- Related Diseases
- Images & Quizzes
- Cholesterol Levels Slideshow Pictures
- Lowering Cholesterol Slideshow
- Take the Cholesterol Quiz
- What is Zocor?
- Is Zocor available as a generic drug?
- Do I need a prescription for Zocor?
- Why is Zocor prescribed to patients?
- What are the side effects of Zocor?
- What is the dosage for Zocor?
- Which drugs or supplements interact with Zocor?
- Is Zocor safe to use during pregnancy or while breastfeeding?
- What else should I know about Zocor?
What is Zocor?
Quick GuideLower Your Cholesterol, Save Your Heart
Why is Zocor prescribed to patients?
- Simvastatin is used for reducing total cholesterol, LDL cholesterol, and triglycerides, and for increasing HDL cholesterol.
- In patients with coronary heart disease, diabetes, peripheral vascular disease, or history of stroke or other cerebrovascular disease, simvastatin is prescribed for reducing the risk of mortality by reducing death from coronary heart disease, reducing nonfatal myocardial infarction (heart attack) and stroke, and reducing the need for coronary and noncoronary revascularization procedures.
What are the side effects of Zocor?
The most common side effects of simvastatin are:
- abdominal pain,
- muscle pain, and
- abnormal liver tests.
- Hypersensitivity reactions
Other side effects include:
What are the more serious side effects of Zocor?
- The most serious potential side effects are liver damage and muscle inflammation or breakdown. Simvastatin shares side effects, such as liver and muscle damage associated with all statins. Serious liver damage caused by statins is rare. More often, statins cause abnormalities of liver tests. Abnormal tests usually return to normal even if a statin is continued, but if the abnormal test value is greater than three times the upper limit of normal, the statin usually is stopped. Liver tests should be measured before simvastatin is started and if there is a medical concern about liver damage thereafter.
- Inflammation of the muscles caused by statins can lead to a serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood. Myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolysis in less than one percent of patients. To prevent the development of rhabdomyolysis, patients taking simvastatin should contact their health care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.
- Statins have been associated with increases in HbA1c and fasting serum glucose levels as are seen in diabetes.
What is the dosage for Zocor?
- The recommended dose range of simvastatin is 10 mg to 40 mg, and it is administered once daily in the evening with or without food. Therapy usually is initiated with 10 or 20 mg daily, but individuals who have a high risk of heart disease can be started on 40 mg daily.
- Simvastatin 80 mg is restricted to patients who have been taking simvastatin 80 mg chronically (for example, for 12 months or more) without evidence of muscle toxicity because the 80 mg dose is associated with increased risk of muscle toxicity, including rhabdomyolysis. Patients who are currently tolerating the 80 mg dose of simvastatin who need to start an interacting drug that should not be taken with simvastatin or is associated with a dose cap for simvastatin should be switched to an alternative statin or statin-based regimen with less potential for the drug-drug interaction.
- Patients that require more than the 40 mg dose should be switched to an alternative drug.
Quick GuideLower Your Cholesterol, Save Your Heart
Which drugs or supplements interact with Zocor?
Decreased elimination of simvastatin could increase the levels of simvastatin in the body and increase the risk of muscle toxicity from simvastatin. Examples of drugs that decrease elimination of simvastatin include
- erythromycin (E-Mycin),
- ketoconazole (Nizoral),
- itraconazole (Sporanox),
- clarithromycin (Biaxin),
- telithromycin (Ketek),
- cyclosporine (Sandimmune),
- nefazodone (Serzone),
- boceprevir (Victrelis),
- telaprevir (incivek),
- voriconazole (Vfend),
- posaconazole (Noxafil), and
- HIV protease inhibitors such as:
They should not be combined with simvastatin.
Large quantities of grape fruit juice (>1 quart daily) also will increase blood levels of simvastatin and should be avoided.
The following drugs should not be used with simvastatin:
- Amiodarone (Cordarone),
- verapamil (Calan Verelan, Isoptin),
- amlodipine (Norvasc),
- danazol (Danocrine),
- ranolazine (Ranexa),
- niacin (Niacor, Niaspan, Slo-Niacin),
- gemfibrozil (Lopid) and
- fenofibrate (Tricor).
Patients taking amiodarone, amlodipine, or ranolazine should not exceed 20 mg, and patients taking verapamil or diltiazem should not exceed 10 mg of of simvastatin daily. Patients taking gemfibrozil or danazol should not take simvastatin.
Chinese patients taking ≥1 g/day of niacin in combination with simvastatin 40 mg have an increased risk of muscle-related side effects. Therefore, these patients should not receive simvastatin 80 mg combined with niacin in doses ≥1 g/day. Simvastatin doses greater than 20 mg daily should be administered cautiously when combined with niacin ≥1 g/day.
Is Zocor safe to use during pregnancy or while breastfeeding?
- Pregnant women should not use simvastatin because the developing fetus requires cholesterol for development, and simvastatin reduces the production of cholesterol. Simvastatin should only be administered to women of child bearing age if they are not likely to become pregnant.
- Because of the risk of adverse effects to the developing infant, simvastatin should not be administered to nursing mothers.
What else should I know about Zocor?
What preparations of Zocor are available?
- Tablets: 5, 10, 20, 40, and 80 mg.
- Orally disintegrating tablets: 10, 20, 40, and 80 mg.
How should I keep Zocor stored?
- Tablets should be stored between 5-30 C (41-86 F).
- Orally disintegrating tablets should be stored between 20-25 C (68-77 F).
How does simvastatin (Zocor) work?
Statins reduce cholesterol by inhibiting an enzyme in the liver (HMG-CoA reductase) that is necessary for the production of cholesterol. In the blood, statins lower total and low density lipoprotein (LDL) or "bad" cholesterol as well as triglycerides. LDL cholesterol is believed to be an important cause of coronary artery disease. Lowering LDL cholesterol levels slows and may even reverse coronary artery disease. Statins also increase high density lipoprotein (HDL) or "good" cholesterol. Raising HDL cholesterol levels, like lowering LDL cholesterol may slow coronary artery disease.
When was simvastatin (Zocor) approved by the FDA?
The FDA approved simvastatin in Decembe, 1991.
Reference: FDA Prescribing Information
Quick GuideLower Your Cholesterol, Save Your Heart
Daily Health News
Subscribe to MedicineNet's Heart Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top simvastatin Related ArticlesComplete List
Cholesterol SlideshowDo you know the different cholesterol levels and what they mean? Learn the alphabet soup of cholesterol testing: LDL, HDL, good, bad, and triglycerides. Pictures show tests, treatments, and critical foods from eggs to avocados.
Cholesterol PictureCholesterol carried in particles of low density (LDL cholesterol) is referred to as the "bad" cholesterol because elevated levels of LDL cholesterol are associated with an increased risk of coronary heart disease. See a picture of Cholesterol and learn more about the health topic.
Complete Blood CountA complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures:
- the concentration of white blood cells,
- red blood cells,
- platelets in the blood, and
- aids in diagnosing conditions and disease such as
- anemia, or
- blood clotting problems.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Portion Distortion QuizAre your portions deceiving you? Take the Food Portion Distortion Quiz to find out how and why gigantic portions trick you into eating more than reasonable amounts of food!
Heart Disease (Coronary Artery Disease)
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include:
- High blood pressure
- High cholesterol
- Family history
Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
CAD SlideshowWhat is heart disease (coronary artery disease)? Learn about the causes of heart disease. Symptoms of heart disease include chest pain and shortness of breath. Explore heart disease diagnosis, treatment, and prevention.
Heart Disease SlideshowLearn about heart disease and heart attack symptoms and signs of a heart attack in men and women. Read about heart disease diagnostic tests, treatments, and prevention strategies.
Heart Disease QuizTake our Heart Disease Quiz to get answers and facts about high cholesterol, atherosclerosis prevention, and the causes, symptoms, treatments, testing, and procedures for medically broken hearts.
Heart: How the Heart WorksThe heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
Cholesterol QuizHigh cholesterol can be a dangerous condition. Take the Cholesterol Quiz to understand what high cholesterol means in terms of your health risks.
Elevated homocysteine levels (hyperhomocysteinemia) is a sign that the body isn't producing enough of the amino acid homocysteine. The condition may be genetic (inherited) called homocystinuria. Homocystinuria is a somewhat rare genetic (inherited) condition that includes symptoms like developmental delays, osteoporosis, blood clots, heart attack, heart disease, stroke, and visual abnormalities died at an early age. There are other causes of the condition like alcoholism.
Supplementing the diet with folic acid and possibly vitamins B6 and B12 supplements can lower homocysteine levels. Currently there is no direct proof that taking folic acid and B vitamins to lower homocysteine levels prevent heart attacks and strokes. Talk to your doctor if you feel you need to have your homocysteine blood levels checked.
Liver Blood TestsAn initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.
Lower Cholesterol TipsNeed to lower your cholesterol levels? Use these smart diet tips to quickly and easily lower your blood cholesterol levels. Choose heart-healthy foods to lower cholesterol and improve your heart health.
RhabdomyolysisRhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include:
- severe burns,
- muscle trauma,
- electrolyte imbalance,
- medications (statins),
- viruses, and
Stroke Symptoms and Treatment
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include
- double vision or vision loss,
- vertigo, and
- difficulty speaking or understanding speech.
A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Trigger Point InjectionTrigger point injection (TPI) treats knots of muscles that form when muscles don't relax. During the procedure, a needle containing anesthetic and/or corticosteroid is inserted into the trigger point. TPI may be used to treat fibromyalgia, myofascial pain syndrome, and tension headaches.
Triglyceride TestTriglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.