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6/11/11

Should You Freak Out After the Government Warning About Simvastatin? What are Statins for Cholesterol? Side Effects?

Should You Freak Out After the Government Warning About Simvastatin? What are Statins for Cholesterol? Side Effects?


Tired of boring party small talk? Ask people if they know the real name of simivastatin (read on for the answer)

What Did the FDA Say About Simvastatin?

In an nutshell, The "Food and Drug Administration is recommending that the use of drugs containing 80 mg of simvastatin—the highest approved dose of the popular cholesterol-lowering statin—be sharply curtailed because of the risk of muscle injury"... Simvastatin comes in doses such as 5,10,20,40 and 80.. In general, the side effects of statins are more prominent with higher doses and also with interactions with other drugs a person is taking simultaneously.




What are Statins and Which Drugs Are They?

Tired of boring party small talk? Ask people if they know the real name of simivastatin, it's butanoic acid, 2,2-dimethyl-,1,2,3,7,8,8a-hexahydro-3,7-dimethyl-8-[2-(tetrahydro-4-hydroxy-6-oxo-2H-pyran-2-yl)-ethyl]-1-naphthalenyl ester, [1S-[1α,3α,7β,8β(2S*,4S*),-8αβ]].





Statins are the most powerful and popular cholesterol lowering drugs. Doctors tend to use them over the older cholesterol fighters because of their proven benefits. You don't need to be Einstein to notice how much is written about them. Just search here on Purple Medical Blog or read a newspaper. The latest wrinkle in the statin story unfolded (after the report recently about the putative value of Niaspan, another kind of drug that works on cholesterol) when the FDA warned about Simvastatin, which is the generic name for Zocor. Other statins include Lipitor,Mevacor and Crestor.

Where does Cholesterol Come From and What the Heck are Enzymes?

The cholesterol we use comes from stuff we eat as well as being made in the liver with the help of an enzyme, HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. For those of you who skipped chemistry, enzymes are molecules that dramatically speed up chemical reactions between other chemicals, to the extent that without the enzyme the reaction effectively stops.

What is the Problem With Statins?

Like all statins, "simvastatin is used to lower the amount of low-density lipoprotein (LDL) cholesterol—known as “bad cholesterol”—in the blood. Simvastatin "is derived synthetically from a fermentation product of Aspergillus terreus". Aspergillus terreus is a fungus, Hey What's Your Problem? Penicillin was from a fungus!!.. And the 80 mg dose of simvastatin has been shown to lower LDL cholesterol by an additional 6% over the 40 mg dose. But myopathy can be debilitating. Moreover, a rare form of myopathy, called rhabdomyolysis, can lead to kidney failure and death".



What is Myopathy and Rhabdomyolysis? What do Statins have to do with Enzymes? What do Statins have to do With the Liver?

Myopathy is basically muscle damage, Rhabdomyolysis is a severe form of muscle damage or breakdown. For some reason statins can sometimes lead to myopathy or rhabdomyolysis, symptoms of which can include muscle pain and darkly colored urine. It's a problem for the kidneys when muscle breakdown products overwhelm the kidney function. Doctors can order a test for a chemical called CK , creatinine kinase in the blood. (Just as they order a certain subset of CPK to look for damage from a heart attack)

Statins are a class of drugs called (or HMG-CoA reductase inhibitors) used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. For those of you who skipped chemistry, enzymes are molecules that dramatically speed up chemical reactions between other chemicals, to the extent that without the enzyme the reaction effectively stops. .

    True or False? All cholesterol is bad?





Besides lowering cholesterol which is a good thing for the heart,there have been reports before that statins may help the heart in other ways. There have even been suggestions( not well documented) that statins might lower the chance of Alzheimer's with the evidence going back and forth. This isn't the first battle in the war of the statins.
  • FDA: Limit Use of 80 mg Simvastatin
  • Is a Blocked Artery in the Heart Like a Clogged Pipe