Editor—Wallace et al have conducted what initially looks like a neat piece of general practice based research into a small but common day to day issue about whether to take simvastatin in the morning or evening, but I do not believe that it amounts to notable evidence to change practice.1
Cholesterol concentration was measured 12 hours closer to the dose in the night dosing group, which may explain the result. Having the drug in higher concentrations during the day when most eating is done may have an important interaction effect on clinical outcomes.
The real question to answer from the patient's point of view is the net benefit to wellbeing from different dosing regimens. This includes convenience factors and impact on compliance with other drug treatment, etc. This study does not take this into account. Simvastatin is usually one of several drugs patients are asked to take.
Competing interests: None declared.
References
- 1.Wallace A, Chinn D, Rubin G. Taking simvastatin in the morning compared with in the evening: randomised controlled trial. BMJ 2003;327: 788. (4 October.) [DOI] [PMC free article] [PubMed] [Google Scholar]