Clicky

TabletWise.com
Pharmacy Website
Clinic Website
 
Final Step!
Thank you
What else can we provide?

Why it's used

Simvastatin is used to reduce the risk of fatalities associated with existing heart diseases (coronary heart diseases). It is a prescription medicine. This medicine works by preventing the enzyme responsible for the production of cholesterol. It also reduces the levels of harmful lipids and increases the levels of beneficial lipids. This medicine helps by preventing cholesterol production in the body and therefore preventing heart diseases. Simvastatin is also used to reduce the risk of non-fatal heart attack and stroke. It is also used to reduce the need for procedures that require perfusion to ischemic parts due to lack of oxygen supply (revascularization) of coronary and noncoronary areas. Simvastatin is also used to reduce the elevated cholesterol, lipids, and triglycerides and to increase the beneficial lipids (Fredrickson type II a and b or familial and nonfamilial heterozygous). Simvastatin is also used to reduce the increased levels of triglycerides in patients with hypertriglyceridemia (Fredrickson type lV hyperlipidemia). Simvastatin is also used to reduce the increased levels of triglycerides and lipids in the patients with primary dysbetalipoproteinemia (Fredrickson type lll hyperlipidemia. Simvastatin is also used to reduce the increased levels of cholesterol and lipids in the patients with homozygous familial hypercholesterolemia which is present by birth. Simvastatin is also used to reduce the increased levels of cholesterol and lipids in the patients with homozygous familial hypercholesterolemia which is present by birth in combination with lipid-lowering treatment. Simvastatin is also used to reduce the increased levels of cholesterol and lipids in children (boys and girls) in combination with diet (heterozygous familial hypercholesterolemia) which is present by birth.
HMG-CoA Reductase Inhibitor
Simvastatin belongs to a class of medicines called HMG-CoA Reductase Inhibitor. HMG-CoA Reductase Inhibitors are a class of lipid-lowering medications, effective at lowering high cholesterol levels. These medicines also reduce the risk of having a heart attack or stroke or developing angina.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Simvastatin, ask your doctor or pharmacist. Use Simvastatin as per the instructions provided by your doctor.
Simvastatin is eaten with food. Treatment with Simvastatin can be started along with diet. Simvastatin is eaten in the evening.
The typical dose of Simvastatin for adults is 5-80 mg once daily in the evening. The usual dose for children is 10-40 mg once daily. The maximum dose for adult patients of Simvastatin is 80 mg per day. Simvastatin is commonly used at the same time every day. This medicine is not known to be addictive or habit-forming.
This medicine is to be used for longer periods of time. Simvastatin should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.
Discuss with your doctor if you develop new symptoms. If you have any kidney disease, Caution should be used when Simvastatin is given to the patients with severe kidney damage. Treatment should begin with a dose of 5 mg/day and should be monitored closely. If you have issues with the health of your liver, Simvastatin is not recommended for use in patients with liver disease due to the increased levels of liver enzymes.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. Taking a higher dose of this medicine may increase the risk of side-effects. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.
If you are giving Simvastatin to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
Consult with your doctor on the consumption of alcohol with Simvastatin. Avoid grapefruit juice while using Simvastatin. Grapefruit juice may affect the functioning of Simvastatin in the body.
Your doctor may request that specific lab tests be performed before you start using Simvastatin. Your doctor may ask you to undergo Liver Panel test. The patients who are being treated with Simvastatin have been found to have an increased level of liver enzymes which may result in fatal or non-fatal liver damage. Therefore, it is recommended to perform a liver function test before starting the therapy. Your doctor may request Prothrombin Time and International Normalized Ratio test. Simvastatin may enhance the effect of anticoagulants, which are used to prevent clotting when used in combination. Prothrombin time, which is the time taken by blood to clot, is found to increase in patients taking both Simvastatin and anticoagulants. Your doctor may request Creatine Kinase test. High creatine kinase values may cause risk of myopathy which may be exhibited as muscle pain and weakness. It may also lead to kidney damage due to the release of a chemical during muscle breakdown (rhabdomyolysis).
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Simvastatin for conditions or symptoms for which it was not prescribed. Do not give Simvastatin to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.
Follow storage instructions on the product package if available. Store Simvastatin 5°C-30°C (41°F-86°F), and away from moisture. Store this medicine away from children and pets.

How to take Simvastatin

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Simvastatin depends on the following factors:
  • patient's age
  • gender
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed
  • response to treatment

Simvastatin Dosage

Dosage for risk of fatalities associated with existing heart diseases (congenital heart diseases)

Adult
  • Recommended: 10-20 mg/day
  • Initial: 10-20 mg once a day in the evening
  • Maximum: 80 mg

Minimum Age

10 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 5 mg, 10 mg, 20 mg, 40 mg and 80 mg

Special Instructions

Oral formulation
Take one tablet daily in the evening with food.

Missed Dose

In case of a missed dose, take it as soon as you remember. If it is the time of the next dose, take the next regular dose but do not take the double dose in order to make up for the missed dose.

Overdose

What to do if you overdose on Simvastatin?
Supportive measures should be undertaken in case of overdose with Simvastatin.
If you think you have overdosed on Simvastatin, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Simvastatin

Before you use Simvastatin, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before you use Simvastatin, tell your doctor of your medical history including liver problems, kidney damage, abnormal absorption of glucose and galactose (Lapp lactase deficiency), muscular disorders, muscular damage due to medicines (statin or fibrate), alcohol abuse, or thyroid problems. Before having any surgery when using Simvastatin, tell your doctor and dentist about all the medicinal products you use including prescription and non-prescription medicines, and any herbal supplements.
The use of this medicine may change liver enzyme (transaminase). The level of liver transaminases is found to increase which may lead to liver problems.
The use of Simvastatin may change alkaline phosphatase. The levels are found to increase.
The use of this medicine may change gamma-glutamyl transpeptidase. The levels are found to increase.
The use of this medicine may change creatine kinase. The levels are found to increase which may lead to myopathy.
The use of Simvastatin may change prothrombin time. Prothrombin time is found to increase when Simvastatin is given in combination with anticoagulants.
Consult with your doctor on the consumption of alcohol with Simvastatin.
Simvastatin is not for use by women and hence pregnant women should not use this medicine. Cholesterol is required for normal development of the fetus and because Simvastatin decreases cholesterol production, it may cause harm to the fetus when given to a pregnant woman. Simvastatin is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. There is a risk for serious side effects in nursing infants. Also, some other drugs in this class may be excreted in milk, hence, mothers taking Simvastatin should not breastfeed their children. Simvastatin may impact fertility in women. If you are trying to conceive, discuss with your doctor on the use of this medicine. For women who are trying to conceive, Simvastatin should be discontinued due to risk to fetus development.
Simvastatin can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Simvastatin can make you feel more sleepy.
This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and do not tan to prevent sunburns. Cover your skin when you are outdoors or use a sunscreen. In case you get a sunburn, consult with your doctor.
Simvastatin may increase side-effects in older patients. Elderly patients may see an increased risk of muscle pain (myopathy).

Simvastatin Side-effects

The following side-effects may commonly occur when using Simvastatin. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Simvastatin. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Simvastatin may cause the following side-effects:
  • a small swelling (nodules)
  • abnormal accumulation of fluid within the body
  • burning sensation in the parts of the body
  • changes to hair/nails
  • chills
  • difficulty in erection (erectile dysfunction)
  • discoloration
  • dizziness (vertigo)
  • dryness of skin/mucous membranes
  • feeling of discomfort
  • gas formation (flatulence)
  • hair loss
  • hives
  • increased eosinophils in the blood (eosinophilia)
  • indigestion (dyspepsia)
  • inflammation of one or more joints, causing pain and stiffness (arthritis)
  • joint pain
  • lack of sleep (insomnia)
  • memory loss caused by brain damage (amnesia)
  • muscle cramps
  • muscle pain and stiffness
  • muscle weakness and skin rash (dermatomyositis)
  • pain in muscle or group of muscles
  • purple or red discolored spots on the skin
  • reddening of the skin, especially around the face, neck, or chest (flushing)
  • redness of the skin by increased blood flow (Erythematous-like syndrome)
  • weakness
  • weakness, swelling, pain, and inflammation in muscles (myopathy including myositis)
The following severe side-effects may also occur when using Simvastatin:
  • endocrine disorders
    Symptoms: high blood glucose levels (diabetes mellitus)
  • skin and subcutaneous tissue disorders
    Symptoms: itchy, red and dry skin caused by inflammation (eczema), severe itching of the skin, sun allergy (photosensitivity), severe skin reactions, a serious, life-threatening allergic reaction (anaphylaxis) and red colored rashes on the skin (erythema multiforme)
  • gastrointestinal disorders
    Symptoms: inflammation of the pancreas (pancreatitis), vomiting and inflammation of the lining of the stomach (gastritis)
    The patient should discontinue the medicine.
  • psychiatric disorders
    Symptoms: confusion and depression
    The patient should discontinue the medicine.
  • blood and lymphatic system disorders
    Symptoms: anemia including hemolytic anemia, inflammation of blood vessels that results in changes in blood vessels (vasculitis), low levels of thrombocytes and decrease in the number of white blood cells
  • heart disorders
    Symptoms: irregular and often rapid heart rate (atrial fibrillation)
  • respiratory system disorders
    Symptoms: inflammation of the airways of the lungs (bronchitis), inflammation of face muscle (sinusitis), shortness of breath (dyspnea) and damage of the lung tissues (interstitial lung disease)
    The patient should discontinue the medicine.
  • urogenital system disorders
    Symptoms: infection in any part of the urinary system (urinary tract infection)
  • musculoskeletal and connective tissue disorders
    Symptoms: Kidney damage by muscle breakdown (rhabdomyolysis)
    Patients should discontinue this medicine.
  • nervous system disorders
    Symptoms: weakness, loss of sensation and pain due to nerve damage and usually in the hands and feet (peripheral neuropathy)
Your doctor has prescribed Simvastatin because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Simvastatin.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Myopathy/rhabdomyolysis

Elderly patients, females, the patients with a thyroid problem (uncontrolled hypothyroidism), history of muscular disorders, muscle damage due to the use of medicines, kidney damage and patients who drink alcohol are at an increased risk when using this medicine. Such patients may have an increased risk of myopathy, rhabdomyolysis with or without kidney damage and rarely fatality. Treatment with Simvastatin should be discontinued if such symptoms appear.

Liver dysfunction

The patients with increased levels of liver enzymes (transaminases) and patients with liver disease are at an increased risk to develop liver damage. Such patients are at an increased risk to develop fatal and non-fatal liver failure. If serious liver damage or yellow discoloration of the skin (jaundice) occurs during the treatment, Simvastatin should be discontinued.

Endocrine function

Levels of glycated red blood cells (HbA1c) are found to increase in the patients on treatment with Simvastatin.

Lung disease

The patients on long-term treatment with Simvastatin are at an increased risk when using this medicine. Such patients may develop shortness of breath, cough, fatigue, weight loss and weakness. If the patients develop these symptoms, treatment with Simvastatin should be discontinued.

High blood glucose (diabetes mellitus)

The patients on treatment with Simvastatin are at risk to develop future high blood glucose as Simvastatin may increase the level of glucose in the blood. Such patients may develop high levels of blood glucose (hyperglycaemia). The patients on treatment with Simvastatin should be carefully monitored for high glucose risk.

Reduced transport proteins function

The patients who carry the gene (SLC01B1) resulting in less active transporter proteins found in the liver (OATP1B1 protein) are at an increased risk. This occurs as a result of inhibition of the proteins due to the interaction of Simvastatin with certain medicines such as cyclosporin in the patients who carry this gene. Such patients are at an increased risk to develop myopathy and rhabdomyolysis. Genotyping for the presence of the gene should be considered as a part of the benefit-risk assessment before prescribing 80 mg of Simvastatin to the patients and high doses should be avoided in those who carry the gene.

Interactions with Simvastatin

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Simvastatin interacts with Strong CYP3A4 inhibitors such as HIV-protease inhibitors e.g.nelfinavir, boceprevir, telaprevir, and cobicistat which are used to treat liver disease. These inhibitors of cytochrome P450 3A4 increase the risk of kidney damage due to muscle breakdown and muscle disease by increasing the level of HMG-CoA reductase inhibitory activity in blood during Simvastatin therapy.
There may be an interaction of Simvastatin with Strong CYP3A4 inhibitors such as (erythromycin, clarithromycin, telithromycin), which are used to treat bacterial infections in the lungs, throat, and ear. These inhibitors of cytochrome P450 3A4 increase the risk of kidney damage due to muscle breakdown and muscle disease by increasing the level of HMG-CoA reductase inhibitory activity in blood during Simvastatin therapy. When telithromycin is used with Simvastatin the risk for the disease increases by 11-times.
Simvastatin may interact with Strong CYP3A4 inhibitors such as (itraconazole, ketoconazole, posaconazole, voriconazole, fluconazole), which are used to treat a number of fungal infections. These inhibitors of cytochrome P450 3A4 increase the risk of kidney damage due to muscle breakdown (rhabdomyolysis) and muscle disease (myopathy) by increasing the level of HMG-CoA reductase inhibitory activity in blood during Simvastatin therapy. When itraconazole is used with Simvastatin, the risk for these disease increases by 10 times. When voriconazole is used with Simvastatin, the adjustment of the Simvastatin dose should be done to reduce the risk of muscle disease (myopathy), including kidney damage due to muscle breakdown (rhabdomyolysis).
Your doctor's guidelines may need to be followed while taking this medicine along with Strong CYP3A4 inhibitors such as nefazodone, used in therapy of depression, aggressive behavior, and panic disorder. The risk of rhabdomyolysis and myopathy is increased by high levels of statin activity in plasma. Nefazodone prevents the metabolic pathway of cytochrome P450 isoform 3A4 which can raise the plasma levels of Simvastatin and may increase the risk of muscle disease.
Special instructions need to be followed while taking this medicine along with Strong CYP3A4 inhibitors such as (cyclosporine which is used to prevent transplant rejection or danazol, which is used to treat allergic conditions and hormonal imbalance in the body). The risk of myopathy, including rhabdomyolysis is increased when Simvastatin is taken with cyclosporine or danazol. The combined use of Simvastatin with gemfibrozil, cyclosporine, or danazol is not recommended.
Your doctor's guidelines may need to be followed while taking this medicine along with Coumarin anticoagulants, which are used to prevent coagulation of blood. Increased prothrombin time and noticeable bleeding have been reported when using Simvastatin and coumarin anticoagulants together. Prothrombin time should be determined before starting Simvastatin during early therapy with coumarin antagonist to ensure that there is no significant alteration of prothrombin time.
Special instructions need to be followed while taking this medicine along with Colchicine, which is used to treat gout. When Simvastatin is taken with colchicine, cases of myopathy, including rhabdomyolysis have been reported. Caution should be taken when Simvastatin is prescribed with colchicine. Close clinical monitoring of the patients is advised when taking this combination of colchicine and Simvastatin.
Simvastatin interacts with Niacin, which is used to treat high cholesterol and heart disease. When Simvastatin is taken with niacin, rare cases of myopathy/rhabdomyolysis have been found. Caution should be taken in case of the Chinese patients when Simvastatin doses exceeding 20 mg/day is used with niacin.
There may be an interaction of Simvastatin with Lipid-lowering drugs such as fibrates, Lomitapide, and gemfibrozil. When Simvastatin is taken with fibrates or lomitapide, the risk of myopathy, including rhabdomyolysis, is increased. Additionally, pharmacokinetic interaction with gemfibrozil resulted in increased Simvastatin blood levels. The combined use of Simvastatin with gemfibrozil should not be used. The dose of Simvastatin must not exceed 40 mg daily in the patients taking Simvastatin with lomitapide.
Simvastatin may interact with Amiodarone, Ranolazine, digoxin or Calcium Channel Blockers (verapamil, diltiazem, or amlodipine), which are used to treat heart disorders. When amiodarone, ranolazine, or calcium channel blockers such as verapamil, diltiazem, or amlodipine is taken with Simvastatin the risk of myopathy, including rhabdomyolysis, gets increased. Digoxin when used with Simvastatin resulted in a slight increase in digoxin level in blood. when Simvastatin therapy is initiated, the patients should be properly monitored.
Simvastatin interacts with Fusidic acid, which is used as topical medicine to treat skin infections. When fusidic acid is used with Simvastatin The risk of myopathy and rhabdomyolysis may be increased. Simvastatin treatment should be discontinued throughout the process of the fusidic acid treatment if treatment with systemic fusidic acid is necessary.
There may be an interaction of Simvastatin with Grapefruit juice, which is used for weight loss, asthma, high cholesterol. When grapefruit juice and Simvastatin (over 1 litre daily) is taken together, it resulted in a 7-fold increase in the absorption of Simvastatin. Intake of grapefruit juice during treatment with Simvastatin should be avoided.
Simvastatin may interact with Rifampicin, which is used to treat bacterial infections. The patients having long-term rifampicin therapy may undergo loss of efficacy of Simvastatin when used together.
This page does not contain all the possible interactions of Simvastatin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Simvastatin is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

Recent Activity