Drug Index

Simvastatin

 
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Mechanism :

Simvastatin is a potent inhibitor of HMG-CoA reductase. Inhibition of HMG-CoA reductase is the basis for an assay in pharmacokinetic studies of the b-hydroxy acid metabolites (active inhibitors) and, following base hydrolysis, active plus latent inhibitors (total inhibitors) in plasma following administration of simvastatin.


Indication :

• Hypercholesterolemia

• Familial hypercholesterolemia


Contraindications :

Contraindicated in active liver disease, renal impairment, unexplained increase in transaminases and in hypersensitivity to simvastatin. Liver function tests should be carried out.


Dosing :

<10 years: Safety and efficacy not established. An initial dose of 5 mg PO once daily titrated up to 10 to 20 mg PO once daily has been used in small studies.

>10 years: 10 mg oral daily evening dose; maximum: 40 mg/day.

Recommended dose: 10-40 mg/day; dose adjustment at 4 weeks or more.


Adverse Effect :

Reversible increases in liver enzymes and creatinine kinase, nausea, diarrhea, constipation, skin rash, peripheral neuropathy, rarely rhabdomyolysis.


Interaction :

Immunosuppressive therapy including Cyclosporin and Prednisolone: May increase plasma statin concentration and the risk of muscle toxicity.
Fibrates/or Nicotinic Acid, Erythromycin, Clarithromycin: May also be associated with an increased risk of serious myopathy.
Itraconazole and Ketoconazole: Increase risk of myopathy with simvastatin.
Warfarin: Anticoagulant effects of warfarin increased by simvastatin.


07/17/2019 10:35:08 Simvastatin
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