title: Switching from high-efficacy lipid-lowering therapies [atorvastatin or rosuvastatin] to simvastatin and the results on low-density lipoprotein cholesterol level.
abstract: BACKGROUND
  In Thai National List of Essential Drugs in 2010, simvastatin is the only medication on the list for the statin group. Patients who previously prescribed other groups of statin were recommended to switch to simvastatin.
  
  
  OBJECTIVE
  Comparison of lipid low-density lipoprotein cholesterol (LDL) levels before and after switching from rosuvastatin or atorvastatin to simvastatin.
  
  
  METHODS
  The study was a retrospective observational study performed in patients older than 18 year-old who were enrolled as an outpatient at Siriraj Hospital during October 2009 and October 2010. From these patients who were switched from atorvastatin or rosuvastatin to simvastatin, LDL level was compared between before and after switching to simvastatin.
  
  
  RESULTS
  Of 276 patients who were switched from atorvastatin to equivalent dose simvastatin, LDL levels increased from 106.20 ± 33.47 mg/dl to 109.61 ± 39.62 mg/dl (p = 0.089). Of 228 patients who were switched from rosuvastatin to a less than equivalent dose simvastatin, LDL levels increased from 112.73 ± 45.94 mg/dl to 114.49 ± 42.70 mg/dl (p = 0.437).
  
  
  CONCLUSIONS
  In the patients who were switched from atorvastatin and rosuvastatin to simvastatin, LDL levels before and after being switched was not significantly different. Moreover patients who had switched from rosuvastatin to a less than equivalent dose ofsimvastatin still had no significant increases in LDL levels after switching.
mesh_terms: D000069059:Atorvastatin; D018954:Drugs, Essential; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D013785:Thailand
chemical_list: D018954:Drugs, Essential; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin