Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Simvastatin.

Alcohol: Consumption of alcohol can increase the risk of liver damage when taking simvastatin. If you  regularly drink more than 3 drinks of alcohol daily, the risk is further increased and you should be closely monitored by your doctor while taking Simvastatin.

Diabetes: Simvastatin, like other medications in this family, may cause a loss of control of blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Simvastatin, and whether any special monitoring is needed.

Grapefruit juice: Don't drink grapefruit juice while taking Simvastatin, as it can increase the amount of simvastatin in the blood and increase the risk of serious side effects.

Kidney problems: People with decreased kidney function should discuss with their doctor how Simvastatin may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Simvastatin, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Simvastatin to build up in the body, causing side effects. If you have a history of liver disease, discuss with your doctor how Simvastatin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Simvastatin, and whether any special monitoring is needed.

Laboratory tests show signs of harmful effects to the liver that may occur for a small percentage of people who take simvastatin. When Simvastatin is stopped, liver function usually slowly returns to normal. Your doctor will perform regular tests to check your liver function.

Simvastatin should not be used by people with active liver disease or by people whose liver function tests are higher than normal.

Muscle effects: In rare cases, serious muscle pain, cramps, and weakness have been associated with the use of statin medications (i.e., cholesterol-lowering medications whose names end in "statin," such as Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvastatin, or simvastatin), especially at higher doses. Before taking this medication, tell your doctor or pharmacist if you:

• are 65 years of age or older
• are female
• are taking other cholesterol-lowering medications such as fibrates (e.g., gemfibrozil, Fenofibrate) or Niacin
• do excessive physical exercise
• have a family history of muscular disorders
• have diabetes
• have had any past problems with the muscles (pain, tenderness) after taking a statin medication
• have Hypothyroidism (low Thyroid) that is not controlled with medication
• have kidney or liver problems
• have undergone surgery or other tissue injury
• regularly drink 3 or more alcoholic drinks daily

Report any unexplained muscle pain, tenderness, weakness, or cramps, or any brown or discoloured urine to your doctor immediately, particularly if you are also experiencing malaise (a general feeling of being unwell) or fever.

Pregnancy: Simvastatin should not be taken during pregnancy. It may cause harm to the unborn baby. If you become pregnant, stop taking Simvastatin and contact your doctor immediately.

Breast-feeding: It is not known if simvastatin passes into breast milk. If you are a breast-feeding mother and are taking Simvastatin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Simvastatin have not been established for children less than 10 years of age or in girls who have not started menstruating.

Seniors: If you are 65 years of age or older, you may experience more side effects. Your doctor will monitor you closely while you are taking Simvastatin.