To be used in line with NICE TA

Jaundice and PBC

To be used in line with NICE TA

Specialist Initiation - use in line with NICE

40mg dose can be titrated up to on specialist recommendation for patient safety reasons as per the Summary Product Characteristics.

5mg, 10mg, 20mg and 40mg tablets. Second line when atorvastatin not suitable or tolerated

MHRA advice regarding high dose simvastatin (May 2010):
• Simvastatin 80 mg should be considered only in patients with severe hypercholesterolaemia and high risk of cardiovascular complications who have not
achieved their treatment goals on lower doses, when the benefits are expected to outweigh the potential risks
• Prescribers treating patients who are taking simvastatin 80 mg or who are being considered for an up-titration to that dose may need to review their
treatment during their next visit, to take into account the new evidence
• Patients who are currently taking simvastatin 80 mg should not stop taking their medicine. However, they should be advised to contact their doctor
immediately if they experience unexplained muscle pain, tenderness, or weakness
• Please report suspected adverse reactions with medicines, including statins, to us via the Yellow Card Scheme (www.yellowcard.gov.uk)