Simvastatin

Simvastatin

Drug monograph · NCLEX study reference
Trade names	Zocor
Therapeutic class	Antihyperlipidemic
Pharmacologic class	Statin
Onset / peak / duration	Onset about 2 weeks; peak 4 to 6 weeks.
Half-life / level	Half-life about 2 to 3 hours (parent); no routine level.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	None.
Pregnancy / lactation	Contraindicated.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Simvastatin (brand name Zocor) — Antihyperlipidemic; Statin.

Identification

• Therapeutic class: Antihyperlipidemic.
• Pharmacologic class: Statin.

Pharmacology

• Mechanism of action: Same statin mechanism; highly CYP3A4 dependent, so more interaction-prone.
• Onset / peak / duration: Onset about 2 weeks; peak 4 to 6 weeks.
• Half-life / therapeutic level: Half-life about 2 to 3 hours (parent); no routine level.

Clinical use

• Indications: Hyperlipidemia, cardiovascular risk reduction.
• Usual dose, route, frequency: 10 to 40 mg PO once daily in the evening.
• Maximum dose / adjustments: Max 40 mg/day (80 mg restricted because of myopathy risk); dose limits with amlodipine, diltiazem, verapamil; caution in renal/hepatic impairment.

Safety

• Contraindications: Active liver disease, pregnancy, lactation, strong CYP3A4 inhibitors.
• Black box warning: None.
• Interactions: Strong CYP3A4 inhibitors and grapefruit juice greatly increase myopathy risk; fibrates; amiodarone; red yeast rice.
• Pregnancy / lactation: Contraindicated.
• High-alert: No.

Adverse effects

• Common side effects: Myalgia, headache, constipation.
• Serious effects to report: Rhabdomyolysis, hepatotoxicity.
• Antidote / reversal: None.

Nursing process

• Assessment before administration: Lipids, LFTs, concurrent medications, pregnancy status.
• Interventions during therapy: Give in the evening; screen for interacting drugs.
• Monitor: Lipids, LFTs, CK if symptomatic.
• Evaluation / expected outcome: LDL reduction without toxicity.

Patient teaching

• Patient teaching: Evening dosing improves effect; avoid grapefruit.
• Notify provider if: Muscle pain, dark urine, jaundice, pregnancy.
• Administration tips: Take in the evening; avoid grapefruit juice.