Generic Zocor - Simvastatin

Simvastatin is a cholesterol-lowering medication that blocks the production of cholesterol (a type of fat) in the body.

Simvastatin reduces low-density lipoprotein (LDL) cholesterol and total cholesterol in the blood. Lowering your cholesterol can help prevent heart disease and hardening of the arteries, conditions that can lead to heart attack, stroke, and vascular disease.

Simvastatin may also be used for other purposes not listed in this medication guide.

In rare cases, simvastatin can cause a condition that results in the breakdown of skeletal muscle tissue. This condition can lead to kidney failure. Call your doctor at once if you have unexplained muscle pain or tenderness, muscle weakness, fever or flu symptoms, and dark colored urine. This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. Do not take simvastatin if you have liver disease or if you are breast-feeding.

Before taking simvastatin, tell your doctor if you have diabetes, underactive thyroid, kidney disease, a muscle disorder, or a blood disorder:

Avoid eating foods that are high in fat or cholesterol. Simvastatin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.
Avoid drinking alcohol while taking simvastatin. Alcohol can raise triglyceride levels, and may also damage your liver while you are taking simvastatin.

There are many other drugs that can interact with simvastatin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

In a study of people with heart disease, results show that high doses of the popular cholesterol-lowering drug Zocor may not prevent heart disease deaths and heart attacks — and may cause muscle damage. But experts say that the new adage of “lower is better” still holds true when it comes to cholesterol.

The study results were presented last month at the European Society of Cardiology Congress 2004 and appear in the new issue of The Journal of the American Medical Association.

High doses of Zocor were associated with increased rates of muscle damage. Nonetheless, study researcher Michael Blazing, MD, said at a news conference at the meeting that doctors should still consider starting treatment at a higher dose and to be more aggressive when prescribing Zocor and other cholesterol-lowering drugs in its class, known as statins. Blazing is with Duke University Medical Center in Durham, N.C.

Asked to clarify that statement, Blazing told WebMD that he and his study colleagues recommend a 40 mg dose, rather than an 80 mg dose of Zocor.

Blazing added that studies of other statins — notably recent studies of high-dose Lipitor — suggest that the high-dose statins are both safe and effective.

His study looked at nearly 4,500 patients who had severe chest pain or a heart attack. The researchers were trying to determine if there was any benefit to starting Zocor right away. Half the patients received early aggressive treatment — 40 mg of Zocor for a month (started within an average of three to four days) followed by 80 mg Zocor — or conservative treatment with four months of placebo followed by 20 mg of Zocor.

The study did show that early aggressive Zocor treatment appeared to slightly decrease the risk of heart disease death, heart attack, and stroke. However, the study findings were not strong enough to be considered significant. All patients also received other traditional heart disease treatments, including aspirin.

In those treated with placebo first, LDL “bad” cholesterol levels increased by 11 percent during the initial placebo phase. LDL then decreased 31 percent from baseline after four months of 20 mg Zocor. However, in those that took Zocor for the entire study, LDL cholesterol decreased by 39 percent over the first four months. LDL then decreased an additional 6 percent following the increase to 80 mg of Zocor.