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Common brand name: Zocor

Type of medication: Part of group of medications called HMG-CoA reductase inhibitors or "statins"

Why is this drug prescribed?
Simvastatin is prescribed, along with dietary changes (restriction of cholesterol and fat intake), to reduce low- density lipoprotein (LDL) and triglycerides. Both are lipids (fats) found in your blood. Simvastatin is used to lower these blood levels:

  • Low-density lipoprotein (LDL) -- cholesterol particle produced by your liver; its job is to transport cholesterol around your body
  • Triglycerides -- form of fat that circulates in the bloodstream (Simvastatin lowers this level in some cases only.)

Simvastatin is used to raise this blood level:

  • High-density lipoprotein -- good or "healthy" cholesterol

High levels of LDL and triglycerides are related to heart disease. Simvastatin helps lower these levels and raise HDL - the good cholesterol. High levels of HDL are linked to a lower risk of heart disease.

How does simvastatin work?
Simvastatin acts mostly on the liver by blocking its ability to produce cholesterol. The liver responds by increasing the number of LDL receptors on the cells. The receptors pull the LDL from the blood into the cells, decreasing the amount of LDL and cholesterol in the blood.

How and when should simvastatin be taken?
Simvastatin comes in tablets and is usually taken once a day in the evening (at dinner or at bedtime). This medication can be taken with or without food. Take it with food if it causes an upset stomach.

Your prescription label tells you how much to take at each dose. Follow these instructions carefully, and ask your doctor or pharmacist to explain any part that you do not understand. Do not skip doses or take less or more of the medication than your doctor prescribes.

The starting dose of simvastatin is usually 20 mg once a day, but your doctor may increase the dose as necessary. Ask your pharmacist any questions you have about refilling your prescription.

What special instructions should I follow while using this drug?

  • Follow a diet and exercise program as recommended by your doctor.
  • Keep all appointments with your doctor and the laboratory so your response to the drug can be monitored. You will have periodic blood tests to make sure your liver and muscles are working properly, and to measure your blood lipid levels.
  • Do not take this medication if you are pregnant, think you might be pregnant, or are breastfeeding.
  • Talk with your health care provider about any other medicines you may be taking, including vitamins, herbals, dietary supplements, and other prescription and nonprescription (over-the-counter) medications.
  • Tell your doctor if you have liver disease or a muscle disorder.
  • Talk to your doctor about consuming grapefruit or grapefruit juice because of a possible drug-food interaction.
  • Before any surgical or dental procedure, or emergency treatment, inform your doctor or dentist that you are taking simvastatin.
  • Follow your doctor's guidelines on smoking, diet, exercise, alcohol, and weight control.
  • Be sure you always have enough of this medication on hand. Check your supply before holidays, vacations or other occasions when you may not be able to easily obtain it
  • NEVER discontinue this medicine without talking to your doctor.

How soon will I see results?
You should be able to see cholesterol-lowering results within 4 to 6 weeks after taking simvastatin. It has been shown to lower LDL by 25 percent to 37 percent. It has also been shown to slightly lower triglyceride levels and raise HDL levels.

What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue with your usual dosing schedule. Do not take a double dose.

What are the common side effects? What can I do about them?
Although side effects from simvastatin are not common, they can occur. Some side effects may include:

  • Abdominal pain, stomach cramps, flatulence (gas), indigestion, diarrhea, or constipation
    Very few people taking simvastatin will notice these side effects. The side effects usually occur when first starting to take simvastatin. The medication rarely needs to be stopped. To prevent stomach upset, take simvastatin with food.
  • Headaches
  • Nausea
  • Unusual tiredness (fatigue)
  • Skin rash

Call your doctor if any of these symptoms are persistent or severe.

  • About 1 percent to 3 percent of people who take HMG-CoA reductase inhibitors develop elevated liver function blood tests.*
  • Blood tests are taken every 6 to 12 weeks for the first 15 months of simvastatin therapy. These blood tests monitor liver enzymes, blood lipids, and the muscle enzyme CK to detect liver and muscle problems, and to evaluate the effectiveness of therapy. These blood tests can usually detect problems before you are aware of any symptoms. If liver enzymes or CK are elevated, they will return to normal within a few weeks after the medication is stopped.

When should I call my doctor?
Call your doctor right away if you:

  • Have muscle pain, weakness, tenderness, or cramps (especially if these occur with a fever).
  • Experience persistent or severe side effects.
  • Develop new symptoms after starting this medication or after your dose has been changed.
  • Have any other symptoms that cause concern.
  • Have any questions or concerns.

What storage conditions are necessary for this drug?

  • Store tablets at room temperature.
  • Keep simvastatin in the container it came in, tightly sealed.
  • Store it away from moisture, heat and direct sunlight. Do not store this medication in the bathroom, near the kitchen sink or in damp places.
  • Keep simvastatin out of the reach of children.
  • Never share your medication with anyone.
  • Never take outdated medications. Some medication prescription labels list an expiration date. If such a date is not on your medication label or if you are unsure how old a medication is, call your pharmacy.

This handout summarizes information to help you understand and safely take your medication. Other information--not included in this handout--may be important for you to know because of your unique health status. Ask your doctor and/or pharmacist for more information on the medications prescribed for you and your unique health care needs.

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