Simvastatin

NHS Choices

About simvastatin

Simvastatin belongs to a group of medicines called statins. It's used to lower cholesterol.

It's also taken to prevent heart disease, heart attack and stroke.

The medicine is available on prescription as tablets. You can also buy a low-strength 10mg tablet from a pharmacy.

Key facts

Simvastatin seems to be a very safe medicine. It's unusual to have any side effects.
Keep taking simvastatin even if you feel well, as you will still be getting the benefits. Most people with high cholesterol don't have any symptoms.
Don't take simvastatin if you're pregnant or think you might be pregnant. This medicine can harm an unborn baby.
Don't drink grapefruit juice while you're taking simvastatin. It doesn't mix well with this medicine.
Simvastatin is also called Zocor and Simvador.

Who can and can't take simvastatin

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

Simvastatin isn't suitable for some people. Tell your doctor if you:

have had an allergic reaction to simvastatin or any other medicines in the past
have liver or kidney problems
are trying to get pregnant, think you might be pregnant, you're already pregnant, or you're breastfeeding
have severe lung disease
regularly drink large amounts of alcohol
have an underactive thyroid
have, or have had, a muscle disorder

How and when to take it

Take simvastatin once a day in the evening.

Simvastatin doesn't upset the stomach, so you can take it with or without food.

How much will I take?

The usual dose 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.

The usual starting dose in children is 10mg each evening. Your child's doctor might increase this after 4 weeks. The maximum dose in children is 40mg.

Your dose depends on the reason for taking it, your cholesterol levels, and what other medicines you're taking.

How to take it

Swallow simvastatin tablets whole with a glass of water.

There's some evidence simvastatin works better at lowering cholesterol if you take it in the evening rather than in the morning.

What if I forget to take it?

If you occasionally forget to take a dose, take your next dose the next day at the usual time. Never take 2 doses at the same time. Never take extra doses.

If you forget doses often, 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.

What if I take too much?

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

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

Side effects

Simvastatin seems to be a very safe medicine. It's unusual to have side effects.

One rare but serious side effect is unexplained muscle pain, tenderness or weakness. This is more likely if you're taking a higher dose of simvastatin. Talk to your doctor or pharmacist if the side effects bother you or don't go away.

Report any unexplained muscle pain, tenderness or weakness to a doctor straight away.

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 tell a doctor if you get:

muscle pain, tenderness, weakness or cramps - these can be signs of muscle breakdown and kidney damage
yellow skin or eyes - this can be a sign of liver problems
a skin rash with pink-red blotches, especially on the palms of the hands or soles of the feet
severe tummy pain - this can be a sign of pancreas problems
a cough, feeling short of breath, and weight loss - this can be a sign of lung disease

Serious allergic reaction

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

A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

The warning signs of a serious allergic reaction are:

getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
wheezing
tightness in the chest or throat
having trouble breathing or talking
swelling of the mouth, face, lips, tongue, or throat

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

You can report any suspected side effect to the UK safety scheme.

Pregnancy and breastfeeding

Simvastatin is not recommended in pregnancy and while breastfeeding.

Talk to your doctor if you're planning to become pregnant. It's best to stop taking simvastatin at least 3 months before you start trying for a baby.

If you become pregnant while taking simvastatin, stop taking the medicine and tell your doctor.

Simvastatin and breastfeeding

It's not known if simvastatin passes into breast milk, but it may cause problems for your baby. You may be able to stop taking simvastatin temporarily while you breastfeed.

Tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

Cautions with other medicines

Some medicines don't mix well with simvastatin including:

some antibiotics and antifungals
some HIV medicines
some hepatitis C medicines
warfarin (stops blood clotting)
ciclosporin (treats psoriasis and rheumatoid arthritis)
danazol (treats endometriosis)
nefazodone (treats depression)
amiodarone (makes your heart stable)
verapamil, diltiazem, amlodipine (for high blood pressure and heart problems)

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 temporarily stop taking your simvastatin

Mixing simvastatin with herbal remedies and supplements

St John's wort, a herbal medicine taken for depression, reduces the amount of simvastatin in your blood, so it doesn't 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're taking any other medicines, including herbal remedies, vitamins or supplements.

Common questions

How does simvastatin work?

Simvastatin acts on the liver to stop it making cholesterol. This lowers your blood cholesterol level.

Are statins safe?

You may have read negative stories about statins, but they're considered to be very safe, effective medicines with few side effects. Sometimes the side effects reported are unrelated to the medicine.

If you're concerned about the safety of statins, talk to your doctor.

Is simvastatin addictive?

No, there's no evidence that simvastatin is addictive.

How long will I take simvastatin for?

Usually, treatment with a statin such as simvastatin is for life.

Can I take simvastatin for a long time?

Simvastatin is safe to take for a long time. In fact, it works best if you take it for a long time.

They've been used for more than 20 years to lower cholesterol.

Are there other cholesterol-lowering medicines?

There are several other statin medicines, including:

atorvastatin
fluvastatin
pravastatin
rosuvastatin

Statins all work in the same way, but they differ in how well they lower cholesterol.

If you have a side effect with one statin, it may not happen with another. Some medicines don't mix well with one statin, but you can take them with a different one.

Your doctor will find the right statin and dose for you, depending on your medical history, cholesterol level and the other medicines you take.

Is there any food or drink I need to avoid?

Don't drink grapefruit juice if you're taking simvastatin. It increases the concentration of simvastatin in your system.

Can I drink alcohol with it?

Yes, you can drink alcohol while taking simvastatin.

However, drinking a lot of alcohol may increase the chances of you getting some side effects. Try not to drink more than 14 units of alcohol a week.

Can I drive or ride a bike?

Occasionally, simvastatin can make you feel dizzy. If this happens to you, don't drive, cycle or use machines or tools until you feel better.

Will it affect my contraception?

For women, simvastatin will not affect contraceptive pills or the morning after pill.

Will it affect my fertility?

Simvastatin doesn't reduce fertility in men or women.

What will happen when I come off simvastatin?

The benefits of simvastatin will only continue for as long as you take it. If you stop taking simvastatin without starting a different cholesterol-lowering treatment, your cholesterol level may rise again.

Talk to your doctor if you want to stop taking the medicine. It's important to find another way to lower your cholesterol. Lowering the dose of simvastatin may be an option too.

Can lifestyle changes help?

Reducing your cholesterol may mean you don't need to be prescribed a statin medicine. There are lifestyle changes you can make that will help lower your cholesterol:

lose excess weight
eat a healthy diet - by decreasing saturated fat and increasing fibre, fruits, vegetables, wholegrains and fish
stop smoking
cut down on alcohol
exercise every day

As part of a healthy diet, it can also help to include foods fortified with plant sterols and stanols, which are proven to help lower cholesterol. You can buy fortified spreads, cheese, cereals, granola bars, orange juice, wholemeal bread and yoghurt-style drinks from most supermarkets.