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Simvatin
Last reviewed: 04.07.2025

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Simvatin is a hypolipidemic drug that reduces serum triglyceride and cholesterol levels.
The drug reduces the likelihood of developing major vascular complications and the need for revascularization in the area of non-coronary and peripheral vessels. It also reduces the risk of developing major coronary disorders and the need for coronary revascularization (PTCA and CABG procedures), and reduces the likelihood of stroke. In addition, the drug reduces overall mortality, reducing mortality associated with coronary heart disease, and reduces the number of hospitalizations due to angina. [ 1 ]
The drug reduces the LDL-C/HDL-C ratio and the total cholesterol/HDL-C ratio. [ 2 ]
Indications Simvatin
It is used in people with a high risk of developing coronary heart disease (with or without hyperlipidemia) - for example, in diabetics, people with a history of stroke or other cerebrovascular diseases, as well as in patients with peripheral vascular disease or coronary heart disease.
It is prescribed as a dietary supplement to reduce elevated total cholesterol, triglycerides, LDL-C and apo B, and in addition to increase HDL-C levels in people with primary hypercholesterolemia (familial heterozygous hypercholesterolemia or mixed hypercholesterolemia) - in situations where diet alone and other non-drug therapies are ineffective.
The medication is used for hypertriglyceridemia and primary dysbetalipoproteinemia.
In addition, it can be used as a supplement to diet and other treatment methods in individuals with the familial form of homozygous hypercholesterolemia to reduce elevated levels of total cholesterol, LDL-C, and apolipoprotein B.
Release form
The drug is released in tablets - 10 pieces inside a blister pack. There are 3 such packs in a pack.
Pharmacodynamics
Simvastatin is a cholesterol-lowering drug that inhibits the action of HMG-CoA reductase (an enzyme involved in intrahepatic cholesterol binding).
The drug reduces the values of total intrahepatic cholesterol, plasma triglycerides and LDL-C. At the same time, the level of VLDL-C also decreases, and the HDL-C indicator moderately increases. [ 3 ]
In addition, the drug improves the activity of the vascular endothelium, has antioxidant properties and suppresses cell migration and proliferation during atherosclerotic processes.
Pharmacokinetics
Being an inactive lactone, simvastatin is absorbed quite well in the gastrointestinal tract and is transformed into its active medicinal form.
During the first intrahepatic passage, over 79% of the absorbed substance is retained inside the liver and undergoes metabolic processes.
Excretion occurs mainly through feces and bile.
The medicinal effect develops over a period of 14 days, reaching its maximum effect after 1-2 months from the start of treatment.
Dosing and administration
The daily dose of the drug is within 10-80 mg; the medicine is taken in the evening, once a day. When selecting the dosage, it can be adjusted at intervals of at least 1 month. Changes are made until the maximum daily dose is reached - 80 mg.
Use in individuals with coronary heart disease or a high risk of developing this disease.
The standard initial dosage for this group of patients is 40 mg, taken once a day (in the evening). Treatment with medications can be started simultaneously with physical therapy and diet.
People with hypercholesterolemia who are not in the risk groups described above.
Before starting therapy, a standard hypocholesterol diet is carried out, which is also followed throughout the entire treatment cycle.
The initial daily dose is often 20 mg, taken once in the evening. For individuals who require a significant (over 45%) reduction in LDL levels, an initial dose of 40 mg may be prescribed.
In people with mild or moderate hypercholesterolemia, Simvatin is used in an initial dosage of 10 mg. The dosage is adjusted, if necessary, according to the scheme described above.
Individuals with the familial form of homozygous hypercholesterolemia.
Based on the data from controlled clinical trials, patients with this type of disease should use daily doses of 40 mg (1x evening dose) or 80 mg (divided into 3 doses - 20 mg in the morning and afternoon, and 40 mg in the evening).
In these patients, the drug is used as an adjunct to another therapy regimen that lowers cholesterol levels (for example, LDL plasmapheresis), or without other therapy when it is not available.
Combined schemes.
Simvatin is effective both in monotherapy and in combination with bile acid sequestrants.
People taking cyclosporine or gemfibrozil with other fibrates, or lipid-lowering doses (≥1 g per day) of niacin together with the drug should not take more than 10 mg of the drug per day.
For individuals using verapamil or amiodarone, the daily dose should be a maximum of 20 mg.
- Application for children
There is no information regarding the therapeutic effect and safety of the drug when used in children, which is why it is not prescribed in pediatrics.
Use Simvatin during pregnancy
Simvatin should not be used during breastfeeding or pregnancy.
Contraindications
Among the contraindications:
- severe intolerance to any of the components of the medication;
- active phase of liver disease;
- an increase in serum transaminase levels that develops for an unknown reason.
Side effects Simvatin
Often the medication is tolerated without complications, but sometimes side effects appear:
- epidermal and allergic disorders: itching, epidermal rash and alopecia;
- problems with digestive function: nausea, dyspepsia, bloating, constipation, vomiting, diarrhea, abdominal pain and pancreatitis. Jaundice or hepatitis occasionally develops;
- disorders of the nervous system: paresthesia, headaches, polyneuropathy, dizziness, asthenia and convulsions;
- signs associated with the activity of the musculoskeletal system: myalgia. Rarely, rhabdomyolysis or myopathy is observed;
- blood system disorders: anemia;
- Others: Vasculitis, arthralgia, rheumatic polymyalgia and arthritis occasionally occur, in addition to urticaria, fever, photophobia, Quincke's edema, facial flushes and lupus-like syndrome. In addition, malaise, dyspnea, eosinophilia, thrombocytopenia and increased ESR levels occasionally develop.
Overdose
Several cases of poisoning with simvastatin substances have been reported (with the maximum dose used being 0.45 g), but no specific complications or signs were observed in patients.
Overdose requires symptomatic measures.
Interactions with other drugs
Simvastatin metabolism processes are realized with the participation of CYP3A4, but it does not have a suppressive effect on this enzyme. In this regard, the introduction of drugs does not change the plasma values of drugs whose metabolism processes occur under the influence of CYP3A4. Agents that strongly inhibit CYP3A4 activity increase the likelihood of myopathy, since they slow down the elimination of simvastatin. Among such agents are ketoconazole with itraconazole, cyclosporine, substances inhibiting HIV protease, clarithromycin with erythromycin and nefazodone.
Use with ritonavir may increase serum simvastatin levels.
The risk of myopathy increases with the use of lipid-lowering drugs that are not potent inhibitors of CYP3A4 but can provoke myopathy when used alone. These include gemfibrozil with other fibrates and lipid-lowering doses of niacin (>1 g per day).
Verapamil and amiodarone may also increase the likelihood of myopathy; other Ca channel blockers do not have this effect.
Grapefruit juice contains 1 or more elements that inhibit the action of CYP3A4 and can increase the plasma level of drugs that are metabolized with the participation of this substance. When consuming juice in small doses (1 glass of 0.25 l per day), it leads to a minimal effect (an increase in the activity of HMG-CoA reductase by 13%), which has no clinical significance. But when consuming it in large portions (over 1 l per day), the intraplasmic activity of agents that inhibit HMG-CoA reductase increases significantly. Because of this, when using simvastatin, you should avoid drinking large volumes of grapefruit juice.
In people using coumarin anticoagulants, the PT value should be determined before starting therapy and regularly monitored during the initial phase of treatment to ensure that new PT values do not significantly deviate. Once this value has stabilized, new PT values are checked at the frequency usually prescribed during therapy with coumarin anticoagulants.
The above procedure is repeated if Simvatin is discontinued or its dosage is adjusted.
Storage conditions
Simvatin should be kept in a place closed to children. Temperature level – maximum 30ºС.
Shelf life
Simvatin is used within a 3-year period from the date of manufacture of the medicinal substance.
Analogues
Analogues of the drug are the medications Vasostat, Simvastatin with Vasilip, Zocor and Allesta.
Attention!
To simplify the perception of information, this instruction for use of the drug "Simvatin" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.