is 20mg of simvastatin a low dose xeloda

The dose is dependent on your body size, the regimen your provider is following, and whether or not it is being used in conjunction with other chemotherapies or radiation therapy.

and formulary information changes. Taking too much of this medication may cause serious or life-threatening side effects.Before taking this medicine, tell your doctor if you have ever had liver or kidney disease, diabetes, or a thyroid disorder, if you are of Chinese descent, or if you drink more than 2 alcoholic beverages daily.Simvastatin can harm an unborn baby or cause birth defects. "Statins are medications that work by reducing the amount of cholesterol made by the liver. 2001
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Simvastatin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. "Simvastatin is used to lower blood levels of "bad" Simvastatin is also used to lower the risk of stroke, heart attack, and other heart complications in people with diabetes, coronary heart disease, or other risk factors.Simvastatin is used in adults and children who are at least 10 years old.In rare cases, simvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, potentially leading to kidney failure. Skip the missed dose if it is almost time for your next scheduled dose.

Moderate reduction of LDL-C desired: 5-10 mg PO qDay in the evening; adjust dose to achieve goalReduction of >40% of LDL-C desired: 40 mg PO qDay in the evening; adjust dose to achieve goalPresence of CHD or at high risk for cardiovascular events, including patients with diabetes, PVD, history of stroke or other cerebrovascular disease: 40 mg PO qDay in the evening adjunct to diet therapy (initiate simultaneously); adjust dose to achieve goalACC/AHA Cholesterol Guideline Recommendations (2013) for adults ≥21 yearsSevere renal impairment (CrCl <30 mL/min): 5 mg qDay initiallyCoadministration with dronedarone, verapamil, or diltiazem: Do not exceed 10 mg/dayCoadministration with amiodarone, amlodipine, or ranolazine: Do not exceed 20 mg/dayCoadministration with lomitapide: Reduce simvastatin dose by 50%, and do not exceed 20 mg/day (or 40 mg/day in those previously tolerating 80 mg/day) when initiating lomitapideLipid determinations should be performed after 4 weeks of therapy and periodically thereafterRare reports of cognitive impairment (eg, memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin useActive liver disease or unexplained transaminase elevationStrong CYP3A4 inhibitors (eg, itraconazole, ketoconazole, erythromycin, clarithromycin, posaconazole, voriconazole, HIV protease inhibitors, cobicistat, nefazodone), gemfibrozil, cyclosporine, and danazolRule out secondary causes of hyperlipidemia prior to initiating therapyNonserious and reversible cognitive side effects may occurIncreased blood sugar and glycosylated hemoglobin (HbA1c) levels reported with statin intakeHeavy alcohol use, history of liver disease, renal failureMonitor LFTs before initiating treatment and thereafter when clinically indicated; reports of fatal and nonfatal hepatic failure in patients taking statinsDiscontinue if markedly elevated CPK levels occur or myopathy is diagnosed or suspectedIncreases in HbA1c and fasting serum glucose levels reported with simvastatinSevere electrolyte, endocrine, or metabolic disordersGrapefruit juice increases simvastatin systemic exposure; avoid large quantities of grapefruit juice (ie, ≥1 quart/day)Contraindicated in women who are or may become pregnantLipid lowering drugs offer no benefit during pregnancy, because cholesterol and cholesterol derivatives are needed for normal fetal developmentAtherosclerosis is a chronic process, and discontinuation of lipid-lowering drugs during pregnancy should have little impact on long-term outcomes of primary hypercholesterolemia therapyThere are no adequate and well-controlled studies of use with statins during pregnancy; however, there are rare reports of congenital anomalies in infants exposed to statins in uteroUnknown if simvastatin excreted in human milk; because a small amount of another drug in this class is excreted in human milk and because of the potential for serious adverse reactions in nursing infants, women taking simvastatin should not breastfeedA decision should be made whether to discontinue nursing or discontinue drug, taking into account the importance of the drug to the motherA: Generally acceptable.

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