Hormonal Simvastatin

Endocrine effects Statins interfere with cholesterol synthesis and lower circulating cholesterol levels and, as such, might theoretically blunt adrenal or gonadal steroid hormone production. Small declines in total testosterone with no commensurate elevation in LH have been noted with the use of fluvastatin. Pravastatin showed inconsistent results with regard to possible effects on basal steroid hormone levels atorvastatin, lovastatin, rosuvastatin, and simvastatin did not reduce basal plasma cortisol concentration or basal plasma testosterone concentration or impair adrenal reserve. Appropriately evaluate patients who display clinical evidence of endocrine dysfunction. Exercise caution when administering HMG-CoA reductase inhibitors with drugs that affect steroid levels or activity, such as ketoconazole, spironolactone, and cimetidine. 

Slc21al) estrone-S, ochratoxin A, thyroid hormones, bile acids Drugs BQ123, dexamethasone, cardiac glycosides, enalapril. fexofenadine, pravastatin Drugs atorvastatin, furosemide, lovastatin, simvastatin... 

The book deals with the minor illnesses or conditions that can be self-treated with advice and treatment from a pharmacist. Three chapters deal with medicines (Chapter 24, nicotine replacement therapy Chapter 32, emergency hormonal contraception and Chapter 2, simvastatin) that have become available without prescription within the last few years and are not treatments for illnesses but are used prophylactically or preventively. 

Increased risk of severe myopathy or rhabdomyolysis increased plasma levels of atorvastatin, lovastatin, and simvastatin because of inhibition of CYP3A4 additive decreases in concentrations or activity of endogenous steroid hormones... 

An isolated report describes raised serum thyroid hormone levels and evidence of thyrotoxicosis in a man taking levothyroxine with lovastatin. In contrast another isolated case report describes hypothyroidism in a woman taking levothyroxine with lovastatin. Another report describes reduced efficacy of levothyroxine in two patients taking simvastatin, one of whom was successfully treated with pravastatin. 

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