The
following information is a summary about Zocor. It
is not intended to replace a doctor's instructions.
Zocor USES
Zocor (Simvastatin) is a cholesterol- lowering medicine.
It inhibits the production of cholesterol by the
liver. It lowers overall blood cholesterol as well
as blood LDL cholesterol levels. LDL cholesterol
is believed to be the "bad" cholesterol
that is primarily responsible for the development
of coronary artery disease. Lowering LDL cholesterol
levels retards progression and may even reverse coronary
artery disease.
Zocor DIRECTIONS
Take your Zocor by mouth as prescribed. May be taken
on an empty or full stomach.
Zocor SIDE EFFECTS
Zocor is generally well-tolerated and side effects
are rare. Minor side effects include constipation,
diarrhea, fatigue, gas, heartburn, and headache.
Major side effects include abdominal pain or cramps,
blurred vision, dizziness, easy bruising or bleeding,
itching, muscle pain or cramps, rash, and yellowing
of the skin or eyes.
Zocor PRECAUTIONS
Zocor is generally well- tolerated. The medication
should be used with caution in patients with alcohol
or other liver diseases. Persistently abnormal liver
tests during treatment are rare, but may lead to
a discontinuation of the medication. Rare cases of
muscle inflammation (myositis) and breakdown have
been reported with simvastatin. Muscle breakdown
causes the release of muscle protein (myoglobin)
into the blood and kidney tubules, resulting in acute
kidney failure. The risk of muscle breakdown is increased
when simvastatin is given together with other medications
such as cyclosporine (Sandimmune), gemfibrozil (Lopid),
erythromycin and nicotinic acid. Simvastatin may
interact with cholestyramine (Questran), warfarin
(Coumadin), and cimetidine (Tagamet) to alter the
blood levels of these medicines. When Coumadin is
given together with simvastatin, blood clotting times
require monitoring to avoid excessive blood thinning
and bleeding. Simvastatin should not be used in children.
Simvastatin is not habit forming.
Zocor DRUG INTERACTIONS
Tell your doctor of all prescription and nonprescription
meds you may use, especially of: carbamazepine, narcotic
pain relievers (e.g., codeine), drugs used to aid
sleep, antidepressants (e.g., SSRI-types such as
fluoxetine or fluvoxamine), MAO inhibitors (e.g.,
furazolidone, linezolid, phenelzine, procarbazine,
selegiline, tranylcypromine), psychiatric medicine
(e.g., nefazodone), "triptan"-type drugs, anti-anxiety
drugs (e.g., diazepam), sibutramine. Also, report
use of certain antihistamines (e.g., diphenhydramine)
which are also present in many cough-and-cold products.
Do not start or stop any medicine without doctor
or pharmacist approval.
Zocor OVERDOSE
If overdose is suspected, contact your local poison
control center or emergency room immediately.
Zocor NOTES
Atorvastatin, cerivastatin #, fluvastatin, lovastatin,
pravastatin, and simvastatin are used to lower levels
of cholesterol and other fats in the blood. This
may help prevent medical problems caused by cholesterol
clogging the blood vessels. These medicines belong
to the group of medicines called 3-hydroxy-3-methylglutaryl
coenzyme A (HMG-CoA) reductase inhibitors. They work
by blocking an enzyme that is needed by the body
to make cholesterol. Thus, less cholesterol is made.
HMG-CoA reductase inhibitors are available only with
your doctor's prescription, in the following dosage
forms: * Oral Atorvastatin o Tablets (U.S. and Canada)
* Cerivastatin o Tablets # * Fluvastatin o Capsules
(U.S. and Canada) * Lovastatin o Extended-Release
Tablets (U.S.) o Tablets (U.S. and Canada) * Pravastatin
o Tablets (U.S. and Canada) * Simvastatin o Tablets
(U.S. and Canada) Before Using This Medicine In deciding
to use Zocor, the risks of taking the medicine must
be weighed against the good it will do. This is a
decision you and your doctor will make. For HMG-CoA
reductase inhibitors, the following should be considered:
Allergies-Tell your doctor if you have ever had any
unusual or allergic reaction to HMG-CoA reductase
inhibitors. Also tell your health care professional
if you are allergic to any other substances, such
as foods, preservatives, or dyes. Diet-Before prescribing
medicines to lower your cholesterol, your doctor
will probably try to control your condition by prescribing
a personal diet for you. Such a diet will be lower
in total fat, particularly saturated fat, and dietary
cholesterol. Many people are able to control their
condition by carefully following their doctor's orders
for proper diet and exercise. Zocor is prescribed
only when additional help is needed and is effective
only when a schedule of diet and exercise is properly
followed. Also, this medicine is less effective if
you are greatly overweight. It may be very important
for you to go on a reducing diet. However, check
with your doctor before going on any diet. Pregnancy-HMG-CoA
reductase inhibitors should not be used during pregnancy
or by women who plan to become pregnant in the near
future. Zocor and similar medicines block formation
of cholesterol, which is necessary for the fetus
to develop properly. HMG-CoA reductase inhibitors
may cause birth defects or other problems in the
baby if taken during pregnancy. An effective form
of birth control should be used during treatment
with these medicines. Check with your doctor immediately
if you think you have become pregnant while taking
this medicine. Be sure you have discussed this with
your doctor. Breast-feeding-Zocor is not recommended
for use during breast-feeding because they may cause
unwanted effects in nursing babies. Children-Studies
on this medicine have been done only in adult patients,
and there is no specific information comparing use
of HMG-CoA reductase inhibitors in children with
use in other age groups. However, atorvastatin, lovastatin,
and simvastatin have been used in a limited number
of children under 18 years of age. Early information
seems to show that these medicines may be effective
in children, but their long-term safety has not been
studied. Older adults-This medicine has been tested
in a limited number of patients 65 years of age or
older and has not been shown to cause different side
effects or problems in older people than it does
in younger adults. Other medicines-Although certain
medicines should not be used together at all, in
other cases two different medicines may be used together
even if an interaction might occur. In these cases,
your doctor may want to change the dose, or other
precautions may be necessary. When you are taking
HMG-CoA reductase inhibitors such as Zocor, it is
especially important that your health care professional
know if you are taking any of the following: * Cyclosporine
(e.g., Sandimmune) or * Gemfibrozil (e.g., Lopid)
or * Clofibrate (e.g., Atromid-S) or * Fenofibrate
(e.g., Tricor) or * Niacin-Use of these medicines
with an HMG-CoA reductase inhibitor may increase
the risk of developing muscle problems and kidney
failure * Digoxin (e.g., Lanoxin)-Use with atorvastatin,
fluvastatin, or simvastatin may increase blood levels
of digoxin, increasing the risk of side effects *
Oral contraceptives, (birth control tablets)-Atorvastatin
may increase the blood levels of the birth control
hormones, increasing the risk of side effects * HIV
protease inhibitors (Amprenavir [e.g., Agenerase],
Indinavir [e.g., Crixivan], Nelfinavir [e.g., Viracept],
Ritonavir [e.g., Norvir], Saquinavir [e.g., Fortovase,
Invirase]) or * Nefazodone (e.g. Serzone)-Use with
simvastatin may increase the risk of developing muscle
problems and kidney failure * Verapamil (e.g. Calan,
Isoptin)-Use with simvastatin may increase the risk
of muscle problems Other medical problems-The presence
of other medical problems may affect the use of HMG-CoA
reductase inhibitors. Make sure you tell your doctor
if you have any other medical problems, especially:
* Alcohol abuse (or history of) or * Liver disease-Use
of Zocor may make liver problems worse * Convulsions
(seizures), not well-controlled, or * Organ transplant
with therapy to prevent transplant rejection or *
If you have recently had major surgery-Patients with
these conditions may be at risk of developing problems
that may lead to kidney failure
MISSED DOSE
If you miss a dose, use Zocor as soon as you remember.
If it is near the time of the next dose, skip the
missed dose and resume your usual dosing schedule.
Do not "double-up" the dose to catch up.
Zocor STORAGE
Store Zocor at room temperature between 36 and 77
degrees F (2 -25 degrees C) away from light and moisture.
