Zocor 10 mg, 20 mg and 40 mg film-coated tablets – simvastatin for lowering cholesterol and preventing heart disease

Zocor contains the active substance simvastatin and belongs to a group of medicines called statins. It is used to lower total cholesterol, "bad" LDL cholesterol and triglycerides in the blood, while raising "good" HDL cholesterol.

High LDL cholesterol can build up in artery walls and form plaque that narrows blood vessels and slows blood flow to the heart and brain, which can lead to a heart attack or stroke. Zocor is always taken together with a cholesterol-lowering diet. In Serbia it is authorised as 10 mg, 20 mg and 40 mg film-coated tablets in packs of 28 tablets.

What is Zocor used for and how should it be taken?

Key facts about the medicine

What is Zocor used for?

According to the patient leaflet, Zocor is used together with a cholesterol-lowering diet in people who have:

• raised cholesterol in the blood (primary hypercholesterolaemia) or raised blood fats (mixed hyperlipidaemia), when diet and other measures (physical activity, weight loss) are not enough;
• an inherited disease – homozygous familial hypercholesterolaemia – as an add-on to diet and other lipid-lowering treatments (e.g. LDL apheresis);
• coronary heart disease or a high risk of it (because of diabetes, a previous stroke or another blood vessel disease) – Zocor reduces the risk of heart disease and cardiovascular death regardless of cholesterol levels.

In most people, high cholesterol causes no symptoms. Have regular check-ups, keep track of your cholesterol values and discuss your target values with your doctor.

How is it taken and dosed?

Zocor is taken once a day in the evening, by mouth, with or without food. The cholesterol-lowering diet should continue throughout treatment. Your doctor chooses the strength based on your condition, other treatment and individual risk.

• Only your doctor may change the dose, at intervals of at least 4 weeks; the overall simvastatin dose range is 5–80 mg daily, and 80 mg is recommended only for adults with very high cholesterol and high risk who have not reached their goal on lower doses. Never take more than 80 mg a day.
• With fibrates (except gemfibrozil and fenofibrate) the dose must not exceed 10 mg daily; with amiodarone, amlodipine, verapamil, diltiazem or medicines containing elbasvir/grazoprevir – not more than 20 mg daily; with lomitapide – not more than 40 mg daily.
• If you also take bile acid sequestrants, take Zocor at least 2 hours before or 4 hours after them.
• Take the medicine long-term, until your doctor tells you to stop.

This is the general dosage from the official leaflet – your doctor decides your dose.

Special patient groups

• Children and adolescents: use has been studied in boys aged 10 to 17 and in girls at least one year after their first period; the medicine has not been studied in children under 10.
• Older patients: no dose adjustment is needed, but the risk of muscle problems is higher at 65 years and above.
• Kidney impairment: no dose change in moderate impairment; in severe impairment (creatinine clearance below 30 mL/min) doses above 10 mg daily are used only with great caution.
• Liver impairment: the medicine must not be taken in active liver disease; if you have had liver disease before, Zocor may not be right for you.
• People of Asian origin: a different dose may be suitable – tell your doctor.

Contraindications – when the medicine must not be used

Do not take Zocor:

• if you are allergic to simvastatin or any of the excipients;
• if you currently have liver problems (active liver disease or unexplained, persistently raised transaminases);
• if you are pregnant or breast-feeding;
• with the following medicines: itraconazole, ketoconazole, posaconazole, voriconazole; erythromycin, clarithromycin, telithromycin; HIV protease inhibitors (e.g. indinavir, nelfinavir, ritonavir, saquinavir); boceprevir, telaprevir; nefazodone; medicines containing cobicistat; gemfibrozil; ciclosporin; danazol;
• if you are taking, or have taken in the last 7 days, fusidic acid by mouth or by injection (risk of rhabdomyolysis);
• at doses above 40 mg if you are also taking lomitapide.

Warnings and precautions

• Your doctor checks liver function with blood tests before and during treatment.
• The risk of muscle breakdown is higher at higher doses (especially 80 mg) and in people who drink large amounts of alcohol, have kidney or thyroid problems, are 65 or older, are female, have had muscle problems with statins or fibrates, or have an inherited muscle disorder in the family.
• Tell your doctor if you have diabetes or are at risk of diabetes (high blood sugar and fats, overweight, high blood pressure) – you will be monitored more closely.
• Tell your doctor if you have severe lung disease, myasthenia or ocular myasthenia (statins may worsen it), or if you are due to have surgery – treatment may need to be paused.
• The medicine contains lactose – if you have an intolerance to some sugars, talk to your doctor.

Interactions with other medicines, food and drink

• The risk of muscle problems is increased by: fusidic acid (treatment is paused), ciclosporin, danazol, antifungals (itraconazole, ketoconazole, fluconazole, posaconazole, voriconazole), gemfibrozil and bezafibrate, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, hepatitis C medicines (boceprevir, telaprevir, elbasvir, grazoprevir), nefazodone, cobicistat, amiodarone, verapamil, diltiazem, amlodipine, lomitapide, daptomycin, colchicine and ticagrelor.
• Tell your doctor especially if you take anticoagulants (warfarin, phenprocoumon, acenocoumarol), fenofibrate, niacin or rifampicin.
• Tell any doctor prescribing a new medicine that you take Zocor.
• Grapefruit juice changes how the body handles Zocor – avoid it.

Pregnancy and breast-feeding

Zocor must not be taken during pregnancy, if you are planning a pregnancy or think you may be pregnant. If you become pregnant during treatment, stop taking it immediately and contact your doctor. It must also not be taken while breast-feeding, as it is not known whether it passes into breast milk.

Driving and using machines

Zocor is not expected to affect the ability to drive or use machines, but some people may feel dizzy after taking it.

Possible side effects

According to the leaflet, rare serious reactions (up to 1 in 1,000 patients) for which you should stop taking the medicine and contact your doctor or emergency department immediately are:

• muscle pain, tenderness, weakness or cramps – rarely serious, with muscle breakdown and kidney damage;
• hypersensitivity reactions: swelling of the face, tongue and throat (angioedema), severe muscle pain in the shoulders and hips, rash and muscle weakness, joint pain or inflammation, inflammation of blood vessels, unusual bruising, hives, sensitivity to sunlight, fever, shortness of breath, lupus-like symptoms;
• inflammation of the liver (yellowing of the skin and eyes, itching, dark urine, pale stools, tiredness, loss of appetite), and very rarely liver failure;
• inflammation of the pancreas, often with severe abdominal pain.

Very rare: anaphylaxis, lichenoid skin eruptions or mouth ulcers, muscle rupture, breast enlargement in men. Rare: anaemia, numbness or weakness of the arms and legs, headache, tingling, dizziness, blurred vision, abdominal pain, constipation, wind, indigestion, diarrhoea, nausea, vomiting, rash, itching, hair loss, weakness, sleep and memory problems, confusion. Frequency not known: erectile dysfunction, depression, lung inflammation with cough and shortness of breath, tendon problems, myasthenia gravis and ocular myasthenia. With statins, diabetes in predisposed people, nightmares and sexual dysfunction have also been reported; liver enzymes and creatine kinase may be raised.

Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: inform your doctor or pharmacist. According to the SmPC only a few cases have been reported (highest dose 3.6 g), and all patients recovered without consequences; treatment is symptomatic.
• Missed dose: do not take a double dose – continue as usual the next day.
• Stopping treatment: talk to your doctor before stopping, because cholesterol may rise again.

Related information

For additional support in caring for your heart and blood vessels, see also the category Coenzyme Q10 products – products in this category do not replace the medicine prescribed for you.

Composition, pack and manufacturer

• Active substance: simvastatin 10 mg, 20 mg or 40 mg per film-coated tablet.
• Excipients – core: butylated hydroxyanisole (E 320), ascorbic acid (E 300), citric acid monohydrate (E 330), microcrystalline cellulose (E 460), pregelatinised starch, magnesium stearate (E 572), lactose monohydrate; coating: hypromellose (E 464), hydroxypropylcellulose (E 463), titanium dioxide (E 171), talc (E 553), yellow iron oxide (E 172 – 10 and 20 mg tablets), red iron oxide (E 172).
• Pack: carton with 2 blisters (Al and PVC/PE/PVDC foil) of 14 film-coated tablets – 28 tablets in total.
• Marketing authorisation holder: ORGANON D.O.O., Milutina Milankovića 7Đ, Belgrade – Novi Beograd. Manufacturers: Merck Sharp & Dohme B.V., Waarderweg 39, Haarlem, the Netherlands; Organon Heist B.V., Industriepark 30, Heist-op-den-Berg, Belgium.

Storage

• Store below 25 °C.
• Keep out of the sight and reach of children.
• Do not use after the expiry date stated on the pack (shelf life: 2 years).

Frequently asked questions

Why is Zocor taken in the evening?

According to the leaflet, Zocor is taken once a day in the evening. It can be taken with or without food; what matters is taking it regularly, at about the same time every day.

Can I drink grapefruit juice while taking Zocor?

No. Grapefruit juice contains substances that change how the body handles Zocor, so it should be avoided during treatment.

What should I do if my muscles hurt during treatment?

Unexplained muscle pain, tenderness, weakness or cramps mean you should contact your doctor immediately. Rarely, muscle problems can be serious and lead to kidney damage, so they should not be ignored.

Can I stop the medicine once my cholesterol is normal?

Not without talking to your doctor. Zocor works while you take it – if you stop suddenly, cholesterol levels may rise again.

Sources

• ALIMS – Summary of Product Characteristics, Zocor® 10 mg film-coated tablets (Serbian)
• ALIMS – Patient leaflet, Zocor® 10, 20 and 40 mg film-coated tablets (May 2024, Serbian)
• ALIMS – Summary of Product Characteristics, Zocor® 20 mg film-coated tablets (Serbian)
• ALIMS – Patient leaflet, Zocor® (20 mg authorisation, Serbian)
• ALIMS – Summary of Product Characteristics, Zocor® 40 mg film-coated tablets (Serbian)
• ALIMS – Patient leaflet, Zocor® 10, 20 and 40 mg film-coated tablets (December 2025, Serbian)

Sources checked on: 24 October 2026.