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simvastatin Index

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Medications and Drugs
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Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: simvastatin

BRAND NAME: Zocor
DRUG CLASS AND MECHANISM: Simvastatin is a cholesterol-lowering drug.
It belongs to a class of drugs called HMG-CoA reductase inhibitors,
commonly called "statins." Other statins include lovastatin (Mevacor),
atorvastatin (Lipitor), fluvastatin (Lescol), and rosuvastatin
(Crestor). Statins reduce cholesterol by inhibiting an enzyme in the
liver (HMG-CoA reductase) that is necessary for the production of
cholesterol. In the blood, statins lower total and LDL ("bad")
cholesterol as well as triglycerides. LDL cholesterol is believed to
be an important cause of coronary artery disease. Lowering LDL
cholesterol levels slows and may even reverse coronary artery disease.
Statins also increase HDL ("good") cholesterol. Raising HDL
cholesterol levels, like lowering LDL cholesterol may slow coronary
artery disease. The FDA approved simvastatin in December 1991.

PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes

PREPARATIONS:
Tablets: 5, 10, 20, 40, and 80 mg.

Oral disintegrating tablets: 10, 20, 40, and 80 mg.
STORAGE:

Tablets should be stored between 5-30 C (41-86 F).
Oral disintegrating tablets should be stored between 20-25 C
 (68-77 F).

PRESCRIBED FOR: Simvastatin is used for reducing total cholesterol,
LDL cholesterol, and triglycerides, and for increasing HDL
cholesterol. In patients with coronary heart disease, diabetes,
peripheral vessel disease, or history of stroke or other
cerebrovascular disease, simvastatin is prescribed for reducing the
risk of mortality by reducing death from coronary heart disease,
reducing nonfatal myocardial infarction (heart attack) and stroke, and
reducing the need for coronary and noncoronary revascularization
procedures.
DOSING: The dose range for is 5-80 mg/day given preferably in the
evening. The usual staring dose is 20-40 mg once daily. Dose
adjustments are made at weekly intervals.

DRUG INTERACTIONS: Decreased elimination of simvastatin could increase
the levels of simvastatin in the body and increase the risk of muscle
toxicity from simvastatin. Examples of drugs that decrease elimination
of simvastatin include erythromycin (E-Mycin), ketoconazole (Nizoral),
itraconazole (Sporanox), clarithromycin (Biaxin), telithromycin
(Ketek), cyclosporine (Sandimmune), nefazodone (Serzone), and HIV
protease inhibitors such as indinavir (Crixivan) and ritonavir
(Norvir). Large quantities of grape fruit juice (>1 quart daily) also
will increase blood levels of simvastatin.
Amiodarone (Cordarone), verapamil (Calan Verelan, Isoptin), danazol
(Danocrine), cyclosporine, niacin (Niacor, Niaspan, Slo-Niacin),
gemfibrozil (Lopid) and fenofibrate (Tricor) also may increase the
risk of muscle toxicity when combined with simvastatin. Patients
taking amiodarone or verapamil should not take more than 20 mg of
simvastatin. Patients taking danazol or cyclosporine should not take
more than 10 mg of simvastatin.

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simvastatin, Zocor
Heart Attack »

What is a heart attack?
A heart attack (also known as a myocardial infarction) is the death of
heart muscle from the sudden blockage of a coronary artery by a blood
clot. Coronary arteries are blood vessels that supply the heart muscle
with blood and oxygen. Blockage of a coronary artery deprives the
heart muscle of blood and oxygen,causing injury to the heart muscle.
Injury to the heart muscle causes chest pain and chest pressure
sensation. If blood flow is not restored to the heart muscle within 20
to 40 minutes, irreversible death of the heart muscle will begin to
occur. Muscle continues to die for six to eight hours at which time
the heart attack usually is "complete." The dead heart muscle is
eventually replaced by scar tissue.

Approximately one million Americans suffer a heart attack each year.
Four hundred thousand of them die as a result of their heart attack.
What causes a heart att...

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