What Zocor is and what it is used for
Zocor tablets contain the active ingredient simvastatin, which is a type of medicine called a statin. (NB. Simvastatin is also available without a brand name, ie as the generic medicine.) Simvastatin works by reducing the production of cholesterol by the liver.
For the sake of simplicity, there are two sorts of cholesterol; a \'bad\' sort called low density lipoprotein (LDL) and a \'good\' sort called high density lipoprotein (HDL). LDL is deposited in the arteries and increases the risk of heart disease by clogging and narrowing the arteries (atherosclerosis), while HDL actually protects the arteries against this.
Simvastatin decreases the production of LDL cholesterol by blocking the action of the enzyme in the liver (called HMG-CoA reductase) that is responsible for its production. This decreases the amount of cholesterol in the liver cells, which causes them to take up LDL cholesterol from the blood. The decreased cholesterol production and increased removal of LDL cholesterol from the blood ultimately results in lowered blood cholesterol levels.
As the body produces most cholesterol at night, statins are generally more effective if taken at night.
Simvastatin also causes a small decrease in the production of other \'bad fats\' in the blood called triglycerides, and a small increase in the level of HDL cholesterol. This results in lowered levels of \'bad fats\' and raised levels of \'good fats\' in the blood.
Statins have an important role in the prevention of coronary heart disease. They reduce the risk of excess cholesterol being deposited in the major blood vessels of the heart (atherosclerosis). Any blockage in the blood vessels limits the amount of blood and therefore oxygen being carried to the heart muscle. This can cause chest pain (angina) and in severe cases can result in a heart attack (myocardial infarction).
Simvastatin is used to lower cholesterol in people who have high levels either due to genetics (familial hypercholesterolaemia) or as a result of diet and lifestyle. This helps to reduce the risk of atherosclerosis, angina and heart attacks (coronary heart disease).
Simvastatin can also be used to reduce the risk of coronary heart disease in people who have already had a heart attack, or who suffer from angina or diabetes. In these people simvastatin slows down hardening of the arteries, regardless of your cholesterol level. It reduces the risk of needing procedures to improve blood supply to the heart, such as a balloon dilation of an artery or a heart bypass graft. It also reduces the risk of heart attack and death.
It is important to continue to follow a cholesterol-lowering diet and exercise regime while taking simvastatin.
‘Zocor’ is used along with diet if you have:
- a raised cholesterol level in your blood (primary hypercholesterolaemia) or elevated fat levels in your blood (mixed hyperlipidaemia)
- a hereditary illness (homozygous familial hypercholesterolaemia) that increases the cholesterol level in your blood. You may also receive other treatments.
- coronary heart disease (CHD) or are at high risk of CHD (because you have diabetes, history of stroke, or other blood vessel disease). ‘Zocor’ may prolong your life by reducing the risk of heart disease problems, regardless of the amount of cholesterol in your blood.
In most people, there are no immediate symptoms of high cholesterol. Your doctor can measure your cholesterol with a simple blood test. Visit your doctor regularly, keep track of your cholesterol, and discuss your goals with your doctor.
Before you take Zocor
Do not take Zocor
- if you are allergic ( hypersensitive) to simvastatin or any of the other ingredients of ‘Zocor’ tablets ( see section 6: Further information)
- if you currently have liver problems
- if you are pregnant or breast-feeding
- if you are taking
- itraconazole or ketoconazole ( medicines for fungal infections)
- erythromycin , clarithromycin, or telithromycin (antibiotics for infections)
- HIV protease inhibitors such as indinavir, nelfinavir, ritonavir, and saquinavir (HIV protease inhibitors are used for HIV infections).
- nefazodone (a medicine for depression).
Take special care with Zocor
- Tell your doctor about all your medical conditions including allergies.
- Tell your doctor if you drink large amounts of alcohol
- Tell your doctor if you have ever had liver disease. ‘Zocor’ may not be right for you.
- Tell your doctor if you are due to have an operation. You may need to stop taking ‘Zocor’ tablets for a short time.
- Your doctor should do a blood test before you start taking ‘Zocor’. This is to check how well your liver is working.
- Your doctor may also want you to have blood tests to check how well your liver is working after you start taking ‘Zocor’.
Contact your doctor immediately if you experience unexplained muscle pain, tenderness or weakness. This is because on rare occasions, muscle problems can be serious, including muscle breakdown resulting in kidney damage; and very rare deaths have occurred.
The risk of muscle breakdown is greater at higher doses of ‘Zocor’ and is greater in certain patients. Tell your doctor if any of the following applies to you:
- you consume large amounts of alcohol
- kidney problems
- thyroid problems
- you are more than 70 years old
- you have ever had muscle problems during treatment with cholesterol-lowering medicines called “statins” or fibrates
- you or close family members have a hereditary muscle disorder.
Using other medicines
It is particularly important to tell your doctor if you are taking any of the following drugs. Taking ‘Zocor’ with any of these drugs can increase the risk of muscle problems (some of these have already been listed in the above section “Do not take Zocor:”)
- ciclosporin ( a medicine often used in organ transplant patients)
- danazol (a man-made hormone used to treat endometriosis)
- medicines like itraconazole or ketoconazole (medicines for fungal infections)
- fibrates like gemfibrozil and bezafibrate (medicines for lowering cholesterol)
- erythromycin, clarithromycin, telithromycin or fusidic acid (medicines for bacterial infections)
- HIV protease inhibitors such as indinavir, nelfinavir, ritonavir and saquinavir (medicines for AIDS).
- nefadozone (a medicine for depression)
- amiodarone,(a medicine used for an irregular heart beat)
- verapamil or diltiazem (medicines for high blood pressure, chest pain associated with heart disease, or other heart conditions)
- large amounts (at least 1 gram each day) of niacin or nicotinic acid (medicines for lowering cholesterol).
As well as the medicines listed above, tell your doctor or pharmacist if you are taking or have recently taken any medicines , including those obtained without a prescription. In particular, tell your doctor if you are taking any of the following:
- medicines to prevent blood clots, such as warfarin phenprocoumon or acenocoumarol (anticoagulants).
- fenofibrate ( another medicine for lowering cholesterol).
Taking Zocor with food and drink
Grapefruit juice contains one or more components that alter how the body uses some medicinal products, including ‘Zocor’. Consuming grapefruit juice should be avoided.
Pregnancy and breast feeding
Do not take ‘Zocor’ if you are pregnant, trying to become pregnant or think you may be pregnant. If you get pregnant while taking ‘Zocor’, stop taking it immediately and contact your doctor. Do not take ‘Zocor’ if you are breast-feeding, because it is not known if the medicine is passed into breast milk.
Ask your doctor or pharmacist for advice before taking any medicine.
‘Zocor’ is not recommended for use in children.
Driving and Using machines
‘Zocor’ is not expected to interfere with your ability to drive or use machinery. However, it should be taken into account that some people get dizzy after taking ‘Zocor’.
Important information about some of the ingredients of Zocor
‘Zocor’ tablets contain a sugar called lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
How to take Zocor
Always take ‘Zocor’ exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
You should stay on a cholesterol-lowering diet while taking ‘Zocor’.
The dose is 1 ‘Zocor’ 5mg, 10mg, 20mg, 40mg or 80mg tablet by mouth once a day.
The 80mg dose is only recommended in patients with very high cholesterol levels at high risk of heart disease problems.
Your doctor will determine the appropriate tablet strength for you, depending on your condition, your current treatment and your personal risk status.
Take ‘Zocor’ in the evening. You can take it with or without food. The usual starting dose is 10, 20 or, in some cases 40mg a day. Your doctor may adjust your dose after at least 4 weeks to a maximum of 80 mg a day. Do not take more than 80mg a day. Your doctor may prescribe lower doses, particularly if you are taking certain medicinal products listed above or have certain kidney conditions. Keep taking ‘Zocor’ unless your doctor tells you to stop.
If your doctor has prescribed ‘Zocor’ along with any bile acid sequestrant (medicines for lowering cholesterol), you should take ‘Zocor’ at least 2 hours before or 4 hours after taking the bile-acid sequestrant.
If you take more Zocor than you should
- Please contact your doctor of pharmacist.
If you forget to take Zocor
- do not take an extra dose, just take the normal amount of ‘Zocor’ at the usual time the next day.
If you stop taking Zocor
- your cholesterol may rise again.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
Possible side effects
Like all medicines, ‘Zocor’ can cause side effects although not everybody gets them.
The following term is used to describe how often side effects have been reported:
The following rare serious side effects were reported.
If any of these serious side effects happen, stop taking the medicine and tell your doctor immediately or go to the emergency room at your nearest hospital.
- muscle pain, tenderness, weakness, or cramps. On rare occasions, these muscle problems can be serious, including muscle breakdown resulting in kidney damage; and very rare deaths have occurred.
- hypersensitivity (allergic) reactions including:
- swelling of the face, tongue and throat which may cause difficulty in breathing
- severe muscle pain usually in the shoulders and hips
- rash with weakness of limbs and neck muscles
- pain or inflammation of the joints
- inflammation of the blood vessels
- unusual bruising, skin eruptions and swelling, hives, skin sensitivity to the sun, fever, flushing
- shortness of breath and feeling unwell
- lupus-like disease picture (including rash, joint disorders, and effects on blood cells)
- inflammation of the liver with yellowing of the skin and eyes, itching, dark-coloured urine or pale-coloured stool, liver failure (very rare)
- inflammation of the pancreas often with severe abdominal pain.
The following side effects have also been reported rarely:
- low red blood cell count (anaemia)
- numbness or weakness of the arms and legs
- headache, tingling sensation, dizziness
- digestive disturbances (abdominal pain, constipation, flatulence, indigestion, diarrhoea, nausea, vomiting)
- rash, itching, hair loss
Elevations in some laboratory blood tests of liver function and a muscle enzyme (creatine kinase) have been observed.
If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
How to store Zocor
Keep out of the reach and sight of children.
Do not put them into another container as they might get mixed up.
If you have any tablets left over when your doctor tells you to stop taking them, return them to your doctor or pharmacist.
Do not take them past the expiry date which is clearly marked on the pack.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicine
Please take Zocor Tablet 80mg as prescribed by your doctor or medical professional. Direction details will be available on your medication container.
Please contact your doctor or medical practitioner to understand more about the side effects of taking Zocor Tablet 80mg.