Simcor

Pronunciation: SIM-va-STAT-in/NYE-a-sin
Generic Name: Simvastatin/Niacin
Brand Name: Simcor

Simcor is used for:

Lowering high cholesterol and triglycerides in certain patients. It also increases high-density lipoprotein (HDL, "good") cholesterol levels. It is used along with an appropriate diet. It may also be used for other conditions as determined by your doctor.

Simcor is an HMG-CoA reductase inhibitor and niacin combination. The HMG-CoA reductase inhibitor works by reducing the production of certain fatty substances in the body, including cholesterol. The niacin works by reducing low-density lipoprotein (LDL, "bad") cholesterol and triglycerides and increasing HDL cholesterol.

Do NOT use Simcor if:

• you are allergic to any ingredient in Simcor


• you are pregnant, may become pregnant, or are breast-feeding


• you have liver problems, unexplained abnormal liver function tests, active peptic ulcer disease, or certain types of active bleeding (arterial bleeding)


• you take amiodarone, cyclosporine, danazol, diltiazem, fibrates (eg, clofibrate, fenofibrate, gemfibrozil), a hepatitis C virus (HCV) protease inhibitor (eg, boceprevir, telaprevir), an HIV protease inhibitor (eg, lopinavir, nelfinavir, ritonavir), itraconazole, ketoconazole, certain macrolide antibiotics (eg, clarithromycin, erythromycin), mibefradil, nefazodone, posaconazole, telithromycin, or verapamil


• you take or have taken conivaptan within the past 7 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Simcor:

Some medical conditions may interact with Simcor. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are able to become pregnant


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a history of liver problems; abnormal liver function tests; yellowing of the skin or eyes; kidney problems; diabetes; underactive thyroid; electrolyte, endocrine, or metabolism problems; blood or bleeding problems (eg, low blood platelet levels); low blood pressure; gout; muscle pain or weakness; seizures; or ulcers


• if you are dehydrated, have a severe infection or a recent serious injury, or are very ill


• if you drink large amounts of alcohol or if you have a history of alcohol abuse


• if you are scheduled to have surgery or if you have received an organ transplant


• if you have taken or are taking immediate-release (short-acting) niacin, another product that contains niacin, or vitamins or other supplements that contain niacin or nicotinamide


• if you have not previously taken simvastatin or a long-acting niacin. Simcor should only be used in patients who already take simvastatin or long-acting niacin

Some MEDICINES MAY INTERACT with Simcor. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Amiodarone, amlodipine, azole antifungals (eg, itraconazole, ketoconazole, posaconazole, voriconazole), colchicine, conivaptan, cyclosporine , danazol, daptomycin, delavirdine, diltiazem, dronedarone, fibrates (eg, clofibrate, fenofibrate, gemfibrozil), fusidic acid, HCV protease inhibitors (eg, boceprevir, telaprevir), HIV protease inhibitors (eg, lopinavir, nelfinavir, ritonavir), imatinib, ketolides (eg, telithromycin), macrolide antibiotics (eg, clarithromycin, erythromycin), mibefradil , nefazodone, ranolazine, streptogramins (eg, dalfopristin, quinupristin), or verapamil because the risk of myopathy (eg, muscle pain, tenderness, weakness) may be increased


• Bosentan, carbamazepine, efavirenz, rifamycins (eg, rifampin), or St. John's wort because they may decrease Simcor's effectiveness


• Anticoagulants (eg, warfarin), digoxin, or macrolide immunosuppressants (eg, tacrolimus) because the risk of their side effects may be increased by Simcor


• Certain medicines for high blood pressure (eg, clonidine, prazosin) because the risk of a sudden drop in blood pressure when sitting or standing up, which may cause dizziness or light-headedness, may be increased by Simcor

This may not be a complete list of all interactions that may occur. Ask your health care provider if Simcor may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Simcor:

Use Simcor as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Simcor by mouth at bedtime with a low-fat snack (eg, low-fat yogurt, banana, crackers with a glass of low-fat milk), unless your doctor tells you otherwise. Taking Simcor with a low-fat snack may reduce flushing and stomach upset from Simcor. Do not take Simcor on an empty stomach.


• Do not drink alcohol or hot drinks, or eat spicy foods around the time you take Simcor. This may also help to reduce the risk of flushing.


• Swallow Simcor whole. Do not break, crush, or chew before swallowing.


• Eating grapefruit or drinking grapefruit juice may increase the amount of Simcor in your blood, which may increase your risk of serious side effects. The risk may be greater with large amounts of grapefruit or grapefruit juice. Avoid large amounts of grapefruit or grapefruit juice (eg, more than 1 quart daily) while you are using Simcor. Talk with your doctor or pharmacist if you have questions about including grapefruit or grapefruit juice in your diet while you are taking Simcor.


• If you take cholestyramine or colestipol, take Simcor at least 4 to 6 hours after you take cholestyramine or colestipol.


• Take Simcor on a regular schedule to get the most benefit from it. Taking Simcor at the same time each day will help you remember to take it.


• Continue to take Simcor even if you feel well. Do not miss any doses.


• If you miss a dose of Simcor, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you miss taking Simcor for several days in a row, contact your doctor before you start to take it again. Your dose may need to be adjusted.

Ask your health care provider any questions you may have about how to use Simcor.

Important safety information:

• Simcor may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Simcor with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Simcor may cause liver problems. Rarely, severe and sometimes fatal liver failure has been reported in patients taking Simcor. Your risk of developing liver problems may be greater if you drink alcohol daily or in large amounts with Simcor, or if you have a history of liver problems. Check with your doctor before drinking alcohol while you are taking Simcor. Tell your doctor right away if you experience symptoms of liver problems (eg, yellowing of the skin or eyes; dark urine; pale stools; severe or persistent nausea, loss of appetite, or stomach pain; unusual tiredness).


• For best results, Simcor should be used along with exercise, a low-cholesterol/low-fat diet, and a weight loss program if you are overweight. Follow the diet and exercise program given to you by your health care provider.


• Do NOT take more than the recommended dose without checking with your doctor.


• Tell your doctor or dentist that you take Simcor before you receive any medical or dental care, emergency care, or surgery. Simcor may need to be stopped for a few days before certain types of surgery.


• Flushing may occur with Simcor and can last for several hours. Take Simcor at bedtime so that flushing will occur during sleep, unless your doctor tells you otherwise. If you are awakened by flushing at night, get up slowly, especially if you feel dizzy or faint, or if you are taking blood pressure medicines. Taking aspirin 30 minutes before you take Simcor may lessen flushing. Talk with your doctor to see if you should take aspirin before you take Simcor or if flushing becomes bothersome.


• Muscle problems (myopathy) may occur with Simcor. The risk of muscle problems may be greater in people who take higher doses of Simcor, in people older than 64 years old, in females, or in people who have kidney problems or low thyroid function. It may also be greater in those who take it with certain other medicines (eg, niacin), especially in Chinese patients. Tell your doctor right away if you notice any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever or general body discomfort.


• Certain conditions may increase your risk of serious muscle problems. These may include dehydration; low blood pressure; major surgery or injury; severe infection; uncontrolled seizures; or serious metabolism, endocrine, or electrolyte problems. Contact your doctor right away if you develop one of these conditions.


• Diabetes patients - Simcor may increase your blood sugar levels. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• Rarely, changes to the skin, hair, and nails (eg, discoloration, dryness, hair loss) may occur. Check with your doctor if these effects become bothersome or cause you concern.


• Simcor may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.


• Simcor has niacin in it. Before you start any new medicine, check the label to see if it has niacin or nicotinamide in it too. This includes vitamins and other supplements. If it does or you are not sure, check with your doctor or pharmacist.


• Women who are able to become pregnant should use effective birth control while taking Simcor. Check with your doctor if you have questions about using birth control.


• Lab tests, including liver function, blood sugar, blood cholesterol, and creatine phosphokinase (CPK) blood levels, may be performed while you use Simcor. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Simcor with caution in the ELDERLY; they may be more sensitive to its effects, especially muscle problems.


• Simcor should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Do not take Simcor if you are pregnant. It may cause harm to the fetus. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Simcor is found in breast milk. Do not breast-feed while taking Simcor.

Possible side effects of Simcor:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; diarrhea; dizziness; flushing (eg, itching, redness, tingling, warmth); headache; nausea; runny or stuffy nose; stomach upset.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); burning, numbness, or persistent tingling; change in the amount of urine produced; dark or red-colored urine; dark, tarry, or bloody stools; decreased sexual ability; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; increased sweating; joint pain; loss of appetite; memory problems; muscle pain, tenderness, or weakness (with or without fever and fatigue); pale stools; red, swollen, blistered, or peeling skin; severe or persistent dizziness or light-headedness; severe or persistent nausea or stomach or back pain; shortness of breath; swelling of the hands, legs, or feet; trouble sleeping; unusual bruising or bleeding; unusual tiredness or weakness; vision changes; vomiting; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Simcor side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Simcor:

Store Simcor at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Simcor out of the reach of children and away from pets.

General information:

• If you have any questions about Simcor, please talk with your doctor, pharmacist, or other health care provider.


• Simcor is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Simcor. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Simcor resources

• Simcor Side Effects (in more detail)
• Simcor Use in Pregnancy & Breastfeeding
• Simcor Drug Interactions
• Simcor Support Group
• 8 Reviews for Simcor - Add your own review/rating

• Simcor Prescribing Information (FDA)


• Simcor Advanced Consumer (Micromedex) - Includes Dosage Information


• Simcor Consumer Overview

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