Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Simvastatin is a cholesterol-lowering drug.
It belongs to a class of drugs called HMG-CoA reductase inhibitors, commonly
called "statins." Other statins include lovastatin (Mevacor), atorvastatin
(Lipitor), fluvastatin (Lescol), and rosuvastatin (Crestor). Statins
reduce cholesterol by inhibiting an enzyme in the liver (HMG-CoA reductase) that is
necessary for the production of cholesterol. In the blood, statins lower total
and LDL ("bad") cholesterol as well as
triglycerides. LDL cholesterol is
believed to be an important cause of coronary artery disease. Lowering LDL
cholesterol levels slows and may even reverse
coronary artery disease. Statins
also increase HDL ("good") cholesterol. Raising HDL cholesterol levels, like
lowering LDL cholesterol may slow coronary artery disease. The FDA approved
simvastatin in December 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
Tablets: 5, 10, 20, 40, and 80 mg.
Oral disintegrating tablets: 10, 20, 40, and 80 mg.
STORAGE:
Tablets should be stored between 5-30 C (41-86 F).
Oral
disintegrating tablets should be stored between 20-25 C (68-77 F).
PRESCRIBED FOR: Simvastatin is used for reducing total cholesterol,
LDL cholesterol, and triglycerides, and for increasing HDL cholesterol. In
patients with coronary heart disease, diabetes,
peripheral vessel disease, or
history of stroke or other cerebrovascular disease,
simvastatin is prescribed
for reducing the risk of mortality by reducing death from coronary heart
disease, reducing nonfatal myocardial infarction (heart attack) and stroke, and
reducing the need for coronary and noncoronary revascularization procedures.
DOSING: The dose range for is 5-80 mg/day given preferably in the
evening. The usual staring dose is 20-40 mg once daily. Dose adjustments are
made at weekly intervals.
DRUG INTERACTIONS: Decreased elimination of simvastatin could increase
the levels of simvastatin in the body and increase the risk of muscle toxicity
from simvastatin. Examples of drugs that decrease elimination of simvastatin
include erythromycin (E-Mycin), ketoconazole (Nizoral), itraconazole (Sporanox),
clarithromycin (Biaxin), telithromycin (Ketek), cyclosporine (Sandimmune),
nefazodone (Serzone), and HIV protease inhibitors such as indinavir (Crixivan)
and ritonavir (Norvir). Large quantities of grape fruit juice (>1 quart daily)
also will increase blood levels of simvastatin.
Amiodarone (Cordarone), verapamil (Calan Verelan, Isoptin),
danazol (Danocrine),
cyclosporine, niacin (Niacor, Niaspan, Slo-Niacin), gemfibrozil (Lopid) and
fenofibrate (Tricor) also may increase the risk of muscle toxicity when combined
with simvastatin. Patients taking amiodarone or verapamil should not take more
than 20 mg of simvastatin. Patients taking danazol or cyclosporine should not
take more than 10 mg of simvastatin.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Cholesterol is the most common type of steroid in the body. The treatment of elevated cholesterol involves not only diet but also weight loss, regular exercise, and medications. By understanding your cholesterol profile you can better manage your cholesterol levels.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay inlcudes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Coronary atherosclerosis is the hardening and narrowing of
the arteries that supply blood to the heart muscle. Coronary atherosclerosis is
the major cause of heart attacks. Heart
attacks
are the major cause of sudden unexpected death
among otherwise healthy adults in the prime of their lives. Heart attacks are
also a significant cause of heart failure (due to weakened heart muscle) in this
country. Heart failure considerably decreases a person's longevity and quality
of life. In dollar terms, coronary heart disease is costly. The total cost of
coronary artery bypass surgery, coronary
angioplasty and stenting, medications,
and hospitalizations exceeds 50 billion dollars annually.
Coronary atherosclerosis, and hence heart attacks, are preventable. A person
can significantly lower his or her risk of heart attack by lowering
high blood
pressure, controlling diabetes, stopping
cigarett...
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