Zocor

[simvastatin]

Patients with Homozygous Familial Hypercholesterolemia

The recommended dosage for patients with homozygous familial hypercholesterolemia is ZOCOR 40 mg/ day in the evening or 80 mg/ day in 3 divided doses of 20 mg, 20 mg, and an evening dose of 40 mg. ZOCOR should be used as an adjunct to other lipid-lowering treatments (e. g., LDL apheresis) in these patients or if such treatments are unavailable.

Adolescents (10-17 years of age) with Heterozygous Familial Hypercholesterolemia

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The recommended usual starting dose is 10 mg once a day in the evening. The recommended dosing range is 10-40 mg/ day; the maximum recommended dose is 40 mg/ day. Doses should be individualized according to the recommended goal of therapy (see NCEP Pediatric Panel Guidelines 6 and CLINICAL PHARMACOLOGY). Adjustments should be made at intervals of 4 weeks or more.
Concomitant Lipid-Lowering Therapy
ZOCOR is effective alone or when used concomitantly with bile-acid sequestrants. If ZOCOR is used in combination with gemfibrozil, the dose of ZOCOR should not exceed 10 mg/ day (see WARNINGS,

Myopathy/ Rhabdomyolysis and PRECAUTIONS, Drug Interactions).
Patients taking Cyclosporine
In patients taking cyclosporine concomitantly with ZOCOR (see WARNINGS, Myopathy/ Rhabdomyolysis), therapy should begin with 5 mg/ day and should not exceed 10 mg/ day.

Patients taking Amiodarone or Verapamil

In patients taking amiodarone or verapamil concomitantly with ZOCOR, the dose should not exceed 20 mg/ day (see WARNINGS, Myopathy/ Rhabdomyolysis and PRECAUTIONS, Drug Interactions, Other drug interactions).

Patients with Renal Insufficiency

Because ZOCOR does not undergo significant renal excretion, modification of dosage should not be necessary in patients with mild to moderate renal insufficiency. However, caution should be exercised

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