History

• The first statin compound was isolated from a mold in the late 1970s, and semi-synthetic derivatives and newer synthetic compounds have since been discovered. Clinically proven to be the most effective class of agents for reducing cardiac risks associated with high cholesterol, statins have moved to the forefront of hyperlipidemia treatment in recent years.
  
  

Mechanism of Action and Uses

• Zocor and its relatives work within the liver by blocking an enzyme---HMGCoA reductase---helpful in the body's production of cholesterol. Inhibition of this step reduces total cholesterol and also decreases "bad" low-density lipoproteins (LDLs) and triglycerides. High LDL levels can lead to the build-up of plaque in the arteries, increasing the risk of heart attack or stroke. Zocor also raises the high-density lipoproteins (HDLs) considered "good" cholesterol.
  
  

Side Effects

• Though Zocor and other statins are generally well tolerated, side effects may occur. The most common side effect of Zocor therapy is liver dysfunction. Liver function tests (LFTs) should be done before beginning Zocor and periodically thereafter.
  
  Other side effects are mild, and include headache, nausea, constipation, fever, vomiting, rash, indigestion and flatulence.
  
  Beyond its effects on the liver, in higher concentrations, Zocor may also cause a rare, but serious deterioration of muscle tissue called rhabdomyolysis. Interactions with other medications may increase the potential for rhabdomyolysis. Patients experiencing muscle pain or weakness, generalized aching and weakness, joint pain or a darkening of urine while taking Zocor should seek urgent medical attention.
  
  As with any medication, allergic reaction is possible. Rash, itching, swelling, breathing or swallowing difficulty are potential symptoms of allergic response and require immediate medical attention. Patients with a known sensitivity to statin medications should not take Zocor.
  
  

Precautions

• Due to potential fetal harm, women who are pregnant or wish to become pregnant should avoid Zocor therapy. Women of childbearing age who do not wish to become pregnant are urged to use contraception during Zocor use. Women who are nursing should also avoid Zocor.
  
  Use of Zocor with certain other medications may increase simvastatin levels and the risk of rhabdomyolysis. These agents include macrolide antibiotics, certain antifungal agents, certain anti-HIV therapies, niacin, fibric acid derivatives and cyclosporine. Patients should double check with their physician or pharmacist to ensure Zocor is safe to take with their other medications.
  
  Zocor may also affect the levels of other medications such as warfarin, digoxin and certain female hormones.
  
  

Considerations

• Zocor may be taken without regard to meals. Bedtime administration is preferred. Zocor should be kept out of reach of children in its original container.