What is the most common adverse effect reported with simvastatin therapy?

• A. Myalgia
• B. Nausea
• C. Rash
• D. Drowsiness

Answer: (A)

Muscle-related symptoms are the most frequent adverse effects seen with statins like simvastatin. The common manifestation is myalgia—muscle pain or aching, sometimes with weakness—that can occur with or without modest rises in CK. This tendency to cause muscle symptoms is more typical than stomach upset, rash, or drowsiness. The underlying idea is that statins affect muscle cell function as they inhibit cholesterol synthesis, and some people are more susceptible, especially at higher doses or when taken with other drugs that raise statin levels. If myalgia appears, assess severity, check CK if symptoms are persistent or concerning, and consider dose adjustment or switching statins if symptoms persist, to prevent progression to more serious muscle injury. While nausea, rash, and drowsiness can occur, they are less commonly reported than myalgia.