Page 1 of 9
Consumer Medicine Information
Simvastatin 10mg, 20mg, 40mg and 80mg Tablets
What is in this leaflet
This leaflet answers some common questions about SIMVACOR. It does not contain all the
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking
SIMVACOR against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may need to read it again.
What is SIMVACOR used for
SIMVACOR helps to lower cholesterol and triglyceride levels.
SIMVACOR is used in people who have coronary heart disease (CHD) or who are at high risk of
CHD (for example, if they have diabetes, a history of stroke or other blood vessel disease).
SIMVACOR may be used in these people, regardless of their cholesterol level to:
help prolong life by reducing the risk of a heart attack
reduce the risk of stroke
reduce the need for surgery to increase blood flow to the heart
reduce the need for hospitalisation due to angina
Everyone has cholesterol and triglycerides in their blood. They are types of blood fat needed by
the body for many things, including building cell walls, making bile acids (which help to digest
food) and certain hormones. However, too much cholesterol can be a problem.
Your body makes cholesterol, but it also comes from food. Normally the body balances the
cholesterol it makes with the cholesterol it gets from food. This means if more cholesterol
comes from food, less is made by the body. However, if you eat a diet high in fat, your body
may not keep this balance and your cholesterol levels rise.
High cholesterol is more likely to occur with certain diseases or if you have a family history of
high cholesterol. When you have high levels of cholesterol, it may 'stick' to the inside of your
blood vessels instead of being carried to the parts of the body where it is needed.
Page 2 of 9
Over time, this can form hard areas, called plaque, on the walls of blood vessels, making it
more difficult for the blood to flow. This blocking of your blood vessels can lead to coronary
heart disease (such as heart attack and angina) and stroke. In people with CHD, SIMVACOR
may slow down the hardening of blood vessels and reduce the risk of developing new plaques.
There are different types of cholesterol, called LDL and HDL cholesterol. LDL cholesterol is the
'bad' cholesterol that can block your blood vessels. HDL cholesterol, on the other hand, is the
'good' cholesterol that is thought to remove the bad cholesterol from the blood vessels.
Triglycerides are an energy source for the body. However, as with cholesterol, too much
triglycerides can be a problem.
How SIMVACOR works
SIMVACOR belongs to a group of medicines known as HMG–CoA reductase inhibitors. It
works by reducing the amount of cholesterol made by the liver. In terms of good and bad
cholesterol, SIMVACOR reduces the bad cholesterol and raises the good cholesterol.
SIMVACOR does not reduce the cholesterol and triglycerides that come from fat in food.
Therefore, when you are taking SIMVACOR, you also need to follow a low fat diet and
other measures, such as exercise and weight control.
In most people, there are no symptoms of high cholesterol or triglycerides. Your doctor can
measure your cholesterol and triglycerides with a simple blood test.
SIMVACOR is not recommended for use in children, as there have been no studies of its effects
Your doctor may have prescribed SIMVACOR for another reason. Ask your doctor if you have
any questions about why SIMVACOR has been prescribed for you.
SIMVACOR is not addictive.
Before you take SIMVACOR
When you must not take it
Do not take SIMVACOR if:
you have an allergy to SIMVACOR, other brands of simvastatin, or any of the
ingredients listed at the end of this leaflet. Symptoms of an allergic reaction may
include skin rash, itchiness, shortness of breath, swelling of the tongue or face, or painful
you are pregnant or breast-feeding. Your baby may absorb this medicine in the womb
or from breast milk and therefore there is a possibility of harm to the baby.
you have liver disease
you have had muscle pain, tenderness or weakness from other medicines used to
treat high cholesterol or triglycerides
the packaging is torn or shows signs of tampering
Page 3 of 9
the expiry date on the pack has passed. If you take this medicine after the expiry date
has passed, it may not work.
If you are not sure whether you should start taking SIMVACOR, talk to your doctor.
Before you start to take it
Tell your doctor if:
you intend to become pregnant or plan to breastfeed. SIMVACOR should not be
used during pregnancy or while breast-feeding.
you have ever had liver disease. Your doctor will do a blood test to make sure you
have no problems with your liver.
you have kidney disease or any other medical problems
you have severe respiratory failure
you drink alcohol regularly
you have any allergies to any other medicines or any other substances, such as
foods, preservatives or dyes.
If you have not told your doctor about any of the above, tell them before you take any
Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines that you buy
without a prescription from your pharmacy, supermarket or health food shop.
Some medicines should not be taken with SIMVACOR as they may increase the risk of muscle
side effects with SIMVACOR. These include:
nefazodone, used to treat depression
protease inhibitors, used to treat HIV infection (including indinavir, nelfinavir, ritonavir,
saquinavir) and Hep C infections
erythromycin, telithromycin, clarithromycin and fusidic acid antibiotics used to treat
ketoconazole, itraconazole, pasoconazole and variconazole used to treat certain fungal
If you are taking any of the above, your doctor may suggest stopping SIMVACOR temporarily or
Some medicines and SIMVACOR may interfere with each other. As taking SIMVACOR with any
of the following medicines can increase the risk of muscle problems (see Side Effects), it is
particularly important to tell your doctor if you are taking:
other medicines to lower cholesterol levels, for example, fibric acid derivatives (such as
gemfibrozil) or nicotinic acid (also known as niacin)
cyclosporin, used to suppress the immune system
Page 4 of 9
verapamil, diltiazem or amlodipine used to treat high blood pressure, angina or other
amiodarone, used to treat irregular heart beat
medicines for preventing blood clots, eg. warfarin
digoxin (a medicine used to control the rhythm of the heart)
It is also important to tell your doctor if you are taking anticoagulants (drugs that prevent blood
clots) such as warfarin, nicotinic acid (also known as niacin) or fenofribrate, another fibric acid
Also tell your doctor if you are taking niacin or a niacin containing product and you are Chinese.
These medicines may be affected by SIMVACOR, may affect how well it works or may increase
the risk of side effects with SIMVACOR. You may need different amounts of your medicine or
you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or avoid while
How to take SIMVACOR
How much to take
Take SIMVACOR only when prescribed by your doctor. Your doctor will tell you how many
tablets you need to take each day. This depends on your cholesterol and triglyceride levels and
other factors, such as kidney disease.
The recommended starting dose is 10mg or 20 mg per day, taken in the evening, which may
need to be increased up to 80 mg daily to have the best effect.
The 80mg dose is only for patients who have not reached their cholesterol goal on the 40mg
People with CHD or risk factors for CHD are usually started on 40 mg per day, taken in the
Swallow SIMVACOR with a glass of water.
Follow all directions given to you by your doctor and pharmacist carefully. They may
differ from the information contained in this leaflet.
If you do not understand the instructions, ask your doctor or pharmacist for help.
When to take it
Take SIMVACOR once a day in the evening.
The liver produces its greatest amount of cholesterol when the body is at rest and when there is
no dietary intake. For most people, this is at night when asleep. Therefore, SIMVACOR is more
Page 5 of 9
effective when taken in the evening. A good time would be after your evening meal. However, it
does not matter whether you take it before or after food.
Take SIMVACOR at about the same time each evening. Taking your tablet(s) at the same
time each evening will have the best effect. It will also help you remember when to take the
How long to take it
SIMVACOR helps lower your cholesterol. It does not cure your condition. Therefore, you must
continue to take it as directed by your doctor if you expect to lower your cholesterol and keep it
down. You may have to take cholesterol-lowering medicine for the rest of your life. If you stop
taking SIMVACOR, your cholesterol levels may rise again.
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when
you are meant to. Otherwise, take it as soon as you remember and then go back to taking your
tablet(s) as you would normally.
If you are not sure whether to skip the dose, talk to your doctor or pharmacist.
Do not take a double dose to make up for the dose that you missed.
If you have trouble remembering to take your tablets, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26) or
go to Accident and Emergency at your nearest hospital, if you think that you or anyone
else may have taken too much SIMVACOR. Do this even if there are no signs of
discomfort or poisoning.
While you are taking
Things you must do
If you become pregnant while you are taking SIMVACOR , stop taking it and contact your
Have your blood fats checked when your doctor says, to make sure SIMVACOR is
If you are about to be started on any new medicine, tell your doctor and pharmacist that
you are taking SIMVACOR.
If you are about to have elective surgery, tell your doctor that you are taking SIMVACOR.
Your doctor may suggest stopping the tablets a few days before surgery.
Things you must not do
Do not give SIMVACOR to anyone else, even if they have the same condition as you.
Page 6 of 9
Things to be careful of
Avoid drinking large quantities of alcohol. Drinking large quantities of alcohol may increase
your chance of SIMVACOR causing liver problems.
Avoid drinking large quantities of grapefruit juice. Grapefruit juice contains one or more
components that alter the metabolism of some medicines, including SIMVACOR. Therefore,
drinking very large quantities (over 1 litre) of grapefruit juice each day increases your chance of
SIMVACOR causing side effects. These include aching muscles, muscle tenderness or
weakness, not caused by exercise. However, one glass (250mL) of grapefruit juice each day
has not been shown to have any significant effect.
Be careful driving or operating machinery until you know how SIMVACOR affects you.
SIMVACOR generally does not cause any problems with your ability to drive a car or operate
machinery. However, as with many other medicines, SIMVACOR may cause dizziness in some
people. Make sure you know how you react to SIMVACOR before you drive a car or operate
Changes to lifestyle that may help reduce the chance of coronary heart disease
Lowering high cholesterol can help reduce your chances of having coronary heart disease
(CHD). However, your chances of having CHD may be increased by several other factors
including high blood pressure, cigarette smoking, diabetes, excess weight, family history of
CHD, being a male and being a woman who has reached menopause.
Some self help measures suggested below may help your condition and help reduce your
chances of having CHD. Talk to your doctor, pharmacist or dietician about these measures and
for more information.
Diet - continue the low fat diet recommended by your doctor, dietician or pharmacist.
Weight - your doctor may advise you to lose weight if you are overweight.
Exercise - make exercise a part of your routine - walking is good. Ask your doctor for
advice before starting exercise.
Smoking - your doctor may advise you to stop smoking or at least cut down.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are
taking SIMVACOR. SIMVACOR helps most people with high cholesterol but it may have
unwanted side effects in a few people.
All medicines can have side effects. Sometimes they are serious, most of the time they are not.
You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
constipation, diarrhoea, wind
stomach upset or pain, feeling sick (nausea)
Page 7 of 9
These are the more common side effects of SIMVACOR. For the most part, these have been
mild and short-lived.
Tell your doctor immediately if you notice any of the following:
aching muscles, muscle tenderness or weakness, not caused by exercise
brown/black coloured urine
On rare occasions, muscle problems can be serious, including muscle breakdown
resulting in kidney damage. The risk of muscle problems is greater for:
patients taking higher doses of SIMVACOR
older patients (65 years of age and older)
patients with abnormal kidney function
patients with thyroid problems.
Tell your doctor immediately if you notice any of the following:
tingling in the hands or feet
yellowing of the skin and/or eyes, also called jaundice
signs of anaemia, such as tiredness, being short of breath, and looking pale
fever, generally feeling unwell
skin rash, itchiness
pinkish, itchy swellings on the skin, also called hives or nettlerash
painful, swollen joints
bruising more easily than normal
larger breasts than normal in men
These may be serious side effects of SIMVACOR. Some of these may be symptoms of an
allergic reaction to SIMVACOR. You may need urgent medical attention. Serious side
effects are rare.
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if
you notice any of the following:
swallowing or breathing
shortness of breath
These are serious side effects. If you have them, you may have had a serious allergic reaction
to SIMVACOR. You may need urgent medical attention or hospitalisation. Serious side effects
Also, tell your doctor if you notice:
Page 8 of 9
breathing problems including persistent cough and/or shortness of breath or fever
These are possible side effects of SIMVACOR.
Liver problems can also occur and may be serious. Your doctor will do blood tests to check your
Other side effects not listed above may also occur in some patients. Tell your doctor if
you notice any other effects.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
After taking SIMVACOR
Keep your tablets in the blister pack until it is time to take them. If you take the tablets out
of the pack they may not keep well.
Keep SIMVACOR in a cool dry place where the temperature stays below 25
Do not store it or any other medicine in the bathroom or near a sink.
Do not leave it in the car or on window sills. Heat and dampness can destroy some
Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres
above the ground is a good place to store medicines.
If your doctor tells you to stop taking SIMVACOR or the tablets have passed their expiry
date, ask your pharmacist what to do with any that are left over.
SIMVACOR 10, 10 mg: Light pink coloured, oval, biconvex film-coated tablets, marked ‘SVN 10’
on one side and ‘NEO’ on the other side.
SIMVACOR 20, 20 mg: Tan coloured, oval, biconvex film-coated tablets, marked with ‘SVN 20’
on one side and ‘NEO’ on the other side.
SIMVACOR 40, 40 mg: Pink coloured, oval, biconvex film coated tablets, marked ‘SVN’ 40 on
one side and ‘NEO’ on the other side.
SIMVACOR 80, 80 mg: Pink coloured, oval, biconvex film coated tablets marked with ‘SVN 80’
on one side and ‘NEO’ on the other side.
SIMVACOR tablets are available in blister & bottle packs..
Page 9 of 9
Other ingredients (excipients)
Citric acid monohydrate
Cellulose – microcrystalline
Starch – pregelatinised maize
Hypromellose – 15
Titanium dioxide E171
Each tablet may also contain one or all of the following: iron oxide red E172, iron oxide black
E172, iron oxide yellow E172.
Cipla Australia Pty Ltd
Level 1 / 132-136 Albert Rd
Unit 5/36 Campbell Ave
CROMER NSW 2099
Australian Register Numbers:
10mg - AUST R 182910
20mg - AUST R 182911
40mg - AUST R 182912
80mg - AUST R 182913
10mg - AUST R 182906
20mg - AUST R 182907
40mg - AUST R 182908
80mg - AUST R 182909
This leaflet was prepared in April 2013.