Zocor

Before or when starting Zocor (Simvastatin), you should be placed on a cholesterol-lowering diet. If appropriate, a health care professional will discuss an individualized program of weight control and physical exercise with you.

The starting dose of Zocor (Simvastatin) depends on your medical conditions and other medications you are taking, and can range from 5 mg to 40 mg taken once daily in the evening. The maximum recommended daily dose is 80 mg, which may be used for some people who have been taking this amount for a long time with no muscle problems or people at high risk of heart disease who have problems taking other "statins." The maximum daily dose may be lower for people taking certain medications.

The maximum dose for children and adolescents 10 to 17 years of age with inherited cholesterol disorders is 40 mg.

For best results in lowering your cholesterol, it is very important that you closely follow the diet suggested by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Zocor (Simvastatin) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Zocor (Simvastatin) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause constipation - to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause stomach ache; it may cause gas and bloating; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

10 mg
Each peach-coloured, oval, biconvex, film-coated tablet, engraved "MSD 735" on one side and plain on the other, contains 10 mg of Zocor (Simvastatin). Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid monohydrate, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, red ferric oxide, talc, titanium dioxide, and yellow ferric oxide.

20 mg
Each tan, oval, biconvex, film-coated tablet, engraved "MSD 740" on one side and plain on the other, contains 20 mg of Zocor (Simvastatin). Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid monohydrate, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, red ferric oxide, talc, titanium dioxide, and yellow ferric oxide.

40 mg
Each brick-red, oval, biconvex, film-coated tablet, engraved "MSD 749" on one side and plain on the other, contains 40 mg of Zocor (Simvastatin). Nonmedicinal ingredients: ascorbic acid, butylated hydroxyanisole, citric acid monohydrate, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinized starch, red ferric oxide, talc, and titanium dioxide.

Do not take Zocor (Simvastatin) if you:

• are allergic to Zocor (Simvastatin) or any ingredients of the medication
• are breast-feeding
• are pregnant or plan to become pregnant
• have active liver disease or unexplained increases in liver function tests
• are taking certain other medications, such as:
  • "azole" antifungal medications (e.g., fluconazole, ketoconazole)
  • protease inhibitors (e.g., boceprevir, ritonavir, telaprevir)
  • macrolide antibiotics (e.g., erythromycin, clarithromycin)
  • medications containing Cobicistat
  • nefazodone
  • Gemfibrozil
  • Cyclosporine
  • Danazol

There may be an interaction between Zocor (Simvastatin) and any of the following:

• Amiodarone
• Amlodipine
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• Aprepitant
• asunaprevir
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• Bicalutamide
• Bezafibrate
• Bosentan
• calcium channel blockers (e.g., amlodipine, Diltiazem, Nifedipine, Verapamil)
• Carbamazepine
• cobicistat
• Colchicine
• conivaptan
• Crizotinib
• cyclosporine
• Cyproterone
• dabigatran
• Dabrafenib
• daclatasvir
• danazol
• Dasatinib
• Deferasirox
• Dronedarone
• elbasvir
• Eltrombopag
• Enzalutamide
• fenofibrate
• gemfibrozil
• grapefruit juice
• grazoprevir
• Haloperidol
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• Mitotane
• Metronidazole
• Modafinil
• nefazodone
• niacin (nicotinic acid)
• niacinamide
• Phenobarbital
• Phenytoin
• primidone
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• quinine
• red yeast rice
• rifabutin
• rifampin
• Risperidone
• St. John's wort
• Sertraline
• Sildenafil
• siltuximab
• simeprevir
• Sitagliptin
• Teriflunomide
• Ticagrelor
• Tocilizumab
• trabectedin
• tyrosine kinase inhibitors (e.g., dasatinib, imatinib, Nilotinib, Sunitinib)
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zocor (Simvastatin). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zocor (Simvastatin).

Alcohol: Consumption of alcohol can increase the risk of liver damage when taking Zocor (Simvastatin). If you regularly drink more than 3 drinks of alcohol daily, the risk is further increased and you should be closely monitored by your doctor while taking Zocor (Simvastatin).

Diabetes: Zocor (Simvastatin), like other medications in this family, may cause a loss of control of blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zocor (Simvastatin), and whether any special monitoring is needed.

Grapefruit juice: Don't drink grapefruit juice while taking Zocor (Simvastatin), as it can increase the amount of Zocor (Simvastatin) in the blood and increase the risk of serious side effects.

Kidney problems: People with decreased kidney function should discuss with their doctor how Zocor (Simvastatin) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Zocor (Simvastatin), and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Zocor (Simvastatin) to build up in the body, causing side effects. If you have a history of liver disease, discuss with your doctor how Zocor (Simvastatin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zocor (Simvastatin), and whether any special monitoring is needed.

Laboratory tests show signs of harmful effects to the liver that may occur for a small percentage of people who take Zocor (Simvastatin). When Zocor (Simvastatin) is stopped, liver function usually slowly returns to normal. Your doctor will perform regular tests to check your liver function.

Zocor (Simvastatin) should not be used by people with active liver disease or by people whose liver function tests are higher than normal.

Muscle effects: In rare cases, serious muscle pain, cramps, and weakness have been associated with the use of statin medications (i.e., cholesterol-lowering medications whose names end in "statin," such as Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvastatin, or Zocor (Simvastatin)), especially at higher doses. Before taking this medication, tell your doctor or pharmacist if you:

• are 65 years of age or older
• are female
• are taking other cholesterol-lowering medications such as fibrates (e.g., gemfibrozil, Fenofibrate) or Niacin
• do excessive physical exercise
• have a family history of muscular disorders
• have diabetes
• have had any past problems with the muscles (pain, tenderness) after taking a statin medication
• have Hypothyroidism (low Thyroid) that is not controlled with medication
• have kidney or liver problems
• have undergone surgery or other tissue injury
• regularly drink 3 or more alcoholic drinks daily

Report any unexplained muscle pain, tenderness, weakness, or cramps, or any brown or discoloured urine to your doctor immediately, particularly if you are also experiencing malaise (a general feeling of being unwell) or fever.

Pregnancy: Zocor (Simvastatin) should not be taken during pregnancy. It may cause harm to the unborn baby. If you become pregnant, stop taking Zocor (Simvastatin) and contact your doctor immediately.

Breast-feeding: It is not known if Zocor (Simvastatin) passes into breast milk. If you are a breast-feeding mother and are taking Zocor (Simvastatin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Zocor (Simvastatin) have not been established for children less than 10 years of age or in girls who have not started menstruating.

Seniors: If you are 65 years of age or older, you may experience more side effects. Your doctor will monitor you closely while you are taking Zocor (Simvastatin).

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Avoid grapefruit and grapefruit juice during your treatment. Grapefruit can seriously affect how this medication works. Avoid excessive alcohol consumption during treatment.