About Zocor
Zocor is a HMG-CoA Reductase Inhibitor, also known as a statin.
This class of treatments for high cholesterol is fairly new,
and appears to work by blocking a liver enzyme which generates
cholesterol. This medication appears to be the most effective
in this class of drugs at lowering unhealthy LDL (low-density
lipoprotein) cholesterol levels, in some cases up to 51%.
Currently, this drug is approved for use in patients with
high cholesterol (hypercholesterolemia, types IIa & IIb)
to reduce the incidence of heart attack and death, as well
as decreasing the incidence of stroke, to halt coronary artery
disease, to increase HDL (high-density lipoprotein) levels
in patients with high cholesterol and those with both high
cholesterol and high triglycerides (mixed dyslipidemia), and
also to treat hyperlipoproteinemia (type three) and hpyertriglyceridemia.
Other accepted uses include: gallstone prevention (as a combination
therapy), lipid disorders occurring with kidney disease, may
improve the balance of LDL and HDL in combination with estrogen
in post-menopausal women.
This treatment should be considered a last resort. The best
way to lower cholesterol is through a program of healthy diet
and exercise, and these need to be maintained during treatment
with Zocor for best results.
Zocor is only available by prescription, use as directed.
Zocor Side Effects
Mild Side Effects: These side effects are unexpected,
and should be reported to your doctor for evaluation. Allergy
(skin rash), constipation, decreased libido or sexual performance,
diarrhea, drowsiness, flu-like symptoms, gas, headache, heartburn,
insomnia, mild stomach pain or cramping, muscle pain (inform
your doctor immediately if you experience muscle pain).
Serious Side Effects: These side effects are very
rare and potentially dangerous. Seek medical treatment immediately
if you experience any of the following. Abnormal liver tests,
fever, kidney failure, severe muscle pain or tenderness, severe
stomach pain, unusual and severe tiredness. There is a case
report of confusion, short-term memory trouble, and unusual
feelings of well-being.
In very rare cases, rhabdomyolosis may occur. This is a breakdown
of muscle tissue, sometimes accompanied by dark urine or muscle
aching. Common rhabdomyolosis risk factors include alcohol or drug
abuse, soft tissue trauma, lack of blood supply to tissue, and seizure
activity. Report muscle aches to your doctor immediately. If the
muscle aches are severe, and accompanied by dark urine, seek emergency
medical treatment at once. Do not exert yourself beyond your doctor's
guidelines or normal activities.
Cautions: This medication is not for everyone. Discuss any
of the following situations or conditions with your doctor to ensure
safe and effective treatment.
- Alcohol: Frequent alcohol use should be discussed
with your doctor prior to treatment. Heavy alcohol use may
worsen your condition.
- Allergies: An allergy to this medication in the
past, or to any other statin, indicates that this treatment
is unsuitable for you. Inform your doctor of any other food
or drug allergies you may have when beginning treatment.
- Kidney Disease: This treatment may cause kidney
damage in rare cases.
- Liver Disease: Active liver disease is a contraindication
for treatment. Impaired liver function is a caution for
treatment, but may not completely rule it out. If you have
unexplained abnormal liver tests, your doctor will likely
want to figure out the cause before starting treatment.
This medication may cause abnormal liver tests.
- Muscle Weakness: Unexplained weakness or tenderness,
or any muscle disorder may indicate that your treatment
proceed with caution. Your doctor may urge you to try other
treatments.
- Pregnancy: This drug is not recommended for pregnant
women, or women who are breast-feeding. If you become pregnant
while using Zocor, stop your treatment immediately and contact
you doctor. Women of childbearing age are encouraged to
use an effective method of contraception while they take
this medicaition.
- Previous Treatment: If you have been treated with
another statin in the past, or if past treatment with Zocor
was unsuccessful, inform your doctor.
- Seizure: Inform your doctor of any seizure condition,
as the risk of liver damage is increased.
- Surgery: Any surgeon or dentist should be informed
in advance of the procedure that you take this medication.
If you have recently had major surgery, your immune system
may be compromised, and your dose may need to be lowered.
Zocor Interactions
Not all medications will be safe to mix with Zocor (simvastatin)
treatment. Some of the following medications will require dosage
adjustments in one of your treatments to be used safely, others
should not be combined at all. Speak to your doctor if you take,
or plan to take any of the following. If you visit multiple prescribing
physicians for specialist treatment, be sure to keep each of them
fully informed regarding medications that may have been prescribed
by another doctor.
- Alcohol - For some individuals, avoidance of alcohol will be
an important part of an overall plan to manage their cholesterol
levels. Follow your doctor's directions regarding alchohol use.
Excessive use is not recommended during treatment for any individuals.
- Antacids - Reduces simvastatin absorption. If you must use
these, speak to your doctor or pharmacist about preventing them
from interfering with your treatment.
- Antiseizure treatments like Cerebyx (fosphenytoin) and Dilantin
(phenytoin) may make simvastatin less effective.
- Atromid-S (clofibrate) - This medication, and other fibric acid
preparations, can increase the risk of muscle damage and kidney
failure when used with statins.
- Azole antifungals - Drugs like Diflucan
(fluconazole), Nizoral (ketoconazole), or Sporanox (itraconazole),
etc., increase the risk of muscle damage. Caution is advised,
you may want to consider all of your treatment options carefully.
- Calan (verapamil) - Increased risk of muscle damage.
- Colestid (colestipol) - Lowers simvastatin levels in the body,
but the combination may provide more effective treatment for lowering
unhealthy LDL cholesterol.
- Garlic - Supplement level dosing not recommended during treatment,
may overly inhibit blood clotting. The small amount of garlic
found in most foods is probably too little for concern, but speak
to your doctor about this if you feel it might be an issue.
- Grapefruit juice - May lead to muscle damage and Zocor
toxicity. Do not combine.
- Lanoxin (digoxin) - This drug may build up to toxic levels when
taken with simvastatin.
- Lopid (gemfibrozil) - Increased risk of muscle damage and kidney
failure when used with statins.
- Macrolide antibiotics like erythromycin (Ery-tab, etc.) may
increase the risk of muscle damage.
- Niacin (vitamin B3) - This vitamin may increase the risk of
muscle damage during treatment, and can increase levels of homocysteine,
an oxidant which increases the risk of heart disease. Taking supplemental
niacin on its own is not recommended, speak to your doctor regarding
safe levels in multivitamin supplements.
- Oral Contraceptives - Birth control pills may be blocked
from clearing from the body when used with this medication, undesirable
high levels of hormone may result.
- Plavix (clopidogrel)
- Protease inhibitors - Drugs like Agenerase (amprenavir), Crixivan
(indinavir), Fortovase (saquinavir), Norvir (ritonavir), or Viracept
(nelfinavir), can increase levels of simvastatin in the body,
leading to a greater chance of muscle damage.
- Sandimmune (cyclosporine) - Increased risk of muscle problems
when used with statins.
- Serzone (nefazodone) - Toxic levels of simvastatin may build
up when these treatments are combined.
- Synercid (dalfopristin, quinupristin) - Can increase the risk
of muscle damage.
- Tricor (fonefibrate) - Increased risk of muscle damage and kidney
failure when used with statins.
- Welchol (colesevelam) - This combination may provide more effective
treatment for lowering unhealthy LDL cholesterol.
Zocor Dosages
Zocor is presently available in 5 mg, 10 mg, 20 mg, 40 mg,
and 80 mg tablets. The tablets have their dosage number stamped
on one side, and 'MSD' followed by a three-digit number on
the other. The 80 mg tablet is lozenge shaped, whereas smaller
dosages will be shield shaped.
The usual starting dose is 20 mg, up to a maximum of 80 mg
daily. Individuals who are over 60, or have compromised immune
systems (due to illness or major surgery), may be started
on 5 mg daily. Your doctor will base your individual dosage
recommendation on their examination findings.
Zocor Directions
If you miss a dose of Zocor, take it as soon as you remember,
unless you are within a few hours of your next dose. In that
case, skip the missed dose and go back to your schedule. Taking
double doses of Zocor is not recommended, as it may lead to
an increased risk of adverse side effects.
These tablets may be split, or crushed. They may be mixed with
most beverages, but avoid taking with grapefruit juice, as
there is an increased risk of muscle damage. If higher dosages of
Zocor are priced identically with lower dosages, it may be cost
effective to purchase a higher dosage tablet and use a pill splitter
to get the correct dose. Your doctor or pharmacist can advise you
on this.
Zocor should be taken on an empty stomach for best absorption.
As most cholesterol is thought to be produced at night, the most
recommended time of use is at bedtime.
This medication may reduce the body's ability to produce Coenzyme
Q10 (CoQ10), also called ubiquinone, an important antioxidant. Supplementation
is recommended. Certain nutritionists suggest that the gel or liquid
forms of this supplement are more available to the body, use as
directed.
Stopping this medication abruptly may lead to a significant increase
in cholesterol levels. Seek your doctor's advice when considering
whether or not to discontinue treatment.
Store Zocor away from direct light and heat. Store in a dry location;
avoid storing it in the bathroom, near sinks, or other areas where
it may become damp. Do not use after the expiration date.
Keep Zocor away from children; both when storing it, and when
discarding any unused medication.
Zocor and Pregnancy
This drug appears to lead to increased infant mortality in animal studies. It is not considered safe for use during any portion of a pregnancy. This drug is not considered safe to use during breast-feeding.
Zocor and Children
No information is available on the safety and effectiveness of this medication in children. It is not presently prescribed for them.
Zocor and Seniors
Seniors tend to build up higher levels of Zocor in their
blood than adults under 60, and the lowest starting dose of
5 mg is recommended. Careful monitoring may still be necessary
to ensure that toxic levels of this treatment do not build
up in the body.
Zocor is a trademark of Merck
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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