Simvastatin belongs to the group of medications known as HMG CoA reductase inhibitors ("statins"). It is used in addition to diet and exercise to lower cholesterol levels.

It is also used to decrease the risk of Heart Attack, Stroke, or death regardless of whether cholesterol levels are high or not for people who have coronary heart disease (CHD) or have other arteries in the body that are blocked, or for those who have Diabetes and are over the age of 40.  It is also used to treat people who have certain inherited cholesterol disorders.

Simvastatin works by blocking an enzyme that helps create cholesterol in the body. As a result, less cholesterol is made and levels of cholesterol in the blood decrease. Simvastatin lowers the level of total cholesterol and low density lipoprotein (LDL, or "bad" cholesterol) and raises high density lipoprotein (HDL, or "good" cholesterol) levels.

The medication usually takes about 2 to 4 weeks to have a significant effect on the cholesterol level in your blood. After this time, your doctor will likely send you for a blood test to check for changes in your cholesterol levels.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of Phl Simvastatin may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Phl Simvastatin may not be used for all of the conditions discussed here.

Your doctor may have suggested Phl Simvastatin for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking Phl Simvastatin, speak to your doctor. Do not stop taking Phl Simvastatin without consulting your doctor.

Do not give Phl Simvastatin to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Phl Simvastatin if their doctor has not prescribed it.

Before or when starting simvastatin, you should be placed on a cholesterol-lowering diet. If appropriate, a health care professional will discuss an individualized program of weight control and physical exercise with you.

The starting dose of Phl Simvastatin depends on your medical conditions and other medications you are taking, and can range from 5 mg to 40 mg taken once daily in the evening. The maximum recommended daily dose is 80 mg, which may be used for some people who have been taking this amount for a long time with no muscle problems or people at high risk of heart disease who have problems taking other "statins." The maximum daily dose may be lower for people taking certain medications.

The maximum dose for children and adolescents 10 to 17 years of age with inherited cholesterol disorders is 40 mg.

For best results in lowering your cholesterol, it is very important that you closely follow the diet suggested by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Phl Simvastatin exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Phl Simvastatin at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Phl Simvastatin. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking Phl Simvastatin. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• Constipation
• Diarrhea
• difficulty getting/maintaining an erection (men)
• gas
• headache
• nausea
• nightmares
• skin rash
• trouble sleeping
• upset stomach

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• breathing problems (e.g., shortness of breath, persistent cough)
• confusion
• memory loss
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
• symptoms of muscle damage (e.g., unexplained muscle pain, tenderness, or weakness, or brown or discoloured urine – especially if you also have a Fever or a general feeling of being unwell)

Stop taking the medication and seek medical attention immediately if any of the following occur:

• severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
• symptoms of a serious allergic reaction (e.g., swelling of the face or throat, Hives, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Phl Simvastatin.

5 mg
Each buff, shield-shaped, coated tablet debossed with "5" on one side and "SV" logo on the other side, contains 5 mg simvastatin. Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid, hypromellose, iron oxide yellow, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, pregelatinised starch, titanium dioxide, and triacetin.

10 mg
Each pink, shield-shaped, coated tablet debossed with "10" on one side and "SV" logo on the other side, contains 10 mg simvastatin. Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid, hypromellose, iron oxide red, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, pregelatinised starch, titanium dioxide, and triacetin.

20 mg
Each tan, shield-shaped, coated tablet debossed with "20" on one side and "SV" logo on the other side, contains 20 mg simvastatin. Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid, hypromellose, iron oxide red, iron oxide yellow, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, pregelatinised starch, titanium dioxide, and triacetin.

40 mg
Each pink, shield-shaped, coated tablet debossed with "40" on one side and "SV" logo on the other side, contains 40 mg simvastatin. Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid, FD&C Blue No. 2 Lake, FD&C Red No. 40 Lake, FD&C Yellow No. 6 Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, pregelatinised starch, titanium dioxide, and triacetin.

80 mg
Each pink, capsule-shaped, coated tablet debossed with "80" on one side and "SV" logo on the other side, contains 80 mg simvastatin. Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid, FD&C Blue No. 2 Lake, FD&C Red No. 40 Lake, FD&C Yellow No. 6 Lake, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, polydextrose, polyethylene glycol, pregelatinised starch, titanium dioxide, and triacetin.

Do not take simvastatin if you:

• are allergic to simvastatin or any ingredients of the medication
• are breast-feeding
• are pregnant or plan to become pregnant
• have active liver disease or unexplained increases in liver function tests
• are taking certain other medications, such as:
• "azole" antifungal medications (e.g., fluconazole, ketoconazole)
• protease inhibitors (e.g., boceprevir, ritonavir, telaprevir)
• macrolide antibiotics (e.g., erythromycin, clarithromycin)
• medications containing Cobicistat
• nefazodone
• Gemfibrozil
• Cyclosporine
• Danazol

There may be an interaction between simvastatin and any of the following:

• Amiodarone
• Amlodipine
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• Aprepitant
• asunaprevir
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• Bicalutamide
• Bezafibrate 
• Bosentan
• calcium channel blockers (e.g., amlodipine, Diltiazem, Nifedipine, Verapamil)
• Carbamazepine
• cobicistat
• Colchicine
• conivaptan
• Crizotinib
• cyclosporine
• Cyproterone 
• dabigatran
• Dabrafenib
• daclatasvir
• danazol
• Dasatinib
• Deferasirox
• Dronedarone
• elbasvir
• Eltrombopag
• Enzalutamide
• fenofibrate
• gemfibrozil
• grapefruit juice
• grazoprevir
• Haloperidol
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone 
• Mitotane
• Metronidazole
• Modafinil
• nefazodone
• niacin (nicotinic acid)
• niacinamide
• Phenobarbital
• Phenytoin
• primidone
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• quinine
• red yeast rice
• rifabutin
• rifampin
• Risperidone
• St. John's wort
• Sertraline
• Sildenafil
• siltuximab
• simeprevir
• Sitagliptin
• Teriflunomide
• Ticagrelor
• Tocilizumab 
• trabectedin
• tyrosine kinase inhibitors (e.g., dasatinib, imatinib, Nilotinib, Sunitinib)
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Phl Simvastatin. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.