Information About Simvastatin (Zocor)

Simvastatin (brand name: Zocor) is a cholesterol-lowering medication that belongs to the statin class of drugs. It is currently the third most potent statin on the market. Like other statins, simvastatin affects all aspects of your cholesterol profile: It lowers LDL and triglycerides and raises HDL. Simvastatin is available in a generic form and is sold over-the-counter in the United Kingdom.Simvastatin blocks an enzyme called "3-hydroxy-3methylglutaryl coenzyme A (HMG CoA) reductase," which is an important protein needed in the production of cholesterol.This medication may be taken with or without food, as directed by your healthcare provider. This medication should not be taken with grapefruits or grapefruit juice, since this can increase the amount of simvastatin in the blood and, therefore, increase the incidence of side effects.

• Individuals who have had an allergic reaction to simvastatin or any of its components.
  
• Women who are pregnant.
  
• Women who are breastfeeding.
  
• Individuals who have active liver disease or have abnormally liver enzyme levels.
  
• Individuals who have a history of alcohol abuse.

The most common side effects include headache, rash, pharyngitis, gastrointestinal problems (such as abdominal pain, dyspepsia, constipation, or flatulence).The following are serious side effects of simvastatin. If you experience any of these rare side effects, contact your healthcare provider immediately:

• Myopathy - such as progressive muscle soreness or weakness
  
• Red- or brown-colored urine

The following drugs may interact with simvastatin, increasing the likelihood of experiencing side effects (especially myopathy). With the exception of cholesterol-lowering drugs listed below, the remaining drugs also increase levels of simvastatin in your body. If you are required to take one of the drugs listed below, your healthcare provider may need to adjust your dose, monitor you more closely for side effects, or discontinue one of the drugs:

• Cholesterol lowering drugs (nicotinic acid, fibrates)
  
• Cyclosporine (Neoral, Sandimmune)
  
• Danazol (Danacrine)
  
• Antifungal drugs ending in "-azole" (ketoconazole (Nizoral), fluconazole (Diflucan), miconazole (Mycelex), itraconazole (Sporanox))
  
• Antibiotics ending in "-mycin" (erythromycin, clarithromycin (Biaxin))
  
• Nefazodone (Serzone)
  
• High blood pressure medications - diltiazem and verapramil
  
• Amiodarone (Cordarone)
  
• HIV Protease Inhibitors - ritonavir (Norvir), amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept)
  
• Efavirenz (Sustiva)
  
• Risperidone (Risperdal)
  
• Quinupristin and dalfopristin (Synercid)

The following drugs may also be affected if taking with simvastatin:

• Warfarin (Coumadin) - may cause blood to not clot as well.

The following drugs may interact with simvastatin by decreasing the amount of simvastatin in the body:

• Antacids containing magnesium or aluminum hydroxide may decrease the concentration of simvastatin in the blood. In order to avoid this interaction, separate your simvastatin dose and antacid dose by at least two hours.
  
• Phenytoin (Dilantin) may cause decreased levels of simvastatin in the blood.
  
• St. John's Wort can lower levels of simvastatin in the blood.
  
• Cholesterol-lowering drugs, like bile acid sequestrants, may reduce the absorption of simvastatin into the blood. In order to avoid this, separate your simvastatin dose and bile acid sequestrant dose by at least four hours.

Disclaimer

This information is just a brief listing and it not inclusive and should not replace the information provided by your healthcare provider or the manufacturer of this drug.

_Sources:

Dipiro JT, Talbert RL. Pharmacotherapy: A Pathophysiological Approach, 6th ed 2005.

Lacy CF, Armstrong LL, Goldman MP, et al. Lexicomp's Drug Information Handbook, 15th ed 2007.