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.
