Simvastatin
Brand: Zocor
No boxed warning on the current FDA label.
- Caution
- Rhabdomyolysis risk rises with dose: the 80 mg dose is restricted, and it is contraindicated with strong CYP3A4 inhibitors, gemfibrozil, and cyclosporine.
- Pregnancy
- Generally avoid in pregnancy: no benefit to the fetus and stopping is recommended for most patients.
Common side effects
- Muscle aches
- Headache
- Elevated liver enzymes
- Nausea
- Constipation
Key interactions
- Avoid grapefruit juice
- Higher muscle-injury risk with certain fibrates
- Some antibiotics and antifungals raise its levels
Counseling points
- Take in the evening
- Report unexplained muscle pain or weakness
- Avoid grapefruit juice
- Report dark urine or yellow skin
- Continue diet and exercise
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