Simvastatin, manufactured commercially and sold under the brand name Zocor in the United States, belongs to a class of drugs known as statins that can lower cholesterol levels. Statins are the most commonly prescribed class of drug in the United States, with 22 percent of all adult Americans taking some type of statin drug, according to Consumer Reports. Statin drugs are effective at lowering cholesterol levels but can also have serious side effects. Different statins have different actions.
Actions
Simvastatin is an HMG-CoA reductase inhibitor, meaning that it blocks the actions of a certain enzyme necessary for your liver to make cholesterol. Most of the cholesterol in your body is manufactured in the liver, not obtained from dietary sources, the American Heart Association explains. Simvastatin can not only lower your cholesterol levels but can also reduce your risk of developing heart disease.
Doses
In adults, the normal starting dose of simvastatin is 20 to 40 mg per day, unless you already have heart disease or significant risks for developing heart disease. If this is the case, your doctor may start with a dose of 40 mg per day. The drug comes in doses from 5 to 80 mg; doses are titrated according to the effects on your cholesterol levels. Higher doses are associated with greater risk of side effects.
Results
At a dose of 20 mg, the average recommended starting dose, simvastatin lowers low-density lipoprotein, the type of cholesterol most likely to increase plaque buildup inside the arteries and raise the risk of developing heart disease by 35 percent, according to Family Practice Notebook. Simvastatin can also lower triglyceride levels by 30 percent. HMG-CoA Reductase Inhibitors in general can raise the "good" type of cholesterol, high-density lipoprotein, which decreases LDL levels by 5 to 15 percent.
Side Effects
Simvastatin can cause side effects ranging from mild to, in rare cases, life-threatening. Typical side effects include muscle and joint pain, the most common side effect according to MayoClinic.com, and gastrointestinal disturbances such as nausea, diarrhea or constipation. More serious side effects include an increase in liver enzymes, which can indicate liver damage. Liver function tests should be done on a regular basis to assess possible liver effects. Persistent increases in liver enzymes of three times normal should prompt discontinuation of the drug, Drugs.com warns. People who already have liver disease should not take this drug. Reports signs of liver damage such as jaundice, fatigue or upper abdominal pain to your physician. Rarely, simvastatin can cause rhabdomyolysis, muscle breakdown that releases myoglobin into the bloodstream. Myoglobin can cause kidney failure. Report severe muscle pain or decreased or dark urine to your doctor promptly.
