Simvastatin

Rare cases of muscle problems and liver problems have been associated with the use of Zocor 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 Zocor without talking to your doctor first if you have liver disease.

Alcohol and Zocor 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 Zocor if you are pregnant, could become pregnant during treatment, or if you are breast-feeding a baby.

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

Zocor 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. Zocor (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.

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

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

Before taking Zocor, 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 Zocor or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

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

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

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

Each dose should be taken with a full glass of water.

For the greatest effect, Zocor 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 Zocor 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 Zocor. 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 talking to your doctor first.

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

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

Do not stop taking Zocor without talking to your doctor first. Zocor 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 Zocor to monitor progress and side effects.

Store Zocor at room temperature away from moisture and heat.

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.

Seek emergency medical attention if an overdose is suspected.

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

Grapefruit and grapefruit juice may interact with Zocor. 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 talking to your doctor first.

Alcohol and Zocor 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.

Rare cases of muscle problems and liver problems have been associated with the use of Zocor 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.

If you experience any of the following serious side effects, stop taking Zocor 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 Zocor 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.

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

cyclosporine (Sandimmune, Neoral);

cholestyramine (Questran) or colestipol (Colestid);

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);

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 Zocor, 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 Zocor. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals and herbal products.