What Pharmacists Say About How Simvastatin Works (Plus 4 More Tips on How to Take It)

Many people live with high cholesterol. It doesn’t usually cause noticeable, short-term symptoms, but it can stir up trouble if left unchecked.

Thankfully, you have many cholesterol treatments to choose from. Statins are a first-choice option to lower cholesterol. They also reduce the risk of heart-related health problems from high cholesterol, such as heart attack and stroke, down the line. They do their best work when used alongside routine exercise and a heart-healthy diet.

Simvastatin (Zocor, FloLipid) is one statin medication. It comes in tablet and liquid forms and can be used to treat different types of high cholesterol. Most people take it once a day, every day.

Promotion disclosure

Simvastatin

Avg retail price

$435.57(Save 97.21%)

GoodRx discount

$12.14

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

If you're new to simvastatin, it’s normal to have questions about how this medication lowers cholesterol — and when you can expect its benefits to kick in. Here, we’ll discuss how simvastatin works and tips to get the most out of your prescription.

1. How does simvastatin work to lower cholesterol? Does it do this quickly?

Simvastatin is a statin medication. It works by blocking hydroxymethylglutaryl-CoA (HMG-CoA), an enzyme (protein) that’s involved in making cholesterol.

Interfering with HMG-CoA slows down the production of new cholesterol. At the same time, your liver is also able to remove low-density lipoprotein (LDL) cholesterol — also known as “bad cholesterol” — from your blood more effectively.

What’s more, these effects can lead to lower triglyceride and higher high-density lipoprotein (“good”) cholesterol levels.

Simvastatin’s cholesterol effects take some time

While simvastatin is an effective medication, it doesn’t start working right away. You’ll likely start seeing improvements in your cholesterol after about 1 to 2 months of use. You might not physically feel any different, but your lab work should start to get better. And as your cholesterol levels start to go down, so does your risk of heart attack, stroke, and other heart-related health problems.

However, simvastatin isn’t a one-and-done treatment. It’s a long-term maintenance medication. Your healthcare provider will likely want to see you 6 to 8 weeks after starting the medication to make sure it’s off to a good start. After that, they’ll likely want to see you every 4 to 6 months to make sure the medication is working as it should and it’s not causing any concerning side effects.

2. What time of day should you take simvastatin?

Try to take simvastatin in the evening. This is because your body makes most of its cholesterol at night. The medication is more effective at fighting cholesterol when it has more targets to go after.

This recommendation is different from some other statins, such as atorvastatin (Lipitor) and rosuvastatin (Crestor). These statins can be taken any time of day. Simvastatin doesn't last as long in the body as these statins, so its effects might not last until the night if you take it in the morning.

Should you take simvastatin with a meal or snack?

You can take simvastatin tablets with or without a meal or snack. The medication’s absorption doesn't change when you take it with food. However, the liquid form of simvastatin, FloLipid, should be taken on an empty stomach. Meals and snacks can make FloLipid less effective.

You should try to avoid drinking grapefruit juice with all forms of simvastatin — especially in large quantities (more than 32 oz per day). Grapefruit juice can interfere with how simvastatin is broken down, which can lead to higher levels of simvastatin in your body, This increases your risk of simvastatin side effects.

3. What happens if you miss a dose of simvastatin?

Missing a dose of medication happens to the best of us. Fortunately, missing one or two doses of simvastatin shouldn’t be a big deal. If it’s still the same day, take the missed dose as soon as you remember. But don’t take extra doses to make up for a missed one.

If you frequently forget to take simvastatin, try to think of ways to jog your memory based on your daily routine. Several missed doses can have a negative impact on your cholesterol management. You can try putting it next to your bed or setting an alarm to help you remember to take it, for example. And if you’re coordinating several medications, a pill organizer may help too.

Tip: Before starting simvastatin, ask your healthcare provider what you should do if you miss a dose of your medication. They can give you personalized advice based on your lifestyle and cholesterol goals.

4. What can you do if you experience simvastatin side effects?

In most cases, you can manage simvastatin side effects at home. Its most common side effects include:

• Headaches

• Abdominal pain

• Constipation

• Nausea

• Upper respiratory infections

Your body should adjust to many of these side effects over time. In the meantime, do your best to drink plenty of water and avoid alcohol to help with headaches. You can try increasing your fiber intake to help with constipation. Plus, avoiding trigger foods, such as spicy or acidic foods, can help with nausea.

When needed, over-the-counter medications are another option. For instance, pain relievers such as acetaminophen (Tylenol) can help with headaches. Laxatives such as polyethylene glycol (Miralax) can help promote bowel movements. And anti-nausea medications such as bismuth subsalicylate (Pepto-Bismol) can help with upset stomach and nausea. Ask your pharmacist which products would be best (and safest) for you.

Simvastatin and muscle pain

Muscle pain is the most notable side effect people think of when they hear the word “statin.” This is particularly true when it comes to simvastatin.

While simvastatin can cause muscle pain, it may be less common than you think. In initial clinical trials, about 4% of people reported muscle pain. And less than 1% of people stopped taking simvastatin because of it. This pain is more likely to happen among older adults, people taking higher doses, and those with kidney problems.

If you experience muscle pain after starting simvastatin, talk to your healthcare provider about how to manage it. If the pain doesn’t go away on its own, they may recommend lowering your dose, taking scheduled breaks from the medication, or trying another statin.

Some cases of muscle problems are more serious. If you’re experiencing intense muscle pain, tea-colored urine, or uncharacteristically intense fatigue, contact your healthcare provider right away. These are possible symptoms of a serious muscle condition called rhabdomyolysis.

5. How can you manage simvastatin interactions?

Some medications can interact with simvastatin and lead to extra side effects. These interactions can happen regardless of when you take your doses throughout the day.

The most common medications and foods that should be avoided with simvastatin include:

• Azole antifungals, such as itraconazole (Sporanox) and ketoconazole

• Macrolide antibiotics, such as erythromycin (E.E.S 400) and clarithromycin (Biaxin XL)

• HIV protease inhibitors, such as atazanavir (Reyataz) and darunavir (Prezista)

• Paxlovid and other medications containing ritonavir

• Gemfibrozil (Lopid)

• Cyclosporine (Sandimmune, Neoral)

• Colchicine (Colcrys, Mitigare)

• Large quantities of grapefruit juice

Other medications don’t need to be avoided completely. But a dosage adjustment may be necessary. You shouldn’t take medications such as diltiazem (Cartia XT) and verapamil (Verelan) with more than 10 mg of simvastatin per day. If you’re taking amiodarone (Pacerone), amlodipine (Norvasc), or ranolazine, it’s not recommended to take more than 20 mg of simvastatin.

Before starting simvastatin, talk with your healthcare provider and pharmacist about the medications and supplements you’re taking. They can look at your medication list and see if any changes need to be made.

How to save on simvastatin

There are ways to save on simvastatin, which is available as a brand-name and generic medication. GoodRx can help you save over 95% off the average retail price of the generic tablets. Generic simvastatin’s price at certain pharmacies is as low as $6.00 with a free GoodRx discount.

Why trust our experts?

Written by:

Crystal Akpede, PharmD Candidate

Crystal currently works as a pharmacy intern at a community outpatient pharmacy located within a health clinic. During pharmacy school, Crystal also served as the secretary for her campus’ chapter of the pharmaceutical fraternity Kappa Psi and the Student National Pharmaceutical Association.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Our editorial standards

Meet our experts