Zocor vs. Vytorin
See how Zocor and Vytorin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Zocor is a single-ingredient statin that lowers LDL cholesterol, while Vytorin combines that same statin with ezetimibe to block cholesterol absorption for extra LDL reduction.
Vytorin's added ezetimibe component can lower LDL more than simvastatin alone, but it costs substantially more without insurance coverage.
Both drugs contain simvastatin, so they share warnings about muscle-related side effects and interactions with strong CYP3A4 inhibitors.
Zocor vs. Vytorin Drug Summary
Zocor
Zocor (simvastatin) is a statin that lowers LDL cholesterol by blocking an enzyme the liver uses to make cholesterol. It is taken as a single tablet once daily, in doses from 10 mg to 80 mg. It has been prescribed since 1991 and is now widely available as a low-cost generic.
Vytorin
Vytorin combines simvastatin, the same statin found in Zocor, with ezetimibe, a drug that blocks cholesterol absorption in the intestine. It is taken as one tablet once daily, in combined doses from 10 mg/10 mg to 10 mg/80 mg. The two-drug combination is designed to lower LDL more than a statin can on its own.
Zocor vs. Vytorin Side Effects
Zocor
Vytorin
Zocor vs. Vytorin Dosage
Zocor
Vytorin
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg/10 mg once daily | At the start |
| Maximum dose | 10 mg/80 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Zocor
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Vytorin
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg/10 mg once daily | At the start |
| Maximum dose | 10 mg/80 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Zocor vs. Vytorin Indications
Zocor
Zocor is FDA-approved to lower LDL cholesterol in adults with primary hyperlipidemia and to treat familial forms of high cholesterol. It also reduces the risk of heart attack, stroke, and death in adults with heart disease or diabetes at high cardiovascular risk. It is not approved for children under age 10.
Lowers LDL cholesterol in primary hyperlipidemia
Treats heterozygous familial hypercholesterolemia (ages 10+)
Adjunct therapy for homozygous familial hypercholesterolemia
Reduces cardiovascular event risk in high-risk adults
Vytorin
Vytorin is FDA-approved to lower LDL cholesterol, total cholesterol, triglycerides, and Apo B, and to raise HDL cholesterol in adults with primary hyperlipidemia. It is also approved for homozygous familial hypercholesterolemia and homozygous sitosterolemia. It is not approved for patients with active liver disease.
Lowers LDL, total cholesterol, and triglycerides
Raises HDL cholesterol
Treats homozygous familial hypercholesterolemia
Treats homozygous sitosterolemia
Zocor vs. Vytorin Pros and Cons
Zocor
Zocor has been used since 1991, giving it decades of long-term safety and outcome data across large populations. It is available as an inexpensive generic, which keeps it accessible for most insurance plans and cash-paying patients. Its main limitation is that, as a statin alone, it may not lower LDL enough for some patients who need additional treatment.
Pros
Decades of long-term real-world safety data
Available as a low-cost generic, roughly $75 to $100 a month without insurance
Simple single-ingredient statin with well-known interactions
Four dose strengths allow gradual titration
Cons
LDL lowering may plateau at higher doses without add-on therapy
Higher myopathy risk at the 80 mg dose, which is restricted
Single mechanism only targets liver cholesterol production
May need a second drug added for very high LDL levels
Vytorin
Vytorin combines simvastatin with ezetimibe to block cholesterol from two directions: production in the liver and absorption in the gut. The IMPROVE-IT trial showed this combination reduced major cardiovascular events compared to simvastatin alone in patients after a heart attack. Its main tradeoff is a much higher price than simvastatin alone.
Pros
Dual mechanism lowers LDL more than a statin alone
IMPROVE-IT trial showed reduced cardiovascular events post-ACS
Combines two cholesterol pathways in a single daily pill
Also approved for homozygous sitosterolemia
Cons
Costs roughly $600 to $650 a month without insurance, before savings programs
Contraindicated in active liver disease
Higher risk of elevated liver enzymes than simvastatin alone
Patients not at goal on 40 mg switch statins rather than titrate up
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