Simvastatin is the generic name for the cholesterol-lowering drug Zocor. Doctors commonly prescribe statins for patients with high cholesterol levels. Drugs in this class inhibit HMG CoA reductase, the enzyme required by the body to produce cholesterol. Statins lower blood cholesterol and reduce cardiac risks. Simvastatin has a side effect profile similar to other statins, with an increased risk of muscle injury. Serious side effects should be reported immediately. A doctor's supervision is required to stop or alter dosage.
Muscle Injury
Muscle pain and weakness are common side effects reported by patients taking statins. Milder forms--myalgia--were reported by 6 percent of people in a clinical trial of Zocor published by Drugs.com. Higher doses--80 mg--can cause severe muscle injury, called rhabdomyolysis. This serious form of muscle breakdown releases the protein myoglobin into the blood and urine. Patients may note dark or red urine from the myoglobin. The enzyme creatine kinase is also released from damaged muscle. The levels of myoglobin and creatine kinase in the blood are markers used to monitor muscle breakdown.
Kidney Failure
The myoglobin released during skeletal muscle breakdown can leak into the kidneys and may result in kidney failure. Risk factors for the muscle damage that can affect the kidneys include being over 65 years old or female, having low levels of thyroid hormone, poor kidney function or diabetes mellitus. Patients taking the highest approved dose--80 mg--are at higher risk. The FDA issued an alert on the increased risk of muscle injury in patients taking the highest dose of simvastatin with the drug Amiodarone.
Increased Liver Function
Persistent elevated liver function measured by blood tests was reported in 1.5 percent of patients in a clinical trial of Zocor published on Drugs.com. Half of these patients continued to take the drug and their liver function returned to normal. Rare cases of hepatits, cholestatic jaundice, fatty changes in the liver, cirrhosis and liver failure were reported. Patients taking statins are closely monitored for increased liver function to detect liver toxicity.
Mood and Memory
Rare cases of depression, suicidal thoughts, delusions, agitation and nightmares are reported side effects. Headache is a common side effect in patients starting simvastatin therapy. A clinical trial report published on Drugs.com includes one incident of gradual memory loss over a year by a participant taking Zocor. The patient recovered fully after switching to a different statin drug.
Temporary Effects
Side effects relating to stomach discomfort, heartburn, excess gas, diarrhea or constipation can occur in patients when they begin taking simvastatin. The problems usually subside after several days.
Skin
Eczema, rash, photosensitivity and alopecia can result from hypersensitivity to simvastatin.
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