side effects

Last reviewed 09/2023

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.