zocor generic side effects

Posted on 21 Дек 201711

Zocor (simvastatin) Side Effects, Dosage, Uses & Generic Info

Zocor (simvastatin) Side Effects, Dosage, Uses & Generic Info
Zocor (simvastatin) is a drug prescribed to reduce triglycerides, total cholesterol (LDL), and increasing HDL cholesterol. Common side effects of Zocor include ...

This restriction requires that specific clinical criteria be met prior to the approval of the prescription. Moderate-intensity therapy: 20-40 mg simvastatin PO qDay; may consider high-intensity therapy agent atorvastatin or rosuvastatin Presence of ASCVD, including stroke/TIA or peripheral arterial disease believed to be of atherosclerotic origin or post-CABG ≤75 years: Treat with high-intensity therapy agent atorvastatin or rosuvastatin >75 years: Administer 20-40 mg simvastatin PO qDay (moderate-intensity therapy); not candidate for high-intensity therapy Coadministration with dronedarone, verapamil, or diltiazem: Do not exceed 10 mg/day Coadministration with amiodarone, amlodipine, or ranolazine: Do not exceed 20 mg/day Coadministration with lomitapide: Reduce simvastatin dose by 50%, and do not exceed 20 mg/day (or 40 mg/day in those previously tolerating 80 mg/day) when initiating lomitapide Patients of Chinese descent taking lipid-modifying doses of niacin (ie, ≥1 g/day): Increased risk of myopathy with simvastatin 40 mg/day; consider lower dose Patients of Asian descent should not receive simvastatin 80 mg coadministered with lipid-modifying doses of niacin-containing products Lipid determinations should be performed after 4 weeks of therapy and periodically thereafter 80 mg/day should be used only for individuals who have been taking simvastatin 80 mg chronically (eg, ≥12 months) without evidence of myopathy or rhabdomyolysis Patients tolerating 80 mg who need to be initiated on an interacting drug that is contraindicated or associated with a maximum dose for simvastatin should be switched to an alternative statin with less potential for drug-drug interactions Patients unable to achieve their LDL-C goal utilizing 40 mg/day should not be titrated to 80 mg (increased risk for myopathy) but should instead be placed on alternative LDL-C-lowering treatment that provides greater LDL-C lowering Adverse drug reactions from overdose may include peripheral neuropathy, diarrhea, increased K+, myopathy, rhabdomyolysis, acute renal failure, elevated LFTs, and eye lens opacities Recommended dosing range: 10-40 mg/day; adjustments should be made at intervals of 4 weeks or more Rare reports of cognitive impairment (eg, memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin use Strong CYP3A4 inhibitors (eg, itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, posaconazole, voriconazole, HIV protease inhibitors, cobicistat, nefazodone, boceprevir, telaprevir), gemfibrozil, cyclosporine, and danazol Increased blood sugar and glycosylated hemoglobin (HbA1c) levels reported with statin intake Monitor LFTs before initiating treatment and thereafter when clinically indicated; reports of fatal and nonfatal hepatic failure in patients taking statins Discontinue if markedly elevated CPK levels occur or myopathy is diagnosed or suspected Increases in HbA1c and fasting serum glucose levels reported with simvastatin Grapefruit juice increases simvastatin systemic exposure; avoid large quantities of grapefruit juice (ie, ≥1 quart/day) Myopathy/rhabodomyolysis with acute renal failure and/or myopathy reported; monitor patient closely Dose adjustment required when coadministered with niacin, amiodarone, verapamil, diltiazem, amlodipine, and ranolazine Predisposing factors for myopathy include advanced age (>65 years), uncontrolled hypothyroidism, and renal impairment Increased risk for myopathy in Chinese patients coadministered niacin >1 g/day; they should not receive simvastatin 80 mg coadministered with lipid-modifying doses of niacin-containing products Withhold or discontinue if myopathy, renal failure, or transaminase levels >3x ULN develop Risk of myopathy is greater in patients taking simvastatin 80 mg/day, especially in the 1st year of treatment Rare reports of immune-mediated necrotizing myopathy (IMNM), characterized by increased serum creatine kinase that persists despite discontinuing statin Risk for myopathy increased when coadministered with other lipid-lowering drugs (other fibrates, ≥1 g/day of niacin, or, for patients with HoFH, lomitapide), colchicine, amiodarone, dronedarone, verapamil, diltiazem, amlodipine, or ranolazine See Contraindications for list of drugs contraindicated because of increased risk for myopathy when coadministered with simvastatin Generally acceptable. Use in LIFE-THREATENING emergencies when no safer drug available. Animal studies show risk and human studies not available or neither animal nor human studies done. This restriction typically limits the quantity of the drug that will be covered.

This website also contains material copyrighted by 3rd parties. Contact the applicable plan provider for the most current information. High-intensity therapy agent atorvastatin or rosuvastatin recommended 40-75 years of age and 10 year estimated risk of ASCVD ≥7. Moderate reduction of LDL-C desired: 5-10 mg PO qDay in the evening; adjust dose to achieve goal Reduction of >40% of LDL-C desired: 40 mg PO qDay in the evening; adjust dose to achieve goal Presence of CHD or at high risk for cardiovascular events, including patients with diabetes, PVD, history of stroke or other cerebrovascular disease: 40 mg PO qDay in the evening adjunct to diet therapy (initiate simultaneously); adjust dose to achieve goal Primary and secondary prevention of atheroschlerotic cardiovascular disease (ASCVD) LDL-C ≥190 mg/dL: High-intensity therapy agent atorvastatin or rosuvastatin recommended Type 1 or 2 diabetes (40-75 years of age): Moderate-intensity therapy: 20-40 mg simvastatin PO qDay Type 1 or 2 diabetes (40-75 years of age and 10 year estimated risk of ASCVD ≥7. The recipient will receive more details and instructions to access this offer.

Please confirm that you would like to log out of Medscape. All material on this website is protected by copyright, Copyright © 1994-2017 by WebMD LLC. Drugs that have quantity limits associated with each prescription. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. This drug is available at a middle level co-pay. Controlled studies in pregnant women show no evidence of fetal risk. Most commonly, these are "preferred" (on formulary) brand drugs. Your list will be saved and can be edited at any time. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

Zocor: Uses, Dosage, Side Effects & Warnings - Drugs.com
Zocor (simvastatin) reduces low-density lipoprotein cholesterol and total cholesterol in the blood. Includes Zocor side effects, interactions and indications.

Find a comprehensive guide to possible side effects including common and rare side effects when taking Zocor (Simvastatin) for healthcare professionals and consumers.

This website also contains material copyrighted by 3rd parties. Animal studies show risk and human studies not available or neither animal nor human studies done. All material on this website is protected by copyright, Copyright © 1994-2017 by WebMD LLC. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. Controlled studies in pregnant women show no evidence of fetal risk.

Please confirm that you would like to log out of Medscape. By clicking send, you acknowledge that you have permission to email the recipient with this information. This drug is available at a middle level co-pay. To view formulary information first create a list of plans. Contact the applicable plan provider for the most current information.

Use in LIFE-THREATENING emergencies when no safer drug available. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. High-intensity therapy agent atorvastatin or rosuvastatin recommended 40-75 years of age and 10 year estimated risk of ASCVD ≥7. Most commonly, these are "preferred" (on formulary) brand drugs. This drug is available at the lowest co-pay. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. Drugs that have step therapy associated with each prescription. The above information is provided for general informational and educational purposes only. HMG-CoA reductase inhibitor; inhibits the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase Converted to maximally active simvastatin acid by nonenzymatic pathways and nonspecific enzymes Metabolites: Beta-hydroxyacid and 6'-hydroxy, 6'-hydroxymethyl, and 6'-exomethylene derivatives (all active) SLCO1B1 (OATP1B1) CC genotype significantly increases AUCs of parent drug and metabolites compared with the CT or TT genotypes This polymorphism is proposed to reduce transport into the liver, the main site of statin metabolism and elimination, resulting in elevated plasma concentrations SLCO1B1 polymorphism is thought to have a lesser effect on the more hydrophilic statins (eg, rosuvastatin, fluvastatin) compared with those that are more lipophilic (eg, atorvastatin, simvastatin) Other genetic polymorphisms of elimination (eg, CYP450, P-glycoprotein) for each individual drug must also be considered, to explain variability for statin clearance among patients that exhibit SCLO1B1 polymorphism Risk of myopathy is 2. Drugs that have quantity limits associated with each prescription.

Zocor (Simvastatin): Uses, Side Effects, Drug Interactions ...

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