Common uses
Zocor (SIMVASTATIN) is an HMG-CoA reductase inhibitor or "statin" used to lower bad cholesterol (LDL) and triglyceride levels in your blood or to raise good cholesterol (HDL) levels in adults. This medicine is used in combination with a low-cholesterol and low-fat diet. Simvastatin may also be used in certain adolescent patients, age 10 to 17 years, who have a genetically caused cholesterol problem. This medicine works by blocking an enzyme that is necessary for your body to make cholesterol. When this enzyme is blocked, your body makes less cholesterol. Keeping your cholesterol level under control may reduce your risk of heart problems and stroke. This medicine is not a cure for high cholesterol, but may help to control it. This medicine may also be used to treat other conditions as determined by your doctor.

Before using
Do not take this medicine if you are also taking fibrates such as gemfibrozil or fenofibrate; hiv protease inhibitors such as ritonavir, lopinavir, nelfinavir; itraconazole; ketoconazole; macrolide antibiotics such as erythromycin, clarithromycin, or troleandomycin; nefazodone; or high-dose niacin (1 gram or more per day).

Additional monitoring of your dose or condition may be needed if you are taking amiodarone, "blood thinners" such as warfarin, bosentan, cyclosporine, dalfopristin or quinupristin, digoxin, diltiazem, fluconazole, imatinib, rifamycins such as rifampin, st. John's wort, verapamil, or voriconazole.

Do not start or stop any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including kidney problems, muscle problems, alcohol use, allergies (especially to other "statins"), pregnancy, or breast-feeding. Certain medical conditions, including low blood pressure; severe infection; uncontrolled seizures; or serious metabolic, endocrine, or electrolyte problems may increase your risk for side effects that can result in kidney problems. Contact your doctor if you develop one of these conditions.

Use of this medicine is not recommended if you have a history of liver disease or ongoing, abnormal liver function test results. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. This medicine may be taken on an empty stomach or with food. If you are taking 1 dose a day, take your dose in the evening or at bedtime as directed by your doctor. Your dosage is based on your medical condition, response to therapy, and the other medicines that you are taking. Do not exceed the recommended dose of this medicine.

Do not drink large amounts of grapefruit juice (greater than 1 quart daily) or eat large amounts of grapefruit while taking this medicine. Store this medicine at room temperature, away from heat and light. For best results, take this medicine regularly. Taking this medicine at the same time(s) each day will help you to remember.

If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Cautions
Do not take this medicine if you have had an allergic reaction to it or are allergic to any ingredient in this product. Follow the dietary plan provided by your doctor. It may take several weeks for this medicine to work. Do not stop using this medicine without first checking your doctor. Keep all doctor and laboratory appointments while you are using this medicine. Laboratory and/or medical tests such as blood cholesterol levels, liver function tests, or muscle tests may be done at the start of therapy and while you are taking this medicine to monitor your progress or to check for side effects.

Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using this medicine. This medicine may increase your risk for liver problems. Alcohol can also increase this risk. Before drinking alcohol, talk with your doctor about the safe use of this medicine and alcohol. This medicine may cause injury to your muscles especially when taken at higher doses or when taken with certain other medicines. Contact your doctor immediately if you experience muscle pain or weakness, especially with a fever.

For women: if you are able to become pregnant, talk with your doctor or pharmacist about the use of effective birth control while taking this medicine. Do not use this medicine if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. It is unknown if this medicine is excreted in breast milk. Do not breast-feed while taking this medicine.

Possible side effects
Side effects that may occur while taking this medicine include constipation, diarrhea, or stomach upset. If they continue or are bothersome, check with your doctor. Contact your doctor immediately if you experience muscle aches, pain, tenderness, or weakness, especially if associated with unusual tiredness and a fever; yellowing of skin or eyes; dark urine; change in the amount of urine; stomach pain; ongoing nausea or vomiting; blurred vision; or unusual bleeding or bruising.

An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

If you take too much
If overdose is suspected, contact your local poison control center or emergency room immediately.

Additional information
For best results, this medicine should be used along with exercise, a low-cholesterol/low-fat diet, and a weight loss program if you are overweight. Follow the dietary plan provided by your doctor. Consult with your doctor. Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. Keep this medicine out of the reach of children and pets. If using this medicine for an extended period of time, obtain refills before your supply runs out.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Some medicines or medical conditions may interact with this medicine. Inform your doctor or pharmacist of all prescription and over-the-counter medicine that you are taking.