Zocor heart-pro (simvastatin)

How does it work?

Zocor heart-pro tablets contain the active ingredient simvastatin, which is a type of medicine called a statin. It works by reducing the production of cholesterol by the liver.

For the sake of simplicity, there are two sorts of cholesterol; a 'bad' sort called low density lipoprotein (LDL) and a 'good' sort called high density lipoprotein (HDL). LDL is deposited in the arteries and increases the risk of heart disease by clogging and narrowing the arteries (atherosclerosis), while HDL actually protects the arteries against this.

Simvastatin decreases the production of LDL cholesterol by blocking the action of the enzyme in the liver (called HMG-CoA reductase) that is responsible for its production. This decreases the amount of cholesterol in the liver cells, which causes them to take up LDL cholesterol from the blood. The decreased cholesterol production and increased removal of LDL cholesterol from the blood ultimately results in lowered blood cholesterol levels.

The body produces most cholesterol at night, so simvastatin is more effective when taken in the evening.

Simvastatin also causes a small decrease in the production of other 'bad fats' in the blood called triglycerides, and a small increase in the level of HDL cholesterol. This results in lowered levels of 'bad fats' and raised levels of 'good fats' in the blood.

Statins have an important role in the prevention of coronary heart disease because they reduce the risk of excess cholesterol being deposited in the major blood vessels of the heart. Any blockage in the blood vessels limits the amount of blood and therefore oxygen being carried to the heart muscle. This can cause angina (chest pain), and in severe cases can result in a heart attack (myocardial infarction).

Statins are normally prescribed by doctors to reduce the risk of heart attacks in people who are at high risk of having a heart attack due to various risk factors, or who already have coronary heart disease (angina or a past heart attack). Zocor heart-pro, however, contains a lower dose of statin than that normally prescribed, and can be bought without a prescription from pharmacies. It is licensed to be sold to people considered to be at moderate risk of a heart attack. Remember that the risk of a heart attack can be lowered through stopping smoking, eating healthily, losing weight and taking regular exercise. This medicine can be used in addition to lifestyle changes to further lower heart attack risk, but you should remember that for it to be effective it will need to be taken long-term.

What is it used for?

Reducing the risk of a heart attack in people at moderate risk of coronary heart disease. Moderate risk is defined as people who have a 10 to 15 per cent chance of having a heart attack in the next ten years. Men aged 55 years and over fall into this category, as do men aged 45 to 55 years and women aged 55 years and over who have one or more of the following risk factors:

family history of coronary heart disease in a parent, brother or sister

currently a smoker or has been in the last five years

overweight (body mass index higher than 25kg/m² or waist measurement larger than 40 inches in men or 35 inches in women)

South Asian ethnic origin (ie, from the Indian subcontinent that includes India, Bangladesh, Pakistan or Sri Lanka).

Your pharmacist can help you assess whether this medicine might be of benefit to you.

Warning!

Before selling you this medicine your pharmacist will need to establish whether it is safe and appropriate for you to take it. You can expect to be asked questions about your age, lifestyle, medical history, family history of heart disease and any medicines you are currently taking.

It is recommended that you avoid drinking excessive amounts of alcohol while taking this medicine.

You should avoid drinking grapefruit juice while taking this medicine. This is because grapefruit juice can affect the metabolism of simvastatin and could increase the amount of the medicine in your blood, thus increasing the risk of side effects.

This medicine may occasionally have side effects on the muscles. For this reason you should inform your doctor immediately if you experience any unexplained muscular symptoms, such as pain, tenderness, cramps or weakness while taking this medicine. Your doctor may need to check for side effects on the muscles by taking a blood test to measure the level of a compound called creatine kinase (CK) in your blood. If this is the case, the test should not be done following strenuous exercise.

This medicine can sometimes cause liver problems. For this reason you should stop taking this medicine and consult your doctor promptly if you develop unexplained itching, yellowing of the skin or eyes, unusually dark urine, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms while taking this medicine.

Use with caution in

High blood pressure (consult doctor before use).

Decreased kidney function (consult doctor before use).

Underactive thyroid gland (consult doctor before use).

Personal or family history of hereditary muscle disorders (consult doctor before use).

People over 70 years of age (consult doctor before use).

History of liver disease.

People who drink large amounts of alcohol.

Hereditary blood disorders called porphyrias.

Not to be used in

Children.

People already taking prescription cholesterol lowering medicines.

People taking the antifungals itraconazole or ketoconazole, the antibiotics erythromycin, clarithromycin or telithromycin, a protease inhibitor for HIV infection, or the antidepressant nefazodone.

History of muscular side effects during previous treatment with a statin or fibrate medicine.

Active liver disease.

People with unexplained raised results in liver function tests.

Pregnancy.

Breastfeeding.

Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Zocor heart-pro tablets contain lactose).

If you have previously had a heart attack or stroke, or have angina, peripheral vascular disease (eg poor blood flow to the legs), a cholesterol level of 5.5mmol/l or greater, high cholesterol levels due to a genetic condition called familial hypercholesterolaemia, or diabetes, this non-prescription medicine will not be suitable for you. These conditions carry a higher risk of heart disease and should be treated by a doctor.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not used by women who are pregnant, trying to get pregnant, or suspect they could be pregnant. Seek further medical advice from your doctor.

It is not known if this medicine passes into breast milk. For this reason, the manufacturer states that it should not be used by breastfeeding women. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. The following are some of the side effects that are known to be associated with this medicine:

abdominal pain

constipation

flatulence

feeling of weakness

headache

dizziness

pins and needles (paraesthesia)

indigestion

nausea and vomiting

diarrhoea

anaemia

liver disorders

rash or itching

hair loss

muscle disorders.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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