Simvastatin

A low dose of simvastatin is 10mg or 20mg and this is usually what your doctor will start you on. If your cholesterol levels are very high you could start on a dose of 40mg. After four weeks, your doctor may adjust your dose up to a maximum of 80mg per day. The 80mg dose is only recommended for adults with very high cholesterol levels and a high risk of heart problems where a lower dose or other treatments have not worked.

How to take simvastatin

Take your simvastatin tablet in the evening (it is more effective at night). You can take it with or without water and should swallow it whole.

If you have also been prescribed a different medicine for lowering cholesterol which contains any bile acid sequestrant, you must take simvastatin 2 hours before you take the bile acid sequestrant or wait until four hours after you have taken the bile acid sequestrant.

What should I do if I forget to take my daily dose of simvastatin?

If you forget to take your dose at the correct time, do not take it when you remember. Take your normal dose at the right time on the next day.

What should I do if I take too much simvastatin?

Taking an extra dose is unlikely to cause you harm but you should contact your doctor or talk to a pharmacist if you take too much simvastatin. The side effect of muscle aches and pains is more common with higher doses so you should seek medical attention to be sure that you are not experiencing muscle breakdown and kidney damage.

Can I drink while taking simvastatin?

You can drink alcohol while taking simvastatin but it is recommended to keep to the guidelines of no more than 14 units per week. This is because large amounts of alcohol can increase the risk of side effects from simvastatin such as muscle breakdown and damage to the kidney and liver.

Can I drink grapefruit juice while taking simvastatin?

It is recommended not to drink grapefruit juice while taking simvastatin because the juice interacts with statins and increases the level of statins in your blood, which can be dangerous.

I feel fine! Do I need to keep taking simvastatin?

There are often no obvious symptoms to indicate that you have high cholesterol. It is recommended to continue taking simvastatin as directed until you have a chance to discuss your situation with your doctor.

It’s easy to test your blood for high cholesterol via our online site in three simple steps:

1. Order your kit online to be sent to an address of your choice
2. Take a finger-prick sample of blood and then send it to our lab
3. Receive the results through your patient account in 2 to 3 days

Your result will give you values for the following:

• Total cholesterol: a healthy level is below 5 mmol/L
• HDL (good cholesterol): a healthy level is above 1 mmol/L
• LDL and non-HDL (bad cholesterol): a healthy level is below 3 mmol/L (LDL) and below 4 mmol/L (non-HDL)
• triglycerides: a healthy level is below 2.3 mmol/L

Your doctor will be able to talk through your results and provide you with recommendations.

You can lower your cholesterol levels by making changes to your lifestyle.

You can:

• stop smoking (smoking can increase your cholesterol)
• reduce your alcohol intake to less than 14 units a week, have alcohol-free days and avoid binge drinking (alcohol gets broken down and turned into cholesterol in our bodies)
• eat a diet that contains less saturated fat: avoid fatty meats, cheese, cakes and biscuits
• exercise for at least 2.5 hours each week

If you need to take medication to reduce your cholesterol levels or prevent heart disease, the most common medicines are statins like simvastatin.

Other types of statin available are:

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• pravastatin (Lipostat)
• rosuvastatin (Creastor)

If statins are not appropriate for you to take there are other medicines, such as ezetimibe. Your doctor can give you more advice on this.

Simvastatin is safe to take. As with all medications, some people will experience side effects. These vary from person to person in terms of symptoms and how they impact your life.

See your doctor right away if you have:

• muscle tenderness, pain, cramps or weakness
• signs of jaundice
• skin rash, especially on the palms of the hands or soles of feet
• feeling short of breath, cough and weight loss
• severe stomach pain
• allergic reaction

Muscle pain can be a sign of muscle breakdown and kidney damage, which is a very serious condition.

The risk of muscle breakdown increases if:

• you are taking a higher dose of simvastatin (80mg)
• your alcohol consumption is high
• you have kidney, thyroid or ongoing muscle problems
• you are female and over 65
• there is a family history of hereditary muscle disorder

The patient information leaflet contains detailed information on the rare and very rare side effects known from simvastatin.

You should tell your doctor about any medication or supplements that you are taking. This is especially important if you are taking any of the following medications which can interact with simvastatin and make it less effective or cause severe side effects.

Tell your doctor if you take:

• fibrates taken to lower cholesterol
• some antibiotics and antifungals
• some hepatitis C medicines
• medicines to treat an irregular heartbeat, hypertension and heart conditions
• some antidepressants
• warfarin (to stop blood clotting)
• cyclosporin (to treat psoriasis and rheumatoid arthritis)
• colchicine (for gout)
• danazol (to treat endometriosis)

Simvastatin is most effective in reducing your risk of heart disease when you also make lifestyle changes such as eating a cholesterol-lowering diet, exercising regularly, stopping smoking and limiting your alcohol intake.

You should not take simvastatin if you:

• have liver or kidney problems
• have severe lung disease
• have an underactive thyroid
• have or have had a muscle disorder (including fibromyalgia)
• are trying to conceive, are pregnant or breastfeeding
• are regularly drinking large amounts of alcohol
• are allergic to the ingredients in simvastatin
• are taking medication that interacts with simvastatin