Does Calcium Interfere With Simvastatin?

Simvastatin is meant to reduce your risk for heart attacks and cardiovascular disease by lowering your cholesterol, while emerging evidence in 2011 indicates that taking calcium supplements might increase your risk for adverse cardiac events. Simvastatin interacts with numerous drugs and supplements, though it is not specifically contraindicated with calcium supplementation, according to the National Center for Biotechnology Information's PubMed Health website. If your doctor prescribes simvastatin, consult her before taking calcium supplements.

Expert Insight

Though calcium supplements are not listed as a contraindication for simvastatin, Drugs.com advises that this does not mean the potential for an interaction is nonexistent. Talk to a doctor or pharmacist before combining a dietary supplement with a medication. Vitamin supplements that are known to interact with simvastatin include niacin, beta-carotene and vitamin E, according to “The Essential Herb-Drug-Vitamin Interaction Guide,” by George T. Grossberg and Barry Fox. Dietary calcium as opposed to calcium supplements is not flagged either, according to PubMed Health, which recommends consuming low-fat, low-cholesterol foods when taking this drug, including cottage cheese and fat-free milk.

Cholesterol, Calcium and Heart Attack Risk

Your doctor may prescribe simvastatin, a statin, to help lower your cholesterol and triglycerides. This, in turn, is meant to decrease your risk for a heart attack, stroke and death or to avoid surgery if you have a medical condition that puts you at high risk for heart and blood vessel problems by improving blood flow. Statins work by slowing your body’s production of cholesterol so cholesterol cannot build on your artery walls, blocking block blood flow. Statins may be overprescribed, however, notes an August 2011 “Lancet” study. Calcium buildup, or calcification, in your blood vessels appears to be a better predictor of your risk for heart attacks and stroke, according to lead study author Michael J. Blaha, which means people who have such a buildup should be targeted for statin use and that people without this buildup are unlikely to benefit from drugs such as simvastatin.

Calcium Supplement Risk

Dietary calcium does not cause calcification, or calcium buildup, in your arteries, so it does not negate the reduced risk for heart attack and stroke that simvastatin is meant to produce, notes "The Daily Mail" newspaper. In fact, high dietary calcium is linked to lower weight and blood pressure, which improves heart health. However, calcium supplementation may raise your risk for a heart attack, according to a July 2010 “BMJ” analysis. In this analysis, researchers involved in 15 randomized trials examining calcium supplements for various conditions pooled their data to look for associations between supplementation and increased risk for cardiovascular events. The analysis recommends rethinking the practice of prescribing calcium supplements to reduce osteoporosis risk in light of the finding.

Considerations

Researchers have more work to do when it comes to pinpointing benefits and risks of statins and calcium supplements, notes M.J. Bolland, lead author for the “BMJ” analysis. Since calcium supplements can increase your bone density, it’s possible they also might increase calcification in your blood vessels and increase your risk for cardiovascular events, Bolland notes. The implications of taking calcium supplements and simvastatin together also are unclear as of 2011, so consult a doctor before combining them. Simvastatin appears to elevate calcium regulatory genes and proteins, including sarcoplasmic reticulum Ca2+-ATPase, or SERCA, and ryanodine receptor 2, or RyR2, according to a June 2005 “Acta Pharmacologicia Sinica” study. This, in turn, can improve cardiac performance. Meanwhile, a 2007 “Journal of Pharmacological Sciences” study concludes that simvastatin increases bone morphogenetic protein 2 expression in cells that are responsible for making bones. Combining the drug with calcium sulfate stimulates bone regeneration, according to lead study author Myat Nyan. The combination also causes soft tissue inflammation, Nyan notes.