Simvastatin Lowers Cholesterol Levels

Simvastatin is a prescription drug from the group of statins that is used to lower cholesterol levels. This is intended to counteract deposits on the walls of blood vessels and reduce the risk of stroke or heart attack. However, taking simvastatin is associated with a wide variety of side effects. Some – such as nausea or headaches – are comparatively harmless. If, on the other hand, muscle pain occurs, you should discontinue treatment, as the active substance can damage the muscles.

Effect of simvastatin

Simvastatin is prescribed for elevated cholesterol when it cannot be lowered by a low-fat diet, weight reduction, and exercise. The active ingredient ensures that less cholesterol is produced in the liver, the level of “bad” LDL cholesterol is lowered and that of “good” HDL cholesterol is raised. This improves the ratio of blood lipids to each other. However, the use of simvastatin not only lowers blood lipid levels, but also simultaneously counteracts the deposition of cholesterol on the walls of blood vessels. This reduces the risk of stroke or heart attack. In patients with coronary heart disease, life expectancy can thus be increased. Simvastatin is generally used for:

  • Elevated levels of cholesterol or lipids in the blood.
  • Homozygous familial hypercholesterolemia – a hereditary disease associated with elevated blood cholesterol levels
  • Patients with cardiovascular disease or at increased risk for such disease.

Side effects of simvastatin

Most patients taking simvastatin do not experience side effects during treatment. Occasionally, elevation of liver enzymes GOT and GPT (transaminases) may occur. In rare cases, side effects such as the following have also been observed:

  • Headache
  • Dizziness
  • Itching
  • Skin rash
  • Sleep disturbance
  • Fever
  • Hair loss
  • Lack of strength

Likewise, gastrointestinal problems such as nausea, vomiting, diarrhea, constipation and abdominal pain may be experienced. Also, the intake may be accompanied by depression, breathing difficulties, joint inflammation and joint pain, and inflammation of the pancreas.

Effects on liver, blood, and muscles

In addition, simvastatin may also have effects on the liver, blood, and muscles. However, similar to the side effects already mentioned, these symptoms rarely occur. The following side effects are possible:

  • Liver: liver inflammation, permanent increase in liver enzyme levels, jaundice.
  • Blood: anemia and blood formation disorders.
  • Musculature: muscle cramps, muscle pain, muscle weakness, muscle diseases, muscle destruction.

If you experience problems with your muscles during treatment with simvastatin, you must immediately inform your treating physician.

Statins can damage the nerves

Simvastatin, like all other statins, can have a damaging effect on the nerves. That is why symptoms such as numbness in the arms or legs and muscle twitching may occur during treatment. In such cases, treatment must be stopped immediately.

Increased blood glucose levels as a result.

It is also typical for statins such as simvastatin to increase blood sugar levels. This can increase the risk of diabetes mellitus. How high the likelihood is depends primarily on whether other risk factors, such as obesity, are already present. If this is the case, blood glucose must be checked at regular intervals in any case.

Dosage of simvastatin

Simvastatin is available in the form of tablets with varying dosages. Low-dose tablets contain 5, 10, 20, or 30 milligrams; higher-dose tablets contain 40, 60, or 80 milligrams. But how long does it take for simvastatin to take effect? It takes about two weeks for the effect to occur. Four to six weeks after starting treatment, the change in cholesterol levels peaks. To lower blood lipid levels, patients are recommended to start with a daily dose of 10 to 20 milligrams of simvastatin; for severely elevated levels, patients can also start with 20 to 40 milligrams.If necessary, the dose can be increased up to 80 milligrams. However, this dose is rarely prescribed today. More than 80 milligrams per day should not be taken under any circumstances. In the case of homozygous familial hypercholesterolemia, the dose is usually started at 40 milligrams, and can also be increased up to 80 milligrams. As a rule, it is then taken in the morning (20 mg), at noon (20 mg) and in the evening (40 mg). To prevent cardiovascular disease, between 20 and 40 milligrams of simvastatin are usually prescribed.

Interactions possible

Simvastatin is broken down in the body by the enzyme CYP-3A4. Therefore, substances that could inhibit the enzyme in its activity should not be taken at the same time as the active substance, or only under certain conditions. Otherwise, there may be an increase in side effects, especially an increased risk of destruction of muscle fibers. Interactions may occur with, among others:

If taking simvastatin and ciclosporin together is unavoidable, the simvastatin dose must be lowered. Otherwise, the intake can cause the muscle disease rhabdomyolysis. This involves dissolution of striated muscle fibers.

Consider contraindications

Simvastatin should not be taken if hypersensitivity to the active ingredient is present. In addition, use is also contraindicated in:

  • Acute disease of the liver (hepatitis) or elevated levels of certain liver enzymes (transaminases).
  • Elevated blood creatine kinase levels
  • A skeletal muscle disease associated with destruction of muscle fibers

Only under special caution Simvastation may be taken in patients over 70 years of age, with hypothyroidism, with impaired renal function and with chronic alcohol abuse. In each case, there is an increased risk of destruction of muscle fibers. This risk is also increased in patients with a family history of hereditary skeletal muscle disease. For this reason, simvastatin should also be taken only after a thorough benefit-risk analysis by the treating physician. This also applies to patients who have experienced muscle symptoms as part of previous treatment with blood lipid-lowering agents (statins or fibrates).

Pregnancy and lactation

Simvastatin should not be taken during pregnancy. To date, in fact, it cannot be ruled out with certainty that damage to the unborn child may occur as a result of taking the active substance. If a child is planned, use of the cholesterol-lowering drug should be stopped immediately. It has not yet been established whether simvastatin passes into breast milk or not. For this reason, it is better not to use the active ingredient during breastfeeding. Children and adolescents should also be prescribed the active substance only in exceptional cases, since the safety of simvastatin for this age group has not been proven beyond doubt.