Generic Name: niacin and simvastatin (NYE a sin and SIM va stat in)
Brand Names: Simcor
What is Simcor?
Simcor contains a combination of niacin and simvastatin.
Simcor is used to lower cholesterol and triglycerides (types of fat) in the blood. Simcor is used along with diet to lower levels of total cholesterol, LDL "bad" cholesterol, and triglycerides and to increase HDL "good" cholesterol.
Niacin, also called nicotinic acid, is a B vitamin (vitamin B3). It occurs naturally in plants and animals, and is also added to many foods as a vitamin supplement. Niacin is also present in many multiple vitamins and nutritional supplements.
Simvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." Simvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).
Simcor may also be used for purposes not listed in this medication guide.
Important information about Simcor
You should not take Simcor if you are allergic to niacin (Niaspan, Niacor, and others) or simvastatin (Zocor, Vytorin), if you are pregnant or breast-feeding, or if you have liver disease, severe bleeding, or a stomach ulcer. In rare cases, simvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.
Never take Simcor in larger amounts, or for longer than recommended by your doctor. Follow your doctor's dosing instructions very carefully. Taking too much Simcor may cause serious or life-threatening side effects.
There are many other drugs that should not be used together with Simcor. Tell your doctor about all medications you use. Keep a list of all your medicines and show it to any healthcare provider who treats you.
Simvastatin can harm an unborn baby or cause birth defects. Do not use Simcor if you are pregnant.
Before taking Simcor, tell your doctor if you have ever had liver or kidney disease, diabetes, gout, or a thyroid disorder, if you are of Chinese descent, or if you drink more than 2 alcoholic beverages daily.
Before taking Simcor
You should not take Simcor if you are allergic to niacin (Niaspan, Niacor, and others) or simvastatin (Zocor, Vytorin), if you are pregnant or breast-feeding, or if you have liver disease, severe bleeding, or a stomach ulcer. In rare cases, Simcor can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. This condition may be more likely to occur in older adults and in people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid). You may also be more likely to develop this condition if you are of Chinese descent.
The following drugs can increase your risk of serious muscle problems if you take them together with simvastatin. These drugs should not be used while you are taking Simcor:
amiodarone (Cordarone, Pacerone);
cyclosporine (Gengraf, Neoral, Sandimmune);
diltiazem (Cardizem, Cartia, Dilacor, Diltia,Diltzac, Taztia, Tiazac);
nefazodone (an antidepressant);
verapamil (Calan, Covera, Isoptin, Verelan);
the antibiotics clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), and telithromycin (Ketek);
the antifungal medications itraconazole (Sporanox), ketoconazole (Nizoral), and posaconazole (Noxafil);
hepatitis C medications such as boceprevir (Victrelis) or telaprevir (Incivek); or
the HIV/AIDS medications atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), saquinavir (Invirase), or tipranavir (Aptivus).
Before you start taking Simcor, tell your doctor if you are already using any of these other medicines:
amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide); or
To make sure you can safely take Simcor at any dose, tell your doctor if you have any of these other conditions:
history of liver or kidney disease;
a thyroid disorder;
if you drink more than 2 alcoholic beverages daily; or
if you are switched to this medication from regular niacin, nicotinic acid, or nicotinamide (or vitamin supplements that contain niacin).
FDA pregnancy category X. Simcor can harm an unborn baby or cause birth defects. Do not take Simcor if you are pregnant. Stop taking this medication and tell your doctor right away if you become pregnant. Use effective birth control to avoid pregnancy while you are taking Simcor. Niacin and simvastatin may pass into breast milk and could harm a nursing baby. Do not breast-feed while you are taking Simcor.
See also: Simcor pregnancy and breastfeeding warnings (in more detail)
How should I take Simcor?
Take Simcor exactly as prescribed. Never take this medicine in larger amounts, or for longer than recommended by your doctor. Follow your doctor's dosing instructions very carefully. Taking too much of this medication may cause serious or life-threatening side effects.
Simcor is usually taken at bedtime with a low-fat snack. Follow your doctor's instructions. Do not take Simcor on an empty stomach.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
Niacin can cause certain side effects such as dizziness, sweating, chills, flushing (warmth, redness, or tingly feeling under your skin), fast or pounding heartbeats, shortness of breath, or feeling like you might pass out. These effects can be made worse if you drink alcohol or hot beverages shortly after you take Simcor. These effects should disappear over time as you keep taking the medicine.
Your doctor may recommend you take aspirin 30 minutes before you take Simcor to prevent certain side effects. Do not take aspirin without your doctor's advice. Follow the label directions or your doctor's instructions about how much aspirin to take.
You may need to stop using Simcor for a short time if you have:
an electrolyte imbalance (such as high or low potassium levels in your blood);
severely low blood pressure;
a severe infection or illness;
surgery or a medical emergency.
If you stop taking Simcor for longer than 7 days in a row, talk with your doctor before restarting the medication. You may need to start with a lower dose.
Niacin can raise your blood sugar, and may cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Simcor.
To be sure Simcor is helping your condition and is not causing harmful effects, your blood will need to be tested often. Visit your doctor regularly. You may need to take Simcor on a long-term basis for the treatment of high cholesterol. Do not stop taking this medication unless your doctor tells you to.
Store Simcor at room temperature away from moisture and heat.
See also: Simcor dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Simcor?
Grapefruit and grapefruit juice may interact with simvastatin and lead to potentially dangerous effects. Do not drink more than 1 quart of grapefruit juice daily.
If you also take cholestyramine (Prevalite, Questran) or colestipol (Colestid), avoid taking them within 4 to 6 hours before or after you take Simcor.
Avoid eating foods that are high in fat or cholesterol. Simcor will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.
Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.
See also: Simcor and alcohol (in more detail)
Simcor side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Simcor: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking Simcor and call your doctor at once if you have any of these serious side effects:
unexplained muscle pain, tenderness, or weakness;
confusion, memory problems;
fever, unusual tiredness, and dark colored urine;
swelling, weight gain, urinating less than usual or not at all;
increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or
nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious Simcor side effects may include:
headache, mild dizziness;
diarrhea, mild nausea;
mild skin rash;
back pain; or
flushing (warmth, redness, or tingly feeling).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Simcor side effects (in more detail)
What other drugs will affect Simcor?
Tell your doctor about all other medications you use, especially:
blood pressure medication;
a blood thinner such as warfarin (Coumadin, Jantoven);
other medicines that contain niacin (Advicor, Niaspan, Niacor, Slo-Niacin, and others); or
any other "statin" medication such as atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Vytorin).
This list is not complete and other drugs may interact with Simcor. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More Simcor resources
Compare Simcor with other medications
Where can I get more information?
- Your pharmacist can provide more information about Simcor.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Simcor only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 4.02. Revision Date: 2012-03-21, 12:26:24 PM.