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Simvastatin

Simvastatin

Overview

Zocor (generic name simvastatin) is prescribed primarily to lower cholesterol.

Heart specialists recognize that coronary artery disease is associated with certain risk factors, including high serum cholesterol, bad LDL cholesterol, elevated triglycerides and reduced levels of protective HDL cholesterol.

Diet, exercise and weight control are usually considered important first-line preventive approaches. When they are insufficient, drugs like Zocor may be important in reducing the risk of heart disease.

This medication has been found to reduce LDL cholesterol and triglycerides while raising HDL a variable amount.

Side Effects and Interactions of Zocor (Simvastatin)

Zocor has relatively few side effects and most people tolerate it well.

Some adverse reactions that may occur include stomachache, constipation, flatulence, diarrhea, nausea, headache, fatigue, and skin rash.

Less common complications include dizziness, muscle pain, change in the sense of taste, insomnia, and numbness or tingling of the hands or feet.

Muscle aches or weakness could be a sign of a serious reaction called rhabdomyolysis or myopathy, and call for a test of kidney function. Kidney failure might be the outcome of untreated myopathy.

Report any symptoms to your physician promptly.

The danger of rhabdomyolysis or myopathy is increased when Mevacor is combined with certain other drugs.

Troleandomycin or erythromycin antibiotics such as E.E.S., E-Mycin, Erythrocin or PCE have been involved in several cases. The new antibiotics Biaxin and Zithromax belong to the same class of drugs, but it is not clear if they have a potential for such an interaction.

Because Zocor is in the same class as Mevacor, this interaction may pose hazards with Zocor as well.

When Zocor is combined with other cholesterol-lowering medicines such as Lopid or niacin be alert for muscle pain, weakness, and kidney damage, as rhabdomyolysis may be more common in this situation.

The transplant drug Sandimmune also appears to increase the risk of this dangerous reaction.

When Zocor is combined with other cholesterol-lowering medicines such as Lopid or niacin be alert for muscle pain, weakness, and kidney damage, as rhabdomyolysis may be more common in this situation.

Zocor may also increase the action of the blood thinner Coumadin; prothrombin time should be closely monitored. Lanoxin levels should also be monitored in people taking both medications.

It’s possible that flavonoids found in the herb Echinacea affect the enzyme (CYP 3A4) responsible for metabolizing many common drugs. If so, medications such as Zocor could reach higher levels in the body.

The herb St. John’s wort might speed elimination of Zocor from the body, which could reduce its effectiveness.

There is a remote but untested possibility that peppermint could increase the effects of cholesterol-lowering drugs such as Zocor. These agents work by inhibiting the enzyme HMG CoA reductase, and menthol has a similar action.

The herb gotu kola may raise cholesterol levels and should not be combined with Zocor.

Check with your physician and pharmacist to make sure Zocor is safe in combination with any other drug or herbs you may take.

Special Precautions

Anyone with liver problems should probably not take Zocor.

Liver enzyme changes have been reported in a small proportion of patients using this medicine, and may indicate serious problems.

Liver function should be tested before anyone starts taking Pravachol and every month or so for the first year. Periodic tests are needed thereafter.

Because cholesterol is essential for the developing fetus, pregnant women should not take Zocor.

Research on animals has also shown optic nerve problems and stroke-like bleeding in dogs on Zocor, but only at relatively high doses. Whether there is a risk for humans remains to be determined.

It is wise to see an ophthalmologist before starting on Zocor. An eye test should also be performed annually to make there is no damage to the lens.

Taking the Medicine

The manufacturer recommends that Zocor be taken at bedtime.

It may be taken without or with meals.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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