If side effects occur, or if you do not respond well to simvastatin, alternatives to the medication are available. A number of other medicines used for treating high cholesterol include other statins (the class of drugs that simvastatin belongs to), fibrates, bile acid sequestrants, nicotinic acid, and cholesterol absorption inhibitors. You may have better results with one of these alternatives.
Lifestyle changes are the first line of treatment for lowering cholesterol. However, for some people, treating high cholesterol with diet, weight control, and exercise alone is not enough. In this case, your healthcare provider can prescribe cholesterol medications. One such medicine is simvastatin (Zocor®). For most people, simvastatin is quite effective at lowering cholesterol. It is also generally well tolerated. However, side effects can occur and people may wish to consider an alternate to simvastatin. These substitutes could include other statins or other cholesterol medicines.
Simvastatin is part of a class of drugs called statins (or HMG-CoA reductase inhibitors). Statins work by blocking a particular enzyme, HMG-CoA reductase, that controls the rate of cholesterol production in the body. This causes the liver to make less cholesterol. Simvastatin also:
- Increases the liver's ability to collect and get rid of LDL cholesterol ("bad cholesterol")
- Increases HDL cholesterol ("good cholesterol")
- Decreases triglycerides.
Several statin medications are available that could be considered an alternative for simvastatin. These include:
- Rosuvastatin calcium (Crestor®)
- Fluvastatin (Lescol®)
- Lovastatin (Mevacor®, Altoprev®)
- Pravastatin (Pravachol®)
- Atorvastatin calcium (Lipitor®).
Other Cholesterol Medicines
Many types of cholesterol medicines are available. Besides statins, alternatives to simvastatin include:
- Bile acid sequestrants (Prevalite®, Questran®, Questran Light®, LoCholest®, Colestid®, WelChol®)
- Nicotinic acid (nicotinic acid, Niacor®, Niaspan®, Nicolar®)
- Fibrates (such as Lopid®, Tricor®, Antara®, Lipofen®, Triglide®, or Lofibra™)
- Cholesterol absorption inhibitors (Zetia®).
There are also combination medicines available, such as Simcor®, Vytorin®, Advicor®, Caduet®, and Liptruzet™.
For lowering cholesterol, the type of medicine your doctor recommends will be based on many things, including your cholesterol levels (total cholesterol, LDL, HDL, and triglycerides), heart disease risk factors, and other medical conditions you may have. Each of these types of medicines works a little differently; so depending on your situation, these possible simvastatin alternatives may or may not make sense for you.
(Click Cholesterol Medications to learn more about these other classes of cholesterol medicines and whether these possible substitutes could make sense in your particular situation.)