Avoid Zeplan with:
- HIV protease inhibitors
Q: I have been on Zocor for several years and have been taking extra vitamin D3 for serveral months. I have been having left humerus pain now for some time. Can this be connected to either of these medications?
A: Zocor (Zeplan) is a cholesterol-lowering medication that belongs to a class of drugs called "statins." Statins work by blocking the production of cholesterol in the body. Side effects of Zocor are more likely to involve pain in the muscles or joints than pain in the bones themselves. Vitamin D3 (cholecalciferol) is a fat-soluble vitamin that is needed for the proper absorption and functioning of calcium. It is needed for the function of bones, muscles, nerves, and the immune system. Vitamin D is found in very few foods, unless added as fortification. The skin is able to synthesize or make vitamin D when it is exposed to sunlight. Either way, vitamin D must be activated in a process that involves both the liver and the kidneys. Vitamin D deficiencies can result with inadequate dietary intake, lack of sunlight exposure, or when people have certain organ problems, including kidney and liver disease. It is possible to get too much vitamin D, which can be dangerous and even life-threatening. Symptoms of too much vitamin D include nausea, vomiting, loss of appetite, constipation, weakness, weight loss, muscle or bone pain, metallic taste in the mouth, confusion, and changes in heart beat. Seek emergency medical attention if you have symptoms of too much vitamin D or if you think you have taken too much vitamin D. Sarah Lewis, PharmD
What Other Drugs Interact with Zeplan?
If your doctor has directed you to use this medication for diabetes, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
This drug has severe interactions with at least 32 different drugs.
This drug has serious interactions with at least 79 different drugs.
This drug has moderate interactions with at least 79 different drugs.
Mild Interactions of Zeplan include:
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.
How should I take Zeplan?
Take Zeplan exactly as prescribed. Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. Taking too much of this medication may cause serious or life-threatening side effects.
Zeplan is usually taken at bedtime or with an evening meal. If you take Zeplan more than once daily, take it with meals. Your doctor may occasionally change your dose to make sure you get the best results.
While using Zeplan, you may need frequent blood tests at your doctor's office.
You may need to take Zeplan on a long-term basis for the treatment of high cholesterol. You may need to stop using this medicine for a short time if you have surgery or a medical emergency. Do not stop taking this medicine unless your doctor tells you to.
Zeplan is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.
Store at room temperature away from moisture, heat, and light.
Before and During Use
What do I need to tell my doctor BEFORE I take this drug?
If you have an allergy to Zeplan or any other part of this drug.If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.If you take any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like certain drugs that are used for HIV, infections, or depression. There are many drugs that must not be taken with this drug. Your doctor or pharmacist can tell you if you are taking a drug that must not be taken with this drug.If you have any of these health problems: Active liver disease or a rise in liver enzymes.If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.If you are breast-feeding. Do not breast-feed while you take this drug.This is not a list of all drugs or health problems that interact with this drug.Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
What are some things I need to know or do while I take this drug?
Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.Have blood work checked as you have been told by the doctor. Talk with the doctor.If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.Follow the diet and workout plan that your doctor told you about.Do not take more than what your doctor told you to take. Taking more than you are told may raise your chance of very bad side effects.Avoid or limit drinking alcohol to less than 3 drinks a day. Drinking too much alcohol may raise your chance of liver disease.Avoid grapefruit and grapefruit juice.If you are Chinese, talk with your doctor. You could have a greater risk of muscle problems.This drug may affect how much of some other drugs are in your body. If you are taking other drugs, talk with your doctor. You may need to have your blood work checked more closely while taking this drug with your other drugs.If you are 65 or older, use this drug with care. You could have more side effects.This drug may cause harm to the unborn baby if you take it while you are pregnant.Use birth control that you can trust to prevent pregnancy while taking this drug.If you are pregnant or you get pregnant while taking this drug, call your doctor right away.
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 (Zeplan) 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
Do not exceed 10 mg Zeplan daily with:
2. Key facts
- Zeplan seems to be a very safe medicine. It's unusual to have any side effects.
- Keep taking Zeplan even if you feel well, as you will still be getting the benefits. Most people with high cholesterol don't have any symptoms.
- Do not take Zeplan if you're pregnant, trying to get pregnant or breastfeeding.
- Do not drink grapefruit juice while you're taking Zeplan. It doesn't mix well with this medicine.
- Zeplan is also called Zocor and Simvador.
People with a history of alcohol abuse and risk of liver disease should not take this drug. For these people, Zeplan can increase the risk of serious liver injury.
In the Heart Protection Study (HPS), involving 20,536 patients (age range 40-80 years, 25% women, 97% Caucasians, 3% other races) treated with Zeplan 40 mg/day (n=10,269) or placebo (n=10,267) over a mean of 5 years, only serious adverse reactions and discontinuations due to any adverse reactions were recorded. Discontinuation rates due to adverse reactions were 4.8% in patients treated with Zeplan compared with 5.1% in patients treated with placebo. The incidence of myopathy/rhabdomyolysis was 10 times upper limit of normal ) in patients on 80 mg/day was approximately 0.9% compared with 0.02% for patients on 20 mg/day. The incidence of rhabdomyolysis (defined as myopathy with a CK >40 times ULN) in patients on 80 mg/day was approximately 0.4% compared with 0% for patients on 20 mg/day. The incidence of myopathy, including rhabdomyolysis, was highest during the first year and then notably decreased during the subsequent years of treatment. In this trial, patients were carefully monitored and some interacting medicinal products were excluded.
Other adverse reactions reported in clinical trials were: diarrhea, rash, dyspepsia, flatulence, and asthenia.
Zeplan may pass into breast milk and could harm a nursing baby. Do not breast-feed while you are taking this medicine.
Because the below reactions are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The following additional adverse reactions have been identified during postapproval use of Zeplan: pruritus, alopecia, a variety of skin changes (e.g., nodules, discoloration, dryness of skin/mucous membranes, changes to hair/nails), dizziness, muscle cramps, myalgia, pancreatitis, paresthesia, peripheral neuropathy, vomiting, anemia, erectile dysfunction, interstitial lung disease, rhabdomyolysis, hepatitis/jaundice, fatal and non-fatal hepatic failure, and depression.
There have been rare reports of immune-mediated necrotizing myopathy associated with statin use .
An apparent hypersensitivity syndrome has been reported rarely which has included some of the following features: anaphylaxis, angioedema, lupus erythematous-like syndrome, polymyalgia rheumatica, dermatomyositis, vasculitis, purpura, thrombocytopenia, leukopenia, hemolytic anemia, positive ANA, ESR increase, eosinophilia, arthritis, arthralgia, urticaria, asthenia, photosensitivity, fever, chills, flushing, malaise, dyspnea, toxic epidermal necrolysis, erythema multiforme, including Stevens-Johnson syndrome.
There have been rare postmarketing reports of cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin use. These cognitive issues have been reported for all statins. The reports are generally nonserious, and reversible upon statin discontinuation, with variable times to symptom onset (1 day to years) and symptom resolution (median of 3 weeks).
Read the entire FDA prescribing information for Zeplan (Oral Suspension)
Why is Zocor prescribed to patients?
- Zeplan is used for reducing total cholesterol, LDL cholesterol, and triglycerides, and for increasing HDL cholesterol.
- In patients with coronary heart disease, diabetes, peripheral vascular disease, or history of stroke or other cerebrovascular disease, Zeplan is prescribed for reducing the risk of mortality by reducing death from coronary heart disease, reducing nonfatal myocardial infarction (heart attack) and stroke, and reducing the need for coronary and noncoronary revascularization procedures.
Q: What is the generic equivalent of Zocor?
A: The generic equivalent of Zocor is known as Zeplan. The generic equivalent of Zocor, Zeplan, is an HMG-CoA reductase inhibitor which is approved for the treatment of hyperlipidemia in several populations of patients. For most medications, generic equivalents are a lower-cost alternative to the more expensive brand-name medication, and the majority of patients observe no changes in therapeutic effect. However, some patients will experience a change in effect and must continue treatment with the brand-name medication. If therapy is changed, by a health care provider, from the brand-name to the generic equivalent of Zocor, cholesterol levels and liver function should be routinely monitored prior to switching treatment options and periodically thereafter. The U.S. Food and Drug Administration (FDA) requires that generic medications be bioequivalent to the brand-name medication and, therefore, exert the same pharmacologic effects in the body. Generic medications are considered, by the FDA, to be identical to the brand-name counterparts in dose, strength, route of administration, safety, efficacy and intended use. Generic medications will appear differently and may have different inactive ingredients, however, the labeling and directions for use remain the same. Frequently reported side effects for the generic equivalent of Zocor are similar those observed in patients being treated with the brand-name medication and may include upper respiratory infections, headache, abdominal pain, constipation and nausea. The warnings and precautions associated with Zocor are also possible with the generic equivalent of Zocor. According to the prescribing information for Zocor, warnings and precautions, possible with treatment, include skeletal muscle effects of myopathy and rhabdomyolysis, and liver enzyme abnormalities. The generic equivalent of Zocor should be administered exactly the same as the brand-name medication. Zeplan is indicated to be administered once daily in the evening. Zeplan can be taken without regard to food.
7. Cautions with other medicines
Some medicines don't mix well with Zeplan, including:
If you're taking Zeplan and need to take one of these medicines, your doctor may: