Simvastatin lowers cholesterol to reduce the risk of heart attack and stroke. Unlike atorvastatin it is taken in the evening, and it interacts with rather more medicines — both worth knowing if you have been switched between the two.
Lowering cholesterol in people who have had a heart attack or stroke, who have angina or peripheral arterial disease, who have familial hypercholesterolaemia, or whose calculated cardiovascular risk is high enough to benefit.
It works alongside diet and activity, and its benefit accumulates over years. You will not feel it working.
Your body makes most of its cholesterol overnight, and simvastatin is short-acting, so an evening dose lines up with that. Atorvastatin and rosuvastatin last longer and can be taken at any time — which is why the advice differs between statins.
Take it once daily in the evening, with or without food, at roughly the same time each day.
Tell your prescriber if you take amlodipine or diltiazem (the simvastatin dose is usually capped), clarithromycin or erythromycin, certain antifungals, ciclosporin, amiodarone, or HIV medicines. Several of these combinations need a dose limit or an alternative statin.
Headache, nausea, digestive upset and cold-like symptoms are the common ones and often settle.
Contact your doctor promptly for unexplained muscle pain, tenderness or weakness, especially with a fever or dark urine — rarely, statins cause a serious muscle problem that needs a blood test.
Also report yellowing of the eyes or skin, or persistent unexplained tiredness. If muscle aches are troublesome but not serious, do not simply stop — a lower dose or a different statin usually solves it.
Statins must not be taken in pregnancy or while breastfeeding. Tell your GP if you are planning a pregnancy.
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