As with any medication, side effects are possible with simvastatin (Zocor®), including problems with the liver. For people taking simvastatin, liver problems can include:
• An increase in liver enzymes
• Hepatitis, which is an inflammation of the liver that can cause tiredness or a general feeling of illness
• Jaundice, or a yellowing of the skin or eyes that can occur due to liver damage
• A fatty change in the liver
• Cirrhosis
• Hepatoma, which is a type of liver cancer.
Increases in liver enzymes occur in about 1 percent of people taking simvastatin. The other liver problems mentioned occur in less than 1 percent of people. Because these problems are so uncommon, it is difficult to tell whether they are caused by the medication itself or something else.
High Liver Enzymes With Simvastatin
Liver enzymes are usually measured to see if a person has liver damage
They do not measure how well the liver is working. A number of things can increase liver enzymes, including certain medicines (such as antibiotics or some anti-inflammatory medicines), alcohol, infections (such as mononucleosis or viral hepatitis), obesity, and diabetes.
Like other statins, simvastatin is known to increase liver enzyme levels. Except in rare cases, this increase in liver enzymes does not cause any symptoms. But as a precaution, your healthcare provider will measure your liver enzyme levels prior to treatment with simvastatin and several months after you start. He or she will also measure your liver enzyme levels if your simvastatin dosage is increased.
If your liver enzymes are high, your healthcare provider may continue to test them on a more frequent basis. If they remain high, he or she may recommend lowering the dose or switching to one of several simvastatin alternatives. When this medication is stopped, in most cases, the liver enzymes return to their pre-simvastatin levels.
Liver Problems With Simvastatin: Warnings and Precautions
Because simvastatin can affect the liver, it is used with caution in people who drink more than a moderate amount of alcohol or have a history of liver disease.
Simvastatin is not recommended for people with liver disease or high liver enzymes before treatment begins.
Possible Symptoms of Liver Problems
Several symptoms can occur in someone who develops liver problems while taking simvastatin. You should contact your healthcare provider if you have any of the following problems:
• Nausea or vomiting
• Stomach pain
• Passing brown or dark-colored urine
• Yellowing of the skin or the whites of the eyes
• Fatigue, or feeling more tired than usual.
Final Thoughts
Liver problems with simvastatin occur rarely; in order to keep you as safe as possible, however, your healthcare provider will routinely check your liver enzyme levels. If they are high, your healthcare provider may recommend lowering your simvastatin dosage or switching medicines.
If you have any questions or concerns about liver problems with simvastatin, make sure to talk with your healthcare provider. He or she understands your situation best and is in the best position to give you recommendations.
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