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==Follow-up==
{{Simvastatin}}
{{CMG}}; {{AE}} {{SS}}


{{familytree/start}}
'''''For patient information about Simvastatin, click [[Simvastatin (patient information)|here]].'''''
{{familytree | | | | | A01 | | | | | A01=Controls of history + physical exam and chest [[CT]] with or without contrast every 6-12 months (first 2 years), then annual controls}}
{{familytree | | | | | |!| | | | | | |}}
{{familytree | | | | | B01 | | | | | B01=Is there evidence of local or regional recurrence<br>OR<br>systemic [[metastasis]]?}}
{{familytree | | | |,|-|^|-|.| | | |}}
{{familytree | | | C01 | | C02 | | | C01=Local or regional recurrence|C02=Systemic [[metastasis]]}}
{{familytree/end}}


{{SB}} ZOCOR<sup>®</sup>,generic
==Overview==
'''Simvastatin''' ([[International Nonproprietary Name|INN]]) ({{pronEng|ˈsɪmvəstætɨn}})  is a [[hypolipidemic agent|hypolipidemic drug]] belonging to the class of pharmaceuticals called "[[statin]]s". It is used to control [[hypercholesterolemia]] (elevated [[cholesterol]] levels) and to prevent[[cardiovascular disease]].  Simvastatin is a synthetic derivate of a fermentation product of ''[[Aspergillus terreus]]''.
==History==
The development of simvastatin was closely linked with the research and development of [[lovastatin]]. Biochemist Jesse Huff and his colleagues at[[Merck & Co.|Merck]] began researching the biosynthesis of cholesterol in the early 1950s. In 1956, [[mevalonic acid]] was isolated from a yeast extract by [[Karl Folkers]], Carl Hoffman, and others at Merck; while Huff and his associates confirmed that mevalonic acid was an intermediate in cholesterol biosynthesis. In 1959, the [[HMG-CoA reductase]] enzyme (a major contributor of internal cholesterol production) was discovered by researchers at the [[Max Planck Institute]]. This discovery encouraged scientists worldwide to find an effective inhibitor of this enzyme.
By 1976, [[Akira Endo (biochemist)|Akira Endo]] had isolated the first inhibitor (compactin ML-236B) from the [[fungus]], ''[[Penicillium|Penicillium citrinium]]'' in Sankyo, Japan.<ref>Liao and Laufs. Pleiotropic Effects of Statins.(2005) Annu. Rev. Pharmacol. Toxicol:45:89-118</ref> In 1979, Hoffman and colleagues isolated lovastatin from a strain of the fungus ''[[Aspergillus|Aspergillus terreus]]''. While developing and researching lovastatin, Merck scientists synthetically derived a more potent HMG-CoA reductase inhibitor from a fermentation product of ''Aspergillus terreus'', which was designated MK-733 (later to be named simvastatin).<!--
  --><ref name = "preview">{{cite book | title=Innovation Management - Strategies, Implementation, and Profits | url=http://www-personal.umich.edu/~afuah/ | editor=Ed. Allan Afuah | year=1998 | publisher=Oxford University Press | author= Olivia Williams, Anne-Marie Jacks, Jim Davis, Sabrina Martinez |chapter=Case 10: Merck(A): Mevacor* | chapterurl=http://www-personal.umich.edu/~afuah/cases/case10.html}}</ref>
==Category==
Alcohols,Carboxylate esters,Lactones,Merck,Statins,Tetrahydropyrans,World Health Organization essential medicines,Neuroprotective agents,Cardiovascular Drugs
==FDA Package Insert==
'''  [[Simvastatin indications and usage|Indications and Usage]]'''
'''| [[Simvastatin dosage and administration|Dosage and Administration]]'''
'''| [[Simvastatin dosage forms and strengths|Dosage Forms and Strengths]]'''
'''| [[Simvastatin contraindications|Contraindications]]'''
'''| [[Simvastatin warnings and precautions|Warnings and Precautions]]'''
'''| [[Simvastatin adverse reactions|Adverse Reactions]]'''
'''| [[Simvastatin drug interactions|Drug Interactions]]'''
'''| [[Simvastatin use in specific populations|Use in Specific Populations]]'''
'''| [[Simvastatin overdosage|Overdosage]]'''
'''| [[Simvastatin description|Description]]'''
'''| [[Simvastatin clinical pharmacology|Clinical Pharmacology]]'''
'''| [[Simvastatin nonclinical toxicology|Nonclinical Toxicology]]'''
'''| [[Simvastatin clinical studies|Clinical Studies]]'''
'''| [[Simvastatin how supplied storage and handling|How Supplied/Storage and Handling]]'''
'''| [[Simvastatin patient counseling information|Patient Counseling Information]]'''
'''| [[Simvastatin labels and packages|Labels and Packages]]'''
==Mechanism of Action==
Simvastatin is a prodrug and is hydrolyzed to its active β-hydroxyacid form, simvastatin acid, after administration. Simvastatin is a specific inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, an early and rate limiting step in the biosynthetic pathway for cholesterol. In addition, simvastatin reduces VLDL and TG and increases HDL-C.
==Interaction with Alcohol==
The drug should be used with caution in patients who consume substantial quantities of alcohol and/or have a past history of liver disease.
==References==
==References==
{{reflist|2}}
{{Reflist|2}}


[[Category:Disease]]
{{Statins}}
[[Category:Types of cancer]]
{{Merck&Co}}
[[Category:Pulmonology]]
[[Category:Lung cancer]]
[[Category:Oncology]]


{{WikiDoc Help Menu}}
[[Category:Alcohols]]
{{WikiDoc Sources}}
[[Category:Carboxylate esters]]
[[Category:Lactones]]
[[Category:Merck]]
[[Category:Statins]]
[[Category:Cardiovascular Drugs]]
[[Category:Drugs]]

Revision as of 15:55, 30 June 2014

Simvastatin
ZOCOR® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Warnings and Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Overdosage
Description
Clinical Pharmacology
Nonclinical Toxicology
Clinical Studies
How Supplied/Storage and Handling
Patient Counseling Information
Labels and Packages
Clinical Trials on Simvastatin
ClinicalTrials.gov

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]

For patient information about Simvastatin, click here.

Synonyms / Brand Names: ZOCOR®,generic

Overview

Simvastatin (INN) (Template:PronEng) is a hypolipidemic drug belonging to the class of pharmaceuticals called "statins". It is used to control hypercholesterolemia (elevated cholesterol levels) and to preventcardiovascular disease. Simvastatin is a synthetic derivate of a fermentation product of Aspergillus terreus.

History

The development of simvastatin was closely linked with the research and development of lovastatin. Biochemist Jesse Huff and his colleagues atMerck began researching the biosynthesis of cholesterol in the early 1950s. In 1956, mevalonic acid was isolated from a yeast extract by Karl Folkers, Carl Hoffman, and others at Merck; while Huff and his associates confirmed that mevalonic acid was an intermediate in cholesterol biosynthesis. In 1959, the HMG-CoA reductase enzyme (a major contributor of internal cholesterol production) was discovered by researchers at the Max Planck Institute. This discovery encouraged scientists worldwide to find an effective inhibitor of this enzyme.

By 1976, Akira Endo had isolated the first inhibitor (compactin ML-236B) from the fungus, Penicillium citrinium in Sankyo, Japan.[1] In 1979, Hoffman and colleagues isolated lovastatin from a strain of the fungus Aspergillus terreus. While developing and researching lovastatin, Merck scientists synthetically derived a more potent HMG-CoA reductase inhibitor from a fermentation product of Aspergillus terreus, which was designated MK-733 (later to be named simvastatin).[2]

Category

Alcohols,Carboxylate esters,Lactones,Merck,Statins,Tetrahydropyrans,World Health Organization essential medicines,Neuroprotective agents,Cardiovascular Drugs

FDA Package Insert

Indications and Usage | Dosage and Administration | Dosage Forms and Strengths | Contraindications | Warnings and Precautions | Adverse Reactions | Drug Interactions | Use in Specific Populations | Overdosage | Description | Clinical Pharmacology | Nonclinical Toxicology | Clinical Studies | How Supplied/Storage and Handling | Patient Counseling Information | Labels and Packages

Mechanism of Action

Simvastatin is a prodrug and is hydrolyzed to its active β-hydroxyacid form, simvastatin acid, after administration. Simvastatin is a specific inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, an early and rate limiting step in the biosynthetic pathway for cholesterol. In addition, simvastatin reduces VLDL and TG and increases HDL-C.

Interaction with Alcohol

The drug should be used with caution in patients who consume substantial quantities of alcohol and/or have a past history of liver disease.

References

  1. Liao and Laufs. Pleiotropic Effects of Statins.(2005) Annu. Rev. Pharmacol. Toxicol:45:89-118
  2. Olivia Williams, Anne-Marie Jacks, Jim Davis, Sabrina Martinez (1998). "Case 10: Merck(A): Mevacor*". In Ed. Allan Afuah. Innovation Management - Strategies, Implementation, and Profits. Oxford University Press.

Template:Statins