Below are questions your patients are likely to ask about SIMCOR, cholesterol and the lifestyle changes you are asking them to make to help them manage their cholesterol. Click on the question to see the corresponding answer. You may want to print this page for your patients to help them better understand SIMCOR and cholesterol. You may also want to direct your patients to the SIMCOR site for consumers, where these FAQs also appear.

Please click here for Important Safety Information you should know about SIMCOR.

Select your question below:

• What is bad cholesterol (LDL)?
• What is good cholesterol (HDL)?
• What are triglycerides?
• Why do I need to eat less saturated fat?
• What is unsaturated fat and do I need to watch how much of it I eat?
• How can fiber help my cholesterol?
• If I can manage my cholesterol with diet, why do I need SIMCOR?
• When would SIMCOR be prescribed?
• How should SIMCOR be taken?
• What are the most common side effects of SIMCOR?
• How long do I need to take SIMCOR?
• Who should not take SIMCOR?
  

What is bad cholesterol (LDL)?

Bad cholesterol is one of the three main lipids (fats) that circulate in your blood. When your bad cholesterol level is high, it can build up on the artery walls along with other substances and form plaque. Over time, this plaque can thicken and restrict blood flow. That’s why it’s important to keep your bad cholesterol (LDL) level down. According to the National Cholesterol Education Program (NCEP) guidelines, the optimal level is <100 mg/dL.² Talk with your healthcare provider about your individual risk factors and LDL cholesterol goal.

What is good cholesterol (HDL)?

Good cholesterol is another lipid (fat) found in the blood. Unlike bad cholesterol (LDL), higher levels of good cholesterol are beneficial. This is because good cholesterol helps carry the bad cholesterol (LDL) out of the arteries to the liver, where it is disposed of. According to the American Heart Association (AHA), an HDL cholesterol level less than 40 mg/dL is low for men and less than 50 mg/dL is low for women.³

What are triglycerides?

Triglycerides are sometimes referred to as the “other bad lipid.” They are carried by the blood to tissues where they can be used for energy or stored in fat cells for future use. As with bad cholesterol (LDL), increased levels of triglycerides can be a medical concern. NCEP and AHA suggest that triglycerides below 150 mg/dL are considered normal.^{2, 3}

Why do I need to eat less saturated fat?

Eating foods with high saturated fat raises your bad cholesterol (LDL) level more than anything else you eat. Saturated fat is found in greatest amounts in fatty cuts of meat, poultry with the skin, and whole-milk dairy products, and in tropical oils like coconut and palm oils. Most other vegetable oils are low in saturated fats.

What is unsaturated fat and do I need to watch how much of it I eat?

Unsaturated fat is another type of fat found in foods, but it not as harmful to your arteries as saturated fat. However, eating too much of any kind of fat can contribute to weight gain that impacts your cholesterol levels. Maintaining an overall low-fat, low-cholesterol diet can help you manage your weight and your cholesterol.

How can fiber help my cholesterol?

Soluble fiber—found in fruits, vegetables and whole grains—helps block the absorption of cholesterol and fats in the foods you eat. Increasing your daily intake of soluble fiber can help lower your bad cholesterol (LDL).

If I can manage my cholesterol with diet, why do I need SIMCOR?

Many people need help reaching their cholesterol goals, even while they follow a low-fat, low-cholesterol diet. SIMCOR is used when treatment with simvastatin alone or niacin extended-release alone is not enough, and when a diet low in saturated fat and cholesterol and other non-drug measures alone have not been successful. SIMCOR is used along with diet to lower levels of total cholesterol, bad cholesterol (LDL) and triglycerides; and to increase good cholesterol (HDL).

SIMCOR should not be used if you have liver problems, stomach ulcers, or serious bleeding problems; in women who are pregnant, may become pregnant, or nursing; and if you are allergic to any product ingredient.

When would SIMCOR be prescribed?

SIMCOR is a combination of two medicines in one pill: simvastatin and niacin extended-release.¹ Both are proven to help manage cholesterol:

• Simvastatin is widely used to lower bad cholesterol (LDL)
• Niacin extended-release is widely used to raise good cholesterol (HDL) and lower triglycerides

SIMCOR is used when treatment with simvastatin alone or niacin extended-release alone is not enough, and when diet and other non-drug measures alone have not been successful. Patients should stay on a diet low in saturated fat and cholesterol while taking this medicine. No additional benefit of SIMCOR on heart disease over and above that shown for niacin alone and simvastatin alone has been demonstrated.

SIMCOR should not be taken by people with liver problems, stomach ulcers, or serious bleeding problems; in women who are pregnant, may become pregnant, or nursing. Contact a health care provider if serious side effects such as unexplained muscle pain, tenderness or weakness develop. This may be a sign of a serious but rare muscle disorder. Blood tests are needed before and during treatment with SIMCOR to check for liver problems. Increases in blood sugar can occur. The most common side effect of SIMCOR is flushing (warmth, redness, itching, and/or tingling of the skin).

How should SIMCOR be taken?

SIMCOR is taken as a once-daily dose. For best results, follow these instructions for taking SIMCOR:

• Talk to your doctor about taking an aspirin or a non-steroidal anti-inflammatory medication (e.g., ibuprofen) approximately 30 minutes before taking SIMCOR to help manage flushing
• Take SIMCOR at bedtime
• To minimize stomach upset, take SIMCOR with a low-fat snack
• Avoid hot or alcoholic beverages and spicy food near the time of taking SIMCOR
• Do not take SIMCOR on an empty stomach
• Swallow the tablets whole; do not crush, break or chew them

What are the most common side effects of SIMCOR?

Patients who take SIMCOR may experience flushing. This is a common side effect associated with the niacin extended-release component of SIMCOR. Flushing is a warmth, redness, itching and/or tingling that can occur on your face, neck, chest, and/or back. It is caused by increased blood flow to the surface of the skin. If this happens to you, remember:

• Flushing typically happens when you start taking SIMCOR or when the dosage is increased
• If awakened by flushing at night, you should get up slowly, especially if feeling dizzy, faint, or taking blood pressure medications
• For some, flushing may be more intense, and additional symptoms, such as dizziness or fainting, rapid or pronounced heartbeat, shortness of breath, sweating, chills, and/or swelling may occur. Notify your doctor if dizziness or fainting occurs.
• Flushing is a common side effect that may subside after several weeks of consistent SIMCOR use.

Other common side effects may include headache, itching, nausea, back pain, and diarrhea.

How long do I need to take SIMCOR?

SIMCOR is intended as a long-term treatment to help you reach and then maintain optimal cholesterol levels. Do not stop taking SIMCOR or change your dose of SIMCOR without speaking with your doctor.

Who should not take SIMCOR?

SIMCOR should not be used if you have liver problems, stomach ulcers, or serious bleeding problems; in women who are pregnant, may become pregnant, or are nursing; and if you are allergic to any product ingredient.

Contact your health care provider if symptoms of unexplained muscle pain, tenderness, or weakness occur, as this may be a sign of a serious but rare muscle disorder, from which rare cases of death have occurred.

1. SIMCOR [package insert]. North Chicago, IL: Abbott Laboratories.
2. Third Report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III). Circulation. 2002;106:3143-3421.
3. Cholesterol levels. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4500. Accessed April 26, 2009.