Simvastatin

Simvastatin
Simvastatin.svg
Simvastatin3Dan.gif
Clinical data
Pronunciationn/
Trade namesZocor, other
AHFS/Drugs.comMonograph
MedlinePlusa692030
License data
Pregnancy
category
  • AU: D
  • US: X (Contraindicated)
Routes of
administration
by mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability5%
Protein binding95%
MetabolismHepatic (CYP3A4)
half-life2 hours for simvastatin and 1.9 hours for simvastatin acid
ExcretionRenal 13%, faecal 60%
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard100.115.749 Edit this at Wikidata
Chemical and physical data
FormulaC25H38O5
Molar mass418.566 g/mol
3D model (JSmol)
  (verify)

Simvastatin, marketed under the trade name Zocor among others, is a lipid-lowering medication.[1] It is used along with exercise, diet, and weight loss to decrease elevated lipid (fat) levels.[1] It is also used to decrease the risk of heart problems in those at high risk.[1] It is taken by mouth.[1]

Serious side effects may include muscle breakdown, liver problems, and increased blood sugar levels.[1] Common side effects include constipation, headaches, and nausea.[1] A lower dose may be needed in people with kidney problems.[1] There is evidence of harm to unborn babies when taken during pregnancy[1][2] and it should not be used by those who are breastfeeding.[1] It is in the statin class of medications and works by decreasing the manufacture of cholesterol by the liver.[1]

Simvastatin was developed by Merck and came into medical use in 1992.[3] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[4] It is available as a generic medication.[1] The wholesale cost in the developing world is US$0.01 to 0.12 per day as of 2014.[5] In the United States it costs between US$0.50 and 1.00 per day.[1] Simvastatin is made from the fungus Aspergillus terreus.[3]

Medical uses

The primary uses of simvastatin are to treat dyslipidemia and to prevent atherosclerosis-related complications such as stroke and heart attacks in those who are at high risk.[1] It is recommended to be used as an addition to a low-cholesterol diet.[1]

In the Scandinavian Simvastatin Survival Study (a placebo-controlled, randomized clinical trial of five years' duration), simvastatin reduced overall mortality in people with existing cardiovascular disease and high LDL cholesterol by 30% and reduced cardiovascular mortality by 42%. The risks of heart attack, stroke, or needing a coronary revascularization procedure were reduced by 37%, 28%, and 37%, respectively.[6]

The Heart Protection Study evaluated the effects of simvastatin in people with risk factors including existing cardiovascular disease, diabetes, or stroke, but having relatively low LDL cholesterol. In this trial, which lasted 5.4 years, overall mortality was reduced by 13% and cardiovascular mortality was reduced by 18%. People receiving simvastatin experienced 38% fewer nonfatal heart attacks and 25% fewer strokes.[7]

Simvastatin has been used to explore whether statins have an effect on delaying on the onset and progression of age-related macular degeneration (AMD).[8] Results from one trial showed participants assigned to simvastatin had lower odds (0.51 OR) of having AMD progression at three years compared to those assigned to placebo, though the results were not significant.[9] Overall, evidence is insufficient to conclude that simvastatin has an effect in delaying the onset and progression of AMD.[8]

Other Languages
العربية: سيمفاستاتين
català: Simvastatina
Cymraeg: Simfastatin
Deutsch: Simvastatin
español: Simvastatina
français: Simvastatine
hrvatski: Simvastatin
Bahasa Indonesia: Simvastatin
italiano: Simvastatina
עברית: סימבסטטין
македонски: Симвастатин
Nederlands: Simvastatine
polski: Simwastatyna
português: Sinvastatina
русский: Симвастатин
српски / srpski: Simvastatin
srpskohrvatski / српскохрватски: Simvastatin
svenska: Simvastatin
українська: Симвастатин
中文: 辛伐他汀