We found a large difference in the plasma levels of simvastatin after two weeks, which was attributed to differences in absorption. Absorption is influenced by food and alcohol intake, but we know that those factors do not account for all the variations seen between individuals. The amount of absorption does vary between individuals though as shown below:
None of our subjects had gastrointestinal side-effects associated with long term treatment with statins like indigestion or diarrhoea (3). We speculate that this may be because they were on type 2 diabetes medication too; another reason why we chose type 2s as patients (4). It’s possible that taking simvastatin with other antidiabetic medications could increase side effects such as hypoglycaemia. One study showed an increased rate of hypoglycaemia when combining metformin and glucose lowering drugs including atenolol/simvastatin combination therapy (5), however more research is needed into this area to confirm these findings before recommendations can be made.