Zocor 40 Mg Film-Coated Tablets
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Zocor® 40mg Film-Coated Tablets 210814[6] Simvastatin 40mg Film-Coated Tablets
(simvastatin)
PACKAGE LEAFLET: INFORMATION FOR THE USER
This medicine is available using any one of the above names but will be referred to as Zocor throughout this leaflet.
Zocor Tablets are also available in other strengths of 10mg, 20mg and 80mg.
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
- If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
What is in this leaflet:
1. What Zocor is and what it is used for
2. What you need to know before you take Zocor
3. How to take Zocor
4. Possible side effects
5. How to store Zocor
6. Contents of the pack and other information
1. WHAT ZOCOR IS AND WHAT IT IS USED FOR.
Zocor is a medicine used to lower levels of total cholesterol, “bad” cholesterol (LDL cholesterol), and fatty substances called triglycerides in the blood. In addition, Zocor raises levels of “good” cholesterol (HDL cholesterol). Zocor is a member of the class of drugs called statins.
Cholesterol is one of several fatty substances found in the bloodstream. Your total cholesterol is made up mainly of LDL and HDL cholesterol.
LDL cholesterol is often called “bad” cholesterol because it can build up in the walls of your arteries forming plaque. Eventually this plaque build-up can lead to a narrowing of the arteries. This narrowing can slow or block blood flow to vital organs such as the heart and brain. This blocking of blood flow can result in a heart attack or stroke.
HDL cholesterol is often called “good” cholesterol because it helps keep the bad cholesterol from building up in the arteries and protects against heart disease.
Triglycerides are another form of fat in your blood that may increase your risk for heart disease.
You should stay on a cholesterol-lowering diet while taking this medicine.
Zocor is used in addition to your cholesterol-lowering diet if you have:
- a raised cholesterol level in your blood (primary hypercholesterolaemia) or elevated fat levels in your blood (mixed hyperlipidaemia)
- a hereditary illness (homozygous familial hypercholesterolaemia) that increases the cholesterol level in your blood. You may also receive other treatments.
- coronary heart disease (CHD) or are at high risk of CHD (because you have diabetes, history of stroke, or other blood vessel disease). Zocor may prolong your life by reducing the risk of heart disease problems, regardless of the amount of cholesterol in your blood.
In most people, there are no immediate symptoms of high cholesterol. Your doctor can measure your cholesterol with a simple blood test. Visit your doctor regularly, keep track of your cholesterol, and discuss your goals with your doctor.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE ZOCOR Do not take Zocor
- if you are allergic ( hypersensitive) to simvastatin or any of the other ingredients of this medicine ( listed in section 6: Contents of the pack and other information)
- if you currently have liver problems
- if you are pregnant or breast-feeding
- if you are taking medicine(s) with one or more than one of the following active ingredients:
- itraconazole, ketoconazole, posaconazole or voriconazole ( used to treat fungal infections)
- erythromycin , clarithromycin, or telithromycin (used to treat infections)
- HIV protease inhibitors such as indinavir, nelfinavir, ritonavir, and saquinavir (HIV protease inhibitors are used for HIV infections).
- boceprevir or telaprevir (used to treat hepatitis C virus infection)
- nefazodone (used to treat depression)
- gemfibrozil (used to lower cholesterol)
- ciclosporin (used in organ transplant patients)
- danazol (a man-made hormone used to treat endometriosis, a condition in which the lining of the uterus grows outside the uterus).
- if you are taking or, in the last 7 days, have taken or been given a medicine called fusidic acid (used to treat bacterial infection)
Ask your doctor if you are not sure if your medicine is listed above.
Warnings and Precautions
Tell your doctor:
- about all your medical conditions including allergies- if you drink large amounts of alcohol.
- if you have ever had liver disease. ZOCOR may not be right for you.
- if you are due to have an operation. You may need to stop taking
Zocor tablets for a short time.
Your doctor should do a blood test before you start taking Zocor and if you have any symptoms of liver problems while you take Zocor. This is to check how well your liver is working.
Your doctor may also want you to have blood tests to check how well your liver is working after you start taking ZOCOR.
While you are on this medicine your doctor will monitor you closely if you have diabetes or are at risk of developing diabetes. You are likely to be at risk of developing diabetes if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure.
Tell your doctor if you have severe lung disease.
Contact your doctor immediately if you experience unexplained muscle pain, tenderness or weakness. This is because on rare occasions, muscle problems can be serious, including muscle breakdown resulting in kidney damage; and very rare deaths have occurred.
The risk of muscle breakdown is greater at higher doses of Zocor, particularly the 80-mg dose. The risk of muscle breakdown is also greater in certain patients. Talk with your doctor if any of the following applies:
- you consume large amounts of alcohol
- you have kidney problems
- you have thyroid problems
- you are 65 years or older
- you are female
- you have ever had muscle problems during treatment with cholesterollowering medicines called “statins” or fibrates
- you or close family members have a hereditary muscle disorder.
Other medicines and Zocor
It is particularly important to tell your doctor if you are taking medicine(s) with any of the following active ingredients. Taking ZOCOR with any of these medicines can increase the risk of muscle problems (some of these have already been listed in the above section “Do not take Zocor”).
- ciclosporin (often used in organ transplant patients)
- danazol (a man-made hormone used to treat endometriosis, a condition in which the lining of the uterus grows outside the uterus)
- medicines with an active ingredient like itraconazole, ketoconazole, fluconazole, posaconazole, or voriconazole (used to treat fungal infections)
- fibrates with an active ingredient like gemfibrozil and bezafibrate (used to lower cholesterol)
- erythromycin, clarithromycin, telithromycin, or fusidic acid (used to treat bacterial infections). Do not take fusidic acid while using this medicine. Also see section 4 of this leaflet.
- HIV protease inhibitors such as indinavir, nelfinavir, ritonavir, and saquinavir (used to treat AIDS)
- boceprevir or telaprevir (used to treat hepatitis C virus infection)
- nefazodone (used to treat depression)
- amiodarone (used to treat an irregular heartbeat)
- verapamil, diltiazem or amlodipine (used to treat high blood pressure, chest pain associated with heart disease, or other heart conditions)
- colchicine (used to treat gout).
As well as the medicines listed above, tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including those obtained without a prescription. In particular, tell your doctor if you are taking medicine(s) with any of the following active ingredients:
- medicines with an active ingredient to prevent blood clots, such as warfarin, phenprocoumon or acenocoumarol (anticoagulants)
- fenofibrate (also used to lower cholesterol)
- niacin (also used to lower cholesterol)
- rifampicin (used to treat tuberculosis).
Also tell your doctor if you are taking niacin (nicotinic acid) or a niacin-containing product and are Chinese.
You should also tell any doctor who is prescribing a new medicine for you that you are taking Zocor.
Zocor with food and drink
Grapefruit juice contains one or more components that alter how the body uses some medicinal products, including Zocor. Consuming grapefruit juice should be avoided.
Pregnancy and Breast-feeding
Do not take Zocor if you are pregnant, trying to get pregnant or think you may be pregnant. If you get pregnant while taking Zocor, stop taking it immediately and contact your doctor. Do not take Zocor if you are breastfeeding, because it is not known if the medicine is passed into breast milk.
Ask your doctor or pharmacist for advice before taking any medicine.
Children
Safety and effectiveness have been studied in 10-17 year old boys and in girls who had started their menstrual period (menstruation) at least one year before (see section 3: How to take Zocor). Zocor has not been studied in children under the age of 10 years. For more information, talk to your doctor.
Driving and using machines
Zocor is not expected to interfere with your ability to drive or to use machinery. However, it should be taken into account that some people get dizzy after taking Zocor.
Zocor contains lactose
Zocor tablets contain a sugar called lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3. HOW TO TAKE ZOCOR
Your doctor will determine the appropriate tablet strength for you, depending on your condition, your current treatment and your personal risk status.
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
You should stay on a cholesterol-lowering diet while taking Zocor.
Dosage:
The recommended dose is 1 ZOCOR 10 mg, 20 mg, 40 mg, or 80 mg tablet by mouth once a day.
Adults:
The usual starting dose is 10, 20 or, in some cases, 40 mg a day. Your doctor may adjust your dose after at least 4 weeks to a maximum of 80 mg a day.
Do not take more than 80 mg a day.
Your doctor may prescribe lower doses, particularly if you are taking certain medicinal products listed above or have certain kidney conditions.
The 80 mg dose is only recommended for adult patients with very high cholesterol levels and at high risk of heart disease problems who have not reached their cholesterol goal on lower doses.
Children:
For children (10-17 years old), the recommended usual starting dose is 10 mg a day in the evening. The maximum recommended dose is 40 mg a day.
Method and duration of administration:
Take Zocor in the evening. You can take it with or without food. Keep taking Zocor unless your doctor tells you to stop.
If your doctor has prescribed Zocor along with another medicine for lowering cholesterol containing any bile acid sequestrant, you should take Zocor at least 2 hours before or 4 hours after taking the bile acid sequestrant.
If you take more Zocor than you should
- please contact your doctor or pharmacist.
If you forget to take Zocor
- do not take an extra dose, just take your normal amount of Zocor at the usual time the next day.
If you stop taking Zocor
- talk to your doctor or pharmacist because your cholesterol may rise again.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Zocor can cause side effects, although not everybody gets them.
The following terms are used to describe how often side effects have been reported:
- Rare (may affect up to 1 in 1000 patients)
- Very rare (may affect up to 1 of 10,000 patients).
- Not known (frequency cannot be estimated from the available data)
The following rare serious side effects were reported.
If any of these serious side effects happen, stop taking the medicine and tell your doctor immediately or go to the emergency room at your nearest hospital.
- muscle pain, tenderness, weakness, or cramps. On rare occasions, these muscle problems can be serious, including muscle breakdown resulting in kidney damage; and very rare deaths have occurred.
- hypersensitivity (allergic) reactions including:
- swelling of the face, tongue and throat which may cause difficulty in breathing
- severe muscle pain usually in the shoulders and hips
- rash with weakness of limbs and neck muscles
- pain or inflammation of the joints (polymyalgia rheumatic)
- inflammation of the blood vessels (vasculitis)
- unusual bruising, skin eruptions and swelling(dermatomyositis), hives, skin sensitivity to the sun, fever, flushing
- shortness of breath (dyspnoea) and feeling unwell
- lupus-like disease picture (including rash, joint disorders, and effects on blood cells)
- inflammation of the liver with the following symptoms: yellowing of the skin and eyes, itching, dark-coloured urine or pale-coloured stool, feeling tired or weak, loss of appetite; liver failure (very rare)
- inflammation of the pancreas often with severe abdominal pain.
The following side effects have also been reported rarely:
- low red blood cell count (anaemia)
- numbness or weakness of the arms and legs
- headache, tingling sensation, dizziness
- digestive disturbances (abdominal pain, constipation, flatulence, indigestion, diarrhoea, nausea, vomiting)
- rash, itching, hair loss
- weakness.
- trouble sleeping (very rare)
- poor memory (very rare), memory loss, confusion.
The following side effects have also been reported but the frequency cannot be estimated from the available information (frequency not known):
- erectile dysfunction
- depression
- inflammation of the lungs causing breathing problems including persistent cough and/or shortness of breath or fever
- tendon problems, sometimes complicated by rupture of the tendon.
Additional possible side effects reported with some statins:
- sleep disturbances, including nightmares
- sexual difficulties.
- diabetes. This is more likely if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure. Your doctor will monitor you while you are taking this medicine.
Laboratory values
Elevations in some laboratory blood tests of liver function and a muscle enzyme (creatine kinase) have been observed.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects, you can help provide more information on the safety of this medicine.
5. HOW TO STORE ZOCOR
Keep out of the sight and reach of children.
Do not take them past the expiry date which is clearly marked on the pack.
Do not store above 30oC. Store in the original package.
If the tablets become discoloured or show any other signs of deterioration, consult your pharmacist who will tell you what to do.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required.
These measures will help to protect the environment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION What Zocor contains
Active ingredient - simvastatin.
Each film-coated tablet contains 40 mg simvastatin.
The other ingredients are: butylated hydroxyanisole (E320), ascorbic acid (E300), citric acid monohydrate (E330), microcrystalline cellulose (E460), pregelatinised starch, magnesium stearate (E572), and lactose monohydrate.
The tablet coating contains hypromellose (E464), hydroxypropylcellulose (E463), titanium dioxide (E171), and talc (E553b) and red iron oxide (E172).
What Zocor looks like and contents of the pack
Brick-red coloured, oval shaped film-coated tablets marked ‘MSD 749' on one side and plain on the reverse.
Available in calendar blister packs of 28 tablets.
Manufacturer and Product Licence Holder
Manufactured by Merck Sharp & Dohme BV, Waarderweg 39, 2031 BN, Haarlem, The Netherlands. Procured from within the EU. Repackaged by Product Licence holder P.I.E. Pharma Ltd., 207 Kenton Road, Harrow, Middlesex HA3 0HD.
POM
PL No: 15361/2426
Leaflet revision and issue date (Ref) 21.08.14[6] Zocor is a trademark of Merck Sharp & Dohme Corp.