simvastatin question?

[meaniebeanie]

i was just wondering what are the main counselling points you need to give about simvastatin to a patient and how to deal with simvastatin and wafarin interaction if prescribed together since sim enhances anticoagulant effect of wafarin? thanks

[Rafael]

i was just wondering what are the main counselling points you need to give about simvastatin to a patient and how to deal with simvastatin and wafarin interaction if prescribed together since sim enhances anticoagulant effect of wafarin? thanks

1- take 1 tablet at NIGHT. cholesterol synthesis occurs massivly at night.
2- report any muscle pain, statins causes myopathy!
3- simvastatin enhances anti-coag effect of warfarin. check stockley, but i guess missing a dose of simvastatin 1-2 time weekly won't harm. otherwise the Dr should be familiar with this situation and put him on lower dose, after monitoring his INR.

[Steve G]

Reinforce the fact that they will be taking the medicine for the rest of their life - it's not just a one off course. Are they also on aspirin? If not, why not? If their 10 year CVD risk is high enough to warrant treatment with a statin, they should also be on aspirin, assuming BP is relatively under control and no contraindications. Also offer lifestyle advice.

As for the simva/warfarin interaction: check INR a week after starting simvastatin and adjust warfarin dose as needed to bring INR back into desired range (unless Stockley says something otherwise). Advise patient to take both drugs regularly, as missing doses of simvastatin could affect INR.

[Ama2007]

what is the minimum age for taking ergocalciferol injection? and can you take it with calceos tablets?

thanks

[Shwampa]

Don't you ever visit the rpsgb site?

http://www.rpsgb.org/pdfs/otcsimvastatincardguid.pdf

[Rafael]

Don't you ever visit the rpsgb site?

http://www.rpsgb.org/pdfs/otcsimvastatincardguid.pdf

your link does not provide the answer for her Question..... your link is about OTC simvastatin sale......
Steve answered her back

[Shwampa]

Dear rayan

Simvastatin OTC or prescriptions carry the same counselling. The other answers were valuable. My point was as pharmacist we should be trained to do basic drug info research by ourselves and seek help for the more complicated cases.

I just wondered whether the poster did try to find the answer by checking basic references: BNF, Stockley..

Oh god..I'll be liked around here!

[johnep]

Agree with you, too many expect to be spoonfed. You should be able to find out things for yourself.
johnep