Simvastatin
Cardiovascular
Older but still widely-prescribed statin, taken in the evening.
Generic name: Simvastatin
Brand names: Zocor, Simvor, Simvastatin Stada
Prescription required
Dosage
Adults: 10–40 mg once daily in the evening. Maximum 40 mg/day routinely; 80 mg reserved for long-term users.
Side effects
Myalgia, raised liver enzymes. Increased rhabdomyolysis risk at 80 mg.
Contraindications
Active liver disease, pregnancy, concomitant itraconazole / ketoconazole / clarithromycin / HIV protease inhibitors / cyclosporine / gemfibrozil.
Description
Simvastatin lowers LDL-C and is dosed in the evening because endogenous cholesterol synthesis peaks at night. Bigger drug-interaction footprint than atorvastatin, particularly with CYP3A4 inhibitors.