simvastatin

Pronunciation:	SIM va stah tin
Brand:	Zocor

What is the most important information I should know about simvastatin?

Rare cases of muscle problems and liver problems have been associated with the use of simvastatin and other similar medicines. Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if accompanied by a fever or flulike symptoms or yellowing of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools. These may be early symptoms of muscle or liver problems.

Do not take simvastatin without first talking to your doctor if you have liver disease.

Alcohol and simvastatin can both be damaging to the liver. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for liver problems can be determined.

Do not take simvastatin if you are pregnant, could become pregnant during treatment, or if you are breast-feeding a baby.

What is simvastatin?

Simvastatin is an HMG CoA reductase inhibitor. Simvastatin blocks the production of cholesterol (a type of fat) in the body.

Simvastatin is used to reduce the total amounts of cholesterol, LDL (bad) cholesterol, triglycerides (another type of fat), and apolipoprotein B (a protein needed to make cholesterol) in your blood. Simvastatin (Zocor) is also used to increase the level of HDL (good) cholesterol in your blood. These actions may reduce the risk of hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease.

Simvastatin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking simvastatin?

Do not take simvastatin without first talking to your doctor if you have liver disease.

Before taking simvastatin, tell your doctor if you

have kidney disease,
drink alcoholic beverages,
have a chronic muscular disease, or
have a blood disorder.

You may not be able to take simvastatin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Simvastatin is in the FDA pregnancy category X. This means that simvastatin is known to cause birth defects if it is taken during pregnancy. Do not take simvastatin if you are pregnant or could become pregnant during treatment.

It is not known whether simvastatin passes into breast milk. Do not take simvastatin without first talking to your doctor if you are breast-feeding a baby.

How should I take simvastatin?

Take simvastatin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

For the greatest effect, simvastatin is usually taken at bedtime or with an evening meal. Follow your doctor's instructions.

Your doctor may want to monitor your liver function with blood tests before starting treatment with simvastatin and every six months after both the start of your treatment and any increase in dose. Depending on the results of these tests, your doctor can determine how much monitoring you will require.

Grapefruit and grapefruit juice may interact with simvastatin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Eat a low-fat, low-cholesterol diet. To realize beneficial effects from simvastatin, avoid fatty, high-cholesterol foods.

It is important to take simvastatin regularly to get the most benefit.

Do not stop taking simvastatin without first talking to your doctor. Simvastatin may need to be taken on a long-term basis for the treatment of high cholesterol.

Your doctor may want you to have blood tests or other medical evaluations during treatment with simvastatin to monitor progress and side effects.

Store simvastatin at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a simvastatin overdose include nausea, diarrhea, stomach distress, and indigestion.

What should I avoid while taking simvastatin?

What are the possible side effects of simvastatin?

If you experience any of the following serious side effects, stop taking simvastatin and seek emergency medical attention or contact your doctor immediately:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
decreased urine or rust-colored urine; or
blurred vision.

Other, less serious side effects may be more likely to occur. Continue to take simvastatin and talk to your doctor if you experience

gas, bloating, nausea, stomach upset, heartburn, abdominal pain, constipation, or diarrhea;
cough;
headache; or
insomnia.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect simvastatin?

Do not take simvastatin without first talking to your doctor if you are taking any of the following medicines:

cyclosporine (Sandimmune, Neoral);
gemfibrozil (Lopid), clofibrate (Atromid-S), or fenofibrate (Tricor);
niacin (Nicolar, Nicobid, Slo-Niacin, others);
erythromycin (E-Mycin, E.E.S., Ery-Tab, others) or clarithromycin (Biaxin);
cholestyramine (Questran) or colestipol (Colestid);
an antifungal medication such as itraconazole (Sporanox), fluconazole (Diflucan), or ketoconazole (Nizoral);
nefazodone (Serzone);
digoxin (Lanoxin, Lanoxicaps);
warfarin (Coumadin);
a protease inhibitor such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), lopinavir-ritonavir (Kaletra), or saquinavir (Invirase, Fortovase);
amiodarone (Cordarone, Pacer one); or
verapamil (Calan, Covera-HS, Isoptin, Verelan).

You may not be able to take simvastatin, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with simvastatin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

Your pharmacist has additional information about simvastatin written for health professionals that you may read.

What does my medication look like?

Simvastatin is available with a prescription under the brand name Zocor. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Zocor 5 mg--shield-shaped, buff, film-coated tablets
Zocor 10 mg--shield-shaped, peach-colored, film-coated tablets
Zocor 20 mg--shield-shaped, tan, film-coated tablets

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 10.02. Revision date: 10/10/05.

This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.