#Cardiovascular #Drug

Simvastatin

evan Jan. 20, 2024

Drug Class	Statin
Mechanism	Reversibly inhibits HMG CoA reductase - the rate limiting enzyme in cholesterol synthesis by the liver Liver responds by increased LDL receptor expression taking in more LDL to plasma cholesterol
Typical Dose	40mg OD to be increased up to 80mg. Taking at night improves efficacy
Indications	Hypercholesterolaemia
Contra-indications	Active liver disease/persistently deranged LFTs Pregnancy/breast feeding When taking clarithromycin
Side-effects	Myositis (achy muscles), may lead to rhabdomyolysis
Interactions	Clarithromycin - increased exposure to simvastatin Cylcosporin - increased risk of myositis Fibrate - increased risk of myositis Warfarin - increased exposure to warfarin
Elimination	ABC transporter mediated biliary excretion
Additional Notes	Only prescribe if diet modification has failed and secondary causes of hyperlipidaemia have been ruled out. Regular LFTs before/during treatment.