Simvastatin (Zocor)

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Background

Simvastatin (SIM), a lactone, is white, crystalline, nonhygroscopic and powdery, practically insoluble in water (30 mcg/ml), and 0.1 (N) HCl (60 mcg/ml). Its precursor is a fermentation product of Aspergillus terreus. It is used for treating coronary heart disease, hyperlipidemia, hypercholesterolemia, atherosclerosis and stroke [1] [2]. SIM is biologically inactive. Oral ingestion hydrolyzed it into the β-hydroxyacid form which is an inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme A (HMG CoA) reductase [2]. In human lung microvascular endothelial cells, it increased the amount of endothelial nitric oxide synthase mRNA [3]. Simvastatin had anti-cancer properties [1]. Its IC50 to inhibit P-glycoprotein is 9 μM [4]. HMG CoA reductase catalyses an early rate-limiting step in the biosynthesis of cholesterol [2]. In both cell lines HepG2 and Huh7, both doses of simvastatin (32 and 64 μM) had a significant inhibitory effect on tumor cell growth as compared to controls (p<0.05). This effect was time-dependent, a simvastatin pre-treatment for 48 h or 72 h significantly reduced cell growth as compared to 24 h pre-incubation (p<0.05). Simvastatin treatment for 48 or 72 h made HepG2 cells exhibit downregulation of CDK1, CDK2, CDK4 and cyclins D1 and E as compared to control tumor cells. Simvastatin treatment for 24, 48 and 72 h made relative expression of cyclin-dependent kinase inhibitors p19 and p27 enhance as compared to control tumor cells [1]. In patients with polygenic hypercholesterolemia and allocated to diet plus 20 mg/day simvastatin for 8 weeks, total cholesterol (-27%), low density lipoproteincholesterol (-33%), and monocyte expression of TNF (-49%) and IL-1( (-35%) significantly decreased (p<0.02) [5].

[1]. Borna Relja, Frank Meder, Kerstin Wilhelm, et al. Simvastatin inhibits cell growth and induces apoptosis and G0/G1 cell cycle arrest in hepatic cancer cells. International Journal of Molecular Medicine, 2010, 26:735-741.
[2]. Dipika Mandal, Probir Kumar Ojha, Bankim Chandra Nandy, et al. Effect of Carriers on Solid Dispersions of Simvastatin (Sim): Physico-Chemical Characterizations and Dissolution Studies. Der Pharmacia Lettre, 2010, 2(4):47-56.
[3]. Ji-Hyun Lee, Dong-Soon Lee, Eun-Kyung Kim, et al. Simvastatin Inhibits Cigarette Smoking–induced Emphysema and Pulmonary Hypertension in Rat Lungs. American Journal of Respiratory and Critical Care Medicine, 2005, 172: 987-993.
[4]. C. Bradley Hare, Mai P. Vu, Carl Grunfeld, et al. Simvastatin-Nelfinavir Interaction Implicated in Rhabdomyolysis and Death. Clinical Infectious Diseases, 2002, 35:e111–2.
[5]. Domenico Ferro, Sandro Parrotto, Stefania Basili, et al. Simvastatin Inhibits the Monocyte Expression of Proinflammatory Cytokines in Patients With Hypercholesterolemia. Journal of the American College of Cardiology, 2000, 36(2): 427–431.