What is the maximum recommended daily simvastatin dose for a person with a *5/*5 SLCO1B1 genotype?

The correct answer to the question regarding the maximum recommended daily simvastatin dose for a person with a *5/*5 SLCO1B1 genotype is 20 mg.

Individuals with the *5/*5 genotype have a significantly reduced function of the SLCO1B1 gene, which encodes for a transporter protein that is responsible for the hepatic uptake of simvastatin and other statins. This reduced function may lead to increased plasma concentrations of simvastatin, heightening the risk of adverse effects, particularly statin-associated myopathy and rhabdomyolysis.

For patients with this genotype, it is essential to carefully monitor and limit the dose of simvastatin to minimize the risk of these complications. Current guidelines recommend a maximum dosage of 20 mg per day for individuals identified as having these specific SLCO1B1 genotype variants. This recommendation reflects a precision medicine approach, tailoring therapy based on genetic predisposition to enhance safety and effectiveness.