Zocor (simvastatin)

What is Zocor?

Zocor is a brand-name prescription medication. It’s FDA-approved to:

• lower high cholesterol (along with a healthy diet) in adults
• lower the risk of cardiovascular problems and death in adults
• lower high cholesterol (along with a healthy diet) caused by a genetic condition called heterozygous familial hypercholesterolemia (HeFH) in children ages 10 to 17 years

Zocor is approved to treat these conditions in certain situations. For more information about how the drug is used, see the “Zocor uses” section below.

Zocor comes as a tablet that you take by mouth. It contains the active drug simvastatin. Simvastatin belongs to a class of medications known as statins. (A medication class is a group of drugs that work together in a similar way).

Effectiveness

For information on the effectiveness of Zocor, see the “Zocor uses” section below.

Zocor generic

Zocor is available as a generic drug called simvastatin. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

Zocor side effects

Zocor can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Zocor. These lists don’t include all possible side effects.

For more information on the possible side effects of Zocor, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Zocor, you can do so through MedWatch.

Mild side effects

Mild side effects of Zocor can include:*

• abdominal (belly) pain
• constipation
• eczema
• nausea
• gastritis (swelling of the stomach lining)
• high blood sugar
• headache^†
• muscle pain or weakness^†
• upper respiratory infection,^† such as bronchitis and sinusitis
• urinary tract infection

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Zocor. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Zocor’s prescribing information.
† For more information on this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Zocor aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Liver problems, such as elevated levels of liver enzymes (proteins). Symptoms can include:
  • fatigue (lack of energy)
  • nausea or vomiting
  • swelling in your abdomen, ankles, or legs
  • urine that is darker than usual
  • jaundice (yellowing of the skin or whites of your eyes)
• Rhabdomyolysis (breakdown of muscles). Symptoms can include:
  • loss of consciousness (not being able to respond to sound or touch)
  • nausea
  • urine that is brown, red, or tea-colored
  • severe muscle pain and weakness
• Allergic reaction.*

* For more information on this side effect, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it.Here’s some detail on certain side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Zocor. It’s not known how frequently this occurs. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing
• severe skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis

Call your doctor right away if you have a severe allergic reaction to Zocor. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Muscle pain or weakness

Muscle pain or weakness may occur while taking Zocor. This risk is highest during your first year of taking the drug. After that, your risk goes down as you continue taking the drug.

In a clinical study:

• 3.7% of people who took Zocor had muscle pain or weakness
• 3.2% of people who took a placebo (a treatment with no active drug) had muscle pain or weakness

Some people may have a higher risk of developing muscle pain and weakness while taking Zocor. See the “Zocor precautions” section to learn more.

In addition, people taking the 80-mg dose of Zocor have a higher risk of developing muscle pain and weakness compared with people using lower doses.

When used with Zocor, certain medications may raise your risk of developing muscle pain and weakness. For more information, see the “Zocor interactions” section below.

When to call your doctor

Call your doctor if you notice any unexplained muscle pain, tenderness, or weakness while taking Zocor. This is especially important if you also experience fever or a general sense of not feeling well. Your doctor may lower your dose of Zocor or have you try a different medication to treat your condition.

In most cases, muscle pain and weakness go away once you stop taking Zocor. However, talk with your doctor if these side effects continue after you stop taking Zocor.

Upper respiratory infection

Some people may develop an upper respiratory infection while taking Zocor. In clinical studies, this was one of the more common side effects reported by people who took the drug.

In one study:

• 8.9% of people who took Zocor had an upper respiratory infection
• 8.1% of people who took a placebo had an upper respiratory infection

The most commonly reported infections were bronchitis and sinusitis. Symptoms of an upper respiratory tract infection may include:

• fatigue
• fever
• headache
• throat pain, especially when swallowing
• wheezing

If you develop symptoms of an upper respiratory infection while taking Zocor, call your doctor.

Headache

Taking Zocor may cause a headache in some people. In a clinical study:

• 2.5% of people who took Zocor reported a headache
• 2.1% of people who took a placebo reported a headache

If you experience bothersome headaches while taking Zocor, talk with your doctor. They may recommend a medication for your headaches, or they may have you switch from Zocor to a different drug.

Weight gain (not a side effect)

Weight gain isn’t a side effect of Zocor.

Zocor belongs to a class of medications known as statins. In the past, there has been debate about whether statin drugs such as Zocor cause weight gain. Currently, there isn’t enough evidence to suggest that Zocor causes weight gain.

However, some researchers have noted that people who use statins tend to increase the amount of calories they eat compared with people who don’t take statins.

It’s important to remember that Zocor (and other statin drugs) aren’t substitutes for a healthy diet and exercise. You should continue to follow the diet and exercise advice from your doctor in addition to taking Zocor as prescribed.

If you have questions or concerns about weight gain while taking Zocor, talk with your doctor.

Zocor dosage

The Zocor dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Zocor to treat
• your age
• other medical conditions you may have
• other medications you may take
• side effects you may experience while taking the medication

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths (5 mg, 10 mg, 20 mg, 40 mg, 80 mg)

Zocor comes as a tablet which you take by mouth. It’s available in five strengths: 5 mg, 10 mg, 20 mg, 40 mg, and 80 mg.

Dosage to lower the risk of cardiovascular problems and death

The recommended dosage to lower the risk of cardiovascular (heart and blood vessel) problems and death is 5 mg to 40 mg of Zocor. The dose is taken once a day, in the evening.

Typically, your doctor will start you on 10 mg or 20 mg once a day. Then they’ll monitor your condition and adjust your Zocor dosage if necessary.

Your doctor may give you a different dosage depending on several factors, including whether you have kidney disease. If you have questions about the dosage that’s right for you, talk with your doctor.

Dosage for high cholesterol in adults

The recommended dosage of Zocor for treating high cholesterol in adults is 5 mg to 40 mg once a day. The dose should be taken in the evening.

Typically, your doctor will start you on a dosage of 10 or 20 mg once a day. Then they’ll monitor your condition and adjust your Zocor dosage if necessary.

For adults with homozygous familial hypercholesterolemia (HoFH) the recommended dose is 40 mg a day taken in the evening.

Your doctor may give you a different dosage depending on several factors, including whether you have kidney disease. If you have questions about the dosage that’s right for you, talk with your doctor.

Dosage for heterozygous familial hypercholesterolemia in children

The recommended dosage for heterozygous familial hypercholesterolemia (HeFH) in children ages 10 to 17 years is 10 mg to 40 mg per day. The dose is taken in the evening.

What if I miss a dose?

If you miss a dose of Zocor, simply skip that dose and take your next regularly scheduled dose. Never take an extra dose to make up for a missed dose. This can raise your risk of side effects.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Zocor is meant to be used as a long-term treatment. If you and your doctor determine that Zocor is safe and effective for you, you’ll likely take it long term.

Zocor uses

The Food and Drug Administration (FDA) approves prescription drugs such as Zocor to treat certain conditions. Zocor may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Zocor for lowering the risk of cardiovascular problems and death

Zocor is FDA-approved to lower the risk of cardiovascular problems and death in adults who have certain conditions (see list below). “Cardiovascular” refers to your heart and blood vessels. Examples of cardiovascular problems include stroke and heart attack.

Conditions that may raise your risk of cardiovascular problems and death while taking Zocor include:

• coronary artery disease
• peripheral vascular disease
• history of stroke or other cerebrovascular disease

Zocor’s effectiveness for lowering the risk of cardiovascular problems and death

Clinical studies have shown Zocor to be effective for lowering the risk of cardiovascular problems and death in adults with conditions.

One clinical study enrolled 4,444 adults with heart disease and followed them for an average of 5.4 years. Each person in this study received help in maintaining a heart-healthy diet. Half of the people also took Zocor every day. The other half took a placebo (a treatment with no active drug) every day.

The researchers found that the risk of dying from heart disease was reduced by 42% in people taking Zocor compared with people who took placebo.

The results also showed that people who took Zocor:

• had a 37% lower risk of having a nonfatal heart attack than people taking a placebo
• had a 28% lower risk of having a fatal or nonfatal stroke or other cerebrovascular disease (disease affecting blood flow to your brain) than people taking a placebo

It’s important to note that your results from taking Zocor may vary from those seen in clinical trials. If you have questions about whether Zocor is right for you, talk with your doctor.

Zocor for high cholesterol in adults

Zocor is FDA-approved to treat high cholesterol in adults, along with a diet low in saturated fat and cholesterol. (For information about how Zocor treats high cholesterol in children, see the “Zocor and children” section below.)

Cholesterol is measured in several ways. “Total cholesterol” is the overall amount of cholesterol found in your blood. Total cholesterol consists of:

• low-density lipoproteins (LDLs), sometimes referred to as “bad cholesterol”
• high-density lipoproteins (HDLs), sometimes referred to as “good cholesterol”
• triglycerides, which are a type of fat that are “building blocks” of cholesterol

Zocor is approved to lower cholesterol in adults with:

• Primary hyperlipidemia or mixed dyslipidemia. For these conditions, Zocor has been shown to reduce total cholesterol and triglycerides, as well as levels of a protein known as apolipoprotein B (Apo B). (High levels of Apo B are a sign of high cholesterol.) Zocor has also been shown to increase HDL levels.
• Hypertriglyceridemia. For this condition, Zocor has been shown to reduce triglycerides.
• Type III hyperlipoproteinemia. For this condition, Zocor has been shown to lower triglycerides and levels of very-low density lipoprotein cholesterol (VLDL-C).
• Homozygous familial hypercholesterolemia (HoFH). For treating HoFH, Zocor should be used with other lipid-lowering treatments.

“High cholesterol” specifically refers to having high levels of LDL. However, Zocor doesn’t only help lower your LDL levels. It has also been shown to reduce total cholesterol, reduce triglycerides, and increase HDL (“good”) cholesterol.

Zocor’s effectiveness for treating high cholesterol in adults

Clinical studies have shown Zocor to be effective for treating high cholesterol.

One study enrolled 4,444 adults with a total cholesterol level between 212 to 309 milligrams per deciliter (mg/dL) and followed them for an average of 5.4 years. (The recommended cholesterol level for most adults is less than 200 mg/dL.)

Each person in this study received help in maintaining a heart-healthy diet. Half of the people also took Zocor every day. The other half took a placebo (a treatment with no active drug) every day.

The results showed that people who took 20 mg to 40 mg of Zocor:

• lowered their total cholesterol by an average of 25%
• reduced their LDL by an average of 35%
• lowered their triglycerides by an average of 10%
• increased their HDL (“good cholesterol”) by an average of 8%

In the study, people who took a placebo didn’t have their total cholesterol, LDL, or triglycerides lowered by a noticeable or consistent amount.

Zocor for heterozygous familial hypercholesterolemia in children

Zocor is approved to treat high cholesterol in children ages 10 to 17 years who have a condition known as heterozygous familial hypercholesterolemia (HeFH). This is a genetic (inherited) form of high cholesterol.

Females taking Zocor for this condition should have had their first period at least 1 year before starting treatment.

High cholesterol rarely causes any symptoms. This means HeFH is typically diagnosed after a blood test finds high cholesterol levels in your child. For this reason, it’s important to ask your doctor about checking for HeFH in your child if:

• either of the child’s biological parents has HeFH
• the child has a parent or sibling with a history of premature heart disease (before age 65 years old for women or age 55 years old for men)
• the child’s LDL level is 160 mg/dL or higher

Zocor’s effectiveness for treating HeFH in children

One clinical study involved 175 children ages 10 to 17 with HeFH. The children took either Zocor or a placebo (a treatment with no active drug) every day for 24 weeks.

At the end of the study, the researchers found that:

• children who took Zocor had their total cholesterol lowered by an average of 26.5%
• children who took a placebo had their total cholesterol raised by an average of 1.6%

The results also showed that:

• children who took Zocor had their LDL (“bad” cholesterol”) lowered by 36.8%
• children who took a placebo had their LDL raised by an average of 1.1%
• children who took Zocor had their Apo B levels* lowered by 32.4%
• children who took a placebo had their Apo B levels lowered by an average of 0.5%

* Apolipoprotein B (Apo B) is a protein. Increased levels of Apo B are a sign of high cholesterol.

Zocor and children

Zocor is approved to treat high cholesterol in children ages 10 to 17 years who have heterozygous familial hypercholesterolemia (HeFH). For more information, see the section above.

Alternatives to Zocor

Other drugs are available that can treat high cholesterol. Some may be a better fit for you than others. If you’re interested in finding an alternative to Zocor, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for high cholesterol

Examples of other drugs that may be used to treat high cholesterol include:

• other statin drugs, such as:
  • atorvastatin (Lipitor)
  • fluvastatin (Lescol XL)
  • lovastatin
  • pitavastatin (Livalo)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
• bile acid binding resins, such as:
  • cholestyramine (Prevalite)
  • colesevelam (Welchol)
  • colestipol (Colestid)
• ezetimibe (Zetia)
• fibrates, such as:
  • fenofibrate (Antara, Lipofen, Tricor)
  • gemfibrozil (Lopid)
• injectable medications, such as:
  • alirocumab (Praluent)
  • evolocumab (Repatha)

Note: Some of these drugs are also approved to reduce the risk of death from heart problems or stroke. For more information on your treatment options, talk with your doctor.

Zocor vs. Lipitor

You may wonder how Zocor compares with other medications that are prescribed for similar uses. Here we look at how Zocor and Lipitor are alike and different.

Ingredients

Zocor contains the active drug simvastatin. Lipitor contains the active drug atorvastatin. Both simvastatin and atorvastatin belong to a class of medications known as statins. (A medication class is a group of drugs that work together in a similar way.)

Uses

Both Zocor and Lipitor are FDA-approved to:

• lower high cholesterol (along with diet) in adults
• lower the risk of cardiovascular problems and death in adults
• lower high cholesterol (along with diet) caused by a genetic condition called heterozygous familial hypercholesterolemia (HeFH) in children ages 10 to 17 years

Drug forms and administration

Both Zocor and Lipitor come as a tablet that you take by mouth once a day.

Side effects and risks

Zocor and Lipitor have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Zocor, with Lipitor, or with both drugs (when taken individually).

• Can occur with Zocor:
  • abdominal (belly) pain
  • constipation
  • eczema
  • headache
  • high blood sugar
  • gastritis (swelling of the stomach lining)
• Can occur with Lipitor:
  • diarrhea
  • joint pain
• Can occur with both Zocor and Lipitor:
  • muscle pain
  • nausea
  • upper respiratory infection
  • urinary tract infection

Serious side effects

This list contains examples of serious side effects that can occur with both Zocor and Lipitor (when taken individually).

• Can occur with both Zocor and Lipitor:
  • liver problems
  • rhabdomyolysis (breakdown of muscles)
  • allergic reaction

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, studies have found both Zocor and Lipitor to be effective for treating high cholesterol.

Zocor and Lipitor have been indirectly compared in a meta-analysis. A meta-analysis looks at data from multiple clinical trials. The researchers who conducted the analysis found Zocor and Lipitor to be similarly effective at lowering the risk of cardiovascular problems and death in adults.

The American College of Cardiology (ACC) releases guidelines on managing high cholesterol. Statins, including Zocor and Lipitor, are included in these guidelines.

The statin your doctor prescribes for you will depend on factors like your age, your cholesterol levels, and your risk of cardiovascular (heart and blood vessel) problems. If you have questions about which statin is right for you, talk with your doctor.

Costs

Zocor generally costs less than Lipitor. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Zocor is available as a generic drug called simvastatin. Lipitor is available as a generic drug called atorvastatin. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

Zocor vs. Crestor

Zocor and Crestor are prescribed for similar uses. Here’s a look at how these drugs are alike and different.

Ingredients

Zocor contains the active drug simvastatin. Crestor contains the active drug rosuvastatin. Both simvastatin and rosuvastatin belong to a class of medications called statins. (A medication class is a group of drugs that work together in a similar way.)

Uses

Below is a list of conditions that the Food and Drug Administration (FDA) has approved Zocor and Crestor to treat.

• Both Zocor and Crestor are FDA-approved to:
  • lower the risk of cardiovascular problems and death in adults
  • treat high cholesterol (along with diet) in adults
• Zocor is also FDA-approved to:
  • treat high cholesterol (along with diet) caused by a genetic condition called heterozygous familial hypercholesterolemia (HeFH) in children ages 10 to 17 years
• Crestor is also FDA-approved to:
  • treat high cholesterol (along with diet) caused by homozygous familial hypercholesterolemia (HoFH) in children ages 7 to 17 years
  • slow the progression of atherosclerosis (narrowing of the arteries)

Drug forms and administration

Both Zocor and Crestor come as a tablet that you take by mouth once a day.

Side effects and risks

Zocor and Crestor have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Zocor, with Crestor, or with both drugs (when taken individually).

• Can occur with Zocor:
  • eczema
  • high blood sugar
  • gastritis (swelling of the stomach lining)
  • upper respiratory infection, such as bronchitis and sinusitis
  • urinary tract infection
• Can occur with Crestor:
  • feeling unusually weak or lacking energy
• Can occur with both Zocor and Crestor:
  • abdominal (belly) pain
  • constipation
  • headache
  • muscle pain
  • nausea

Serious side effects

This list contains examples of serious side effects that can occur with both Zocor and Crestor (when taken individually).

• Can occur with both Zocor and Crestor:
  • liver problems
  • rhabdomyolysis (breakdown of muscles)
  • allergic reaction

Effectiveness

These drugs haven’t been directly compared in clinical studies. However, studies have found both Zocor and Crestor to be effective for treating high cholesterol and lowering the risk of cardiovascular problems and death in adults. Both drugs have also been found to be effective at treating high cholesterol caused by certain genetic conditions in children.

The American College of Cardiology (ACC) releases guidelines on managing high cholesterol. Statins, including Zocor and Crestor, are included in these guidelines.

The statin your doctor prescribes for you will depend on factors like your age, your cholesterol levels, and your risk of cardiovascular (heart and blood vessel) problems. If you have questions about which statin is right for you, talk with your doctor.

Costs

Brand-name Zocor generally costs less than Crestor. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Zocor is available as a generic drug called simvastatin. Crestor is available as a generic drug called rosuvastatin. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

Zocor and alcohol

There isn’t a known interaction between taking Zocor and consuming alcohol.

However, excessive alcohol use can damage your liver. Liver damage is also a potential side effect of Zocor. Consistently drinking large amounts of alcohol during your Zocor treatment could raise your risk of liver problems.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink during your Zocor treatment. Also, if you have a history of heavy drinking or liver damage, be sure to tell your doctor before you begin taking Zocor.

Zocor interactions

Zocor can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Zocor and other medications

Below this article discusses medications that can interact with Zocor. It doesn’t cover all drugs that may interact with Zocor.

Before taking Zocor, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

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

Zocor and strong CYP3A4 inhibitors

Taking Zocor with medications that inhibit (slow down) the activity of an enzyme called CYP3A4 can increase the levels of Zocor in your body. CYP3A4 helps your body break down drugs. When this process is slowed down, it raises your risk of side effects from Zocor.

Certain drugs have stronger or weaker effects on CYP3A4. Zocor shouldn’t be used with medications that are strong CYP3A4 inhibitors.

Examples of strong CYP3A4 inhibitors include:

• antibiotics, such as clarithromycin and erythromycin
• antifungals, such as ketoconazole and itraconazole (Sporanox)

Talk with your doctor before using Zocor if you’re taking any of these medications. They’ll help determine the best medications for safely treating your conditions.

Zocor and cyclosporine or danazol

Zocor shouldn’t be taken with cyclosporine (Gengraf, Sandimmune) or danazol. Taking these drugs with Zocor can raise your risk of muscle pain or weakness.

Cyclosporine is used to help prevent the rejection of a transplanted organ. It’s also used to help treat rheumatoid arthritis and psoriasis. Danazol is a medication used to treat endometriosis. It can also help prevent attacks of hereditary angioedema.

If you’re taking cyclosporine or danazol, talk with your doctor before taking Zocor. They can determine the best medications to safely treat your condition.

Zocor and gemfibrozil and other fibrates

You shouldn’t take gemfibrozil (Lopid) while taking Zocor. Gemfibrozil is a fibrate drug used for lowering the amount of fats, such as triglycerides, in your blood. Taking this drug with Zocor greatly increases your risk of developing muscle pain or weakness.

Before taking Zocor, you should also tell your doctor if you’re taking another fibrate drug, such as fenofibrate. Zocor can interact with these medications, although the interaction isn’t as serious as with gemfibrozil. If you need to take Zocor with these other fibrates, your doctor may lower your dose of Zocor or your fibrate. Or they may decide to use a different medication to treat your condition.

Other medications may also raise your risk of muscle pain or weakness if taken with Zocor. Examples of these medications include:

• amiodarone (Pacerone)
• calcium channel blockers, such as
  • amlodipine (Norvasc)
  • diltiazem (Cardizem, Cartia XT)
  • verapamil (Calan SR, Verelan)
• cobicistat
• colchicine (Colcrys)
• dronedarone (Multaq)
• nefazodone
• niacin (Niacor, Niaspan)
• protease inhibitors used for treating HIV, such as ritonavir (Norvir)
• ranolazine (Ranexa)

Talk with your doctor before taking Zocor if you’re taking any of these medications. They may decide to prescribe a lower dose of Zocor or your other medication. Or they may have you try a different medication to treat your condition.

Zocor and digoxin

Taking Zocor with digoxin (Lanoxin) can increase the amount of digoxin in your body. Digoxin levels that are too high can lead to dangerous side effects.

Digoxin is used to treat atrial fibrillation and heart failure in adults and children.

If you need to take Zocor and digoxin together, your doctor will closely monitor your digoxin levels. They may also change your digoxin dose to lower your risk of side effects.

Zocor and certain blood thinners

Taking Zocor with certain blood thinners (called coumarin anticoagulants) may increase the effects of the blood thinners. This could cause you to bleed more. An example of a coumarin anticoagulant is warfarin (Coumadin, Jantoven).

If you need to take this type of blood thinner with Zocor, your doctor may need to monitor your bleeding risk more often. Talk with your doctor about any blood thinning medications you take.

Zocor and herbs and supplements

Taking Zocor with St. John’s wort may affect the levels of Zocor in your body. This could make Zocor less effective.

Ask your doctor whether St. John’s wort is safe for you to take during your Zocor treatment. They may recommend an alternative to St. John’s wort, or they may change your Zocor dosage.

Zocor and foods

Zocor can interact with grapefruit. Therefore, you should avoid drinking grapefruit juice or eating grapefruit while taking Zocor.

Grapefruit contains a chemical that can interfere with your body’s ability to break down Zocor. This can lead to higher-than-normal levels of Zocor in your blood, which may raise your risk of side effects from the drug.

Common questions about Zocor

Here are answers to some frequently asked questions about Zocor.

Is Zocor a blood thinner?

No, Zocor isn’t a blood thinner.

Blood thinners help prevent blood clots. Blood clots can cause cardiovascular problems such as a heart attack or stroke. Some blood thinners work by keeping blood cells from sticking together. Others increase the amount of time it takes for clots to form.

Zocor doesn’t thin your blood. Instead, it reduces the amount of cholesterol your body makes. By doing this, Zocor lowers your risk of cardiovascular problems. This is because when there’s too much cholesterol in your blood, it can raise your risk of blood clots.

It’s important to note that taking Zocor with certain blood thinners, such as warfarin (Coumadin, Jantoven), may increase the effects of the blood thinners. This could cause you to bleed more. If you need to take a blood thinner with Zocor, your doctor may need to monitor your bleeding risk more often.

How long will Zocor stay in my system?

Zocor doesn’t stay in your system very long. The drug gets broken down and removed from your body within about 1 day.

Will Zocor cure my high cholesterol?

No, Zocor won’t cure your high cholesterol. Currently, there isn’t a cure for high cholesterol.

However, studies have shown that along with a healthy diet, Zocor can help lower your cholesterol. This can reduce your risk of heart disease and other health problems, such as stroke.

If you have additional questions about treating your high cholesterol, talk with your doctor.

Do I need to follow a certain diet while taking Zocor?

No, there isn’t any specific diet you need to follow while taking Zocor. However, it’s important to note that Zocor doesn’t take the place of a healthy diet.

People with high cholesterol or heart disease, or who are at risk of heart disease, should maintain a diet low in saturated fat and cholesterol. The American Heart Association offers dietary recommendations for managing cholesterol and lowering your risk of heart disease. These tips include:

• eating less saturated fat, meat, and solid fats (like butter or lard)
• eating more fresh fruit, vegetables, fiber, and whole grains

As with other statins, you should maintain a heart-healthy diet while taking Zocor. Otherwise, the medication may be less effective.

If you have questions about following a heart-healthy diet, talk with your doctor or dietitian.

Is Zocor safe for older adults?

In general, yes, Zocor is safe for older adults. Clinical studies of Zocor included nearly 6,000 adults who were ages 65 years or older. In these studies, the researchers didn’t notice any differences in safety or effectiveness when Zocor was used in older adults compared with people under age 65 years.

However, people ages 65 years and older may have a higher risk of developing muscle weakness or pain from taking Zocor. For this reason, your doctor may take extra precautions (such as ordering blood tests) before prescribing Zocor if you’re over age 65. Your doctor may also decide to use a different medication to treat your condition.

If you have questions about whether Zocor is safe for you to take based on your age or other factors, talk with your doctor.

Do I need regular cholesterol screenings?

Yes, adults ages 20 years and older should get tested regularly for high cholesterol. High cholesterol rarely causes any symptoms. Therefore, many people often don’t realize they have high cholesterol until a serious complication occurs, such as a heart attack or stroke.

If you have questions about what your cholesterol should be or how often you should get it checked, talk with your doctor.

How to take Zocor

You should take Zocor according to your doctor’s or healthcare provider’s instructions.

Zocor comes as tablets that you take by mouth.

When to take

Typically, Zocor is taken once a day in the evening. However, be sure to take the drug as your doctor prescribes.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful too.

Taking Zocor with food

Zocor may be taken with or without food.

Can Zocor be crushed, split, or chewed?

The manufacturer of Zocor hasn’t stated whether the tablets can be crushed, split, or chewed. Talk with your doctor or pharmacist if you have trouble swallowing Zocor tablets.

Zocor use with other drugs

Depending on the condition it’s being used to treat, Zocor may be taken on its own or with other drugs.

Examples of other drugs that may be used with Zocor to treat high cholesterol include:

• bile acid binding resins, such as:
  • cholestyramine (Prevalite)
  • colesevelam (Welchol)
  • colestipol (Colestid)
• ezetimibe (Zetia)
• injectable medications, such as:
  • alirocumab (Praluent)
  • evolocumab (Repatha)

Zocor cost

As with all medications, the cost of Zocor can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Zocor, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Zocor, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Zocor, or if you need help understanding your insurance coverage, help is available.

Medication Assistance Tool provides lists of programs that may help to lower the cost of Zocor. For more information and to find out if you’re eligible for support, visit the organization’s website.

Generic version

Zocor is available in a generic form called simvastatin. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.

If your doctor has prescribed Zocor and you’re interested in using simvastatin instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

How Zocor works

Zocor is FDA-approved to help lower cholesterol in adults and in children ages 10 to 17 years. Specifically, Zocor is approved to:

• lower high cholesterol (along with a healthy diet) in adults
• lower the risk of cardiovascular problems and death in adults
• lower high cholesterol (along with a healthy diet) caused by a genetic condition called heterozygous familial hypercholesterolemia (HeFH) in children ages 10 to 17 years

Zocor is approved to treat these conditions in certain situations. For more information about how the drug is used, see the “Zocor uses” section above.

What cholesterol is

Cholesterol is a type of lipid, which is a fat-like substance made naturally in your liver. Cholesterol gets a bad reputation, but it’s necessary for your body to work properly. For example, cholesterol is vital for producing vitamin D and certain hormones.

Because cholesterol can’t travel through your blood on its own, your liver also makes lipoproteins. Lipoproteins are particles that carry cholesterol through the bloodstream. There are two major types of lipoproteins: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

Having too much LDL cholesterol is known as high cholesterol. This is why LDL is often referred to as “bad” cholesterol. When LDL levels are too high, LDL cholesterol can begin to build up on the walls of your arteries. This buildup is called cholesterol plaque.

Cholesterol plaques narrow your blood vessels. This limits your blood flow and raises your risk of developing blood clots. Cholesterol plaques can also break off the artery walls and travel through the bloodstream. This could lead to serious problems, such as heart attack or stroke if the plaques reach the heart or brain.

HDL is often called “good” cholesterol because it works to carry LDL cholesterol back to your liver so it can be removed from your body. In this way, HDL helps prevent cholesterol plaques from forming in your arteries.

What Zocor does

Zocor works by preventing your body from making cholesterol. Specifically, Zocor blocks an enzyme called HMG-CoA reductase. An enzyme is a protein your body makes to help speed up reactions, such as making cholesterol.

HMG-CoA is one of the most important enzymes for making cholesterol. By blocking this enzyme, Zocor reduces your levels of cholesterol, LDL, triglycerides, and very-low density lipoprotein (VLDL) in your blood. Zocor also increases the levels of HDL in your blood.

By preventing your body from making cholesterol, Zocor can lower your risk of cardiovascular problems such as heart attack and stroke. This is because when there’s too much cholesterol in your blood, it can raise your risk of blood clots.

How long does it take to work?

Zocor begins working as soon as you take your dose. Zocor reaches its highest levels in your body about 4 hours after you take your dose.

However, you likely won’t feel Zocor working in your body. This is because of how the drug works, and because high cholesterol doesn’t cause symptoms in most people.

Zocor and pregnancy

You shouldn’t take Zocor while pregnant. Studies have shown that Zocor (like other statins) can cause birth defects if used during pregnancy.

If you’re pregnant or planning a pregnancy, talk with your doctor about your other treatment options. If you become pregnant while taking Zocor, stop taking the medication right away and call your doctor.

Zocor and birth control

Zocor isn’t safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Zocor.

For more information about taking Zocor during pregnancy, see the “Zocor and pregnancy” section above.

Zocor and breastfeeding

You shouldn’t use Zocor while breastfeeding. It’s not known whether the drug passes into human breast milk. However, if it does pass into breast milk, Zocor could cause serious side effects in a breastfed child.

If you have questions about the best way to feed your child during your Zocor treatment, talk with your doctor.

Zocor precautions

Before taking Zocor, talk with your doctor about your health history. Zocor may not be right for you if you have certain medical conditions or other factors affecting your health, including the following.

Note: For more information about the potential negative effects of Zocor, see the “Zocor side effects” section above.

Having a higher risk of developing muscle pain or weakness

Muscle pain and weakness is a possible side effect of Zocor. Some people have a higher risk of developing this side effect because of certain factors, such as:

• being age 65 years and older
• being born female (assigned female at birth)
• being of Chinese ancestry
• having kidney disease
• having untreated low levels of thyroid hormones

If any of these risk factors apply to you, talk with your doctor before taking Zocor.

Liver disease

You shouldn’t take Zocor if you currently have liver disease. This is because Zocor can damage your liver. If you have a history of liver disease, you may have a higher risk of this side effect from taking Zocor. Before taking Zocor, tell your doctor if you currently have liver disease or have had it in the past.

Excessive alcohol use

Consistently drinking large amounts of alcohol can cause liver damage. Liver damage is also a potential side effect of Zocor. Drinking excessively during your Zocor treatment could raise your risk of liver problems. Before taking Zocor, talk with your doctor if you have a history of excessive alcohol use.

Allergic reaction

If you’ve had an allergic reaction to Zocor or any of its ingredients, you shouldn’t take Zocor. Ask your doctor other medications that may be better options for you.

Pregnancy

It’s not safe to use Zocor while pregnant. For more information, see the “Zocor and pregnancy” section above.

Breastfeeding

Zocor shouldn’t be taken while breastfeeding. For more information, see the “Zocor and breastfeeding” section above.

Zocor overdose

Do not use more Zocor than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Zocor

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Zocor expiration, storage, and disposal

When you get Zocor from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Zocor tablets should be stored at a room temperature of 41ºF to 86ºF (5ºC to 30ºC) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Zocor and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.