Experiences with
Simvastatin

Simvastatin is used to lower cholesterol if you’ve been diagnosed with high blood cholesterol. It’s also taken to prevent heart disease, including heart attacks and strokes. It belongs to a group of medicines called statins.

Your doctor may prescribe simvastatin if you have a family history of heart disease, or a long-term health condition such as rheumatoid arthritis, or type 1 or type 2 diabetes.

Simvastatin is available on prescription as tablets. You can also buy it as a low strength, 10mg tablet from a pharmacy.

Simvastatin is also available as tablets combined with other medicines that lower cholesterol:

Cholib – combined with fenofibrate
Inegy – combined with ezetimibe

Who can take simvastatin

Simvastatin can be taken by most adults and children over the age of 10 years.

Who may not be able to take simvastatin

Simvastatin is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:

have ever had an allergic reaction to simvastatin or any other medicine
have liver or kidney problems
are trying to get pregnant, are already pregnant, or you’re breastfeeding
have lung disease
regularly drink large amounts of alcohol
have an underactive thyroid
have ever had a muscle disorder (including fibromyalgia)
you have a history of myasthenia gravis or ocular myasthenia

Dosage

The usual dose of simvastatin for adults is between 10mg and 40mg once a day. People with very high cholesterol levels may be prescribed a higher dose of 80mg a day.

Your dose will depend on why you need the medicine, your cholesterol levels, and other medicines you’re taking. Ask your doctor or pharmacist for advice if you’re unsure how much to take.

Do not reduce your dose without talking to your doctor first.

Doses for children

Your child’s doctor will work out the dose that is right for them. This will depend on their age and why they need simvastatin.

The usual starting dose of simvastatin in children is 10mg. This dose may be increased to a maximum of 40mg.

How to take it

Take simvastatin once a day in the evening. This is because your body makes most of its cholesterol at night, so simvastatin works better at lowering cholesterol at night than in the morning.

Simvastatin does not upset your stomach, so you can take it with or without food.

Swallow simvastatin tablets whole with a glass of water

Do not drink grapefruit juice while you’re taking simvastatin. It can increase the level of simvastatin in your blood.

How long to take it

Usually, treatment with a statin such as simvastatin is for life. The benefits will only continue for as long as you take it. If you stop taking simvastatin without starting a different treatment, your cholesterol may rise again.

If you forget to take it

If you forget to take your dose, take it as soon as you remember it. If you do not remember until the following day, skip the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take extra doses.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Stopping simvastatin

You may want to stop simvastatin if you think you’re having side effects.

Talk to your doctor first to see if it really is a side effect of simvastatin or an unrelated problem. Your doctor may advise you to lower your dose or change your medicine.

You will not get any withdrawal symptoms. However, stopping simvastatin may cause your cholesterol to rise. This increases your risk of heart attacks and strokes.

If you want to stop taking your medicine, it’s important to find another way to lower your cholesterol.

If you take too much

Taking an extra dose of simvastatin is unlikely to harm you.

Talk to your pharmacist or doctor if you’re worried or if you take more than 1 extra dose.

Common side effects

Like all medicines, simvastatin can cause side effects in some people, but not everybody gets them.

Talk to your doctor or pharmacist if you do get any side effects and they bother you, or do not go away. They may recommend trying a lower dose of simvastatin, or a different statin.

Serious side effects

It happens rarely, but less than 1 in 1,000 people taking simvastatin may have a serious side effect.

Stop taking simvastatin and call a doctor or call 111 now if:

you get unexplained muscle pain, tenderness, weakness or cramps (this is more likely if you’re taking a higher dose of simvastatin, and it can happen a few weeks or months after you first start taking this medicine) – this can be signs of muscle breakdown and kidney damage
the whites of your eyes turn yellow, or your skin turns yellow (although this may be less obvious on brown or black skin), or if you have pale poo and dark pee – this can be signs of liver problems
you get a skin rash with pink-red blotches, especially on the palms of your hands or soles of your feet – this could be a sign of the skin reaction, erythema multiforme
you have severe stomach pain – this can be a sign of acute pancreatitis
you have a cough, feel short of breath, and have lost weight – this can be a sign of lung disease
you have a weakness in your arms or legs that gets worse after activity, or if you get double vision, drooping eyelids, problems swallowing or shortness of breath – these can be a sign of myasthenia gravis

you develop severe breathing or swallowing problems

Meds - serious side effects A&E safety messaging

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to simvastatin.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of simvastatin. For a full list see the leaflet inside your medicines packet.

Simvastatin and pregnancy

Simvastatin is not recommended in pregnancy. If you become pregnant while taking simvastatin, stop taking the medicine and tell your doctor.

Talk to your doctor if you are planning to get pregnant. Whether you continue taking simvastatin or not depends on the reason you're taking it.

It may be possible to switch to a medicine that is better during pregnancy. Your doctor may decide that it's better for you to keep taking simvastatin until you have a positive pregnancy test and then stop.

Simvastatin and breastfeeding

It might be OK to take simvastatin while breastfeeding, but you may also be told to stop taking your medicine until you are not breastfeeding. Your doctor or pharmacist will help you decide.

It’s not yet known how much simvastatin passes into breast milk, but it’s likely to be a very small amount. It's unlikely to cause any side effects in your baby, or affect their cholesterol. However, until we know more about taking simvastatin while breastfeeding, other medicines may be recommended.

If you notice that your baby is not feeding as well as usual, or is not putting on weight as you would expect, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.

Simvastatin and fertility

There's no clear evidence that taking simvastatin reduces fertility in either men or women.

However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Some medicines affect the way that simvastatin works and can increase the chances of you having serious side effects, such as muscle damage.

Tell your doctor or pharmacist if you are taking any of the following medicines:

antibiotics, such as clarithromycin, rifampicin or fusidic acid
medicines used to treat fungal infections, such as fluconazole or ketoconazole
some HIV medicines
medicines used to treat hepatitis C virus infection
warfarin, a medicine used to help prevent blood clots
ciclosporin, a medicine to treat psoriasis and rheumatoid arthritis
danazol, a medicine to treat endometriosis
amiodarone, a medicine that helps your heart rhythm get back to normal in atrial fibrillation
verapamil, diltiazem or amlodipine, medicines for high blood pressure and heart problems
colchicine, a medicine used to treat gout

If you're taking simvastatin and need to take one of these medicines, your doctor may:

prescribe a lower dose of simvastatin
prescribe a different statin medicine
recommend that you stop taking your simvastatin for a while

Mixing simvastatin with herbal remedies and supplements

St John's wort, a herbal medicine taken for depression, reduces the level of simvastatin in your blood, so it does not work as well. Talk to your doctor if you're thinking about starting St John's wort, as it will change how well simvastatin works.

Tell your doctor or pharmacist if you are taking a Coenzyme Q10 (CoQ10) supplement. Supplements can affect the way other medicines you may also be taking work.

There is no clear evidence that taking CoQ10 at the same time as simvastatin will benefit your health. More research is needed.

There's not enough information to say that other herbal remedies and supplements are safe to take with simvastatin. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.