What is zocor?

Zocor is the brand name for a generic drug called Simvastatin.

Zocor is a drug used to control the elevated level of the “bad” cholesterol (LDL) in the blood. Zocor also increase the level of the “good” cholesterol or HDL (High Density Lipoprotein), and have a role in lowering the triglycerides in patients with hypertriglyceridemia.

As the level of “bad” cholesterol decreases, so decreases the risk of having a stroke, a heart attack or or other heart complications. So in the end Zocor reduces the mortality in patients with risks of Coronary heart disease or other cardiovascular problems and the need for coronary and non-coronary revascularization procedures.

zocor molecular formula

Image:Zocor molecular model

If you want to learn more, read “the mechanism of zocor“.

Zocor side effects

Sometimes side effects are observed if you use other drugs, so you must tell your doctor everything about other medical conditions and drugs you are using so the proper dose of zocor for your case can be prescribed.

You should tell your doctor if you have any of these conditions:

  • Diabetes
  • History of liver disease
  • History of kidney disease
  • Hypothyroidism
  • If you regularly drink achololic beverages.
  • Medicines that contain niacin

The greatest side effect of zocor is myopathy (muscle injury). Myopathy is observed in patients taking zocor 80mg or in other patients taking lower doses of zocor but that are actually on other drugs. For more information read zocor and muscle pain.

There is a risk of rhabdomyolysis resulting in kidney failure or even death if zocor is used with amiodarone.

Also, it is contraindicated the use of zocor with:

  • Itraconazole
  • Ketoconazole
  • Posaconazole
  • Erythromycin
  • Clarithromycin
  • Telithromycin
  • HIV protease inhibitors
  • Nefazodone
  • Gemfibrozil
  • Cyclosporine
  • Danazol

You should stop using Zocor if you have any of these symptoms and consult a doctor:

  • Muscle pain, tenderness or weakness / tiredness
  • Hives
  • swelling on your face, lips, throat, tongue or legs
  • dark colored urine, urinating less than usual or not at all, pain or burning while urinating
  • nausea
  • lost of appetite
  • stomach pain

Other zocor side effects not so common are:

  • Insomnia
  • Headache
  • Constipation
  • Diarrea
  • Skin rash
  • Sore throat, sneezing, stuffy nose

When taking Zocor you should avoid grapefruit or grapefruit-containing products. More info on the section zocor and grapefruit.

Zocor should not be used by patients who have liver problems or by women in their pregnancy. Zocor can cause birth defects. Also, women who are breast-feeding should not use Zocor. More info on zocor and pregnancy.

To report other suspected zocor side effects, contact Merck Sharp & Dohme Corp (a subsidiary of Merck & Co., Inc) at 1-877-888-4231 or FDA at 1-800-FDA-1088 or visit the official website of FDA at www.fda.gov/medwatch.

Zocor dosage

zocor 20mg

Zocor tablets dosage, forms and strengths

  • Tablets ZOCOR 5 mg are buff, oval, film-coated tablets, coded MSD 726 on one side and ZOCOR 5 on the other.
  • Tablets ZOCOR 10 mg are peach, oval, film-coated tablets, coded MSD 735 on one side and plain on the other.
  • Tablets ZOCOR 20 mg are tan, oval, film-coated tablets, coded MSD 740 on one side and plain on the other.
  • Tablets ZOCOR 40 mg are brick red, oval, film-coated tablets, coded MSD 749 on one side
  • Tablets ZOCOR 80 mg are brick red, capsule-shaped, film-coated tablets, coded 543 on one side and 80 on the other.
Doctors prescribe doses from 5 to 80mg (usually from 5 to 40mg) ONCE A DAY IN THE EVENING.

Zocor dosage is unique for every patients, as it depends on a lot of factors such as other medical conditions a patient might have.

As with any other drug you should take the doctor’s prescription dosage very seriously. High doses of Zocor, not only causes injury to muscle tissue and kidneys, but sometimes can even be life-threatning.

Do not exceed zocor 10mg daily if taking:

  • Verapramil
  • Diltiazem

Do not exceed zocor 20mg daily if taking:

  • Amlodipine
  • Amiodarone
  • Ranolazine
  • Chinese patients using niacin-containing medicals

For adolescents with Heterozygous Familial Hypercholesterolemia the recommended dose is 10-40mg/day

Patients with renal impairment are started on zocor 5mg/day and closely monitered.

For patients at high risk for a Coronary heart disease event due to risk factors such as diabetes, history of stroke or other vascular disease, the recommended dose is on zocor 40 mg.

The FDA has limited the use of doses of 80mg to only those patients who have not had any signs of muscle injury for the last 12 months.

Doses over 80mg (prescribed before FDA recommandation), had a lot of side effects and the level of lowering of LDL in not so much different from doses lower than 80mg.

Lipid determinations should be performed after 4 weeks of therapy and periodically thereafter, in order to monitor the patient condition more acurately and prescribe the right dosage of zocor.

Zocor and muscle pain

High doses of zocor can cause myopathy (mucle injury) including rhabdomyolysis, manifested as muscle pain, tenderness or weakness. With high doses is intended doses of 80mg or similar injuries are observed in patients which take lower doses, but that are actually on other drugs such as Amiodarone or Verapamil.

List of drugs which can cause myopathy when used with zocor:

  • Nefazodone (antidepressant)
  • Cyclosporine (immunosupressant, used in organ transplantation)
  • Clarithromycin, Erythromycin,Telithromycin (common antibiotics)
  • Danazol
  • HIV drugs

Predisposing factors for myopathy include:

  • advanced age (≥65 years)
  • female gender,
  • uncontrolled hypothyroidism
  • renal impairment.

If you have any symptoms like muscle pain, tendeness or weakness, the treatment should be stopped immediately and go see a doctor.

zocor myopathy

Zocor and grapefruit

zocor and grapefruit

Grapefuit juice is an inhibitor of an enzyme in the small intestine, which plays an important role in breaking down of various statins like zocor (also lipitor, mevacor). So grapefruit slows down the metabolization of zocor, resulting in a high level of zocor in the blood.

A high level of zocor is toxic, so patients taking zocor should avoid grapefruit or other grapefruit-containing products.

It is recommended that you don’t drink more than 1 quart of grapefruit-juice daily. Better not to drink at all grapefruit or other related products.

This effect of the grapefruit can persist up to 3 days, so you can not drink grapefruit juice in the morning and take zocor in the evening.

zocor and grapefruit

Zocor and alcohol

Alcohol increases the level of triglycerides and also causes a lot of damage to the liver.
When you abuse acohol, the liver functions are lowered and the liver cannot uptake zocor properly. This results in a higher dose of zocor in the blood and a higher risk of developing one of the zocor side effects.

The taking of alcohol with zocor is not prohibited, but not recommended. In an experiment done on rats the weren’t any significant damages of zocor taken with moderate doses of alcohol. The recommended alcohol dosage in humans is individual, so you should discuss it with your doctor.

However, we would recommend you to stop drinking at all if you have any cardiovascular problems. But stopping an addiction is not something you can do reading a paragraph in a website on the internet. So we really recommend you to read one of the books listed below.

Zocor and chinese population

zocor in chinese population

There is an increased risk of myopathy in Chinese patients taking lipid-modifying doses (>1g/day niacin) of Niacin-containing drugs.
The cause of this increased risk is still unkown, nor it is known if other Asian patients have the same problems as well.

So doctors should be very cautious when prescribing doses over 20mg/day for Chinese patients. Also zocor 80mg is not recommended at all for these patients.

The mechanism of zocor

As you now know from the post what is zocor, zocor is a cholesterol lowering drug.

Cholesterol in our body is a result of the fat we eat from food and the fat our body produces. We have 2 types of cholesterol; LDL (also called “bad cholesterol”) and HDL (the “good cholesterol”).
LDL form aggregates on the wall of the arteries. Doing so the arteries diameter is narrowed and as a result there is a slow or blocked blood flow. So LDL cholesterol is the main cause of heart disease or stroke.

The biosynthesis of cholesterol is a complex process. At one step HMG-CoA is converted to mevalonate. The reaction is made possible by the “HMG-CoA reductase” enzyme. Zocor inhibits this enzyme, thus preventing the synthesis of cholesterol.

cholesterol production

Zocor or simvastatin ?

Simvastatin is the generic drug of the brand name Zocor.

There is a myth that generic drugs cost less than brand name ones because they are less effective. This is not true.All generic drugs are required by the FDA to have the same performance and quality as their respective brand name drugs.

In 2008 the results of 38 clinical trails were evaluated and the conlusions were that the generic cardiovascular drugs worked as better as the brand name ones.

The main difference, however, between brand name drugs and the generic ones is in the price. A generic drug costs 80-85% less than their respective brand name.
zocor vs simvastatin

Zocor storage

You should store Zocor in room temperature and in a place away from the reach of children, moisture, height and light.

Zocor tablets should be stored in places with a temperature 41-86 degrees F (5-30 degrees C)

Oral disintegretaing zocor tablets should be stored in places with a temperature 68-77 degrees F (20-25 degrees C)

zocor storage