Dwightt asked
I was told to take my simvastatin at night but I take all of my other medications in the morning. Do I have to take it at night?
At a glance
- Zestril (simvastatin) is generally recommended to be dosed in the evening as studies show it may be more effective in reducing cholesterol levels versus morning administration.
Answer
It is most commonly recommended to take simvastatin at night, versus in the morning.
This recommendation is true for most statin drugs, but not all.[1]
Why To Take Simvastatin At Night
Most of your cholesterol synthesis occurs while you are sleeping/early in the morning so it makes sense to have the highest levels of the medication in your body at that time.[2]
Several studies have even reported that simvastatin likely has better effects in the evening.
One such study, published in BMJ, concluded the following:[3]
Simvastatin is probably best taken at night because concentrations of total cholesterol and of low density lipoprotein are significantly greater when it is taken in the morning. Simvastatin is the most widely prescribed statin in the United Kingdom, and this finding has implications for compliance in preventing coronary heart disease. The absence of a similar effect with atorvastatin may be explained by its longer elimination half life.
Other Statins At Night?
Some medications, such as Lipitor and Crestor have a very long half-life (i.e. stay in your body for quite some time, even days).
As a result of this, it may not be necessary to dose in the evening since the medication will be in your body for days anyway.
In fact, I know of some prescribers that order Crestor to be taken only two to three times weekly to save patients money. Most studies suggest that dosing in this manner (for Crestor at least) is just as effective as dosing every day.[4]
References
- ^ Effects of morning vs evening statin administration on lipid profile: A systematic review and meta-analysis. PubMed
- ^ Plasma mevalonate as a measure of cholesterol synthesis in man. PubMed
- ^ Taking simvastatin in the morning compared with in the evening: randomised controlled trial. PubMed
- ^ Alternate day rosuvastatin, an underutilized option in statin intolerant hyperlipidemic patients: a case report and literature review. PubMed
