Simvastatin is a Medicine belongs to Cardiovascular drugs group whose information about Brand can be referenced from   Book : Martindale    Page : 1496   Edition : 38  

  ►   Brandname : Zocor, Simcard, Simchol, Simlo, Simvotin, Sivastin
  ►  Strength : Tablet with 5 mg.  Tablet with 10 mg.  Tablet with 20 mg.  Tablet with 40 mg.  Tablet with 80 mg. 

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 633   Edition : 12  
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Oral
Reference :-   Book : Martindale    Page : 1489   Edition : 38  

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Cardiovascular risk reduction Oral 20 40 mg Tablet o.d. In the evening.
2 Hyperlipidaemia Oral 10 20 mg Tablet In the evening.
3 Patients with homozygous familial hypercholesterolaemia Oral 40 mg Tablet o.d. In the evening, up to a maximum of 80mg once daily in the evening.

Ref :-  Book : Martindale    Page : 1489   Edition : 38  



Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Familial homozygous hypercholesterolaemia 10 Year 17 Year Oral 10 mg Tablet h.s.
2 Hyperlipidaemia 5 Year 10 Year Oral 10 mg Tablet h.s.
3 Hyperlipidaemia 10 Year 18 Year Oral 10 mg Tablet h.s.

Ref :- Book : Martindale    Page : 1490   Edition : 38  
►  Side Effect : Gastrointestinal disturbance, Headache, Rashes, Dizziness, Insomnia, Hyperglycaemia, Diabetes mellitus, Peripheral neuropathy, Depression, Sexual dysfunction, Reversible cognitive impairment, Intestinal lung disease, Alopecia, Hypersensitivity reactions, Anaphylaxis, Angioedema, Urticaria, Photosensitivity reactions, Fever, Flushing, Dyspnoea, Thrombocytopenia, Toxic epidermal necrolysis, Dermatomyositis, Lupus-like syndrome, Hepatitis, Hepatic failure, Pancreatitis, Myalgia, Muscle weakness, Myopathy
Ref :-   Book : Martindale    Page : 1492   Edition : 38.  

►  Drug Interaction : Drug interaction of Simvastatin is with Fibrates, , HIV- protease inhibitors, , Coumarin Anticoagulant,  Gemfibrozil , Cyclosporine , Itraconazole , Ketoconazole , Erythromycin , Clarithromycin , Telithromycin, Nefazodone, Danazol, Amiodarone , Verapamil
Ref :-   Book : Martindale    Page : 1494   Edition : 38.  


  ►    Mechanism of Drug Drug Interaction :  Drugs that can cause myopathy when given alone increase the risk of myopathy with all statins; these drugs include fibric acid derivatives (fibrates or gemfibrozil), and nicotinic acid. The risk of myopathy is also increased by drugs that increase the plasma concentrations of statins, by inhibiting their metabolism or by inhibiting their uptake into the liver. Since the statins have different metabolic pathways, these interactions depend on the individual drug concerned. Simvastatin is metabolised by the cytochrome P450 isoenzyme CYP3A4, as are atorvastatin and lovastatin, and interactions may occur with drugs that inhibit this enzyme, including ciclosporin, itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV-protease inhibitors, nefazodone, danazol, amiodarone, and verapamil; there may also be a similar interaction with grapefruit juice. Such combinations should be used with caution, if at all, and dose reduction may be advised UK licensed product information contra-indicates the use of simvastatin in patients receiving potent CYP3A4 inhibitors. Fluvastatin is metabolized mainly by CYP2C9, while pravastatin and rosuvastatin are not significantly metabolised; interactions interactions specific to these statins are discussed on and, respectively. Statins may also have effects on other drugs. Bleeding and increases in prothrombin time have been reported in patients taking simvastatin or other statins with coumarin anticoagulants.
Ref :-   Book : Martindale    Page : 1494   Edition : 38.  


►  Contraindication : Pregnancy, Patients with active liver disease, Patients who already have unexplained persistently raised serum-aminotransferase concentrations., Should be stopped if marked or persistent increases in serum-aminotransferase concentrations., Used with caution in patients at risk of rhabdomyolysis, Should be stopped if creatine phosphokinase increases significantly or if myopathy is diagnosed., With renal impairment as the risk of myopathy
Ref :-   Book : Martindale    Page : 1494   Edition : 38.  
  ►  Mechanism of Action :   Simvastatin is a lipid regulating drug; it is a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase), the ratedetermining enzyme for cholesterol synthesis. Inhibition of HMG-CoA reductase leads to reduced cholesterol synthesis in the liver and lower intracellular cholesterol concentrations; this stimulates an increase in low-density-lipoprotein (LDL)-cholesterol receptors on hepatocyte membranes, thereby increasing the clearance of LDL from the circulation. HMG-CoA reductase inhibitors (also called statins) reduce total cholesterol, LDL-cholesterol, and very-low-density lipoprotein (VLDL)-cholesterol concentrations in plasma. They also tend to reduce triglycerides and to increase high-density lipoprotein (HDL)-cholesterol concentrations
Ref :-   Book : Martindale    Page : 1489   Edition : 38.  

Pathway of DIETARY Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- Garlic with same pathway.   Angeer with Another pathway.  

  ►  Pathway with its reference as follows :-
  • Hypolipidemic effect. --- (Joseph, Baby. "Pharmacognostic And Phytochemical Properties Of Ficus Carica Linn –An Overview". International Journal of PharmTech Research 3.1 (2017): 08-12,. Print. )
  • HMGCoA reductase inhibitor --- (Siddiqui,, 1. (2014). EFFECTS OF HMG-COA REDUCTASE INHIBITORS (SIMVASTATIN AND HERBAL FORMULATION OF ALLIUM SATIVUM) ON LIVER FUNCTION TEST IN PATIENTS WITH TYPE 2 DIABETES MELLITUS RELATED DYSLIPIDEMIA. WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES, 3(ISSN 2278 – 4357), 1791-1799. )

  •   ►  URL --
  • file:///C:/Users/Administrator/Downloads/article_wjpps_1413025339%20(3).pdf .
  • http://sphinxsai.com/Vol.3No.1/pharm_jan-mar11/pdf/JM11(%20PT=03)%2008-12.pdf .

  • DIETARY Substance Interactions


    ​   ► This Medicine interact with :- IRON with Dietary Substance is Drug Inhibitor.  

      ►  Reference :-
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand

  •   ►  URL -- https://books.google.co.in/books?id=WZhj8EO9N3sC&pg=PA49&lpg=PA49&dq=The+New+Age+of+nutritional+and+herbal+remedies.++book&source=bl&ots=UVld-vNZL0&sig=5KwkKUUvW45p0TkfVUCtMZxnbow&hl=en&sa=X&ved=0ahUKEwiajLCNocrOAhVMto8KHfD2D-4Q6AEIMDAE#v=onepage&q=The%20


    ContraIndication DIETARY Substance


    ​   ► This Medicine contraindicate with :- NIACIN with Taking large amount of niacin along with HMG-CoA reductase inhibitors may cause muscle disorders that can become serious ..   VITAMIN E with Improve blood vessel elasticity more than simvastatin alone ..   COQ10 with Impairs coenzyme Q10 metabolism ..  

      ►  Reference :-
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Michael, Z. (2007). Hand book of nutrition. New York: Thieme Stuttgart

  •   ►  URL -- http://www.lifestyle-clinic.net/wp-content/uploads/2013/07/A-Z_Guide.pdf
    http://197.14.51.10:81/pmb/AGROALIMENTAIRE/Handbook%20of%20Nutrition.pdf

    ►   Route of Elimination :   Biliary, Fecal, Hepatic (Metabolism)
    Ref :-   Book : Martindale    Page : 1496   Edition : 38.  

    ►    Plasma Half-life :   Min value :-   12 hours,    Max value :-   NA
    Ref :-   Book : Goodman    Page : 896   Edition : 12.  

    ►    Peak Plasma Concentration :   Min value :-   1,    Max value :-   4 hours.  
    Ref :-   Book : Goodman    Page : 896   Edition : 12.