Zocor
Simvastatin
Drug Class and Mechanism of Action of Zocor
Zocor (Simvastatin) is a hypolipidemic drug (cholesterol- lowering medicine). It acts by inhibiting the production of cholesterol by the liver by inhibiting the enzyme needed for cholesterol synthesis. It lowers overall blood cholesterol as well as blood LDL cholesterol (considered to be the "bad" cholesterol that is primarily responsible for the development of coronary artery disease) levels. Lowering LDL cholesterol levels stops progression and may even reverse coronary artery disease (narrowing of coronary arteries due to deposition of cholesterol).
Therapeutic Uses of Zocor
Generally high blood cholesterol is treated at first with exercise, weight loss, and a diet low in cholesterol as well as saturated fats. When these measures fail, cholesterol-lowering medications such as Zocor can be used.
The National Cholesterol Education Program (NCEP) has published treatment guidelines (which takes into account the level of LDL cholesterol as well as the presence of other risk factors like diabetes, hypertension or high blood pressure, smoking, low HDL cholesterol level which is considered as ‘good cholesterol’, and family history of early coronary heart disease) for use of medications like Zocor. The lowering of cholesterol by Zocor is dose related. Blood cholesterol determinations are performed in regular intervals during treatment so that dosage adjustments can be made.
Direction of use of Zocor
Zocor should be taken as per direction of your doctor. If you do not understand the directions given by your doctor, ask your pharmacist, nurse, or doctor to explain them to you. Each dose of Zocor should be taken with a full glass of water. To get the best effect, Zocor is usually taken at bedtime or after dinner. Your doctor may want to monitor your liver function with blood tests before starting treatment with Zocor and every six months after both the start of your treatment and any increase in dose of Zocor. Depending on the results of the liver function tests, your doctor can determine how much monitoring you will require and at what dose it should be taken. Grapefruit and grapefruit juice may interact with Zocor and the interaction could lead to potentially dangerous effects. You should not take grapefruit or its juice while taking Zocor. Discuss the use of grapefruit and grapefruit juice with your doctor if you want to include these in your diet. You should not increase or decrease the amount of grapefruit or grapefruit juice in your diet without consulting your doctor.
The diet should be low-fat, low-cholesterol, while taking Zocor. You should avoid fatty, high-cholesterol foods to get the maximum benefits of it. It is also important to take Zocor regularly to get the most benefit. Do not stop taking simvastatin without first consulting your doctor. Zocor generally need to be taken on a long-term basis for the treatment of high cholesterol level in blood. You should have blood tests or other medical evaluations during treatment with simvastatin to monitor progress and side effects of the drug.
If You Miss a Dose of Zocor
If you miss a dose of Zocor, you should take it as soon as possible. But if it is almost time for the next dose, you should skip the missed dose and take only the next regularly scheduled dose. You do not need to take an extra dose of this medication for missing a dose.
How to Store Zocor
Zocor should be stored at room temperature in a tightly closed container away from heat, moisture and direct light. Store it in a place which is out of reach of children. Do not store Zocor in your bathroom.
More Information About Zocor
- There are reports of rare cases of muscle problems and liver problems associated with the use of simvastatin and other similar medicines. Consult your doctor immediately if you experience any of the side effects like unexplained muscle pain, tenderness, or weakness (especially if accompanied by a fever or flu like symptoms or yellowing of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools). These may be early warning signs of muscle or liver problems with Zocor.
- If you experience any of the serious side effects, you should stop taking Zocor and get emergency medical attention or contact your doctor immediately. The serious side effects of Zocor are allergic reaction (the symptoms of allergic reaction are difficulty in breathing; closing of the throat; swelling of the lips, tongue, or face; or hives, skin rash etc.), decreased urine or rust-colored urine, blurring of vision.
- There may be some less serious side effects of Zocor. Continue to take Zocor and consult your doctor if you experience any less serious side effects of Zocor like headache, insomnia, cough, gas, bloating, nausea, stomach upset, heartburn, abdominal pain, constipation, or diarrhea etc.
- There may be some side effects other than those listed here. Talk to your doctor about any side effect that seems unusual or that is especially bothersome or persistent.
Precautions to be Taken While Taking Zocor
- Grapefruit and grapefruit juice may interact with Zocor and which (the interaction) may lead to potentially dangerous effects. The use of grapefruit and grapefruit juice should be discussed with your doctor. You not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
- Zocor is generally well- tolerated. Alcohol and Zocor can damage the liver. Alcohol should be used only in moderation due to increased chance of liver damage with Zocor. Discuss the use of alcohol with your doctor so that the potential for liver problems can be determined. The medication should be used with caution in patients with alcoholic liver disease or other liver diseases. Persistently abnormal liver function tests during treatment with Zocor are rare, but may need discontinuation of the medication.
- If Coumadin and Zocor are given together, blood clotting times should be monitored to avoid excessive blood thinning and as a result excessive bleeding. Simvastatin should not be used in children and it is not habit forming or has no addiction liability.
- Rare cases of myositis (muscle inflammation) and breakdown of muscles have been reported with Zocor. Breakdown of muscle can cause the release of muscle protein known as myoglobin, into the blood and kidney tubules, which results 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, nicotinic acid etc. Zocor may interact with cholestyramine (Questran), warfarin (Coumadin), and cimetidine (Tagamet) to alter the blood levels of these medicines.
Possible Adverse Effects of Zocor
- Zocor (Simvastatin) is generally well-tolerated and side effects are rare. Minor side effects of it include nausea, constipation, diarrhea, fatigue, gas in stomach, heartburn, and headache.
- Major side effects of Zocor include abdominal pain or abdominal cramps, blurring of vision, dizziness, easy bruising or bleeding, itching, muscle pain or cramps, rash, and yellowing of the skin or eyes.
