Precautions and Warnings of Simvastatin

• Simvastatin can interact with certain substances (see Drug Interactions With Simvastatin).
   
• If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting simvastatin. Alcohol can affect the way the liver works, indirectly affecting simvastatin.
   
• Statins have been known to cause an increase in liver enzymes. Therefore, it is recommended that you have a blood test that looks at your liver function before starting simvastatin and several months after treatment has started. These tests may also be recommended if the dosage is changed.
   
• Rhabdomyolysis (the severe breakdown of muscles) and other serious muscle problems have rarely been reported with simvastatin and other statins. However, you are at greater risk of developing muscle problems (such as rhabdomyolysis) while taking this drug if you:

• Have kidney damage

• Are elderly

• Are not being properly treated for hypothyroidism

• Are taking certain medications, such as fibrates (Lopid^®), niacin, cyclosporine, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, or antifungal medicines (see Drug Interactions With Simvastatin).

• Drink grapefruit juice or use grapefruit products (see Grapefruit Juice and Zocor).

Make sure to contact your healthcare provider immediately if you experience any muscle pain, weakness, or tenderness, especially if you also have a fever or feel ill (see Zocor and Muscle Pain).

• Simvastatin is a pregnancy Category X medicine, which means it could potentially cause harm to your unborn child. The safety of the drug in pregnant women has not been established. If you are pregnant, talk with your healthcare provider immediately (see Zocor and Pregnancy).
   
• It is not known whether simvastatin passes through breast milk. Therefore, you should ask your healthcare provider whether to stop nursing or discontinue simvastatin use.
   

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