Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about RANSIM tablets (simvastatin).
It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
This leaflet was last updated on the date at the end of this leaflet. More recent information may be available. The latest Consumer Medicine Information is available from https://www.ebs.tga.gov.au/ and may contain important information about the medicine and its use of which you should be aware.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking RANSIM against the benefits it is expected to have for you.
If you have any concerns about using/taking this medicine, ask your doctor or pharmacist. Keep this leaflet with this medicine. You may need to read it again.
What RANSIM Tablets are used for
RANSIM tablets help to lower cholesterol and triglyceride levels.
RANSIM tablets are used in people who have coronary heart disease (CHD) or who are at high risk of CHD (for example, if they have diabetes, a history of stroke, or other blood vessel disease).
RANSIM tablets may be used in these people, regardless of their cholesterol level to:
- Help prolong life by reducing the risk of a heart attack
- Reduce the risk of stroke
- Reduce the need for surgery to increase blood flow to the heart
- Reduce the need for hospitalisation due to angina
Everyone has cholesterol and triglycerides in their blood. They are types of blood fat needed by the body for many things, including building cell walls, making bile acids (which help to digest food) and certain hormones. However, too much cholesterol can be a problem.
Your body makes cholesterol, but it also comes from food.
Normally the body balances the cholesterol it makes with the cholesterol it gets from food. This means if more cholesterol comes from food, less is made by the body. However, if you eat a diet high in fat, your body may not keep this balance and your cholesterol levels rise.
High cholesterol is more likely to occur with certain disease or if you have a family history of high cholesterol.
When you have high levels of cholesterol, it may ‘stick’ to the inside of your blood vessels instead of being carried to the parts of the body where it is needed. Over time, this can form hard areas, called plaque, on the walls of blood vessels, making it more difficult for the blood to flow. This blocking of your blood vessels can lead to coronary heart disease (such as heart attack and angina), and stroke.
In people with CHD, RANSIM may slow down the hardening of blood vessels and reduce the risk of developing new plaques.
There are different types of cholesterol, called LDL and HDL cholesterol. LDL cholesterol is the ‘bad’ cholesterol that can block your blood vessels. HDL cholesterol, on the other hand, is the ‘good’ cholesterol that is thought to remove the bad cholesterol from the blood vessels.
Triglycerides are an energy source for the body. However, as with cholesterol, too much triglycerides can be a problem.
How RANSIM works
RANSIM tablets belong to a group of medicines known as HMG-CoA reductase inhibitors. It works by reducing the amount of cholesterol made by the liver. In terms of good and bad cholesterol, RANSIM reduces the bad cholesterol and raises the good cholesterol.
RANSIM tablets do not reduce the cholesterol and triglycerides that come from fat in food.
Therefore, when you are taking RANSIM tablets, you also need to follow a low fat diet and other measures, such as exercise and weight control. In most people, there are no symptoms of high cholesterol or triglycerides. Your doctor can measure your cholesterol and triglycerides with a simple blood test.
Safety and effectiveness have been studied in 10-17 year old boys and in girls, who had started their menstrual period at least one year before (see How to take RANSIM). RANSIM tablets have not been studied in children under the age of 10 years. For more information, talk to your doctor.
Your doctor may have prescribed RANSIM tablets for another reason. Ask your doctor if you have any questions. About why RANSIM tablets have been prescribed for you.
RANSIM tablets are not addictive.
Before you take RANSIM
When you must not take it
Do not take RANSIM tablets if:
- you have an allergy to RANSIM or other brands of simvastatin, or any of the ingredients listed at the end of this leaflet.
Symptoms of an allergic reaction may include skin rash, itchiness, shortness of breath, swelling of the tongue or face or painful joints.
- you are pregnant or breast-feeding
Your baby may absorb this medicine in the womb or from breast milk and therefore there is a possibility of harm to the baby.
- you have liver disease
- you have had muscle aches, tenderness or weakness, from other medicines used to treat high cholesterol or triglycerides.
- the expiry date has passed
If you take this medicine after the expiry date has passed, it may not work.
- the packaging is torn or shows signs of tampering
If you are not sure whether you should start taking RANSIM, talk to your doctor.
Before you start to take it
Tell your doctor if:
- you intend to become pregnant or plan to breast feed
RANSIM should not be used during pregnancy or while breast-feeding.
- you have unexplained muscle pain, tenderness or weakness not caused by exercise. This is because on rare occasions, muscle problems can be serious, including muscle breakdown resulting in kidney damage that can lead to death.
Your doctor may do a blood test to check for certain muscle problems.
- you are taking niacin or a niacin-containing product, particularly if you are Chinese
- you have ever had liver disease
Your doctor will do a blood test to make sure you have no problems with your liver.
- you have kidney disease or any other medical problems
- you drink alcohol regularly
- you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
If you have not told your doctor about any of the above, tell them before you take any RANSIM.
Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines you buy without a prescription from a pharmacy, supermarket or health food shop. Some medicines should not be taken with RANSIM tablets as they may increase the risk of muscle side effects with RANSIM tablets. It is particularly important to tell your doctor if you are taking:
- nefazodone, used to treat depression
- protease inhibitors, used to treat HIV infection, including indinavir, nelfinavir, ritonavir, saquinavir
- certain hepatitis C virus protease inhibitors (such as boceprevir or telaprevir)
- gemfibrozil, used to treat high cholesterol levels
- cyclosporin, used to suppress the immune system
- erythromycin, clarithromycin and fusidic acid, antibiotics used to treat infections
- ketoconazole and itraconazole, posaconazole and voriconazole, used to treat certain fungal infections
If you are taking any of the above, your doctor may suggest stopping RANSIM temporarily or permanently.
Some medicines and RANSIM may interfere with each other. Because taking RANSIM with any of the following drugs can increase the risk of muscle problems (see Side Effects), it is particularly important to tell your doctor if you are taking:
- other medicines to lower cholesterol levels, for example, other fibrates, nicotinic acid (also known as niacin)
- warfarin, or other drugs used to prevent blood clots
- chochicine, used for gout
- verapamil, diltiazem or amlodipine, used to treat high blood pressure, angina or other heart conditions)
- amiodarone, used to treat irregular heart beat
- digoxin, used to treat heart failure
These medicines may be affected by RANSIM tablets, may affect how well it works, or may increase the risk of side effects with RANSIM. You may need different amounts of your medicine, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking RANSIM tablets.
You should also tell any doctor who is prescribing a new medication for you that you are taking RANSIM.
How RANSIM tablets are given
How much to take
Take RANSIM tablets only when prescribed by your doctor. Your doctor will tell you how many tablets you need to take each day.
This depends on your cholesterol and triglyceride levels and other factors, such as kidney disease.
For adults, the recommended starting dose is 10 mg or 20 mg per day, taken in the evening, which may need to be increased up to 80 mg daily to have the best effect.
Because of the increased risk of muscle problems, the 80 mg dose is only for patients at high risk of heart disease problems who have not reached their cholesterol goal on lower doses.
People with CHD or risk factors for CHD are usually started on 40 mg per day, taken in the evening.
For children (10-17 years old), the recommended usual starting dose is 10 mg a day in the evening. The maximum recommended dose is 40 mg a day.
Swallow RANSIM with a glass of water.
Follow all directions given to you by your doctor and pharmacist carefully. They may differ from the information contained in this leaflet.
If you do not understand the instructions, ask your doctor or pharmacist for help.
When to take it
Take your RANSIM tablets once a day in the evening. The liver produces its greatest amount of cholesterol when the body is at rest and when there is no dietary intake. For most people this is at night when asleep. Therefore, RANSIM is more effective when taken in the evening. A good time would be after your evening meal. However, it does not matter whether you take it before or after food.
Take RANSIM at about the same time each evening. Taking your tablets at the same time each evening will have the best effect. It will also help you to remember when to take the tablets.
How long to take it
RANSIM tablets help lower your cholesterol. It does not cure your condition. Therefore, you must continue to take it as directed by your doctor if you expect to lower your cholesterol and keep it down. You may have to take cholesterol-lowering medicine for the rest of your life. If you stop taking RANSIM, your cholesterol levels may rise again..
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, then go back to taking it as you would normally.
If you are not sure whether to skip the dose, talk to your doctor or pharmacist.
Do not double a dose to make up for the dose that you missed.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints.
If you take too much (Overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at your nearest hospital, if you think that you or anyone else has taken too much of RANSIM tablets. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention. Keep these telephone numbers handy.
While you are using RANSIM tablets
Things you must do
If you become pregnant while taking RANSIM tablets, stop taking it and contact your doctor immediately.
Have your blood fats checked when your doctor says, to make sure RANSIM is working.
If you are about to be started on any new medicine, tell your doctor or pharmacist that you are taking RANSIM tablets.
If you are about to have elective surgery, tell your doctor that you are taking RANSIM tablets. Your doctor may suggest stopping the tablets for a few days before surgery.
Things you must not do
Do not give this medicine to anyone else, even if they have the same condition as you.
Do not use RANSIM tablets to treat any other complaints unless your doctor tells you to.
Do not stop taking RANSIM tablets, or lower the dose, without first checking with your doctor.
Things to be careful of
Be careful driving or operating machinery until you know how RANSIM affects you.
RANSIM tablets generally does not cause any problems with your ability to drive a car or operate machinery. RANSIM tablets may make you dizzy. This may affect your ability to drive or operate machinery. Make sure you know how you react to RANSIM tablets before you drive a car, operate machinery, or do anything else that could be dangerous if you are not alert.
Avoid drinking large quantities of alcohol. Drinking large quantities of alcohol may increase your chance of RANSIM tablets causing liver problems.
Avoid drinking grapefruit juice. Grapefruit juice contains one or more components that alter the metabolism of some medicines, including RANSIM.
Changes to lifestyle that may help reduce the chance of coronary heart disease
Lowering high cholesterol can help reduce your chances of having coronary heart disease (CHD). However, your chances of having CHD may be increased by several other factors including high blood pressure, cigarette smoking, diabetes, excess weight, family history of CHD, being a male and being a woman who has reached menopause.
Some self help measures suggested below may help your condition and help reduce your chances of having CHD. Talk to your doctor, pharmacist, or dietician about these measures and for more information.
Continue the low fat diet recommended by your doctor, dietician or pharmacist.
Make exercise a part of your routine – walking is good. Before starting any exercise, ask your doctor about the best kind of programme for you.
Your doctor may advise you to stop smoking or at least cut down.
Your doctor may suggest losing weight if you are overweight.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking RANSIM. RANSIM helps most people with high cholesterol, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist any questions you may have. Tell your doctor if you notice any of the following and they worry you:
- stomach upset or pain, feeling sick (nausea)
- constipation, diarrhea, wind
These are the more common side effects of RANSIM tablets. For the most part these have been mild and short-lived.
Tell your doctor immediately if you notice any of the following:
- aching muscles, muscle tenderness or weakness, not caused by exercise (in very rare cases this may not go away after stopping RANSIM tablets)
- brown/black coloured urine
On rare occasions, muscle problems can be serious, including muscle breakdown resulting in kidney damage that can lead to death.
The risk of muscle problems is greater for:
- patients taking higher doses of RANSIM tablets, particularly the 80 mg dose
- older patients (65 years of age and older)
- female patients
- patients with abnormal kidney function
- patients with thyroid problems
Tell your doctor immediately if you notice any of the following:
- tingling in the hands or feet
- signs of anaemia, such as tiredness, being short of breath, and looking pale
- fever, generally feeling unwell
- skin rash, itchiness
- pinkish, itchy swellings on the skin, also called hives or nettlerash
- painful, swollen joints
- bruising more easily than normal
- larger breasts than normal in men
These may be serious side effects of RANSIM tablets. Some of these may be symptoms of an allergic reaction to RANSIM tablets. You may need urgent medical attention. Serious side effects are rare.
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following:
- swelling of the face, lips, mouth, throat or tongue which may cause difficulty in swallowing or breathing
- shortness of breath
These are serious side effects. If you have them, you may have had a serious allergic reaction to RANSIM tablets. You may need urgent medical attention or hospitalisation. Serious side effects are rare.
Also, tell your doctor if you notice:
- hair loss
- muscle cramps
- trouble sleeping
- poor memory, memory loss, confusion
- feelings of depression
- erectile dysfunction
- breathing problems including persistent cough and/or shortness of breath or fever
There are other side effects that have been reported with RANSIM tablets.
Liver problems also can occur and may be serious. Your doctor will do blood tests to check your liver.
Tell your doctor immediately if you have the following symptoms of liver problems:
- feel tired or weak
- loss of appetite
- upper belly pain
- dark urine
- yellowing of your skin or the whites of your eyes
Other side effects not listed above may also occur in some patients. Tell you doctor if you notice anything else that is making you feel unwell. Do not be alarmed by this list of possible side effects. You may not experience any of them.
After using it
Keep your tablets in the original pack until it is time to take them. If you take the tablets out of the box or the original pack they may not keep well.
Keep your RANSIM in a cool, dry place where it stays below 25°C. Do not store it, or any other medicine, in the bathroom or near a sink. Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines.
Keep this medicine where young children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking RANSIM or you find that they have passed their expiry date, ask your pharmacist what to do with any tablets that are left over.
What it looks like
- RANSIM 10 mg tablets are peach-coloured, film-coated, oval-shaped tablets debossed with ‘SST’ on one side and ‘10’ on other side with intact coating.
- RANSIM 20 mg tablets are tan-coloured, film-coated, oval-shaped tablets debossed with ‘SST’ on one side and ‘20’ on other side with intact coating.
- RANSIM 40 mg tablets are brick red-coloured, film-coated, oval-shaped tablets debossed with ‘SST’ on one side and ‘40’ on other side with intact coating.
- RANSIM 80 mg tablets are brick red-coloured, film-coated, round tablets debossed with ‘RX 793’ on one side.
RANSIM tablets are supplied in PVC/PVDC/Al blister packs of 30 tablets.
- RANSIM 10 mg tablets – 10 mg of Simvastatin
- RANSIM 20 mg tablets – 20 mg of Simvastatin
- RANSIM 40 mg tablets – 40 mg of Simvastatin
- RANSIM 80 mg tablets – 80 mg of Simvastatin
- Pregelatinised maize starch
- Ascorbic acid
- Citric acid monohydrate,
- Microcrystalline cellulose
- purified water
- isopropyl alcohol
- croscarmellose sodium
- magnesium stearate
- Opadry 20A54963 Pink (10 mg)
- Opadry 20A56532 Brown (20 mg)
- Opadry 20A54964 Pink (40 mg)
- Opadry 20A54614 Pink (80 mg)
Australian Registration Numbers
- RANSIM 10 mg: AUST R 120591
- RANSIM 20 mg: AUST R 120612
- RANSIM 40 mg: AUST R 120616
- RANSIM 80 mg: AUST R 120617
RANSIM is supplied in Australia by:
Ranbaxy Australia Pty Ltd.
Suite 4.02, Building D, Level 4
12 – 24 Talavera Road
North Ryde, NSW 2113
This leaflet was prepared in March 2013.
Published by MIMS May 2014