Antihypercholesterolaemic effect of Simcam improves the survival of patients with angina pectoris and previous myocardial infarction.
Simcam helps in increasing the clearance of LDL from the circulation.

Simcam given prophylactically in patients with ischaemic heart diseases.

Reduces the risk of peripheral vascular and cerebrovascular disease.

Well tolerated even in long term therapy flexible and easy dosage.
Pharmacokinetics
Simvastatin is absorbed from the gastro-intestinal tract and is hydrolysed to its active B-hydroxyacid from, other active metabolites have been urine, mainly in inactive form. The half life of metabolites is 1.9 detected and a number of inactive metabolites are also formed. Simvastatin undergoes extensive first pass metabolism in the liver, its primary site of action. Less that 5% of the oral dose has been reported to reach the circulation as active metabolites. Both simvastatin and its B-hydroxyacid metabolites are about 95% bound to plasma proteins. It is mainly extracted in the faeces via the bile as metabolites. About 10 to 15% is recovered in the hours.
Adverse Effect and Precautions

The commonest adverse effects of therapy with simvastatin and other statins are gastro-intestinal disturbances. Other adverse effect reported include headache, skin rashes dizziness, blurred vision, insomnia and dysgeusia. Reversible increase in serum aminotransferase concentrations may occur and liver function should be monitored. Hepatitis and pancreatitis have been reported.

A hypersensitivity syndrome whose features have included angioedema has been reported. Myopathy, characterised by myalgia and muscle weakness and associated with increased creatine phosphokinase concentrations has been reported, especially in patients taking simvastatin concurrently with immunosuppressants, fibric acid derivatives or nicotinic acid. Rarely rhabdomyolysis with acute renal failure may develop. It should be discontinued if marked or persistent increases in serum-aminotransferase or creatine-phosphokinase concentrations occur. It should be use with caution in patients with severe renal impairment.

Interactions

There is an increase risk of myopathy if certain drugs such as immunosuppressants (notably cyclosporin) fibiric acid derivatives or nicotinic acid are given concurrently with statins. Bleeding and increases in prothrombin time have been reported in patients taking simvastatin with coumarin anticoagulants. Raised concentrations of simvastain have occurred patients also given mibefradil.
Uses & Administration

Simvastatin is a lipid regulating drug: it is a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase), the rate determining enzyme for cholesterol synthesis. HMG-CoA reductase inhibitors (also called statins) reduce total cholesterol, low density lipoprotein (LDL) cholesterol and very-low-density lipoprotein (VLDL) cholesterol concentration in plasma, They also tend to reduce triglycerides and to increase high-density lipoprotein (HDL) cholesterol concentration considered to exert their hypocholesterolaemic action by stimulating an increase in LDL-receptors on hepatocyte membranes thereby increasing the clearance of LDL from the circulation.

Simvastatin is used in the treatment of hypercholesterolaemias, particularly in type lla and llb hyperlipoproteinaemias, Statins may not be effective in patients with homozygous familial hypercholesterolaemia who lack functional LDL-receptors. Simvastatin is also given prophylactically in hypercholesterolaemic patients with ischaemic heart disease. Simvastatin is given by mouth in an initial dose of 5 to 10 mg in the evening: an initial dose of 20 mg may be used in patients with ischaemic heart disease. The dose may be adjusted at intervals of not less than 4 weeks up to a maximum of 40 mg once daily in the evening. A maximum of 10 mg daily is recommended in those taking immunosuppressants.
Availability

Simcam 10 mg tablets in blister of 10 tablets.
Simcam 20 mg tablets in blister of 10 tablets.