Simvastatin, Oral Tablet

Medically reviewed by University of Illinois-Chicago, Drug Information Group on October 31, 2016Written by University of Illinois-Chicago, Drug Information Group

Important warnings

  • Myopathy and rhabdomyolysis warning: Simvastatin and other statin drugs can sometimes cause myopathy (muscle disease). They can even cause rhabdomyolysis (severe muscle breakdown). Rhabdomyolysis can lead to kidney failure. You have an increased risk of each condition if you:
    • are a senior
    • are female
    • have kidney disease
    • have low thyroid function

    Tell your doctor right away if you experience:

    • unexplained muscle weakness or tenderness
    • persistent muscle pain
    • abdominal pain
    • fever
    • dark-colored urine
  • Warning for liver disease and alcohol misuse: People with active liver disease shouldn’t use simvastatin. People with a history of alcohol abuse or liver disease should discuss the risks of this drug with their doctor. For these people, simvastatin can increase the risk of serious liver injury.

What is simvastatin?

Simvastatin is a prescription drug. It comes in two forms: a tablet and a suspension. Both forms are taken by mouth.

Simvastatin oral tablet is available as the brand-name drug Zocor. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Why it's used

Simvastatin oral tablet is used to:

How it works

Simvastatin belongs to the drug class known as HMG-CoA reductase inhibitors, also called statins. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Statins work to reduce the body’s cholesterol production. They also reduce the amount of cholesterol and triglycerides moving through the body. High cholesterol and triglycerides are associated with increased risk of:

  • heart disease
  • stroke
  • heart attack

Statins are usually used in combination with lifestyle changes, such as changes to diet and exercise.

Simvastatin side effects

Simvastatin oral tablet doesn’t drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with simvastatin include:

  • headache
  • nausea
  • stomach pain
  • constipation
  • muscle pain or weakness
  • joint pain
  • upper respiratory infections

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • rhabdomyolysis (muscle breakdown)
  • severe muscle pain or weakness
  • muscle spasms
  • kidney failure
  • liver toxicity
  • jaundice (yellowing of the skin)
  • severe anemia
  • severe allergic reaction, with symptoms such as fever and trouble breathing
  • rash of any kind
  • extreme sensitivity to the sun
  • diarrhea
  • feeling weak or very tired
  • severe stomach pain
  • severe nausea or vomiting
  • severe swelling of the hands, feet, and ankles

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Simvastatin and diabetes

Q:

Can taking simvastatin increase my risk of diabetes?

A:

There is a small risk of increased blood sugar levels and even diabetes from taking simvastatin. Your doctor should occasionally check your blood sugar levels while you take simvastatin. If you already have diabetes, your doctor should regularly check your blood sugar level. Your doctor should also regularly check your hemoglobin A1C level, which can indicate if your average blood sugar level has been high over an extend period (2–3 months).

Healthline Pharmacist Review TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Simvastatin may interact with other medications

Simvastatin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with simvastatin are listed below.

Strong CYP3A4 Inhibitors

These drugs block your body from breaking down simvastatin. This can lead to very high levels of the drug in your body. It can also increase side effects, including rhabdomyolysis.

These drugs should not be used with simvastatin. If treatment with these drugs is required, the use of simvastatin must be on hold during the course of treatment. Examples of these drugs include:

  • ketoconazole
  • itraconazole
  • voriconazole
  • posaconazole
  • erythromycin
  • clarithromycin
  • telithromycin
  • cyclosporine
  • danazol
  • nefazodone
  • boceprevir
  • telaprevir
  • ritonavir
  • tipranavir
  • indinavir
  • fosamprenavir
  • darunavir
  • atazanavir
  • nelfinavir
  • cobicistat

Other cholesterol-lowering drugs

When used with simvastatin, some cholesterol drugs can increase side effects such as myopathy or rhabdomyolysis. If you use these drugs with simvastatin, your doctor may lower your dosage of simvastatin. Examples of these drugs include:

  • gemfibrozil
  • fenofibrate
  • niacin
  • lomitapide

With niacin, the risk of myopathy and rhabdomyolysis is higher when the drug is taken in larger doses, and in people of Chinese descent.

Calcium channel blockers and other drugs that increase risk for myopathy or rhabdomyolysis

Using simvastatin with these drugs can increase the risk of myopathy or rhabdomyolysis. Your doctor may discuss other medication options or lower your dosage of simvastatin. Examples of calcium channel blockers include:

  • amlodipine
  • diltiazem
  • verapamil

Do not take more than 10 mg of simvastatin with diltiazem or verapamil, or more than 20 mg of simvastatin with amlodipine.

Other drugs that increase risk of myopathy or rhabdomyolysis include:

  • amiodarone
  • dronedarone
  • ranolazine

Heart drug

Digoxin is used to treat heart failure and arrhythmias. Taking simvastatin with digoxin can increase levels of digoxin in your body. If you’re taking both drugs, your doctor may want to monitor your digoxin level more closely.

Gout drug

Colchicine is a drug used to treat gout. Using simvastatin with colchicine can increase the risk of both myopathy and rhabdomyolysis.

Warfarin (blood thinner)

When taken with warfarin, simvastatin can increase the blood-thinning effects of warfarin. This can lead to an increased risk of bleeding. Your doctor monitor your warfarin level more closely if you’re taking these two drugs at the same time.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Simvastatin warnings

This drug comes with several warnings.

Alcohol warning

People with a history of alcohol abuse and risk of liver disease should not take this drug. For these people, simvastatin can increase the risk of serious liver injury.

Food interaction warning

Avoid grapefruit juice while taking simvastatin. Grapefruit juice can increase simvastatin levels in your body and increase the risk of side effects.

Warnings for people with certain health conditions

For people with low thyroid function (hypothyroidism) or diabetes: Simvastatin and other statin drugs can sometimes cause rhabdomyolysis. Having hypothyroidism or diabetes raises your risk for this condition. Other risk factors include:

  • being a senior
  • being female
  • having kidney disease
  • use of drugs that interact with simvastatin

Tell your doctor right away if you experience:

  • unexplained muscle weakness or tenderness
  • continuous muscle pain
  • diarrhea
  • fever
  • dark-colored urine

For people with liver disease: People with active liver disease, such as cirrhosis or hepatitis, shouldn’t use simvastatin.

Warnings for other groups

For pregnant women: Simvastatin is a category X pregnancy drug. Category X drugs should never be used during pregnancy.

Simvastatin blocks the production of cholesterol, which is important for the developing baby.

If you’re pregnant and need treatment for high cholesterol or triglycerides, talk to your doctor. They can discuss other treatment options during pregnancy.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: It isn’t known if simvastatin enters breast milk. However, because of the risk of severe side effects, this drug shouldn’t be used during breastfeeding. Talk to your doctor about other cholesterol treatment options while breastfeeding.

How to take simvastatin

All possible dosages and forms may not be included here. Your dose, form, and how often you take it may depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Drug forms and strengths

Generic: Simvastatin

  • Form: oral tablet
  • Strengths: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg

Brand: Zocor

  • Form: oral tablet
  • Strengths: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg

Dosage for high cholesterol

Adult dosage (ages 18 years and older)

  • Typical starting dosage: Simvastatin is often started at 10–20 mg per day. However, the dosage may range from 5 mg to 40 mg per day. You should take this drug once a day in the evening.
  • Dosage increases: Your doctor will gradually adjust your dosage if needed.

Child dosage (ages 10–17 years)

  • Typical starting dosage: 10 mg per day.
  • Note: Doses above 40 mg per day have not been studied in this age group.

Child dosage (ages 0–9 years)

This medication has not been studied in children below age 10 years.

Dosage for reducing the risk of heart disease and heart attack and stroke in people with heart disease

Adult dosage (ages 18 years and older)

  • Typical starting dosage: Simvastatin is often started at 10–20 mg per day. However, the dosage may range from 5 mg to 40 mg per day. You should take this drug once a day in the evening.
  • Dosage increases: Your doctor will gradually adjust your dosage if needed.

Child dosage (ages 10–17 years)

  • Typical starting dosage: 10 mg per day.
  • Note: Doses above 40 mg per day have not been studied in this age group.

Child dosage (ages 0–9 years)

This medication has not been studied in children below age 10 years.

Special dosage considerations

  • For people with kidney disease: Having kidney disease may affect your dosage. People with advanced kidney disease usually require a lower dosage. Talk to your doctor about your treatment with simvastatin if you have kidney disease.
  • For people with liver disease: If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at increased risk of side effects. If you have active liver problems, you should not use this medication.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Take as directed

Simvastatin is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all or stop taking it: If you have high cholesterol and don’t take your simvastatin, you risk having increased cholesterol levels, developing heart disease, and having a heart attack or a stroke.

If you don't take it on schedule: Not taking simvastatin every day, skipping days, or taking doses at different times of the day may also increase your risk for high cholesterol levels, heart attack, or stroke.

If you miss a dose: If you miss a dose, take the next dose as scheduled. Don’t double your dose.

How can I tell if the drug is working: Your cholesterol and triglyceride levels should be within healthy levels while taking it.

Important considerations for taking simvastatin

Keep these considerations in mind if your doctor prescribes simvastatin for you.

General

  • You can take simvastatin with or without food. Taking it with food may reduce nausea.
  • Take simvastatin in the evening to maximize its effects. Cholesterol production in the body is highest at nighttime.

Storage

  • Store the tablets between 41°F and 86°F (5°C to 30°C).
  • Keep the tablets in a tightly closed, light-resistant container.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They won’t damage your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

While you take simvastatin, your doctor will want to make sure that it isn't affecting your liver and kidneys. Your doctor may perform a baseline liver function test (an initial liver function test that is repeated in a few months). They may also do additional liver and kidney function tests during treatment.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained here in is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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