Simvastatin (Antihyperlipidemic)

Question 1

What is the brand name for Simvastatin?

Answer 1

Zocor

Question 2

What are the available strengths for Zocor tablets?

Answer 2

5mg, 10mg, 20mg, 40mg, 80mg

Question 3

What are the indications for Zocor?

Answer 3

Typical -statin indications. Cholesterol, LDL, HDL

Question 4

What are the indicated doses for Zocor?

Answer 4

10-40mg per day usually.
If given for a patient taking it for family history, 40mg in 2-3 divided doses
If given in patients age 10-17, start with 10mg/day in the evening and titrate up to a maximum of 40mg in 4 week intervals.

Question 5

What should the providers monitor for a patient on Simvastatin?

Answer 5

Lipid Panel, Liver Function Test

Question 6

What is the mechanism of action for Simvastatin?

Answer 6

After oral ingestion, simvastatin is hydrolyzed to its b-hydrolyzed form, becoming a specific inhibitor of HMG-CoA reductase

Question 7

What are the drug interactions of Simvastatin?

Answer 7

• May increase warfarin or digoxin levels
• Coadministration with potents CYP3A4 INHIBITORS is contraindicated
• Do not exceed 10mg/day when used with verapamil or diltiazem
• Do not exceed 20mg when used with amiodarone, amlodipine, or ranolazine

Question 8

What are the contraindications of Zocor?

Answer 8

• Contraindicated in patients hypersensitive to any components, during pregnancy or lactation, in patients with active liver disease or unexplained persistent elevation of serum transaminases and in patients taking strong CYP3A4 inhibitors.
• Use with caution in patients with any amount of liver dysfunction and in patients who consume large amounts of alcohol.
• It is recommended that liver function test be performed every 4-6 weeks of the first 15 months of therapy & periodically thereafter.
• Increases in serum transaminase levels of more than 3 times the normal level should warrant DC
• If serum transaminases do not return to normal, a live biopsy should be considered.
• May cause optic nerve degeneration
• May cause myopathy or rhabdomyolysis
• Pregnancy Category X

Question 9

What are the adverse effects of Simvastatin?

Answer 9

Constipation, MUSCLE PAIN, and dyspepsia

Question 10

What should the RPh tell their patients on Zocor?

Answer 10

• Contact physician if symptoms of myopathy occur
• Closely follow prescribed diet
• Avoid overexposure to sunlight due to possibility of photosensitivity
• DO NOT become pregnant during therapy
• Limit alcohol intake during treatment
• If dose is missed take ASAP. If taken within 12 hours of the next dose, skip the next dose.
• Grapefruit juice increases plasma levels and should be avoided