Zocor

Zocor has a pronounced hypolipidemic effect.

Indications Zocora

It is used to treat people who are at high risk of developing coronary heart disease, regardless of their blood lipid levels. This group includes people with the following concomitant disorders:

• cerebrovascular diseases, including stroke (history);
• diseases affecting the peripheral circulatory system;
• diabetes mellitus (the drug prevents the development of complications in the area of peripheral vessels and reduces the need for revascularization, as well as leg amputation).

The drug is also used in the treatment of people diagnosed with coronary heart disease and patients with hypercholesterolemia. In these disorders, Zocor helps prevent atherosclerotic lesions of the heart vessels, as well as the development of other complications.

The prescription of the drug is also justified for the following disorders:

• people with high levels of apolipoprotein B and total cholesterol, as well as cholesterol associated with low-density lipoproteins - in combination with dietary nutrition;
• hypertriglyceridemia;
• people with low cholesterol and high-density lipoprotein levels associated with primary hypercholesterolemia (during the diet);
• familial homozygous hypercholesterolemia (in combination with other therapies and diet).

Release form

The drug is released in tablets, 14 pieces per blister pack. The box contains 1 or 2 such packs.

Pharmacodynamics

The tablets contain the active component simvastatin, which is converted into active compounds during hydrolysis. The product of simvastatin metabolism inhibits the enzyme HMG-CoA reductase, which is a participant in the first stage of cholesterol biosynthesis.

As a result, under the influence of Zocor, there is a marked decrease in the volume of total cholesterol, as well as the values of cholesterol synthesized with the help of lipoproteins with low and extremely low density. In addition, the cholesterol level decreases within the triglyceride plasma.

When using simvastatin, there is a simultaneous increase in cholesterol levels (pronounced), synthesized with the help of lipoproteins with high density.

The drug is effective in various forms of hyperlipidemia (familial, heterozygous, and non-familial). In addition, it works well in mixed hyperlipidemia, in situations where diet is not enough to stabilize plasma lipid levels.

The level of lipids inside the plasma decreases after 2 weeks from the beginning of therapy. Peak values are observed during the 4th-6th week of the course. Then, during the intake of the drug, this result is maintained.

After completion of the course of therapy, there is a gradual return of plasma total cholesterol levels to the initial values observed before the start of drug use.

Pharmacokinetics

Peak values of simvastatin metabolism products in the blood are observed after 1.3-2.4 hours after taking a single dose of the drug. Absorption of orally administered simvastatin is approximately 85%.

The highest values of the active element, in comparison with other tissues, are observed inside the liver.

During the first passage of the drug through the hepatic bloodstream, simvastatin is metabolized, after which it, together with its metabolic products, is excreted from the body along with bile.

Eating immediately after taking the medication does not affect its pharmacokinetic properties. No accumulation of simvastatin in body tissues is observed during long-term treatment.

Dosing and administration

The tablets should be taken without reference to meal times. The daily dose should be taken in the evening, all at once – there is no need to divide it into several separate doses.

The average daily dose of the drug is 5-80 mg. You cannot take more than 80 mg of the drug per day.

The portion size is selected by the attending physician, who must take into account the plasma lipid indices. The dosage can be adjusted no more than once per month.

For the treatment or prevention of coronary heart disease (in combination with diet), the drug is prescribed at a dose of 40 mg per day.

If dietary treatment fails to eliminate hypercholesterolemia, Zocor should be taken at 20 mg per day. If it is necessary to reduce plasma lipid levels by 45% or more, the initial daily dosage may be 40 mg.

In case of mild or moderate hypercholesterolemia, the daily dose may be reduced to 10 mg.

The doctor selects the required dose of the drug, having previously determined the lipid index and monitored the effectiveness of the therapeutic effect after the start of the course. If there is no result after the 1st month of treatment, it is necessary to increase the dose of the drug, but do it gradually - until the desired effect is achieved.

In the treatment of familial hypercholesterolemia, which is homozygous (along with diet and other means), the initial daily dose is 40 mg. Another scheme can also be used - with the intake of 80 mg of the drug per day, with 20 mg to be taken during the day, and 40 mg - in the evening.

For adolescents, when eliminating the familial form of homozygous hypercholesterolemia, 10 mg/day is used. It is prohibited to prescribe more than 40 mg of the drug per day to adolescents.

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Use Zocora during pregnancy

Prescribing Zocor to pregnant or breastfeeding women is contraindicated. During use during pregnancy, fetal development disorders may be observed.

If a lactating woman needs to take the drug, she should stop breastfeeding for the duration of therapy.

Contraindications

Among the absolute contraindications of the drug:

• problems with the processes of metabolism and absorption of lactose;
• acute liver pathologies;
• a significant and persistent increase in the number of transaminases of unknown origin;
• the presence of hypersensitivity to the components of the drug.

Conditional contraindications, in which the medication is prescribed with caution:

• decreased functional activity of the liver or kidneys;
• alcoholism;
• people who have suffered from diabetes for a long time.

Side effects Zocora

Taking the medication may cause the development of the following side effects:

• pain or discomfort in the abdomen, problems with the process of defecation and flatulence;
• feeling of general weakness, headaches and anemia;
• convulsions, paresthesia, dizziness, sleep or memory disorders, and polyneuropathy;
• alopecia, rashes on the skin surface and itching.

Rarely, when using simvastatin, patients have experienced rhabdomyolysis or myopathy, as well as decreased liver function. There are also reports of myalgia. But in general, the drug is tolerated by patients without complications.

Due to drug intolerance, an increase in ESR values may be observed, as well as the appearance of vasculitis, arthritis, dermatomyositis, as well as arthralgia, thrombocytopenia, angioedema and eosinophilia.

Overdose

In case of poisoning, standard procedures used to eliminate the consequences of drug overdose are used.

Interactions with other drugs

When combined with bile acid sequestrants, the drug has a pronounced positive effect.

When used together with cyclosporine, fibrates, and also niacin in lipid-lowering doses, no more than 10 mg of the drug can be used per day.

It is prohibited to take more than 20 mg of Zocor per day when used simultaneously with amiodarone or verapamil.

Simvastatin does not affect the activity of CYP3 A4 enzymes.

Combination with drugs that inhibit the activity of the CYP3 A4 element increases the risk of rhabdomyolysis or myopathy. It is prohibited to combine the drug with erythromycin, ketoconazole, as well as itraconazole, telithromycin and nefazodone.

The risk of rhabdomyolysis or myopathy increases with concomitant use with diltiazem, cyclosporine, danazol, and also with amiodarone, niacin, gemfibrozil, as well as fibrates, fusidic acid and verapamil.

The effect of Zocor (in a dose of 20-40 mg/day) potentiates the properties of coumarin anticoagulants. This increases the likelihood of bleeding in a patient taking these drugs simultaneously.

Consumption of more than 1 L of grapefruit juice per day results in a clinically significant increase in plasma simvastatin levels, which also increases the risk of rhabdomyolysis.

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Storage conditions

Zocor should be kept in a dark place, out of reach of small children. Temperature indicators – no higher than 25°C.

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Shelf life

Zocor can be used for 2 years from the date of manufacture of the drug.

Application for children

Since there is not enough information regarding the use of the drug in children, it is not prescribed to patients under 10 years of age.

Zocor is prescribed to adolescents to eliminate familial hypercholesterolemia of heterozygous type (in combination with diet). The effect of the drug helps to reduce the values of cholesterol, triglycerides, and also apolipoprotein B.

The medication can be prescribed to a teenage girl only if her menstruation began at least 1 year ago.

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Analogues

The following medications are analogs of the drug: Avestatin, Levomir and Simlo with Simvastatin, and in addition Simvakard, Vabadin, Aterostat, Simvor and Zovatin with Simgal.

Reviews

Zocor receives many positive reviews regarding its therapeutic effect - it helps to reduce cholesterol levels. But it should be remembered that it should be taken only for the period selected by the attending physician, strictly following the instructions, and in no other way.

Many good reviews were also left about the preventive properties of the medication.