Simvastatin

Simvastatin tablets are available in different strengths: 10 mg, 20 mg, 40 mg and 80 mg. Your dose of simvastatin will depend on why you're taking it, your cholesterol levels, and other medicines you may be taking.

• For high cholesterol: The usual dose is 10 mg or 20 mg once a day, at night. Depending on your cholesterol levels, your prescriber may increase your dose after a few weeks to 40 mg at night. If you have very high cholesterol levels you may be prescribed a higher dose of 80 mg a day.
• To prevent heart attacks and strokes: The usual dose is 20 mg or 40 mg once a day, at night. I f you have very high cholesterol levels you may be prescribed a higher dose of 80 mg a day.
• Follow advice: Always take your simvastatin exactly as your healthcare provider has told you. The pharmacy label on your medicine will tell you how much simvastatin to take, how often to take it, and any special instructions.

• Timing: Take simvastatin once a day. Some people may recommend taking simvastatin in the evening, but there is little difference in effect. In general, the best time to take it is at a convenient time that suits you so that you remember to take it. It's best to take it at the same time each day.
• Food: You can take simvastatin with or without food.
• Missed dose: If you forget your dose, take it as soon as you remember that day. But if it's nearly time for your next dose, just take the next dose at the usual time. Don't take double the dose.

Here are some things to know when you're taking simvastatin. Other things may be important as well, so ask your healthcare provider what you should know about.

• Alcohol: Avoid drinking large amounts of alcohol while you're taking simvastatin. Heavy drinking can increase your risk of side effects such as problems with your liver.
• Avoid large quantities of grapefruit: Having large quantities of grapefruit while taking simvastatin can increase your risk of side effects. But eating 1 serving of marmalade, no more than half a grapefruit or drinking no more than a standard glass (250 mL) of grapefruit juice each day, shouldn't be a problem. It's best to allow 12 hours between having these foods and taking your simvastatin dose, so if you take your statin in the morning have your grapefruit at night.
• Tests and monitoring: You may need to see your healthcare provider regularly when you first start taking simvastatin to make sure the dose is right for you. High cholesterol doesn’t have any symptoms so you won’t notice any changes after taking simvastatin. That's why it’s important to have a blood test to check the changes in your cholesterol levels.
• Keep taking simvastatin regularly: To reduce your cholesterol effectively, you must keep taking simvastatin every day. Treatment with simvastatin is usually long term.
• Get the full benefit: To get the full benefit of a statin, it's important to eat a healthy diet, exercise regularly and limit your alcohol intake. It's best to eat a low-fat diet, and reduce the amount of saturated fat you eat. Read more about fats.
• Other medicines: Simvastatin interacts with some medicines, herbal supplements and rongoā Māori, so check with your healthcare provider or pharmacist before starting simvastatin or before starting any new medicines or supplements.
• Pregnancy or breastfeeding: Talk to your healthcare provider if you're pregnant, planning a pregnancy or want to breastfeed.

Like all medicines simvastatin can cause side effects, although not everyone gets them. If you're concerned about any symptoms you think might be related to your medicine, talk to your healthcare provider. The following information offers some guidance but doesn't include all possible side effects.

Common side effects

Tell your healthcare provider if they bother you.

• Constipation (hard to poo) or diarrhoea (runny poo), stomach upset, bloating or gas in the tummy, nausea (feeling sick).
• Problems sleeping, headache, dizziness, tiredness.

Muscle aches and pains

Some people will have muscle aches and pains when taking statins. It's difficult to determine if these symptoms are directly caused by the medicine, since aches and pains tends to become more common with age, especially in individuals over 50. This side effect is rarely serious and often goes away with time. If your pain comes on shortly after you start your statin, or gets worse, see your healthcare provider. They'll check an enzyme called creatine kinase to see if the aches and pains are possibly being caused or made worse by the statins.

If so:

• a lower dose or a different statin may be prescribed, or
• you may choose to continue living with the aches because of the benefits of the statin, or
• you may discuss stopping taking your statin with your healthcare provider.

Your healthcare provider will also want to check for a rare but serious condition called rhabdomyolysis (muscle inflammation and damage). They will check any other medicines you're taking. Rhabdomyolysis can be caused by an interaction between statins and some other medicines including antibiotics.

Tell your healthcare provider immediately or phone Healthline free on 0800 611 116 if these occur

• Signs of problems with your liver such as dark coloured urine, yellowing of the skin or eyes, sharp pain in your stomach area.
• Symptoms of a serious muscle problem such as ongoing muscle weakness or pain, dark pee (urine).

Read more about medicines and side effects and reporting a reaction you think might be a side effect.