Simvastatin is one of the most commonly prescribed medications for cholesterol and in todays
video we are going to go over the most common side effects that can happen with this medication
as well as some less common ones that you need to be aware of before starting.
Hi everybody, I'm Dr. Erik Richardson a board certified Family Practice physician.
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Today we are going to be talking about one of the most common medications that we use
to treat high cholesterol called simvastatin.
This is a medication that has been available in the United States since 1992 and was originally
released under the name Zocor.
It belongs to the class of medications called HMG CoA reductase inhibitors or more commonly
referred to as Statins.
They work by inhibiting a part of an enzyme process which your body uses in the production
of cholesterol.
When you stop that process, you produce less cholesterol, so your levels go down.
That's a simplistic explanation but it is a lot more complicated than that.
Overall though, it is felt that Simvastatin and the statin medicatios in general work
on helping preventing and stabilizing plaques that can form.
If these plaques get large enough, they can either block the blood vessels or can become
weak and rupture causing an acute heart attack or stroke.
Your doctor has probably recommended that you take this medication because they felt
that because of either your health conditions such as a prior heart attack or stroke or
diabetes or because of the level of your cholesterol they felt that you needed some extra help
in decreasing this risk.
Taking cholesterol medication of course isn't the only thing that you should be doing to
decrease your risk.
The most important things, like making diet and lifestyle changes as well as stopping
smoking, we aren't going to get into in this video, but that doesn't lessen the importance
of working on making these changes.
No matter what we prescribe, if you aren't working on those changes you aren't going
to find the benefit that you are looking for.
So what do you need to know about this medication.
Well, first of all it comes in a tablet of 5, 10, 20, 40 and 80mg.
It is meant to be taken once a day with the top effective dose of 80mg.
Most cholesterol production happens at night so it seems to work better if you take it
in the evening.
An important thing to remember about this medication specifically, and cholesterol medications
in general, is that it only works while you are taking it.
I have people come in all the time with their cholesterol high after we originally had it
controlled telling me that they stopped the medicine because we fixed it.
Unfortunately, this isn't the way it works.
Unless you have some underlying lifestyle issues that are causing your high cholesterol
and you fix those, you need to stay on the medication.
Don't stop them unless you discuss it with your doctor.
Simvastatin is a great choice in cholesterol medications because most people do really
well with it without any significant side effects.
That being said, any medication has a potential for side effects and simvastatin is no different.
Just like any other medication that you take.
If you look at the package insert where they list the different side effects, you will
read a long list.
For simvastatin, they list symptoms such as upper respiratory infection, headaches, abdominal
pain, constipation, urinary tract infection, nausea, heartburn, insomnia and some mild
liver enzyme elevations.
I would say that these are fairly uncommon in general, but certainly possible.
In my experience, as well as what we have seen in the studies, the most common reason
that we see people not tolerate being on simvastatin is because of some type of muscle or joint
pain.
These can be a feeling of muscle aches, similar to what you may feel when you get sick with
the flu, muscle cramps or weakness.
This still is not common, but if there is something that is going to bother a patient,
this is the most common one that we see.
It doesn't necessarily mean that it is a significant issue or there is something dangerous going
on.
There is a condition where severe pain could point to something more concerning, but I'll
get to that in a minute.
Usually, all we do is have you stop the medication and the symptoms go away.
In some, who we really feel need to be on the medication, we will switch you to a different
one in the same class and usually they are able to do better.
There are some people though that just can't tolerate taking any of them so it's not worth
it for them to be on it.
If you are having these types of symptoms make sure you work with your doctor to find
out what is best for you.
Now, there are other rare side effects that you need to be aware of and watch out for
The first one is a condition that is called Rhabdomyolysis.
This is a condition where you get a breakdown of the muscles that sends byproducts to the
kidneys causing kidney damage or even failure.
This is very uncommon but If you have severe muscle pains while taking this medication,
then get into your doctor to get some blood work and have this evaluated.
Other more serious reactions can include liver toxicity, allergic reactions, pancreatitis,
changes to your blood counts including certain anemias and decreased white blood cell productions.
These aren't common but can be monitored by your doctor while you take this medication.
There are some conditions that we need to talk about that being on these medications
long term, can possibly put you at risk for.
There have been some concerns regarding use of statins and its effect on memory and dementia.
There have been reports of memory changes while being on this medication as well as
others in the same class.
Larger studies looking at this, haven't found a significant correlation between the two,
but it doesn't mean that it can't happen.
If you notice memory changes upon starting this medication, it would be worth talking
to your doctor about it.
Some have seen that this may be more common in medications fat bound medications like
atorvastatin and simvastatin.
Switching to one of the more water bound statins like rosuvastatin or pravastatin may be helpful.
This is definitely a discussion you should have with your doctor if you notice any issues.
Now it's important to understand though that this hasn't been found to cause actual dementia.
Studies looking at their effect on dementia, have actually shown some role in the prevention
of it happening.
Another area that needs to be discussed is the risk that statin's may play in the development
of diabetes.
Large studies looking at this have shown that there may be a small increased risk of developing
diabetes while taking these types of medications.
This risk appears to increase the higher the dose that you are taking.
The risk is small, but certainly something to keep in mind.
Overall though, when compared to the benefit that was found by taking it, for those felt
to be higher risk for heart disease, it is felt to be worth the risk.
This definitely is an individual decision that you need to discuss with your doctor
on how this may apply to you.
When you look at side effects and risks of medications, it's easy to get worried and
not want to take it due to the possibility of something that could happen.
And in actuality, this may be the right thing for you.
It's important though when making these decisions to step back and look at the big picture.
You have to look at your own individual risks and see why this may be important for you.
If you have already had a heart attack, a stroke or you have diabetes the data is very
clear that being on these medications, if you can tolerate them well, is definitely
worth the small risks of problems.
If you have not had any of these problems and your doctor is recommending you take this
for what we call primary prevention of heart disease, then talk to them about why they
think you are at higher risk.
Look at what your risk factors are and talk to your doctor about how you can change those
risk factors.
If you smoke, quit smoking, if you have a horrible diet and aren't exercising then make
the commitment to make those changes.
You can't say that you don't want to take a medication that has known benefits because
you think it's going to "kill you" and still continue to eat garbage, not exercise and
smoke.
Overall this is a great medication to treat your cholesterol and decrease your risk of
heart attack in stroke.
I use it a lot because as I said before, the side effects tend to be minimal, it has great
studies showing that it works, and finally it's pretty cheap.
Luckily its generic and you can get it for a good price.
In fact a 30 day supply will run you under $10 in most pharmacies.
If diet and lifestyle changes have not been enough to control your cholesterol and your
doctor recommends that you take simvastatin as part of your treatment regimen, hopefully
you have a little more confidence in using this as a part of your treatment plan.
Well, I hope found this information to be helpful.
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Now don't go anywhere, because if you are looking at ways that you can make that start
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Well, until next time, this is FamilyMed with Dr. Richardson, and remember, take care of
your body because it's the only one you have.