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ZOCOR 20 MG FILM-COATED TABLETS

Active substance(s): SIMVASTATIN / SIMVASTATIN

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Package leaflet: Information for the patient

ZOCOR® 10, 20, 40 mg
Film-coated Tablets

Simvastatin
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. See section 4.
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 contains the active substance simvastatin. 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
medicines 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)
• cobicistat
• 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 have taken in the last 7 days, a medicine called
fusidic acid (a medicine for bacterial infection) orally or by injection.
The combination of fusidic acid and ZOCOR can lead to serious muscle
problems (rhabdomyolysis).
Do not take more than 40 mg ZOCOR if you are taking lomitapide (used to
treat a serious and rare genetic cholesterol condition)
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.
• if you are Asian, because a different dose may be applicable to you.

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
cholesterol-lowering medicines called “statins” or fibrates
• you or a close family member have a hereditary muscle disorder.
Also tell your doctor or pharmacist if you have a muscle weakness that is constant.
Additional tests and medicines may be needed to diagnose and treat this.
Children and adolescents
Safety and effectiveness of ZOCOR 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.
Other medicines and ZOCOR
Tell your doctor if you are taking, have recently taken or might take any other
medicine(s) with any of the following active ingredients. Taking ZOCOR with
any of the following medicines can increase the risk of muscle problems (some
of these have already been listed in the above section “Do not take ZOCOR”).
• If you need to take oral fusidic acid to treat a bacterial infection
you will need to temporarily stop using this medicine. Your doctor
will tell you when it is safe to restart ZOCOR. Taking ZOCOR with
fusidic acid may rarely lead to muscle weakness, tenderness
or pain (rhabdomyolysis). See more information regarding
rhabdomyolysis in section 4.
• 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 or telithromycin (used to treat bacterial
infections)
• HIV protease inhibitors such as indinavir, nelfinavir, ritonavir, and
saquinavir (used to treat AIDS)
• Hepatitis C antiviral agents such as boceprevir, telaprevir, elbasvir or
grazoprevir (used to treat hepatitis C virus infection)
• nefazodone (used to treat depression)
• medicines with the active ingredient cobicistat
• 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)
• lomitapide (used to treat a serious and rare genetic cholesterol
condition)
• 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).
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 breast-feeding, because
it is not known if the medicine is passed into breast milk.
Ask your doctor or pharmacist for advice before taking any medicine.
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.

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 of 1000 people)
• Very rare (may affect up to 1 of 10,000 people)
• 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 rheumatica)
• 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
8146,8147



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.
• muscle pain, tenderness, or weakness that is constant that may not go
away after stopping ZOCOR (frequency not known).
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 or pharmacist. This includes any
possible side effects not listed in this leaflet.
You can also report side effects directly (see details below). By reporting side
effects you can help provide more information on the safety of this medicine.
United Kingdom: Yellow Card Scheme at: www.mhra.gov.uk/yellowcard
Ireland: HPRA Pharmacovigilance, Earlsfort Terrace, IRL - Dublin 2;
Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie;
E-mail: medsafety@hpra.ie
Malta: ADR Reporting at: www.medicinesauthority.gov.mt/adrportal
5. How to store ZOCOR
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date (“EXP”) which is stated on the
container.
Do not store above 25°C. Keep blister in outer carton in order to protect from
moisture.
Do not throw away any medicines via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. These measures
will help protect the environment.
6. Content of the pack and other information
What ZOCOR contains
The active substance is simvastatin (10 mg, 20 mg or 40 mg)
The other ingredients are: butylated hydroxyanisole (E320), ascorbic acid (E300),
citric acid monohydrate (E330), microcrystalline cellulose (E460), pregelatinized
starch, magnesium stearate (E572), and lactose monohydrate. The tablet
coating contains hypromellose (E464), hydroxypropylcellulose (E463), titanium
dioxide (E171), and talc (E553b). The 10 mg and 20 mg tablets also contain
yellow ferric oxide (E172) and red ferric oxide (E172). The 40 mg tablets also
contain red ferric oxide.
What ZOCOR looks like and contents of the pack
Zocor 10mg are peach-coloured, oval-shaped tablets marked ‘MSD 735’
Zocor 20mg are tan-coloured, oval-shaped tablets marked ‘MSD 740’
Zocor 40mg are brick-red coloured, oval-shaped tablets marked ‘MSD 749’
Zocor Tablets are available in packs containing 28 tablets, 4 tablets or
one tablet.
Not all pack sizes may be marketed.
Marketing Authorization Holder and Manufacturer
The Marketing Authorisation Holder in the UK and Malta is Merck Sharp & Dohme
Limited, Hertford Road, Hoddesdon, Hertfordshire EN11 9BU, UK. The Marketing
Authorisation Holder in Ireland is Merck Sharp & Dohme Ireland (Human Health)
Ltd, Red Oak North, South County Business Park, Leopardstown, Dublin 18,
Ireland.
The manufacturer of the 10 mg and 20 mg tablets is Merck Manufacturing
Division, Merck Sharp & Dohme Limited, Shotton Lane, Cramlington,
Northumberland NE23 3JU, UK.
The manufacturer of the 40 mg tablets is Merck Sharp & Dohme BV,
Waarderweg 39, 2031 BN, Haarlem, The Netherlands.
This medicinal product is authorised in the Member States of the EEA
under the following names:
Austria ZOCORD
Belgium ZOCOR
Denmark ZOCOR
Finland ZOCOR
France ZOCOR
Germany ZOCOR 10 mg Filmtabletten; ZOCOR 20 mg Filmtabletten;
ZOCOR FORTE 40 mg Filmtabletten; ZOCOR FORTE XL 80 mg Filmtabletten
Greece ZOCOR
Ireland ZOCOR
Italy SINVACOR
Luxembourg ZOCOR
Netherlands ZOCOR
Norway ZOCOR
Portugal ZOCOR
Spain ZOCOR; ZOCOR FORTE (for 40 mg tablets)
Sweden ZOCORD
United Kingdom ZOCOR
This leaflet was last revised in: June 2017
© Merck Sharp & Dohme Limited 2017. All rights reserved.

PIL.ZCR.16.UK.4854-IB-060
XXXXXXX-XX

For Position Only

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 simvastatin 5 mg, 10 mg, 20 mg, 40 mg, or 80 mg 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.
Use in children and adolescents:
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 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 a double dose to make up for a forgotten tablet. 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.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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