Factors affecting a sufficient simvastatin dose include cholesterol level readings, medications being currently taken, the patient's medical history. A simvastatin dose can range from a 5 mg dose to an 80 mg dose. Simvastatin is a hypolipidemic drug that can decrease total cholesterol levels and low-density lipoproteins, or "bad cholesterol" levels.
Although very effective in lowering levels of "bad cholesterol" and raising levels of high density lipoproteins, or "good cholesterol," even the lowest simvastatin dose can cause side effects. These side effects can include gastrointestinal upset, muscle pain, and weakness. In addition, joint pain, cognitive loss, and itching can occur. Most of these side effects are mild and temporary, however, and typically resolve soon after therapy begins.
Along with cholesterol-reducing medications, lifestyle changes can prove effective in reducing blood cholesterol levels. These include consuming a low-fat diet, exercising, and losing weight. Quitting smoking and maintaining a healthy blood pressure may have a beneficial effect to cholesterol levels. For those who need help in quitting smoking, a physician can recommend a smoking cessation program sponsored by a hospital.
A simvastatin dose of 80 mg may be helpful in the prevention of heart attacks, but as the dosage increases, so does the risk for side effects or adverse reactions. Since side effects are common and sometimes even affect patient compliance with the medication, other methods of reducing cholesterol may be attempted before a medication treatment plan is considered.
Even when a simvastatin dose of 20 mg is prescribed, the physician should warn the patient of the dangers of consuming grapefruit or grapefruit juice. Combining simvastatin and grapefruit products can increase the risk of toxic side effects because grapefruit can increase the blood concentration of the medication. Other juices such as orange juice and cranberry juice have not been shown to have the same effect.
Certain people cannot tolerate hypolipidemic drugs, so other means of cholesterol management need to be explored. Some health care providers recommend the B vitamin niacin to lower cholesterol levels, as well as triglycerides, another blood lipid. Niacin, however, can produce side effects such as severe flushing, known as a "niacin flush." Although niacin can be purchased as an over-the-counter supplement, people should not take it without first discussing it with their doctors.
Periodic blood tests are typically done on people who are taking simvastatin and other lipid-lowering medications. These blood tests are recommended to evaluate serum levels of liver enzymes, to make sure the medications are not negatively affecting the liver. If test results are excessively abnormal, the physician may advise his patient to stop taking the medication.