Zocor interactions: Alcohol, medications, and other factors

Before you start Zocor treatment, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Zocor interacts with supplements, herbs, or vitamins, see the “Zocor and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Zocor. Keep in mind that this table doesn’t include all drugs that may interact with Zocor. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “When to avoid Zocor” section below.
† For details about Zocor’s side effects, see this article.
‡ For details about this interaction, see the “Drug interactions in depth” section below.

In some cases, factors or conditions could prevent your doctor from prescribing Zocor due to the risk of harm. These are known as contraindications. Zocor’s contraindications include:

Having certain liver conditions

Doctors typically will not prescribe Zocor to people with certain liver conditions. These conditions include acute (sudden) liver failure and decompensated cirrhosis. This is because Zocor may cause elevated liver enzymes, which can worsen liver conditions.

If you have acute liver failure or decompensated cirrhosis, talk with your doctor before taking Zocor. They’ll likely prescribe a treatment option other than Zocor for you.

Taking certain drugs that increase the risk of Zocor’s side effects

Doctors typically will not prescribe Zocor with certain drugs that increase the risk of Zocor’s side effects. This includes drugs that slow the breakdown of Zocor and drugs that increase the risk of muscle problems.

Zocor is broken down by a specific enzyme (a type of protein) in your body. Certain medications may significantly slow the activity of this enzyme. Taking Zocor with these medications can cause your body to break down Zocor more slowly than it should. This can raise the level of Zocor in your system, increasing your risk of side effects from the drug.*

Below are examples of these medications:

• nefazodone
• cobicistat (Tybost)
• certain antifungals, such as itraconazole (Sporanox, Tolsura) and ketoconazole
• certain antibiotics, such as clarithromycin and erythromycin (Ery-Tab, others)
• certain antivirals, such as ritonavir (Norvir) and nelfinavir (Viracept)

As with Zocor, other medications may cause muscle problems as a side effect. These problems include severe muscle weakness and rhabdomyolysis (muscle breakdown that may lead to kidney damage). Taking Zocor with these medications together may further increase this risk.

Below are examples of these medications:

• danazol
• cyclosporine (Gengraf, others)
• gemfibrozil (Lopid)

Before you start treatment with Zocor, tell your doctor if you take any of the medications listed above. They aren’t likely to prescribe Zocor with these drugs. Your doctor can tell you about other treatments for your condition.

* For details about Zocor’s side effects, see this article.

Having had an allergic reaction to Zocor or any of its ingredients

If you have had an allergic reaction to Zocor or any of its ingredients, your doctor will likely not prescribe Zocor. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Zocor, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Zocor.

There aren’t any known interactions between Zocor and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Zocor treatment. This is because consuming large amounts of alcohol can cause liver damage. Zocor may also cause elevated liver enzymes, which can be a sign of liver damage. So drinking alcohol during Zocor treatment may increase the risk of liver damage.

If you have questions about drinking alcohol while taking Zocor, talk with your doctor.

Here’s a closer look at certain drug interactions of Zocor.

Colchicine

Colchicine (Colcrys, others) is prescribed for certain inflammatory conditions, including gout.

Interaction result: Taking Zocor with colchicine may increase the risk of muscle problems with either drug. These problems include severe muscle weakness and rhabdomyolysis. To learn about Zocor’s side effects, see this article.

Interaction explained: Both Zocor and colchicine can cause muscle problems when taken individually. Taking these medications together may further increase this risk.

Steps you or your doctor may take: Before starting treatment with Zocor, tell your doctor if you’re taking colchicine. They can tell you whether it’s safe to take these medications together.

If your doctor prescribes Zocor with colchicine, tell them right away if you experience muscle pain or weakness. Your doctor may recommend watching closely for these symptoms after starting Zocor. You should also monitor for symptoms if your doctor increases your colchicine or Zocor dosage. If you have muscle problems, your doctor can tell you how to manage this side effect.

To learn more about Zocor and colchicine, talk with your doctor or pharmacist.

Warfarin

Warfarin (Jantoven) is prescribed to treat and help prevent blood clots in certain situations.

Interaction result: Taking Zocor with warfarin may increase warfarin’s effect as a blood thinner.

Interaction explained: Warfarin works by keeping your body from making certain substances that help your blood clot. In this way, warfarin makes your blood less likely to clot. However, the drug’s effect also increases your risk of bleeding.

When warfarin is taken with Zocor, warfarin may have a greater effect on blood clotting substances. This can further increase your risk of bleeding.

Steps you or your doctor may take: Before starting Zocor treatment, tell your doctor if you’re taking warfarin. They can recommend whether it’s safe for you to take these medications together.

If your doctor prescribes Zocor with warfarin, they may give you more frequent blood tests to check how well warfarin is working.

It’s also important to watch for symptoms of severe bleeding while taking these drugs together. Examples of symptoms include bloody stool, bloody urine, and coughing up blood. If you have these symptoms, tell your doctor right away. They’ll tell you how to manage this side effect.

To learn more about Zocor and warfarin, talk with your doctor or pharmacist.

Calcium channel blockers

Calcium channel blockers (CCBs) are prescribed to treat high blood pressure and certain heart conditions.

Interaction result: Taking Zocor with CCBs may increase the risk of side effects from Zocor. These side effects can include severe muscle weakness and rhabdomyolysis. To learn about Zocor’s side effects, see this article.

Interaction explained: CCBs may slow the activity of an enzyme that helps break down Zocor in your body. Taking Zocor with CCBs can cause your body to break down Zocor more slowly than it should. This can raise the level of Zocor in your system, increasing your risk of side effects.

Examples of CCB drugs: Here are some CCBs that may interact with Zocor:

• amlodipine (Norvasc, others)
• diltiazem (Cardizem, others)
• verapamil (Verelan, Verelan PM)
• nicardipine

Steps you or your doctor may take: Before taking Zocor, be sure your doctor knows if you’re taking a CCB. They can recommend whether it’s safe to take these medications together.

If your doctor prescribes Zocor with a CCB, they may prescribe a lower Zocor dosage than is typical. Doing so may help reduce the risk of side effects from Zocor.

To learn more about Zocor and CCBs, talk with your doctor or pharmacist.

Zocor may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Zocor.

Zocor interactions with supplements

Zocor may interact with red yeast rice supplements, which some people take to help lower their cholesterol levels.

However, Zocor and red yeast rice supplements work similarly in your body. Taking them together can increase your risk of having muscle problems as a side effect. These problems can include severe muscle weakness and rhabdomyolysis (muscle breakdown that may lead to kidney damage). Due to this risk, your doctor may recommend avoiding red yeast rice supplements while taking Zocor.

Before you start treatment with Zocor, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. Sharing this information with them may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Zocor interactions with herbs

Zocor may interact with St. John’s wort, which some people take to help ease symptoms of depression and other conditions.

St. John’s wort may speed up the activity of an enzyme that helps break down Zocor in your body.

By speeding up this enzyme, St. John’s wort can cause Zocor to break down too quickly. And this may lead to a low level of Zocor in your system. If the level of Zocor in your body is too low, the drug may not work for your condition.

If you take St. John’s wort, tell your doctor before starting Zocor treatment. They may advise you to stop taking St. John’s wort and can suggest a different treatment option.

Zocor and vitamins

There are no specific reports of vitamins interacting with Zocor. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Zocor.

Zocor interactions with food

Zocor may interact with grapefruit and grapefruit juice.

Grapefruit products may slow the activity of an enzyme that helps break down Zocor in your system. By slowing this enzyme, grapefruit products can raise the level of Zocor in your body. Having a high level of Zocor in your system increases your risk of side effects from the drug. (For details about Zocor’s side effects, see this article.)

Due to this risk, your doctor may recommend limiting or avoiding grapefruit and grapefruit juice while you’re taking Zocor.

Zocor and vaccines

There aren’t any known interactions between Zocor and vaccines. You can ask your doctor or pharmacist to find out whether you’re due for any vaccines.

Zocor and lab tests

Zocor isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

ZOCOR INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Zocor. Taking Zocor with cannabis products could increase your risk of side effects from Zocor.

Before you start treatment with Zocor, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Zocor. Before you take this drug, be sure to talk with your doctor about your health history. Zocor may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Zocor include:

• Liver conditions: If you have acute (sudden) liver failure or decompensated cirrhosis, your doctor will likely not prescribe Zocor. For more information, see the “When to avoid Zocor” section above. If you have a different liver condition, such as alcohol-related liver disease, talk with your doctor. They can recommend whether Zocor is a safe treatment option.
• Kidney conditions: If you have a kidney condition, such as kidney failure, talk with your doctor before taking Zocor. Having a kidney condition may increase your risk of side effects from Zocor. To reduce this risk, your doctor may prescribe a lower Zocor dosage than is typical.
• Underactive thyroid: If you have an underactive thyroid, talk with your doctor before starting Zocor treatment. Having an underactive thyroid that isn’t well-managed could increase your risk of muscle problems with Zocor. To reduce this risk, your doctor may treat this condition before prescribing Zocor.
• Chinese ancestry: If you’re of Chinese ancestry, talk with your doctor before starting treatment with Zocor. People of this ancestry may have a higher risk of muscle problems with Zocor. Your doctor can recommend whether Zocor is a safe treatment option for you.
• Being age 65 years or older: If you’re age 65 years or older, talk with your doctor before taking Zocor. People this age may have a higher risk of muscle problems with Zocor. To reduce this risk, your doctor may prescribe you a lower dosage than is typical.
• Allergic reaction: If you’ve had an allergic reaction to Zocor or any of its ingredients, your doctor will likely not prescribe Zocor. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It may not be safe to take Zocor while breastfeeding. The drug may pass into breast milk and lead to side effects in a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Zocor. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: It may not be safe to take Zocor while pregnant. The drug may cause congenital anomalies (commonly known as birth defects) because of the way it works in the body. If you’re pregnant or planning to become pregnant, tell your doctor before starting Zocor. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Zocor. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Zocor label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Zocor doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Zocor by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Zocor. These resources might help:

• Overview of Zocor: For a general overview of Zocor, you can see this article.
• Side effects: If you’re interested in the side effects of Zocor, see this article. Another option is to refer to the Zocor prescribing information.
• Dosage specifics: To learn about the dosage of Zocor, see this article.
• Facts about your condition: To learn more about the conditions Zocor is prescribed to treat, see our cholesterol and cardiovascular health hubs.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.