What is simvastatin

A hypolipidemic drug, that is, one with activity in reducing levels of harmful LDL cholesterol and anti-inflammatory activity. Reductase inhibitor.

Take only under medical supervision

It is a statin like lovastatin, pravastatin. 

Statins are taking on a key role in the prevention and treatment of heart disease, particularly hypercholesterolemia, and possess immunomodulatory properties.

Studies on the multiple positive effects of simvastatin:

This study finds simvastatin effective in the treatment of colon cancer in the presence of mutant p53 (1) and Doxorubicin-resistant cells (2).

It was shown, in vivo, to be an effective neuroprotectant on photoreceptors exposed to all-trans-retinal (3).

It attenuated cardiac hypertrophy in diabetic rats (4).

This study showed that simvastatin could play a role in controlling hyperlipidemia and, in turn, reduce PASI score in psoriatic patients (5).

The results of this work suggest that intra-articular administration of simvastatin-conjugated gelatin hydrogel could be used as a potential new therapy for osteoarthritis (6).

Systematic administration of simvastatin could reduce the infiltration of polymorphonuclear neutrophils into brain tissue as well as alleviate neuroinflammation in a rat model with intracerebral hemorrhage (7).

Although statins are well tolerated, myopathy and other adverse effects are a challenging problem, being the main reason for poor adherence to treatment and failure in lowering cardiovascular risk. Statin intolerance is the subject of ongoing research, as these drugs are widely used. There are alternative options of treatment if statin intolerance emerges, that is, lowering the dose, intermittent dosages, and/or combining a statin with other drugs, such as ezetimibe, proprotein convertase subtilisin-kexin type 9 inhibitors, bempedoic acid, angiopoietin-like 3 protein inhibitors, and nutraceuticals. If even the lowest statin dose cannot be tolerated, a nonstatin regimen is recommended to reduce LDL cholesterol levels (8).

Like all drugs it can cause side effects. Always ask the physician.

Chemical and physical properties

• Molecular Formula : C₂₅H₃₈O₅
• Molecular Weight : 418.574 g/mol
• CAS : 79902-63-9
• UNII AGG2FN16EV
• EC Number: 616-751-8
• DSSTox Substance ID: DTXSID0023581
• MDL number  MFCD00072007
• PubChem Substance ID 329751099
• InChI=1S/C25H38O5/c1-6-25(4,5)24(28)30-21-12-15(2)11-17-8-7-16(3)20(23(17)21)10-9-19-13-18(26)14-22(27)29-19/h7-8,11,15-16,18-21,23,26H,6,9-10,12-14H2,1-5H3/t15-,16-,18+,19+,20-,21-,23-/m0/s1
• InChl Key      RYMZZMVNJRMUDD-HGQWONQESA-N
• SMILES    CCC(C)(C)C(=O)OC1CC(C=C2C1C(C(C=C2)C)CCC3CC(CC(=O)O3)O)C
• IUPAC   [(1S,3R,7S,8S,8aR)-8-[2-[(2R,4R)-4-hydroxy-6-oxooxan-2-yl]ethyl]-3,7-dimethyl-1,2,3,7,8,8a-hexahydronaphthalen-1-yl] 2,2-dimethylbutanoate
• ChEBI    9150
• NACRES NA.24

Synonyms : 

• (1S,3R,7S,8S,8aR)-8-(2-((2R,4R)-4-Hydroxy-6-oxotetrahydro-2H-pyran-2-yl)ethyl)-3,7-dimethyl-1,2,3,7,8,8a-hexahydronaphthalen-1-yl 2,2-dimethylbutanoate
• Zocor
• Synvinolin
• Sinvacor
• Denan
• Lipex
• MK-733e

References______________________________________________________________________

(1) Nežić L, Amidžić L, Škrbić R, Gajanin R, Nepovimova E, Vališ M, Kuča K, Jaćević V. Simvastatin Inhibits Endotoxin-Induced Apoptosis in Liver and Spleen Through Up-Regulation of Survivin/NF-κB/p65 Expression.  Front Pharmacol. 2019 Feb 15;10:54. doi: 10.3389/fphar.2019.00054. eCollection 2019

(2) Środa-Pomianek K, Michalak K, Palko-Łabuz A, Uryga A, Szczęśniak-Sięga B, Wesołowska O Simvastatin Strongly Augments Proapoptotic, Anti-inflammatory and Cytotoxic Activity of Oxicam Derivatives in Doxorubicin-resistant Colon Cancer Cells. Anticancer Res. 2019 Feb;39(2):727-734. doi: 10.21873/anticanres.13169.

(3) Zhang T, Gillies M, Wang Y, Shen W, Bahrami B, Zeng S, Zhu M, Yao W, Zhou F, Murray M, Wang K, Zhu L. Simvastatin Protects Photoreceptors from all-trans-retinal Induced Oxidative Stress with Up-regulation of Interphotoreceptor Retinoid Binding Protein. Br J Pharmacol. 2019 Mar 1. doi: 10.1111/bph.14650

(4) Han Q, Liu Q, Zhang H, Lu M, Wang H, Tang F, Zhang Y. Simvastatin Improves Cardiac Hypertrophy in Diabetic Rats by Attenuation of Oxidative Stress and Inflammation Induced by Calpain-1-Mediated Activation of Nuclear Factor-κB (NF-κB). Med Sci Monit. 2019 Feb 15;25:1232-1241. doi: 10.12659/MSM.913244.

(5) Trong HN, Tat TN, Anh TTN, Uyen NP, Van TN, Hau KT, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Efficacy of Adding Oral Simvastatin to Topical Therapy for Treatment of Psoriasis: The Vietnamese Experience.  Open Access Maced J Med Sci. 2019 Jan 27;7(2):237-242. doi: 10.3889/oamjms.2019.060. eCollection 2019 Jan 30.

(6) Tanaka T, Matsushita T, Nishida K, Takayama K, Nagai K, Araki D, Matsumoto T, Tabata Y, Kuroda R. Attenuation of osteoarthritis progression in mice following intra-articular administration of simvastatin-conjugated gelatin hydrogel.  J Tissue Eng Regen Med. 2019 Jan 15. doi: 10.1002/term.2804.

(7) Zhang J, Shi X, Hao N, Chen Z, Wei L, Tan L, Chen Y, Feng H, Chen Q, Zhu G. Simvastatin Reduces Neutrophils Infiltration Into Brain Parenchyma After Intracerebral Hemorrhage via Regulating Peripheral Neutrophils Apoptosis.  Front Neurosci. 2018 Dec 18;12:977. doi: 10.3389/fnins.2018.00977. eCollection 2018.

(8) Diaconu CC, Iorga RA, Furtunescu F, Katsiki N, Stoian AP, Rizzo M. Statin intolerance: new data and further options for treatment. Curr Opin Cardiol. 2021 Jul 1;36(4):487-493. doi: 10.1097/HCO.0000000000000874.