Acoles

by Harrison

Active ingredient: Simvastatin

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About Simvastatin

Hypolipidaemic/Anti-atheroma

Uses

Adjunct to diet for reduction of total cholesterol, LDL-cholesterol, apolipoprotein B and triglycerides in primary hypercholesterolaemia, heterozygous familial hypercholesterolaemia or combined hyperlipidaemia when response to diet and other pharmacological measures is inadequate. To lower LDL:HDL ratio and total cholesterol:HDL ratio by raising HDL. Reduce risk of mortality, coronary death and non-fatal MI. Reduce risk for patients undergoing myocardial revascularization and to slow progression of coronary atherosclerosis, in coronary heart disease where plasma cholesterol level of 5.5 mmol/l or greater. Adjunct to diet for reduction of total cholesterol, LDL-cholesterol and apolipoprotein…

How to take it

Adults: Hyperlipidaemia: Initially 10 mg at night adjusting at minimum 4 wk intervals according to response. Usual range 10-80 mg daily a single dose at night. Prevention of cardiovascular events in patients with atherosclerotic cardiovascular disease or Diabetes Mellitus: Initially 20 mg at night adjusting at minimum 4 wk intervals according to response. Usual range 80 mg daily a single dose at night. Homozygous familial hypercholesterolaemia: 40 mg at night or 80 mg daily in three divided doses. Children: Under 5 yr, not recommended. Hyperlipidaemia including familial hypercholesterolaemia: 5-10 yr, initially 10 mg at night increased, if necessary, at intervals of at least 4 wk to max 20…

Side effects

Constipation, flatulence, headache, asthaenia, nausea, dyspepsia, abdominal pain diarrhoea, rash, alopecia, dizziness, muscle cramps, myalgia, pancreatitis, paraesthesia, peripheral neuropathy, anaemia, hepatitis, jaundice. Rarely, rhabdomyolysis, myopathy; measure creatine phosphokinase levels; withdraw therapy if markedly raised. Reports of immune-mediated necrotising myopathy.

Pregnancy and breastfeeding

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Active liver disease. Women must be protected by non-hormonal contraceptive methods. Precautions: History of liver disease. Monitor liver function before and 3 months after starting treatment. Advise patients to report unexplained muscle weakness or pain; monitor creatine kinase levels, withdraw if >5xULN. Renal impairment, hypothyroidism, history of muscle toxicity or muscle disorders, alcohol abuse, female, elderly (more than 65 years). Risk of interstitial lung disease; advise patients to report symptoms. Risk factors for diabetes; monitor patients with risk factors, incl…

Advice

Take with or without meals in evening. Take medication at same time each day. Contact prescriber if there is chest pain, muscle pain, weakness, dizziness, memory loss, depression, personality changes, numbness, weakness, tingling, cramps, vision changes or skin rash. Avoid high intake of grapefruit juice (>1 L per day). Take low-fat, cholesterol-lowering diet. Have periodic blood tests as advised by prescriber to check drug's effectiveness.

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Interactions with Simvastatin

Digoxin, coumarin anticoagulants, cyclosporin, gemfibrozil and other fibrates, nicotinic acid, erythromycin, clarithromycin, macrolide antibiotics, azole antifungals, other CYP3A4 inhibitors, immunosuppressants, nefazodone, protease inhibitors, grapefruit juice, danazol, amiodarone, calcium-channel blockers, QATP1B inhibitors, BCRP inhibitors (e.g., elbasvir, grazoprevir), rifampicin, colchicine, cobicistat, lomitapide, with or within 7 days of systemic fusidic acid.

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Compiled by Healify Pharmacy from published drug references. How we compile it →

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