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Updated: Aug 17, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Effect of splitting simvastatin tablets for control of low-density lipoprotein cholesterol
David Parra1, Nick P Beckey, Harsha S Raval
1Section of Clinical Pharmacy, Patient Support Service, Department of Veterans Affairs Medical Center, West Palm Beach, Florida 33410-6400, USA. david.parra@med.va.gov
Abstract:
The efficacy, safety, and economics of a voluntary conversion from whole simvastatin tablets to split tablets in 6 Veterans Affairs medical centers were retrospectively evaluated in 3,787 patients who received a consistent daily dose (5 to 40 mg) of simvastatin in 1999. Baseline and final low-density lipoprotein cholesterol levels and average change from baseline were not significantly different between groups (p >0.05), nor were the incidence of transaminase increases (p >0.05) or measurements of patient compliance (p = 0.07). Widespread implementation of this initiative resulted in a cost avoidance of >$1.2 million in the 6 medical centers and $10.3 million across the Veterans Affairs medical system in 1999, with >$46 million avoided in 2003.
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