Editing Simvastatin (section)

==Pharmacology ==
{{Main|Statin}}

=== Pharmacodynamics ===
All statins act by inhibiting 3-hydroxy-3-methylglutaryl (HMG) coenzyme A reductase. [[HMG-CoA reductase]], the [[Rate-determining step|rate-limiting]] [[enzyme]] of the [[HMG-CoA reductase pathway]], the [[metabolic pathway]] responsible for the endogenous production of [[cholesterol]]. Statins are more effective than other lipid-regulating drugs at lowering [[Low-density lipoprotein|LDL]]-cholesterol concentration, but they are less effective than the [[fibrate]]s in reducing triglyceride concentration. However, statins reduce cardiovascular disease events and total mortality irrespective of the initial cholesterol concentration. This is a major piece of evidence that statins work in another way than the lowering of cholesterol (called pleiotropic effects).<ref>{{cite journal | vauthors = Pedersen TR | title = Pleiotropic effects of statins: evidence against benefits beyond LDL-cholesterol lowering | journal = American Journal of Cardiovascular Drugs | volume = 10 | pages = 10–7 | year = 2010 | issue = Suppl 1 | pmid = 21391729 | doi = 10.2165/1158822-S0-000000000-00000 | s2cid = 23195784 }}</ref>

Simvastatin is an effective serum [[lipid]]-lowering drug that can decrease [[low density lipoprotein]] (LDL) levels by up to 50%.{{citation needed|date=June 2012}} Simvastatin had been shown to interact with lipid-lowering transcription factor PPAR-alpha<ref name="pmid26118928">{{cite journal | vauthors = Roy A, Jana M, Kundu M, Corbett GT, Rangaswamy SB, Mishra RK, Luan CH, Gonzalez FJ, Pahan K | display-authors = 6 | title = HMG-CoA Reductase Inhibitors Bind to PPARα to Upregulate Neurotrophin Expression in the Brain and Improve Memory in Mice | journal = Cell Metabolism | volume = 22 | issue = 2 | pages = 253–65 | date = August 2015 | pmid = 26118928 | pmc = 4526399 | doi = 10.1016/j.cmet.2015.05.022 }}</ref> and that interaction might control the neurotrophic action of the drug.

=== Pharmacokinetics ===
The drug is in the form of an inactive [[lactone]] that is [[hydrolysis|hydrolyzed]] after ingestion to produce the active β-hydroxyacid form. Simvastatin is primarily metabolized by [[CYP3A4]] yielding products which are also active HMG-CoA reductase inhibitors.<ref name="Zocor FDA label">{{cite web | title=Zocor- simvastatin tablet, film coated | website=DailyMed | date=9 August 2023 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8f55d5de-5a4f-4a39-8c84-c53976dd6af9 | access-date=17 January 2024}}</ref>