Simvastatin is a HMG CoA reductase inhibitor which is used to alter the intake of lipids in your diet. This drug is commonly prescribed as an intervention when the patient is starting to develop atherosclerotic vascular disease from hypercholesterolemia. The goal of this mediation is to reduce the risk of stroke, heart attack and CHD death. A great deal of the therapy that is associated with this drug will revolve around an altered diet. Your doctor will give you strict recommendations regarding foods that are to be increased as well as those which should be avoided to improve your condition. These instructions should be followed carefully to help ensure that your simvastatin dosage can be effective.
Indications and Usage
Simvastatin is sold under the brand name Zocor and is used to help manage hypercholesterolemia alongside an altered diet which avoids saturated fat and foods high in cholesterol. Simvastatin is often prescribed when other medications and dieting measures have not been effective, though those with coronary heart disease may start on this medication right away. Your dosage will be adjusted over time to reflect how your body is reacting to the medication and whether or not your diet is having the proper effect on altering your cholesterol readings. You will need to have your triglyceride numbers as well as LDL and HDL levels in your body checked regularly to determine if you can continue taking your medication as prescribed.
Dosing will range from 5-40 mg per day, and increase to the recommended dose of 10-20 mg per day as needed. Those with a high risk for CHD will be given 40 mg per day. Doses should not exceed 80 mg per day in any case. Adolescents may be given a starting dose of 10 mg per day which will be increased as necessary.
If you are taking simvastatin alongside other cholesterol medications you should talk with your doctor about what size dose is appropriate for you. Patients in this case are often restricted to 10 mg per day.
There is no direct risk for using simvastatin while pregnant, but you may need to consider discontinuing your dosage or reducing your dose size during this time. Those who are breastfeeding have a risk of passing this drug to their infants through the milk. Talk with your doctor about what risks this involved and whether or not you should stop taking your medication during this time.
There is a higher risk for myopathy in Chinese patients using this drug. Most patients in this group are restricted to 20 mg per day to help avoid this risk. Doses should not exceed 40 mg per day unless it has been proven that you are not at risk for this condition.
Doses should not exceed 40 mg per day in adolescents. Children should not be given simvastatin because they are at a higher risk for skeletal defects. Those who may be at risk for these conditions should talk this over with your doctor before starting a simvastatin prescription so you are aware of the risks and what you should do if you begin to show symptoms.
Those with livery enzyme abnormalities may not be able to take a full dose of simvastatin. You may need to have your liver function tested in order to determine what size dose is appropriate for you.
Simvastatin Side Effects
The most common side effects associated with simvastatin include nausea, vomiting, abdominal pain, dyspepsia, diarrhea, flatulence, tenderness, itching, lack of energy, weakness, runny or stuffy nose, and upper respiratory infections. In clinical studies it was shown that only about 1.4 percent of users have these side effects. These side effects are not dangerous, but should be reported to your doctor to ensure that you do not need to adjust your medication. You should also inform your doctor if your side effects do not stop or become worse over time.
If you begin to experience joint pain, muscle aches or cramps, gastritis, hepatitis, pancreatitis, difficulty breathing, difficulty swallowing, fever, sore throat, bronchitis, sinusitis, irregular heartbeat, shortness of breath, swelling of the legs, vertigo, fatigue, depression, spinning sensation, anxiety, insomnia, memory loss, eczema, rashes, blisters, sensitivity to light, urinary tract infections, breast development in med, worsening cataracts, diabetes mellitus, or impotence you may be having a severe reaction to simvastatin. Report any of these side effects to your doctor immediately and ask if you should continue taking your medication. Do not stop taking simvastatin unless your doctor tells you to do so.
Adolescents ages 10-17 are at a higher risk of developing headache, nausea and abdominal pain while on simvastatin. These conditions may not be serious, but should be reported to your doctor. Your doctor may determine that altering your child's prescription can help alleviate these side effects.
In severe cases simvastatin can cause muscle damage including rhabdomylosis. These side effects cause the breakdown of muscle, which increases the level of protein in the blood. Leaving this condition unchecked can lead to kidney failure. Excessive protein in the blood can also cause cirrhosis of the liver. This is much more common when simvastatin is combined with other drugs. If you begin to notice dark colored urine, muscle pain, weakness or stiffness that is severe, contact your doctor right away to be checked for this condition. Cirrhosis of the liver may also have symptoms including loss of appetite, jaundice, itching, fatigue and a tendency to bruise easily.
You should not take simvastatin alongside CYP3A4 inhibitors such as cyclosporine or danazol as these drugs inhibit the effectiveness of the other. You may also see plasma concentrations become altered when you combine this medication. You should also avoid taking lovastatin metabolism in vitro while on simvastatin as it can alter your plasma concentration levels. This includes using voriconazole during your simvastatin therapy.
Using other lipid controlling drugs or calcium channel blockers may inhibit the effectiveness of your medication. Talk to your doctor about how to adjust these prescriptions to ensure that your condition will be managed properly. You may also need to avoid supplements that include heavy doses of digoxin or niacin as these could increase your risk of developing myopathy or rhabdomylosis. Chinese patients who are at an additional risk for developing these conditions should talk to their doctors about how to alter their diet to avoid taking in excessive amounts of niacin.