Wintergreen Medical Center
324-A Beacon Drive
Winterville, NC  28590
Office 252-551-5595
Fax     252-321-7762
Calvin Ellis, PA-C
Leslie Sexton, PA-C
Bob Barwick, PA-C
Simvastatin Warnings

1.  For the actual wording approved by the FDA (Food and Drug Administration), and published by Merck,
the manufacturer of Zocor (simvastatin) and Vytorin (simvastatin and ezetimibe), go to  
www.simvastatininfocenter.com.

2. The issues that are associated with higher doses of simvastatin that are the subject of this warning are
moderate muscle damage (myopathy) and severe muscle damage (rhabdomyolysis).

3.  Simvastatin comes in 10mg, 20mg, 40mg and 80mg tablets.

4.  If you have taken 80mg of simvastatin for more than 12 months, and have had no significant problems
with muscle damage/pain, then there is no need to stop it.

5  The risk of severe muscle damage on simvastatin 80mg is 4 cases per 1000 patients taking 80 mg.

6.  The risk of moderate muscle damage on simvastatin 80mg is 6 cases per 1000 patients taking 80 mg.

7.  The risks of muscle damage on lower strengths are significantly less, depending on the strength of the
drug.

8.  If you take verapamil, diltiazem, or amlodipine (common blood pressure meds) and take more than
40mg, please call our office for an appointment.  We may need to modify your dosage of simvastatin or
change it to another medication.

9   In our opinion, this warning is unfortunate, since simvastatin 80mg is very potent at lowering very high
LDL cholesterol levels.  The only other meds that lower LDL cholesterol as much as simvastatin 80mg,  are
Lipitor 40mg or higher, and Crestor, and both of these are currently NOT available as generic.

10. If you have any further questions regarding simvastatin, please call our office at 551-5595 for an
appointment.

11. For a 2 page summary of medications to avoid on simvastatin and a summary of the above information,
please click here for a pdf copy.