Simvastatin Flashcards
What is simvastatin and how does it work?
A statin
HMGcoA reductase inhibitor
An enzyme that plays a role in cholesterol synthesis in the body
Therefore it blocks the HMGcoA reductase receptor preventing synthesis of cholesterol
What are the uses of simvastatin ?
Used to treat hypercholesterolemia - reducing LDL’s and triglycerides
Also used to reduce the risk of strokes or surgery in those that are at risk of developing heart disease or those that have it.
Another use is for Familial heterozygous hypercholesterolemia - children between 10-17 that can not remove cholesterol normally
What is the usual dose range and stage of simvastatin ?
Usual dose range is between 10 to 80 mg
recommended starting dose is 10mg - 20mg daily in the evening (as it is believed cholesterol production peaks at night, therefore taking it at night is preferred)
Starting dose is 40mg for those with a greater risk of heart disease
80mg is reserved for patients that have tolerated simvastatin in the past with no signs of toxicity. however is is usually recommended to switch the patient to another statin if they have experienced adverse side effects.
What are side effects of simvastatin?
- Abdominal pain
- Constipation
- Nausea
- Headache
- upper respiratory tract infection
- memory loss/ confusion
- muscle pain/ cramping
Rare but more serious side effects:
- Jaundice
- Liver failure
- Rhabdomyolysis (breakdown of muscle tissue resulting in release of proteins that may be damaging to kidneys) - usually dose dependent.
What are some drug interactions with simvastatin?
Antifungals like itraconazole and ketoconazole
antibiotics like erythromycin and clarithromycin
HIV protease inhibitors
Calcium channel blockers like verapamil and Diltiazem - max recommended dose is 10mg per day.
Amiodarone, amlodipine & ranolazine - max dose 20mg/day of statin
Grapefruit juice
Precautions and best practices for simvastatin
Unless otherwise directed, take at night
avoid grapefruit juice if possible (it increases the amount of drug in your blood)
Report any muscle she that occurs especially if accompanied by other symptoms
