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Side effects

Authoring team

The side effects of Simvastatin and Pravastatin are described. These include:

  • about 7% of patients experience gastro-intestinal side effects, e.g. abdominal pain, constipation and flatulence

  • less frequently, headache and musculoskeletal symptoms

  • changed biochemical profiles - increased liver transaminases (aspartate aminotransferase or alanine transferase) and levels of the muscle enzyme creatine kinase

  • myositis (muscle pain plus an increase in CK greater than 10 times the upper limit of normal) occurs in less than 0.2% of patients receiving simvastatin

  • rhabdomyolysis:
    • with resultant renal damage
    • a rare side effect of simvastatin
    • often the result of a drug interaction with cyclosporin A, gemfibrozil or nicotinic acid

The adverse effects profile for all statins are similar. Check the summary of products characteristics before prescribing a particular statin.

Reference:

  • Thompson GR. Adverse reactions profile:simvastatin and pravastatin. Prescriber's journal 1993;33(5):217-20.
  • Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344, 1383-89
  • Horton, R. Reversing risk in coronary disease. Lancet 1998; 344:1497-8.
  • Factfile (6/98). British Heart Foundation.

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