Simvastatin excretion

Lactation Lovastatin and atorvastatin are excreted in the milk of rats atorvastatin is likely to be excreted in breast milk it is not known whether lovastatin, rosuvastatin, and simvastatin are excreted in breast milk a small amount of pravastatin is excreted in breast milk fluvastatin is present in breast milk in a 2 1 ratio (milk plasma). 

Pravastatin and fluvastatin are almost completely absorbed after oral administration oral doses of lovastatin and simvastatin are absorbed from 30 to 50%. Similarly, pravastatin and fluvastatin are active as such, whereas lovastatin and simvastatin must be hydrolyzed to the acid. Due to first-pass extraction, the primary action of these drugs is on the liver. All are biotransformed, with some of the products retaining activity. Excretion takes place principally through the bile and feces, but some urinary elimination also occurs. Their half-lives range from 1.5 to 2 hours. 

In hepatorenal syndrome (HRS), which is an acute episode, the clearance of renally excreted drugs and metabolites (pravastatin, simvastatin, rosu-vastatin, acipimox, fibrates) may be reduced. During an episode of HRS, anti-hyperlipidaemic medication should be withheld. 

The hypolipidemic agent pravastatin differs from other HMG-CoA reductase inhibitors (e.g., lovastatin and simvastatin) because it has greater hydrophihcity as a result of the hydroxyl group attached to its decalin ring. The hydro-phihc nature of pravastatin accounts for its minimal penetration into the intracellular space of nonhepatic tissues, including an apparent inability to cross the blood-brain barrier. The drug is also well tolerated because it is rapidly absorbed and excreted, and does not accumulate in plasma even with repeated administration. 

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