Why is this Simvastatin prescribed?

Simvastatin is a cholesterol-lowering drug. Your doctor may prescribe Simvastatin in addition to a cholesterol-lowering diet if your blood cholesterol level is too high, and if you have been unable to lower it by diet alone. For people at high risk of heart disease, current guidelines call for considering drug therapy when LDL levels reach 130. For people at lower risk, the cut-off is 160. For those at little or no risk, it's 190.

In people with high cholesterol and heart disease, Simvastatin reduces the risk of heart attack, stroke and "mini-stroke" (transient ischemic attack) and can stave off the need for bypass surgery or angioplasty to clear clogged arteries

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Simvastatin is usually prescribed only if diet, exercise, and weight-loss fail to bring your cholesterol level under control. It's important to remember that Simvastatin is a supplement to--not a substitute for--those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because together they may lower your risk of heart disease.

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Do not take Simvastatin if you have ever had an allergic reaction to it or are sensitive to it. Do not take Simvastatin if you have active liver disease.

Do not take Simvastatin if you are pregnant or plan to become pregnant.

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Simvastatin tends to enhance the effects of the blood-thinning drug Coumadin and the heart medication Lanoxin. Combining it with the following drugs increases the chance of muscle damage:

Amiodarone (Cordarone)
Clarithromycin (Biaxin)
Clofibrate (Atromid-S)
Cyclosporine (Sandimmune, Neoral)
Erythromycin (PCE and others)
Fenofibrate (Tricor)
Gemfibrozil (Lopid)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Nefazodone (Serzone)
Nicotinic acid or niacin (Niaspan)
Protease inhibitors (used in the treatment of HIV), including Agenerase, Crixivan, Fortovase, Invirase, Norvir, and Viracept
Verapamil (Calan)

If you are taking Simvastatin with any of these drugs (or with large quantities of grapefruit juice) alert your doctor immediately at the first sign of muscle pain or weakness. If you need to take erythromycin, Biaxin, Nizoral, or Sporanox, the doctor may temporarily take you off Simvastatin.

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You will have to follow a standard cholesterol-lowering diet before starting treatment with Simvastatin and continue this diet while using Simvastatin. All doses should be adjusted to your individual needs.

ADULTS The usual starting dose is 20 milligrams once a day in the evening. If your cholesterol is especially high, the doctor may start with a dose of 40 milligrams. The dosage can be adjusted every 4 weeks. Some people with severe, hereditary high cholesterol may be prescribed as much as 80 milligrams a day, taken in doses of 20, 20, and 40 milligrams, along with other treatments.

Those who have severe kidney disease should use Simvastatin with caution. The recommended starting dose is 5 milligrams per day. When combined with cyclosporine, niacin, Atromid-S, Lopid, or Tricor, the dosage of Simvastatin should not exceed 10 milligrams a day. When combined with Calan or Cordarone, the dosage of Simvastatin should not exceed 20 milligrams a day.

CHILDREN 10 TO 17 YEARS OLD The recommended starting dose is 10 milligrams once a day in the evening. The dosage may be increased every 4 weeks, as determined by the doctor, up to a maximum of 40 milligrams a day. Girls must have been menstruating for at least 1 year before starting therapy with Simvastatin.

The safety and effectiveness of Simvastatin in children under 10 years old or in doses greater than 40 milligrams a day have not been studied

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Although no specific information about Simvastatin overdose is available, any medication taken in excess can have serious consequences. If you suspect an overdose of Simvastatin, seek medical attention immediately.

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