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Zocor ® (Simvastatin) is a cholesterol-lowering prescription drug that inhibits the production of cholesterol by the liver. It lowers overall blood cholesterol as well as blood LDL cholesterol levels. Zocor is indicated in addition to diet for patients with high cholesterol when diet changes and exercise are inadequate. Zocor is used along with dietary changes (with restriction in cholesterol and fat intake) to reduce the amount of cholesterol and certain fatty substances in your blood.

Zocor ®


Product Dosage Qty Consult Price Order
  Zocor 20 mg 30 Tabs FREE
  Zocor 20 mg 60 Tabs FREE
  Zocor 20 mg 90 Tabs FREE
  Zocor 40 mg 30 Tabs FREE
  Zocor 40 mg 60 Tabs FREE
  Zocor 40 mg 90 Tabs FREE
  Zocor 80 mg 30 Tabs FREE
  Zocor 80 mg 60 Tabs FREE
  Zocor 80 mg 90 Tabs FREE



Zocor ® is manufactured by Merck & Co. Inc.

Chemical Name : Simvastatin

Important Note
The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

Uses
High blood cholesterol is first treated with exercise, weight loss, and a diet low in cholesterol and saturated fats. When these measures fail, cholesterol-lowering medications such as Simvastatin can be used. LDL cholesterol is believed to be the "bad" cholesterol that is primarily responsible for the development of coronary artery disease. Lowering LDL cholesterol levels retards progression and may even reverse coronary artery disease.

Zocor ( Simvastatin ) is used with dietary changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and certain fatty substances in your blood. Accumulation of cholesterol and fats along the walls of your arteries (a process known as atherosclerosis) decreases blood flow and, therefore, the oxygen supply to your heart, brain, and other parts of your body. Zocor ( Simvastatin ) is a lipid-lowering agent derived synthetically from a fermentation product of Aspergillus terreus.

For patients with coronary heart disease (CHD) and high cholesterol, Zocor ( Simvastatin ) is indicated as an addition to diet to reduce the risk of death by reducing coronary death, to reduce the risk of heart attack, to reduce the risk for undergoing cardiac procedures and to reduce the risk of stroke or transient ischemic attack.

Before starting treatment with Zocor ( Simvastatin ), try to lower your cholesterol by other methods such as diet, exercise, and weight loss. Ask your doctor about how best to do this. Any other medical problems that can cause high cholesterol should also be treated.

How to take this medication
Follow the Zocor ( Simvastatin ) directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Zocor ( Simvastatin ) may be taken on an empty or full stomach.

Eat a low-cholesterol, low-fat diet. Avoid foods with excess fat in them such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter, shortening, lard, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips, coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.

Side Effects
Although most patients can tolerate treatment with Zocor ( Simvastatin ) well, it may cause side effects, some of which could be serious. Side effects are usually mild and short-lived. Side effects may occur from Zocor ( Simvastatin ) treatment include flatulence, stomach pain or cramps, diarrhea, constipation, heartburn, headache, blurred vision, dizziness, rash or itching and upset stomache.

Precautions
Zocor ( Simvastatin ) is not recommended for children or patients under 20 years of age. Before taking Zocor ( Simvastatin ), tell your doctor if you have a chronic muscular disease, require major surgery, or have a blood disorder. Tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids; antifungal medications such as itraconazole (Sporanox) and ketoconazole (Nizoral); digoxin (Lanoxin); erythromycin; medications that suppress the immune system such as cyclosporine (Neoral, Sandimmune); oral contraceptives (birth control pills); other cholesterol-lowering medications such as cholestyramine (Questran), colestipol (Colestid), gemfibrozil (Lopid), and niacin (nicotinic acid); and vitamins.


Zocor ( Simvastatin ) should not be used by nursing mothers because of potential adverse side effects to the nursing infant. Simvastatin should not be used by pregnant women.

Drug Interactions
Zocor ( Simvastatin ) is generally well- tolerated, but should be used with caution in patients with alcohol or other liver diseases. Rare cases of muscle inflammation (myositis) and breakdown have been reported with Zocor ( Simvastatin ). Muscle breakdown causes the release of muscle protein (myoglobin) into the blood and kidney tubules, resulting in acute kidney failure. The risk of muscle breakdown is increased when Zocor ( Simvastatin ) is given together with other medications such as cyclosporine (Sandimmune), gemfibrozil (Lopid), erythromycin and nicotinic acid. Zocor ( Simvastatin ) may interact with cholestyramine (Questran), warfarin (Coumadin), and cimetidine (Tagamet) to alter the blood levels of these medicines. When Coumadin is given together with simvastatin, blood clotting times require monitoring to avoid excessive blood thinning and bleeding. Simvastatin should not be used in children. Simvastatin is not habit forming.

About 1% of patients who took Zocor ( Simvastatin ) in clinical trials developed elevated levels of some liver enzymes. Patients who had these increases usually had no symptoms. Elevated liver enzymes usually returned to normal levels when Zocor ( Simvastatin ) was stopped. Persistently abnormal liver tests during treatment are rare, but may lead to a discontinuation of the medication.

Some patients taking lipid-lowering agents similar to Zocor ( Simvastatin ) and coumarin anticoagulants (a type of blood thinner) have experienced bleeding and/or increased blood clotting time. Patients taking these medicines should have their blood tested before starting therapy with Zocor ( Simvastatin ) and should continue to be monitored.

Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately.

Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage
Store at room temperature between 36 and 77 degrees F (2 -25 degrees C) away from light and moisture.

 

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 Statins are used for preventing and treating atherosclerosis that causes chest pain, heart attacks, strokes, and intermittent claudication in individuals who have or are at risk for atherosclerosis. Risk factors for atherosclerosis include abnormally elevated cholesterol levels, a family history of heart attacks (particularly at a young age), increasing age, and diabetes. Most individuals are placed on statins because of high levels of cholesterol. Though cholesterol reduction is important, heart disease is complex and, as discussed previously, other factors such as inflammation may play a role. Thirty-five percent of individuals who develop heart attacks do not have high blood cholesterol levels, yet most of them have atherosclerosis. This means that high levels of cholesterol are not always necessary for atherosclerotic plaques to form. Because it is not clear which effect of statins is responsible for their benefits, the goal of treatment with statins should not be only the reduction of cholesterol to normal levels, but rather the prevention of the complications of atherosclerosis-angina, heart attacks, stroke, intermittent claudication, and death. This concept is important because it allows for individuals who have or are at risk for atherosclerosis, but do not have high levels of cholesterol, to be considered for treatment with statins. Statins, like ACE inhibitors, are an important class of drugs because some of these drugs have been shown to reduce the incidence of heart attacks, strokes, and death.

What are the statin drugs : The statins are the most widely used medications today in lowering LDL cholesterol. Most of the clinical trials that showed heart attack reduction and improved longevity used one of the statins as the cholesterol lowering medication. Statins are well tolerated with low side effect rates when used long term. Statins not only lower blood LDL cholesterol levels, they also help increase HDL cholesterol levels. The statin medicines that are now on pharmacy shelves in the U.S. (putting the brand name first in capital letters followed by the generic name in parentheses) are: Lescol (fluvastatin sodium) made by Novartis Lipitor (atorvastatin calcium) made by Parke-Davis and Pfizer Mevacor (lovastatin) made by Merck Pravachol (pravastatin sodium) made by Bristol-Myers Squibb Zocor (simvastatin) made by Merck The statins act by repressing or inhibiting an enzyme called HMG-CoA reductase. The role of this enzyme is the promotion of a chemical reaction early in the synthesis of cholesterol. By inhibiting HMG-CoA reductase, the statins hinder the production (synthesis) of cholesterol by the liver. Diminished synthesis of cholesterol in the liver in turn stimulates (increases) the activity of LDL receptors on the surface of liver cells. Increasing LDL receptor activity decreases LDL cholesterol levels in blood. Studies have conclusively established that lowering LDL cholesterol with diet and statins reduces the risk of a second heart attack. The prevention of recurrent heart attacks in patients who have already suffered a heart attack is called secondary prevention. Studies have also demonstrated that reducing LDL cholesterol with diet and statins reduces the risk of having the first heart attack. Prevention of heart attacks in those who have never had a heart attack is called primary prevention. Studies have also confirmed that reducing LDL cholesterol benefits both men and women. For more information regarding the side effects, precautions, and drug interactions of the various statins, please read the Statins article, and visit the Medications area.

How can levels of HDL cholesterol be raised : The first step in increasing HDL cholesterol levels (and decreasing LDL/HDL ratios) is life style modification. When life style modifications are insufficient, medications are used. In prescribing medications or medication combinations, doctors have to take into account medication side effects as well as presence or absence of other abnormalities in cholesterol profiles. Regular aerobic exercise, loss of excess weight (fat), and cessation of cigarette smoking cigarettes will increase HDL cholesterol levels. Regular alcohol consumption (such as one drink a day) will also raise HDL cholesterol. However, there are different subclasses of HDL cholesterol which have varying degrees of effectiveness in preventing atherosclerosis. Alcohol is believed to increase the level of the less important subtype of HDL cholesterol. Because of other adverse health consequences of excessive alcohol consumption, alcohol is not recommended as a standard treatment for low HDL cholesterol. Medications that are effective in increasing HDL cholesterol include nicotinic acid (niacin), gemfibrozil (Lopid), estrogen, and to a lesser extent, the statin drugs (discussed below).

Risk factors for heart attacks : Abnormally low HDL cholesterol levels. The size of the LDL cholesterol particles in the blood may be too small. Scientists have found that the size of LDL cholesterol particles in the blood is predominantly genetically inherited. People who have small and dense LDL cholesterol particles have a higher risk of developing atherosclerosis and heart attacks than those who have larger and more buoyant particles. Elevated Lp(a) cholesterol levels. The level of Lp(a) cholesterol is also predominantly genetically inherited. Individuals with elevated levels of Lp(a) cholesterol have a higher rate of atherosclerosis and risk of heart attacks. Elevated homocysteine levels.

 

 

 

 

 

20th August 2008