducing cardiovascular risk in people with diabetes
• Slowing the progression of atherosclerosis, which is plaque buildup in arteries

Your liver makes about 75% of the cholesterol in your body. Simvastatin blocks an enzyme called HMG-CoA reductase. This enzyme is essential for cholesterol production. When the enzyme is blocked, your liver makes less cholesterol.

With less cholesterol being made, your liver pulls existing cholesterol from your blood. This process lowers the amount of cholesterol circulating through your arteries. Over time, this reduces plaque buildup and lowers your risk of heart problems.

Adults typically start with 10 mg to 20 mg taken once daily in the evening. Your doctor may adjust your dose based on your cholesterol levels. The usual dosage range is 5 mg to 40 mg per day. The maximum dose is 40 mg daily. Doses of 80 mg are rarely used due to increased risk of muscle problems. Take simvastatin with or without food. Your doctor determines your specific dose based on your cholesterol goals and other health factors.

• Headache
• Stomach pain or upset stomach
• Constipation or gas
• Muscle aches or weakness
• Tiredness
• Memory problems or confusion
• Elevated liver enzymes shown on blood tests

Serious side effects include severe muscle pain or weakness, dark urine, yellowing of skin or eyes, and signs of liver problems. Contact your doctor immediately if you experience unexplained muscle pain, especially with fever or unusual tiredness. Rare cases of muscle breakdown called rhabdomyolysis can occur and require emergency care.

• Grapefruit juice can increase simvastatin levels and raise the risk of side effects
• Other cholesterol medications like gemfibrozil may increase muscle damage risk
• Certain antibiotics including clarithromycin and erythromycin
• Antifungal medications such as itraconazole and ketoconazole
• HIV medications including protease inhibitors
• Heart medications like amiodarone, diltiazem, and verapamil
• Niacin in doses higher than 1 gram per day
• Cyclosporine, an immune system medication
• Warfarin and other blood thinners may need dose adjustments

Your doctor should check your cholesterol levels before you start simvastatin and regularly while you take it. A lipid panel measures your LDL cholesterol, HDL cholesterol, and triglycerides. Most people get tested after 4 to 12 weeks on the medication, then every 3 to 12 months. Your doctor should also monitor your liver function with blood tests that measure ALT and other liver enzymes. Liver tests are typically done before starting treatment and as needed if you have symptoms. If you experience muscle pain or weakness, your doctor may check a creatine kinase test to assess muscle damage.