Doctors' Answers to "Frequently Asked Questions" - Zocor

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Lipitor vs. Zocor [posted 1/13/99]
Question: What are the pros and cons on Lipitor vs. Zocor? Is one preferred over the other?

Answer: They're pretty similar. Lipitor is somewhat more potent mg for mg, but they have similar side effects and lowering of cholesterol. I use them interchangeably.

Zocor [posted 1/13/99]
Question: Do you have any information on Zocor?

Answer: Zocor is a HMG Co A Reductase drug used to lower cholesterol by inhibiting an enzyme in the liver responsible for cholesterol metabolism. Usually fairly symptom free, but will need ongoing liver function tests and regular medical evaluations.

Zocor vs. Lipitor [posted 12/10/98]
Question: I have been taking Zocor for aprox. two years now and it has dramatically lowered my cholesterol level. Recently my health care provider has informed me that they will no longer pay for the Zocor and has suggested other drugs. My doctor now has me taking Lipitor instead. I am now experiencing depression and sore muscles. Is there a big difference between the two drugs?

Answer: Lipitor is a little more potent and I have some patients who have side effects with Lipitor who do not on Zocor. Usually, if your doctor documents this they will make an exception. Also, you can basically cut your cost in 1/2 by buying double your dosage and cutting them in 1/2 with a pill splitter available in any pharmacy.

Zocor Reaction [posted 8/12/98]
Question: I have been taking Zocor now for four days and have experienced tremendous insomnia. I was told by my pharmacists to take the one pill a day the last thing after eating before bedtime. I have followed those instructions and I get wide awake, with no desire to sleep. Last night I stayed awake until 4:30 a.m. before ever dropping off to sleep. Has any one else had such a reaction?

Answer: Not a common effect. Try taking it first thing in the morning. Theoretically, taking it at night will have a better effect on cholesterol, but if your sleep is involved, try the early morning.

Zocor Side Effect? [posted 8/11/98]
Question: Are there any reports on Zocor as a contributor to so called floppy valves?

Answer: No.

Zocor and Impotence [posted 8/11/98]
Question: Can Zocor cause impotence as a side effect?

Answer: I have had two patients who complain of this. However, it is hard to know if it is the medication or hardening of the arteries (the reason you take the drug in the first place). If you stop the drug it would clearly be gone by 1-2 weeks. If you see no difference, it is not the drug. In general, I do not see this problem with the drug.

Zocor Side Effects [posted 7/31/98]
Question: I would like to know if stomach problems can occur while taking zocor. I have been taking zocor fro 3 months. The last couple of weeks I have been have gastro problems. When I eat a meal, I immediately start to burp and feel terrible. Sometimes it starts at breakfast and sometimes it doesn't bother me at all. I also take vitamins and I have stopped most of my vitamins to see if it is the zocor that is doing it. I also take 10 grams of prinivil a day.

Answer: Very uncommon on zocor unless it is liver toxicity. Have your liver functions been checked?

Zocor Side Effect [posted 7/30/98]
Question: Can there be side effects from Zocor that could cause impotency?

Answer: Uncommon to rare.

Zocor - Effect on Liver [posted 7/23/98]
Question: What can you tell me about the drug zocor? I am concerned about side effects to my liver.

Answer: Zocor belongs to a class of drugs called HMG-Co A Reductase drugs. This is a class which inhibits one of the enzymes in the liver responsible for regulation of cholesterol metabolism. In effect, the switch that turns cholesterol metabolism on and off. Since 85% or so of your cholesterol is made by your liver this is a powerful drug. Zocor is one of the more efficient drugs in this class and is used extensively. Occasional patients (one in 300 or so) will experience liver problems and the drug will need to be stopped. This will necessitate liver monitoring (blood tests). However, if the liver enzymes rise, the drug can be stopped before any damage occurs. I monitor my patients every 3-4 months the first year and about every 6 months after that. In the lower dosing necessary for most patients (40 mg a day or less), the drug is incredibly safe. You will need monitoring, but the risk is almost nil.

Zocor
Question: It has been recommended by my doctor that I take zocor to lower my cholesterol level. However, since being diagnosed with fibromyalgia I have been taking arthrotec and paxil. Would there be any adverse effects? Muscle and joint pain are already being experienced, before taking zocor.

Answer: Shouldn't be a problem. In view of the ongoing muscle pain, I'd check CPK values to ensure they don't elevate with zocor. This is an uncommon problem About 1% or less of patients have side effect.

Zocor Reactions
Question: Other than manufacturer information, is there any information dealing with reactions to the cholesterol lowering drug zocor? Specifically, male breast enlargement with associated pain and increased nerve sensitivity.

Answer: Breast enlargement is one of the potential risks. I have about 1-2% of patients with thisproblem. Initially, I was a disbeliever, but I've seen it enough now to understand that it is real. Why it hits some and not others is unclear. You might try other lipid lowering agents like Pravachol. I've had some luck with this.

Zocor Side Effects
Question: I had been taking Zocor for approximately 7 years from 1989 to 1996. While taking the drug I suffered general debility on a number of occasions and definite mood swings. I also suffered quite frequently from digestive related problems and back pains. I also felt that I was very susceptible to any virus I came into contact with, suffering severe flu on a number of occasions. I stopped taking the drug approximately one year ago and after a matter of weeks I felt that I was much fitter in myself and my mental state appeared to be much more stable. In this time I had no days off work due to any sickness. I revisited my local hospital some weeks ago and advised them of the improvement in my health, but despite my protestations the doctor insisted that I recommence treatment with Zocor. Within a matter of days my general health had deteriorated and I contracted a severe bout of flu which I have still not shaken and is now affecting my chest quite severely. My doctor keeps insisting that there is no connection and that any side-effects from Zocor are only very mild digestive related disorders. Any further information on the side-effects of Zocor would be appreciated along with any confirmation as to whether my symptoms are related.

Answer: This is unusual, but if it affects you this way, it does. I suspect that the flu like feeling really is a drug interaction rather than a true infection. That is, your body’s reaction to the drug. Zocor is generally well tolerated, but some individuals will experience the less common side effects. Common side effects include liver toxicity, occasional muscle inflammation, and rash. If it makes you feel crummy stop taking it.

Zocor
Question: I would like to know if there are any side effects to this medicine?

Answer: Zocor(simvastatin) is one of class of cholesterol lowering agents referred to as HMG-CoA reductase inhibitor. This is an enzyme in the liver responsible for the production of cholesterol by the liver. Inhibition of this enzyme will reduce the production of cholesterol by the liver; hence, lowering total cholesterol. Because it is a selective inhibitor of one enzyme, it tends to have few side effects. However, like any medicine it has potential problems. These include potential liver toxicity(necessitating regular liver tests), occasional patients have some sort of reaction with muscle inflammation(occasionally severely so) for unclear reasons. There are other side effects like rashes, but it is usually very well tolerated if liver functions are checked and there is no muscle inflammation.

Zocor vs. Mevacor
Question: My husband is 44 and has a congenital heart valve problem, which throws blood back to the heart and therefore the heart is enlarged. He was taking Mevacor and questran for mildly high cholesterol. His cardiologist suggested that he switch from Mevacor to Zocor because there is less effect on the liver. Our primary physician says this is not the case and that mevacor and zocor are basically the same. Which doctor is correct?

Answer: They both have similar effects on the liver. However, zocor is more effective and will get a lower cholesterol for the same risk.

Irregular Heartbeat
Question: I take zocor and plendil for high blood pressure and have been taking it for about 1yr. with in the last month or so my heart feels like it is skipping beats at times. Also I’ve been getting sore spots on my gums and roof of my mouth that last a few days then clears up and then comes back in awhile. I have had arrhythmia before about 5 yrs ago and it cleared up in about 1 week. My doctor run tests and didn't seem to be to worried about it. I just wonder if it is the medicine that I am taking that could be causing this. Since I’ve been on the medication I just haven't felt right. I’m 45 yrs old if that matters. I’ve been on high blood pressure medicine for about 10 yrs. and zocor for about 2 yrs. thanks for your time

Answer: I suspect if you were going to have a problem it would have been at first. It is unusual to develop these problems in the course of taking them. One exception would be if Zocor is causing liver function abnormalities-easily checked with a blood test. However, depending on your blood pressure stop it for a few days and see what happens with the arrhythmia. This will need to be coordinated with your MD to watch your BP off the medications.



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