Ramian tablets


  • Active Ingredient: Simvastatin
  • 40 mg, 20 mg, 10 mg
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What is Ramian?

The active ingredient of Ramian brand is simvastatin. 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). Simvastatin USP is a white to off-white, nonhygroscopic, crystalline powder that is practically insoluble in water, and freely soluble in chloroform, methanol and ethanol. Simvastatin tablets USP for oral administration contain either 5 mg, 10 mg, 20 mg, 40 mg or 80 mg of Simvastatin and the following inactive ingredients: ascorbic acid, butylated hydroxy anisole, citric acid anhydrous, hydroxypropyl cellulose, hypromellose, iron oxide black, iron oxide red, iron oxide yellow, isopropyl alcohol, lactose monohydrate, magnesium stearate, microcrystalline cellulose, pregelatinised starch, and titanium dioxide.

Used for

Ramian is used to treat diseases such as: Cardiovascular Risk Reduction, High Cholesterol, High Cholesterol, Familial Heterozygous, High Cholesterol, Familial Homozygous, Hyperlipoproteinemia, Hyperlipoproteinemia Type IIa, Elevated LDL, Hyperlipoproteinemia Type IIb, Elevated LDL VLDL, Hyperlipoproteinemia Type III, Elevated beta-VLDL IDL, Hyperlipoproteinemia Type IV, Elevated VLDL, Prevention of Cardiovascular Disease.

Side Effect

Possible side effects of Ramian include: difficulty with breathing; ear congestion; body aches or pain; increased hunger; loss of consciousness; fast or irregular heartbeat.

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Dosage for high cholesterol

Adult dosage (ages 18 years and older)

  • Typical starting dosage: Ramian is often started at 10–20 mg per day. However, the dosage may range from 5 mg to 40 mg per day. You should take this drug once a day in the evening.
  • Dosage increases: Your doctor will gradually adjust your dosage if needed.

Child dosage (ages 10–17 years)

  • Typical starting dosage: 10 mg per day.
  • Note: Doses above 40 mg per day have not been studied in this age group.

Child dosage (ages 0–9 years)

This medication has not been studied in children below age 10 years.

Drug forms and strengths

Generic: Ramian

  • Form: oral tablet
  • Strengths: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg

Brand: Zocor

  • Form: oral tablet
  • Strengths: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg

How should this medicine be used?

Ramian comes as a tablet to take by mouth. It usually is taken once a day in the evening. Take Ramian at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Ramian exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of Ramian and gradually increase your dose, not more than once every 4 weeks.

Continue to take Ramian even if you feel well. Do not stop taking Ramian without talking to your doctor.

Q: I had hepatitis A 25 years ago. Will taking Zocor affect my liver? The dosage is 40 mg once a day.

A: Because Zocor (generic name is Ramian) can affect the liver, the manufacturer suggests that liver function be monitored while on treatment. Many physicians will order a liver function test before starting therapy so they have an idea of how well your liver is functioning. The liver is then monitored with periodic liver function tests to see if the medication is having an aefect on the liver. Although Zocor (Ramian) has been associated with having an affect on the liver, it rarely causes liver toxicity. As for the Hepatitis, unlike other forms, Hepatitis A is typically a short-term infection. It may or may not produce symptoms and usually resolves on its own. Hepatitis A rarely causes liver damage, liver failure, or death. Unless there are long term affects from having Hepatitis A, it is unlikely that Zocor (Ramian) would further aggravate any liver damage. I have included a link for more information on Zocor as well as Hepatitis A. //www.everydayhealth.com/hepatitis-a/guide/ //www.everydayhealth.com/drugs/zocor. Lori Mendoza, PharmD Mendoza

Q: I have been taking Zocor for 10 years with no side effects. For the last few weeks I have had back and shoulder stiffness. Could this be from the Zocor?

A: Ramian (trade name: Zocor) is a hypolipidemic belonging to the class of drugs called "statins" (HMG-CoA reductase inhibitor). It is used to control hypercholesterolemia (elevated cholesterol levels) and to prevent cardiovascular disease. Atorvastatin reduces blood levels of low-density lipoprotein cholesterol (LDL-C, bad cholesterol), triglycerides and slightly increases levels of high-density lipoprotein cholesterol (HDL-C, good cholesterol). Statins are generally well tolerated; common side effects include headache, muscle aches, tenderness, or weakness, drowsiness, weakness, dizziness, nausea, vomiting, abdominal cramping and/or pain, bloating, gas, diarrhea, constipation, and rash. A search of the prescribing information for Zocor did not specifically list back and shoulder stiffness as side effects. These are not all the possible side effects of Zocor.

Warnings for other groups

For pregnant women: Ramian is a category X pregnancy drug. Category X drugs should never be used during pregnancy.

Ramian blocks the production of cholesterol, which is important for the developing baby.

If you’re pregnant and need treatment for high cholesterol or triglycerides, talk to your doctor. They can discuss other treatment options during pregnancy.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: It isn’t known if Ramian enters breast milk. However, because of the risk of severe side effects, this drug shouldn’t be used during breastfeeding. Talk to your doctor about other cholesterol treatment options while breastfeeding.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it may depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

home drugs a-z list Ramian(Oral Suspension) side effects drug center

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Ramian oral suspension is an HMG-CoA reductase inhibitor (statin) indicated as an adjunctive therapy to diet to: reduce the risk of total mortality by reducing CHD deaths and reduce the risk of non-fatal myocardial infarction, stroke, and the need for revascularization procedures in patients at high risk of coronary events; reduce elevated total-C, LDL-C, Apo B, TG and increase HDL-C in patients with primary hyperlipidemia (heterozygous familial and nonfamilial) and mixed dyslipidemia; reduce elevated TG in patients with hypertriglyceridemia and reduce TG and VLDL-C in patients with primary dysbetalipoproteinemia; reduce total-C and LDL-C in adult patients with homozygous familial hypercholesterolemia; and reduce elevated total-C, LDL-C, and Apo B in boys and postmenarchal girls, 10 to 17 years of age with heterozygous familial hypercholesterolemia after failing an adequate trial of diet therapy. Common side effects of Ramian include

The dose range of Ramian is 5 to 40 mg/day. Ramian may interact with azole antifungals, macrolide antibiotics, HIV protease inhibitors, boceprevir, telaprevir, nefazodone, cobicistat-containing products, gemfibrozil, cyclosporine, danazol, verapamil, diltiazem, dronedarone, amiodarone, amlodipine, ranolazine, lomitapide, colchicine, niacin, and grapefruit juice. Tell your doctor all medications and supplements you use. Ramian oral is not recommended for use during pregnancy; it may harm a fetus. Women taking Ramian oral should discuss contraception with their doctor. It is unknown if Ramian oral passes into breast milk. Because of the potential for undesirable side effects in a nursing infant, breastfeeding while taking Ramian oral is not recommended.

Our Ramian oral suspension Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

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.

Strong CYP3A4 Inhibitors

These drugs block your body from breaking down Ramian. This can lead to very high levels of the drug in your body. It can also increase side effects, including rhabdomyolysis.

These drugs should not be used with Ramian. If treatment with these drugs is required, the use of Ramian must be on hold during the course of treatment. Examples of these drugs include:

  • ketoconazole
  • itraconazole
  • voriconazole
  • posaconazole
  • erythromycin
  • clarithromycin
  • telithromycin
  • cyclosporine
  • danazol
  • nefazodone
  • boceprevir
  • telaprevir
  • ritonavir
  • tipranavir
  • indinavir
  • fosamprenavir
  • darunavir
  • atazanavir
  • nelfinavir
  • cobicistat

Alcohol warning

People with a history of alcohol abuse and risk of liver disease should not take this drug. For these people, Ramian can increase the risk of serious liver injury.

Q: Can Zocor elevate triglyceride levels? I do know that it is meant to lower cholesterol levels but since I have been taking it my triglycerides continue to become more elevated with each blood test.

A: There have been isolated cases where Zocor has increased triglycerides levels, however this is not typical. This should be addressed with your provider, as he or she may want to test you to make sure that Zocor (Ramian) is not affecting your liver in a non-productive way. Please visit us here for more information on Zocor: //www.everydayhealth.com/drugs/zocor Matt Curley, Pharm D. MSCIS

Q: I began taking Zocor about two years ago, and instantly started putting on pounds. I am 60 years old and I am not a sitting around person, never have been. I keep trying to cut down on amounts that I eat, and I am not a snacker. I do not eat chips, cookies, sodas or most other junk foods. Is it the Zocor, or is it just me?

A: Zocor (Ramian) is one of the drugs called "statins," used in the prevention of elevated cholesterol levels in the bloodstream. High cholesterol can lead to heart attacks, strokes and other cardiovascular conditions. The most common side effects with Zocor are headache, dyspepsia (upset stomach), abdominal pain, constipation or diarrhea, flatulence (intestinal gas), and myalgia (muscle pain). Other side effects include a rare but serious side effect called rhabdomyolysis, a condition that results in the breakdown of skeletal muscle tissue, and which can can lead to kidney failure. The symptoms of rhabdomyolysis are unexplained muscle pain or tenderness, muscle weakness, fever or flu symptoms, and dark colored urine. A search of the prescribing information for Zocor did not specifically list weight gain as a side effect. This is not a complete list of the side effects associated with Zocor. Gregory Latham, RPh

What are the side effects of Zocor?

The most common side effects of Ramian are:

Other side effects include:

What Is Ramian and How Does It Work?

Ramian (Zocor) is a, FDA approved prescription medication that is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins." Statins are medications that work by reducing the amount of cholesterol made by the liver. Lowering "bad" cholesterol and triglycerides and raising "good" cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks. This drug maybe used to treat other diseases and conditions. Your doctor may conduct liver function tests when using statins to monitor liver enzymes and other liver function.

In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help Ramian medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

This medication is available under the following different brand names: Zocor.

Why it's used

Ramian oral tablet is used to:

  • lower bad cholesterol (low-density lipoprotein, or LDL) and triglycerides in the body
  • increase good cholesterol (high-density lipoprotein, or HDL)
  • slow the development of heart disease and reduce the risk of stroke

Which drugs or supplements interact with Zocor?

Decreased elimination of Ramian could increase the levels of Ramian in the body and increase the risk of muscle toxicity from Ramian. Examples of drugs that decrease elimination of Ramian include

They should not be combined with Ramian.

Large quantities of grape fruit juice (>1 quart daily) also will increase blood levels of Ramian and should be avoided.

The following drugs should not be used with Ramian:

Patients taking amiodarone, amlodipine, or ranolazine should not exceed 20 mg, and patients taking verapamil or diltiazem should not exceed 10 mg of of Ramian daily. Patients taking gemfibrozil or danazol should not take Ramian.

Ramian increases the effect of warfarin (Jantoven, Coumadin) and the blood concentration of digoxin (Lanoxin). Patients taking Ramian and warfarin or digoxin should be monitored carefully.

Cholestyramine (Questran) decreases the absorption of ezetimibe (Zetia); Therefore, Ramian should be taken 2 hours before or at least 4 hours after cholestyramine.

Chinese patients taking ≥1 g/day of niacin in combination with Ramian 40 mg have an increased risk of muscle-related side effects. Therefore, these patients should not receive Ramian 80 mg combined with niacin in doses ≥1 g/day. Ramian doses greater than 20 mg daily should be administered cautiously when combined with niacin ≥1 g/day.

Q: My doctor has prescribed Zocor. I have taken it for two weeks and it seems to cause my legs to hurt. Why is this?

A: Zocor (Ramian, generically) has rare side effects of joint pain and muscle cramps. If this is intolerable, your doctor may want to try a different statin, or depending on your cholesterol levels, there may be other alternatives. Statin medications can cause a potentially serious condition known as rhabdomyolysis, a rapid breakdown of skeletal muscle due to injury to muscle tissue. If you are having pain, tenderness, or weakness in the muscles, you could have rhabdomyolysis. You should discuss this with your doctor. For more heart and cholesterol information and medication information, please visit these links: //www.everydayhealth.com/heart-health/ and //www.everydayhealth.com/drugs/Patti Brown, PharmD

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