Due to the unknown effects of the increased exposure to ezetimibe in patients with moderate to severe hepatic impairment, Zetia is not recommended in these patients. Fredrickson type III hyperlipidemia. Supportive measures should be taken in the event of an overdose. Itakura H, Vaughn D, Haller DG, O'Dwyer PJ "Rhabdomyolysis from cytochrome p-450 interaction of ketoconazole and simvastatin in prostate cancer. Elevated alkaline phosphatase and γ-glutamyl transpeptidase have also been reported. About 5% of patients had elevations of CK levels of 3 or more times the normal value on one or more occasions. tecta money order online store
Take atorvastatin exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. In such patients, prothrombin time should be determined before starting simvastatin and frequently enough during early therapy to ensure that no significant alteration of prothrombin time occurs. Once a stable prothrombin time has been documented, prothrombin times can be monitored at the intervals usually recommended for patients on coumarin anticoagulants. If the dose of simvastatin is changed or discontinued, the same procedure should be repeated. Simvastatin therapy has not been associated with bleeding or with changes in prothrombin time in patients not taking anticoagulants.
What is the most important information I should know about simvastatin Zocor? Many other drugs can interact with simvastatin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you. Gently clean and dry the affected area. If you are using a lotion or foam product, shake the container well before using as directed on the label. For skin irritation, apply to the affected area usually up to 3 to 4 times a day or as directed by your doctor. For or other anal conditions, apply the medication to the affected area usually after each or up to 4 to 5 times a day, or as directed by your doctor. Do not use this medication inside the rectum. Spray the foam onto a clean tissue and apply to the affected area. If you are using the hemorrhoidal cream, you may use the applicator that comes with it. Clean the applicator after each use.
Zetia may be administered with a statin in patients with primary hyperlipidemia or with fenofibrate in patients with mixed hyperlipidemia for incremental effect. For convenience, the daily dose of Zetia may be taken at the same time as the statin or fenofibrate, according to the dosing recommendations for the respective medications. Tell us on WebMD's Coping with Cholesterol message board. To lower the chance of giving to your partner, do not have sexual contact during an outbreak or if you have symptoms. You can spread even if you do not have symptoms. HMG-CoA reductase. Inhibition of HMG-CoA reductase is the basis for an assay in pharmacokinetic studies of the β-hydroxyacid metabolites active inhibitors and, following base hydrolysis, active plus latent inhibitors total inhibitors in plasma following administration of simvastatin.
Sinzinger H, Wolfram R, Peskar BA "Muscular side effects of statins. Angiograms were evaluated at baseline, two and four years. The co-primary study endpoints were mean change per-patient in minimum and mean lumen diameters, indicating focal and diffuse disease, respectively. Zocor significantly slowed the progression of lesions as measured in the Year 4 angiogram by both parameters, as well as by change in percent diameter stenosis. In addition, simvastatin significantly decreased the proportion of patients with new lesions and with new total occlusions. Each tablet contains 5 mg of simvastatin. This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor directs you to do so. A different medication may be necessary in that case. Jim Shaw, stylist: I would ask your oncologist. At my salon, our customers usually wait until their hair has grown to 2-3 inches long for highlights and 1-2 inches long for a single process color. Question: I have to color my gray hair every 2 weeks. Is there something I can do to make my color last longer? Guo J, Meng F, Ma N, Li C, Ding Z, Wang H, Hou R, Qin Y. Meta-analysis of safety of the coadministration of statin with fenofibrate in patients with combined hyperlipidemia. Moderate less than 3X ULN elevations of serum transaminases have been reported following therapy with simvastatin. These changes appeared soon after initiation of therapy with simvastatin, were often transient, were not accompanied by any symptoms and did not require interruption of treatment. After you stop taking Aubagio, you may need to be treated with other medicines to help your body eliminate teriflunomide quickly. If you do not undergo this drug elimination procedure, teriflunomide could stay in your body for up to 2 years. Follow your doctor's instructions. However, in studies with another structurally-related statin, skeletal malformations were observed in rats and mice. Use fenofibrate regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. After you stop taking Aubagio, the drug could stay in your body for up to 2 years. You may need to be treated with other medications to help your body eliminate teriflunomide quickly. Follow your doctor's instructions.
But surgeon Michael Richman, MD, is unconvinced. He tells WebMD that there is no way to know from the study design if the tendon problems reported by the patients had anything to do with their statin use. Zetia reduces total-C, LDL-C, Apo B, non-HDL-C, and TG, and increases HDL-C in patients with hyperlipidemia. Administration of Zetia with a statin is effective in improving serum total-C, LDL-C, Apo B, non-HDL-C, TG, and HDL-C beyond either treatment alone. Administration of Zetia with fenofibrate is effective in improving serum total-C, LDL-C, Apo B, and non-HDL-C in patients with mixed hyperlipidemia as compared to either treatment alone. The effects of ezetimibe given either alone or in addition to a statin or fenofibrate on cardiovascular morbidity and mortality have not been established. In 4- to 12-week toxicity studies in mice, ezetimibe did not induce cytochrome P450 drug metabolizing enzymes. In toxicity studies, a pharmacokinetic interaction of ezetimibe with statins parents or their active hydroxy acid metabolites was seen in rats, dogs, and rabbits. As I said earlier, there is no direct evidence that water-soluble statins produce less muscle problems as compared to fat soluble statins. If the muscle pains are tolerable with or without a CK elevation less than 10 times the upper limit of normal, the Muscle Panel recommends that statin therapy be continued at the same dose or a reduced dose. Generally it is my experience that muscle aches do go away or become tolerable to the patients if the statin is continued. Many physicians are too quick to stop statins with any muscle aches. Simvastatin is used in adults and children who are at least 10 years old. Women of childbearing age should be advised to use an effective method of birth control to prevent pregnancy while using Zetia added to statin therapy. Discuss future pregnancy plans with your patients, and discuss when to stop combination Zetia and statin therapy if they are trying to conceive. Patients should be advised that if they become pregnant they should stop taking combination Zetia and statin therapy and call their healthcare professional. PDF. World Health Organization. Retrieved 25 September 2013. Coumarin anticoagulants: Concomitant use with ZOCOR prolongs INR. Achieve stable INR prior to starting ZOCOR. Monitor INR frequently until stable upon initiation or alteration of ZOCOR therapy. Help may come from ongoing trials looking at whether Lipitor or Zocor can help people who already have Alzheimer's disease. Those trials are nearly over; results are expected next year. Similar CNS vascular lesions have been observed with several other drugs of this class. Therapy with lipid-altering agents should be considered in those individuals at increased risk for atherosclerosis-related clinical events as a function of cholesterol level, the presence of CHD, or other risk factors. Use: Treatment of patients with relapsing forms of multiple sclerosis. Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. It is recommended that liver function tests be performed before the initiation of Zocor, and thereafter when clinically indicated. All patients treated with Zocor should be advised to report promptly any symptoms that may indicate liver injury, including fatigue, anorexia, right upper abdominal discomfort, dark urine or jaundice. Butylated hydroxyanisole is added as a preservative. prinivil
Drug Interactions 7 Clinical Pharmacology 12. Atorvastatin is usually taken once a day, with or without food. Take the medicine at the same time each day. It may take up to 4 weeks before you get the full benefit of this drug. This is a bulk package and not intended for dispensing. Fenofibrate is only part of a treatment program that may also include diet, exercise, and weight control. Follow your doctor's instructions very closely. They had a choice of: muscle pain, joint pain, digestion problems, loss of memory or other. Digoxin In one study, concomitant administration of digoxin with simvastatin resulted in a slight elevation in digoxin concentrations in plasma. Suspension is administered to patients with severe renal impairment. Risks increase with higher doses and concomitant use of certain medicines. In one study, concomitant administration of digoxin with simvastatin resulted in a slight elevation in digoxin concentrations in plasma. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Zetia in the treatment of homozygous sitosterolemia. cheap avelox sales avelox
Other health problems: Before taking a medicine, be sure your doctor or pharmacist knows about all your health problems. Other health problems may affect your medicine. Or the medicine for one health problem may affect another health problem. The Story of Statins. Oxford University Press. Harm to unborn babies and newborns: If you are pregnant, trying to get pregnant, or breastfeeding, ask your doctor or pharmacist if any of the medicines you take could harm your baby. While using atorvastatin, you may need frequent blood tests. Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high cholesterol or triglycerides do not feel sick. Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased. Retrieved 2011-06-09. The cholesterol-lowering drug simvastatin can cause severe muscle damage and should not be prescribed in high doses to patients who have taken it for less than a year or in any dose to people taking certain drugs, health officials said Tuesday. In 11 patients with reductions in LDL-C, the mean LDL-C changes for the 40- and 80-mg doses were 14% range 8% to 23%, median 12% and 30% range 14% to 46%, median 29% respectively. One patient had an increase of 15% in LDL-C. Another patient with absent LDL-C receptor function had an LDL-C reduction of 41% with the 80-mg dose. Women who are pregnant or may become pregnant. Serum cholesterol and triglycerides increase during normal pregnancy, and cholesterol or cholesterol derivatives are essential for fetal development. Because HMG-CoA reductase inhibitors statins decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, Zocor may cause fetal harm when administered to a pregnant woman. Atherosclerosis is a chronic process and the discontinuation of lipid-lowering drugs during pregnancy should have little impact on the outcome of long-term therapy of primary hypercholesterolemia. There are no adequate and well-controlled studies of use with Zocor during pregnancy; however, in rare reports congenital anomalies were observed following intrauterine exposure to statins. In rat and rabbit animal reproduction studies, simvastatin revealed no evidence of teratogenicity. Zocor should be administered to women of childbearing age only when such patients are highly unlikely to conceive. Get emergency medical help if you have any signs of an allergic reaction to fenofibrate: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Grundy SM "Can statins cause chronic low-grade myopathy? Repatha is injected under the skin. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes. Jacob SS, Jacob S, Williams C, Deeg MA. Simvastatin, fenofibrate, and rhabdomyolysis. How should I take Zetia? Tell your doctor about any prescription and nonprescription medicines you are taking or plan to take, including natural or herbal remedies. cheapest letrozole purchase now visa
If you also take cholestyramine, colesevelam, colestipol: these other medicines should be taken at least 1 hour after or 4 hours before you take fenofibrate. In post-marketing experience with Zetia, cases of myopathy and rhabdomyolysis have been reported. Most patients who developed rhabdomyolysis were taking a statin prior to initiating Zetia. However, rhabdomyolysis has been reported with Zetia monotherapy and with the addition of Zetia to agents known to be associated with increased risk of rhabdomyolysis, such as fibrates. Zetia and any statin or fibrate that the patient is taking concomitantly should be immediately discontinued if myopathy is diagnosed or suspected. Duits N, Bos FM "Depressive symptoms and cholesterol-lowering drugs. Clinical studies have demonstrated that elevated levels of total-C, LDL-C and Apo B, the major protein constituent of LDL, promote human atherosclerosis. In addition, decreased levels of HDL-C are associated with the development of atherosclerosis. Epidemiologic studies have established that cardiovascular morbidity and mortality vary directly with the level of total-C and LDL-C and inversely with the level of HDL-C. Like LDL, cholesterol-enriched triglyceride-rich lipoproteins, including very-low-density lipoproteins VLDL intermediate-density lipoproteins IDL and remnants, can also promote atherosclerosis. The independent effect of raising HDL-C or lowering TG on the risk of coronary and cardiovascular morbidity and mortality has not been determined. Reduce the risk of total mortality by reducing CHD deaths. Do not share this medication with others. Dr. Dara Cohen, a professor of medicine in the department of endocrinology, diabetes and bone disease at the Icahn School of Medicine at Mount Sinai in New York City. "There was no data regarding weight, ethnicity and family history -- all important risk factors for the development of diabetes. This drug should not be used in patients without familial hypercholesterolemia or atherosclerotic cardio vascular disease. Myalgia is a non-specific common complaint of muscle ache and there are no abnormalities of the on a blood test. Myalgia has rarely been examined in clinical trials and it is thought that some type of muscle aches can occur in up to 30% of patients on statins. Plosker GL, Mctavish D "Simvastatin - a reappraisal of its pharmacology and therapeutic efficacy in hypercholesterolaemia. Now it's time for me to consult with legal counsel. Caution should be exercised when Zocor is administered to patients with severe renal impairment. order sotalol from china sotalol
In a rat model, where the glucuronide metabolite of ezetimibe SCH 60663 was administered intraduodenally, the metabolite was as potent as the parent compound SCH 58235 in inhibiting the absorption of cholesterol, suggesting that the glucuronide metabolite had activity similar to the parent drug. There are different ways to place the bladder back to its normal position. Store at room temperature. Different products have different storage needs. The cause of the interaction is not known. Our Zocor simvastatin Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. Bad publicity about the potential side effects doesn't help matters since it distracts attention from the beneficial effects of the medications, she said. Handle this medicine carefully. Dropping an injection device can cause it to break. Do not use an injection device that has been dropped onto a hard surface, even if you cannot see a break in it. Call your pharmacist for new medicine. Choose from Top Nursing Uniform Companies. All sizes, styles and popular name brands available. Mevacor had no effect on risk of either Alzheimer's disease or Parkinson's disease. This is about 15 times less likely than dying in a car accident in a year. If, however, a patient who is currently tolerating the 80-mg dose of ZOCOR needs to be initiated on an interacting drug that is contraindicated or is associated with a dose cap for simvastatin, that patient should be switched to an alternative statin with less potential for the drug-drug interaction. Patients should be advised of the increased risk of myopathy, including rhabdomyolysis, and to report promptly any unexplained muscle pain, tenderness or weakness. If symptoms occur, treatment should be discontinued immediately. Drug Interactions The risk of myopathy and rhabdomyolysis is increased by high levels of statin activity in plasma. Simvastatin is metabolized by the cytochrome P450 isoform 3A4. Certain drugs which inhibit this metabolic pathway can raise the plasma levels of simvastatin and may increase the risk of myopathy. It is important to keep the infected ears clean and dry. Try not to get the infected ears wet when bathing. Avoid unless your doctor tells you otherwise. Along with lowering cholesterol levels in the blood, statins reduce inflammation around the cholesterol buildup called a plaque. This may lower the risk that the plaque will break apart and cause a blood clot that can lead to a heart attack or stroke. What about side effects? Store at room temperature away from light and moisture.
Zocor group vs 256 deaths in the placebo group. Product Information. Zocor simvastatin. Since fat-soluble statins can easily enter the inside of the muscle cells, theoretically muscle damage should be increased with their use, as water-soluble statins do not easily get into the muscle cells. This hypothesis has not been confirmed and cases of Rhabdomyolysis, while rare, occurring about 1 time for every 15 million prescriptions written, has occurred with all statins. Increases in HbA1c and fasting serum glucose levels have been reported with HMG-CoA reductase inhibitors, including Zocor. Dose adjustments should be made at intervals of 2 to 4 weeks. Approximately 78% and 11% of the administered radioactivity were recovered in the feces and urine, respectively, over a 10-day collection period. Ezetimibe was the major component in feces and accounted for 69% of the administered dose, while ezetimibe-glucuronide was the major component in urine and accounted for 9% of the administered dose. Pedersen, TR 2010. "Pleiotropic effects of statins: Evidence against benefits beyond LDL-cholesterol lowering". American Journal of Cardiovascular Drugs. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. edyl.info hydroxyzine
In clinical trials, there was no excess of myopathy or rhabdomyolysis associated with Zetia compared with the relevant control arm placebo or statin alone. However, myopathy and rhabdomyolysis are known adverse reactions to statins and other lipid-lowering drugs. LDL apheresis in these patients or if such treatments are unavailable. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. All were prescribed statins between 2006 and 2008 -- the most recent time period for which numbers are available. The risk of having a hospital-verified non-fatal MI was reduced by 37%. In most cases, these elevations were mild, transient, and not associated with clinical symptoms. dapoxetine to buy in uk
All medicines can cause side effects. Many people don't have side effects. And minor side effects sometimes go away after a while. Serious. These medicines may interact and cause very harmful effects. Patients should be instructed to report symptoms of muscle pain, weakness, or tenderness. If such symptoms develop, creatine kinase should be measured, and if elevated, simvastatin should be discontinued. The value of regular monitoring of creatine kinase is not known. It is not known whether ezetimibe is excreted into human breast milk. In rat studies, exposure to total ezetimibe in nursing pups was up to half of that observed in maternal plasma. Because many drugs are excreted in human milk, caution should be exercised when Zetia is administered to a nursing woman. Zetia should not be used in nursing mothers unless the potential benefit justifies the potential risk to the infant. It is now recommended that liver function tests be performed with Zocor at the start of therapy and periodically such as semi-annually only for the first year of treatment or until one year after the last elevation in dose. Previously, liver function testing for patients on Zocor was recommended at the start of treatment, at six and twelve weeks, and semiannually for the duration of treatment. Adjustments should be made at intervals of 4 weeks or more. Your care provider will show you the best places on your body to inject Repatha or place the on-body infusor. Use a different place each time you give an injection. Do not inject into the same place two times in a row. purchasing aromasin outside the united states
Thank you for joining us for WebMD Ask the Hair Health Specialists. Be sure to check in again on Wednesday, Feb. My practice is to obtain a baseline CK enzyme level before starting statins to see if it is elevated. When a patient on a statin develops myalgia symptoms, I closely monitor them and if severe, I will get a CK level to see if there is any muscle damage. Do not consider Communities as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. Bladder suspension surgery works well to treat stress incontinence in most cases. Success rates for open retropubic suspension surgery range from 85%-90%. But, the effects do not last forever. Symptoms can return over time, usually after five years. Putting faith in credentials can lead to some very bad outcomes. We have all witnessed what can happen in botched plastic surgeries. Bernie Madoff had very high credentials. The best on Wall Street, and people trusted their money with him. But even though the study indicates that there may be a role for statins in multiple sclerosis treatment one way or another, exactly how they would be used still has to be worked out, Vollmer says. Lie on your side with the treated ear upward. Hold the dropper directly over the ear and place the prescribed number of drops into the ear canal. To help the drops roll into the ear of an adult, hold the earlobe up and back. For children, hold the earlobe down and back. Keep the head tilted with the treated ear upward for 5 minutes or insert a soft cotton plug if so directed. Another way to give this medication is to place a cotton wick in the ear canal and moisten it with the prescribed number of drops as often as directed. The wick should be replaced at least once a day. What are the possible side effects of simvastatin Zocor? Because the below reactions are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure. MONDAY, Sept. 15, 2014 HealthDay News -- Patients prescribed -lowering drugs are more likely to fill their and gain health benefits if the medications are cheaper generic brands, new research suggests. Included as part of the PRECAUTIONS section. benadryl
Zocor had an original patent expiry date of January 2006, but was extended by the United States Patent Trademark Office PTO to expire on June 23, 2006. Summaries for patients. Muscle abnormalities in four patients taking statins to treat unfavorable cholesterol levels. Pedersen TR, Berg K, Cook TJ, Faergeman O, Haghfelt T, Kjekshus J, Miettinen T, Musliner TA, Olsson AG, Pyorala K, Thorgeirsso "Safety and tolerability of cholesterol lowering with simvastatin during 5 years in the scandinavian simvastatin survival study. Cholesterol is critical to the normal function of every cell in the body. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Both simvastatin and its β-hydroxyacid metabolite are highly bound approximately 95% to human plasma proteins. Rat studies indicate that when radiolabeled simvastatin was administered, simvastatin-derived radioactivity crossed the blood-brain barrier. It is reversible on stopping statin. Simvastatin Zocor is a, FDA approved prescription medication that is used along with a proper diet to help lower "bad" cholesterol and fats such as LDL, triglycerides and raise "good" cholesterol HDL in the blood. It belongs to a group of drugs known as "statins. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day. Continue using it for the full time prescribed, even if symptoms disappear after a few days. Stopping this medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection. Other statins did perform more favorably than Lipitor, Crestor and Zocor in terms of diabetes, the research found. Treatment with Zocor produced significant relative risk reductions for all components of the composite endpoints. Valacyclovir works best when the amount of medicine in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day. Though it's often more effective than other multiple sclerosis treatments, its side effects limits it to 5% to 10% of people with multiple sclerosis. Talk to your doctor about the benefits and risks. cheapest permethrin purchase now online
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No specific diagnostic signs were observed in rodents. At these doses the only signs seen in dogs were emesis and mucoid stools. When all patients receiving Zetia with a statin were compared to all those receiving the corresponding statin alone, Zetia significantly lowered total-C, LDL-C, Apo B, non-HDL-C, and TG, and, with the exception of pravastatin, increased HDL-C compared to the statin administered alone. LDL-C reductions induced by Zetia were generally consistent across all statins. Do not take any red yeast rice products while you are taking simvastatin because some red yeast rice products may also contain a statin called lovastatin. Taking simvastatin and red yeast rice products together can increase your risk of serious muscle and liver problems. meclizine
Repeat the above steps for the other ear if so directed. Do not rinse the dropper. Replace the cap after use. Women who are pregnant or may become pregnant. Because statins decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, Zetia in combination with a statin may cause fetal harm when administered to pregnant women. Additionally, there is no apparent benefit to therapy during pregnancy, and safety in pregnant women has not been established. If the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus and the lack of known clinical benefit with continued use during pregnancy.
Always be sure you get specific information on the medicine you're taking. For a full list of warnings, check the information that came with the medicine you're using. If you have questions, talk to your pharmacist or doctor. Reduce elevated TG in patients with hypertriglyceridemia and reduce TG and VLDL-C in patients with primary dysbeta-lipoproteinemia. Zetia is a medicine used to lower levels of total cholesterol and LDL bad cholesterol in the blood. Zetia is for patients who cannot control their cholesterol levels by diet and exercise alone. It can be used by itself or with other medicines to treat high cholesterol. You should stay on a cholesterol-lowering diet while taking this medicine.
Chinese patients applies to other Asian patients. Geng Q, Ren J, Chen H, Lee C, Liang W. Adverse events following statin-fenofibrate therapy versus statin alone: a meta-analysis of randomized controlled trials. Never take simvastatin in larger amounts, or for longer than recommended by your doctor. Follow your doctor's dosing instructions very carefully. Taking too much of this medication may cause serious or life-threatening side effects. Pediatric Use Safety and effectiveness of simvastatin in patients 10-17 years of age with heterozygous familial hypercholesterolemia have been evaluated in a controlled clinical trial in adolescent boys and in girls who were at least 1 year post-menarche. Patients treated with simvastatin had an adverse reaction profile similar to that of patients treated with placebo. Doses greater than 40 mg have not been studied in this population. In this limited controlled study, there was no significant effect on growth or sexual maturation in the adolescent boys or girls, or on menstrual cycle length in girls.