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Simvastatin[1] or sinvastatin[1] is a drug of the statin family used to lower blood cholesterol levels. Its importance is great, given the significance of cholesterol as a cardiovascular risk factor.

Simvastatin is a white crystalline powder, which is practically insoluble in water and soluble in chloroform, methanol and ethanol. It is actually a lactone, and it is its β-hydroxylated metabolite (β-hydroxy acid of simvastatin or acid simvastatin) that exhibits pharmacological activity.

Both simvastatin and its β-hydroxyacid metabolite bind intensely to plasma proteins (approximately 95%). It crosses the blood-brain barrier, as well as the placental barrier, and it is not known whether it appears in the milk of nursing mothers taking the drug.

Simvastatin undergoes an intense hepatic first-pass effect, so bioavailability is low (<5%). The major active metabolites of simvastatin present in human plasma are the β-hydroxy acid of simvastatin and its 6′-hydroxy, 6′-hydroxymethyl, and 6′-exomethylene derivatives.

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Take the missed dose as soon as you remember it. However, if it is near the time of your next dose, skip the missed dose and continue taking your regular dose. Do not double the dose to make up for a missed dose.What side effects may I notice from this medicine?

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In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, has had a seizure, has difficulty breathing, or cannot be awakened, call emergency services immediately at 911.What other important information should I know?

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Take the missed dose as soon as you remember it. However, if it is near the time of your next dose, skip the missed dose and continue taking your normal dose. Do not double the dose to make up for a missed dose.What side effects may I notice from this medicine?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, has had a seizure, has difficulty breathing, or cannot be awakened, call emergency services immediately at 911.What other important information should I know?

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