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Simvastatin (Zocor)

Updated: Jun 20, 2021


Typically supplied as the following:


  • Immediate Release Oral Tablet: 5 MG, 10 MG, 20 MG, 40 MG, 80 MG

  • Oral Suspension (Flolipid): 20 MG/5 ML, 40 MG/5 ML


Simvastatin (Zocor) belongs to the class of medicines commonly refer to as statins. They work by inhibiting the key step in the synthesis or production of cholesterol in the body. In doing so, they help to reduce the amount of cholesterol, particularly Low Density Lipo-Protein Cholesterol (LDL-C) in the blood. Cholesterol is important for the normal function of the body cells and a quick lipid profile or lipid panel test can help physicians determine the amounts of the different types of cholesterol in your body. Having too much or a high level of cholesterol, especially LDL-C, can be detrimental to the overall health.

As noted by the American Heart Association, a high level of LDL-C has been associated with a higher risk for heart diseases. Simvastatin is usually prescribed by physicians as an adjunct to diet and exercise in patients with multiple risk factors for a heart disease. Depending on the reduction goal in LDL-C desired, simvastatin doses can be further divided into different treatment intensities. Though it varies from patient to patient, but the common starting dose is between 5 and 10 mg. The starting dose is generally higher in patients who have existing heart conditions or at a high risk for a new heart disease. The Initial dose is often times slowly increased by physicians, based on patient’s tolerance, until the desired goal LDL-C and total cholesterol is achieved. Physicians tend to stay away from increasing patients’ dose to 80 mg or starting at a relatively higher dose due to the risk of severe muscle weakness and pain. Click chat with a pharmacist for more about indications and treatment.

When is a good time to take my Simvastatin?

It is recommended to take simvastatin in the evening per the prescribing information. This may be due in part to its relatively shorter half-life following consumption compared to other statins. Also, it is important to note that cholesterol biosynthesis varies throughout the day from person to person and usually peaks at night. Thus, choosing the right statin to meet this factor is always important. According to a 2018 review of current evidence, shorter-acting statins are suggested for night time dosing, while the longer acting ones are suggested to be dosed anytime of the day. For a better efficacy, simvastatin should be taken in the evening unless advised differently by your physician.




I am looking into using CBD oil for a current condition. Does it interact with simvastatin?

CBD oil may potentially interact with your simvastatin and other prescription medications. Discuss with your physician or pharmacist before starting CBD oil. Click lets chat to get connected with one of our pharmacist.


Does simvastatin really causes muscle ache?


One of the common side effects of simvastatin is severe muscle pain and weakness. Certain risk factors such as high dose (intensity) of statins, age, concurrent medications, and underlying medical conditions (liver disease) among others increase this risk significantly. Stop

use and discuss with your physician or pharmacist if you are experiencing this side-effects while on atorvastatin. Some patients may have to be evaluated for different cholesterol medications or a much lower intensity statin, while others may be restarted at a lower dose of simvastatin.

My mother takes amlodipine for blood pressure. She is also on simvastatin and recently mentioned about muscle pain. We read online there may be an interaction. Is this accurate?

The prescribing information does recommend a maximum daily dose of 20 mg for simvastatin when taking in combination with amlodipine. Amlodipine is a di-hdropyridine calcium channel blocker, and it is often prescribed alone or in combination with other medications to help lower blood pressure. Amlodipine is also a moderate inhibitor of the 3A4 subgroup of the liver enzyme collectively referred to as cytochrome P450. This isoform of the P450 enzyme play a key role in the metabolism of many prescription drugs including simvastatin. Drugs like amlodipine which inhibit this metabolic pathway to some degree can raise the levels of simvastatin in the body increase, and consequently increasing the risk of muscle damage (manifests as muscle pain and weakness). If your mother is on a daily dose of 20 mg or higher of simvastatin, please discuss this interaction with her physician.


I drink grapefruit juice often, should I totally avoid it while on simvastatin?

Simvastatin is metabolized extensively or broken down into active and inactive products by a class of liver enzymes called cytochrome P450. Grape fruit juice is thought to contain one or more components that may affect the function of the 3A4 subgroup of this liver enzyme, which play a key role in the metabolism of many prescription drugs including atorvastatin. Consumption of grape fruit juice, especially in large amounts, while on simvastatin may hinder how quickly the medication is removed from your body contributing to an increase risk of side-effects (muscle pain, weakness, and acute kidney injury)

When can I stop taking simvastatin? Can I take red yeast rice supplement instead?

You should always talk to your doctor or pharmacist before stopping your prescription medications. They should also be aware when you start or stop an over the counter medication. Red yeast rice is a commercially available herbal supplements that is marketed to help reduce cholesterol in the body. In 2013, the US Food and Drug Administration (FDA) issued warnings against taking red yeast rice products due to the lack of assurance about its efficacy and safety. Like many commercially available products that are not evaluated by the FDA for safety and standardized preparation methods prior to marketing, you should always consult with your pharmacist and doctor before consumption.



I was recently started on simvastatin, should I continue taking this medicine after I become pregnant.

Limited published data on the use of simvastatin during pregnancy are insufficient to determine a drug-associated risk. Nevertheless, it is known that simvastatin inhibits cholesterol production in the body. Thus, there is a possibility that it may potentially have some effects on fetal development. Discuss with your doctor or pharmacist if you are planning to become pregnant while on simvastatin.

Have more questions? Click Let's Chat to be connected with one of our pharmacists.

2019.

References:

  • Awad K, Banach M; The optimal time of day for statin administration: a review of current evidence. Current Opinion in Lipidology. 29(4):340–345, AUGUST 2018

  • Cholesterol Abnormalities and Diabetes. American Heart Association Website. Accessed Oct 20, 2019.

  • Simvastatin tablet, film coated [prescribing information]. East Windsor, NJ: Aurobindo Pharma USA, Inc.2019


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