Zocor is the brand name of simvastatin, available in tablet form. It is used along with dietary therapy to lower total cholesterol; LDL, or bad, cholesterol; and triglycerides, which is how fat is stored in the body. Zocor is also used in patients with high cholesterol to prevent death from cardiovascular events, such as heart attack, stroke and decreased oxygen in the body. The medication is effective, but always discuss the safety information regarding a prescription to avoid interactions.
Actions of Zocor
Zocor belongs to the class of medications called the HMG-CoA reductase inhibitors, which are commonly called the statins. This drug blocks the enzyme HMG-CoA reductase and thereby prevents the formation of cholesterol in the body. It is one of the longer-acting medications and one of the most potent in its class, according to "Pharmacotherapy: A Pathophysiologic Approach."
Zocor Metabolism
The liver is the primary site of Zocor metabolism, or breakdown. The liver has a high concentration of a family of enzymes called the cytochrome P450 enzymes. Zocor is metabolized by the cytochrome P450 3A4 enzyme, written as CYP 3A4; this may lead to interactions and side effects.
Side Effects
The interaction between grapefruit juice and Zocor increases the risk of developing side effects. Common side effects such as constipation, stomach pain and passing gas may worsen or occur more frequently. Serious reactions include rhabdomyolysis and myopathy, states the "Drug Information Handbook." Rhabdomyolysis is the breakdown of muscle fibers that leads to release of the fiber contents into the blood. These contents are filtered by the kidneys and can cause kidney damage and failure. Myopathy is the malfunction of muscle fibers. Symptoms of rhabdomyolysis and myopathy include muscle and joint pain, abnormal urine color, muscle weakness, stiffness and fatigue.
Grapefruit Juice
Grapefruit and grapefruit juice may inhibit, or block, the actions of CYP 3A4 and can increase the level of Zocor in the blood. Furancoumarins, such as quercetin, naringin and bergamottin, are chemicals found in grapefruit juice that are potent CYP 3A4 inhibitors. Patients on Zocor should not consume products that contain grapefruit juice. Read all food labels to ensure that no grapefruit juice is present to avoid serious effects.
References
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al.; 2008
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- PubMed Health: Rhabdomyolysis
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