Simvastatin
- Class: Statin
- Used for: high cholesterol
- Say it: SIM-vuh-stat-in
- Forms: tablet
Mnemonic: SIMvastatin is the interaction-prone one
Same mechanism as atorvastatin, but heavily dependent on CYP3A4 for clearance. Its dose has to be capped alongside common drugs like amlodipine and diltiazem.
Same mechanism as atorvastatin, but heavily dependent on CYP3A4 for clearance. Its dose has to be capped alongside common drugs like amlodipine and diltiazem.
Suffix -STATIN: Every -STATIN brings cholesterol production to a STANDSTILL.
The stem is the whole message: -statin means HMG-CoA reductase is blocked, so the liver makes less cholesterol and pulls LDL out of the blood to make up the difference. Learn the suffix once and every member here is the same mechanism at a different strength. All drug suffixes ›
The stem is the whole message: -statin means HMG-CoA reductase is blocked, so the liver makes less cholesterol and pulls LDL out of the blood to make up the difference. Learn the suffix once and every member here is the same mechanism at a different strength. All drug suffixes ›
Side effects
Common: muscle aches, constipation, raised liver enzymes
Serious: rhabdomyolysis
Typical dose
10–40 mg once daily at night
80 mg is no longer recommended because of myopathy. Maximum 20 mg alongside amlodipine.
Check yourself
Why is simvastatin taken in the evening while atorvastatin can be taken at any time?
- Simvastatin is short-acting, and cholesterol synthesis peaks overnight
- It causes insomnia if taken in the morning
- It has to be taken with the evening meal to be absorbed
- Morning doses cause muscle pain
Show answer
A. Simvastatin is short-acting, and cholesterol synthesis peaks overnight
Matching a short-acting drug to the body's own production rhythm gets more out of the same dose. Atorvastatin's long half-life covers the overnight peak whenever it is swallowed.
See it, don't memorize it
The app has the mechanism comic and a patient case for Simvastatin – plus the name link, the class mnemonic, pronunciation you can hear, and a self-check, for the top 100 drugs. One purchase, no subscription, no account.