Vazilip, analogi yaku Russia ya mankhwala omwe ali ndi mitengo ndi ndemanga

- hypercholesterolemia yoyamba ya mitundu IIa ndi IIb, kuphatikizapo polygenic hypercholesterolemia, heterozygous cholowa hypercholesterolemia ndi hyperlipidemia yosakanikirana. Mankhwalawa amagwiritsidwa ntchito ngati monotherapy panthawi yomwe zakudya ndi njira zina zochizira sizikukwanira.

- Kuchepetsa kufa kwa mtima ndi chikhodzodzo mwa odwala omwe ali ndi matenda a mtima kapena matenda a shuga, omwe amakhala ndi cholesterol yokhazikika kapena yokwera kuti athe kuwongolera zina zomwe zingayambitse ngozi komanso mtima.

Zokambirana za mankhwala a Vasilip zolembedwa za amayi

. Tformin amathandizira magazi a fibrinolytic magazi mwa kuponderezana ndi inhibitor ya minofu ya mtundu wina wa "plasminogen activator inhibitor." G adati cholesterol iyenera kuchepa. Ngati sichitha, ndiye kuti Vasilip. Ndili ndi magazi ambiri - hemoglobin-154. Ndimalemera kale mapiritsi.

. Ngati mumatenga zovuta za Oksilik, sizikuchepetsa kwenikweni, koma mumakhala ndi mwayi woyesa l-thyroxine Metformin adakulamulirani kuti mufulumizitse kagayidwe kazakudya komanso kugwiritsa ntchito shuga, mawu anu pa Vasilip ndi chitsimikizo kuti mankhwalawa sakukhudzana ndi iwo eni - izi zinali zokumana nazo payekha. Vasilip sanandithandizirenso - ndinamwa Roxer kwa miyezi 3. Ma cookie oterewa, omwe amakhala ngati ma yarins, jannins ndi diana - amangowononga mazira anu, koma osakhudza kuchuluka kwa LH, ngakhale mutakhala kuti muli ndi prolactin OK, zomwe zikutanthauza zambiri)) ) Utrozhestan ayenera kuledzera ndipo osasiya ngati pakufunika kutero mmodzi, osati awiri. Mavitamini amakhala mu gawo loyamba la glutamic acid katatu patsiku pa piritsi kuyambira 5 mpaka 15 DC + foil + iodine, komanso kuyambira 16 mpaka 2.

2. Zotsutsana

Malinga ndi malangizo, vasilip imaphatikizidwa mu:

• matenda osiyanasiyana a chiwindi mu gawo yogwira,
• kuchuluka kwa chiwindi transaminase ochokera kosadziwika,
• kugwiritsa ntchito vascom ndi zoletsa,
• Hypersensitivity pazomwe zimapanga mankhwala,
• mimba.

Chenjezo limalangizidwa kugwiritsa ntchito mankhwalawa pazinthu zotsatirazi:

• pamaso pa mbiri yakale ya matenda a chiwindi,
• ndi kuphwanya kwambiri dongosolo la endocrine,
• ndi matenda a metabolic
• ndi matenda oopsa, mwachitsanzo, sepsis,
• ndi ochepa hypotension (kupsinjika kuposa zomwe zakhazikitsidwa),
• Ndi kuvulala ndi mikwingwirima ya magawo osiyanasiyana,
• ndi mawonekedwe osalamulirika a khunyu,
• ndi myopathy (wotchedwa matenda osachiritsika, omwe amapita patsogolo, omwe minyewa ya minofu imalephera),
• nthawi ya opaleshoni,
• ndi kumwa mowa mwauchidakwa.

3. Zotsatira zoyipa

Vasilip amatha kupereka zovuta pa thupi la munthu, zomwe ambiri ndi:

Matendawa, kulephera kupweteka kwa impso, palpitations, kuchepa kwa kugonana ndizosowa.

4. Njira makonzedwe a mankhwala

Vasilip amatengedwa pakamwa, ndipo mlingo umatha kukhazikitsidwa malinga ndi zomwe zikuwonetsa komanso kuchuluka kwa matendawa kuchokera ku 5 mpaka 80 mg (mlingo waukulu wa mankhwalawa umagwiritsidwa ntchito pochiza kwambiri hypercholesterolemia kapena pamaso pa chiwopsezo chovuta kwambiri pantchito yoyendetsa mtima.

Nthawi yovomerezeka imasankhidwa ndi dokotala wokhazikika. Mlingo wapamwamba ndi 10 mg ya mlingo umodzi tsiku lililonse, ndipo malinga ndi mawonekedwe apadera mankhwalawa amawonjezeka nthawi 2-8.

Sinthani mlingo wa mankhwalawa osaposa 1 nthawi pamwezi.

5. Zochita Zamankhwala

1. Mankhwalawa amatha kupititsa patsogolo zotsatira za anticoagulants, omwe angayambitse magazi.
2. Zimawonjezera kuchuluka kwa Digoxin m'magazi, chifukwa chake, odwala omwe ali ndi chithandizo chotere amafunika kuyang'aniridwa ndi madokotala.

Kuyang'anira munthawi yomweyo ndi cytostatics ndi antifungal agents (ketoconazole, Itraconazole), ma fibrate, milingo yayitali ya nicotinic acid, immunosuppressants, ndi proteinase inhibitors kwambiri kumawonjezera chiopsezo cha rhabdomyolysis.

6. Mankhwala osokoneza bongo

Pali milandu yodutsa muyeso wa Vasilip, komabe, sizinachititse zovuta komanso kuphwanya kwakukulu. Ngakhale zili choncho, ngati mankhwala ambiri ali ndi mankhwalawa, ndikofunikira kutenga ma enterosorbents ndikumatsuka m'mimba, ndikuwunika mayendedwe amthupi, makamaka impso ndi chiwindi.

7. Kutulutsa mawonekedwe ndi moyo wa alumali

Mankhwalawa amapangidwa ndi makampani azachipatala momwe amapangira mapiritsi omwe amakhala atapangidwa filimu panja.

Piritsi limodzi litha kukhala la mitundu yosiyanasiyana - 10 mg, 20 mg, 40 mg.

Mu phukusi - 14 kapena 28 zidutswa.

Moyo wa alumali wa Vasilip ndi zaka zitatu.

Zofananira zodziwika bwino ndi mankhwala a Vasilip:

Pamaukonde a mankhwala, mankhwalawo amagulitsidwa pamitengo yotsatirayi (kutengera mlingo):

• ku Russia - kuyambira 328 mpaka 587 rubles,
• ku Ukraine - kuchokera pa 82 mpaka 148 hhucnias.

Odwala omwe amamwa mankhwalawa adawona kuchepa kwa mafuta m'thupi, kuwongolera zochitika, komanso kuthana kwa mankhwalawa.

Komabe, izi zikuwonetsa kuwonetsa zovuta zoyipa zomwe zimasowa kumapeto kwa kutenga Wazilip. Mutha kuwerenga mwatsatanetsatane ndemanga za odwala omwe adagwiritsa ntchito Vazilip kumapeto kwa nkhaniyi.

11. Malangizo apadera

1. Musanayambe chithandizo ndi Vazilip, muyenera kuchita zowerengera za mawonetsedwe a chiwindi ndikuwunikanso zochitika za chiwindi transaminases pakatha miyezi 1.5-2. Odwala omwe amalandira simvastatin tsiku lililonse pamlingo waukulu (80 mg) nthawi zambiri amayang'aniridwa kuti azichita chiwindi - kamodzi pakatha miyezi itatu. Ndi kuchuluka kwa ntchito ya transaminases, mankhwala a Vasilip atha.
2. Odwala a myasthenia gravis, myalgia, kapena chizindikiro chowonjezeka cha CPK mankhwala omwe ali ndi mankhwalawo ayimitsidwa.
3. Simvastatin siyikulimbikitsidwa ngati pali chiopsezo cha rhabdomyolysis kapena kulephera kwa aimpso (chifukwa cha ochepa hypotension, matenda opweteka kwambiri, kusokonezeka kwakukulu kwa metabolic, kuvulala).
4. Zida za Vasilip zimakhudza chitukuko cha mwana wosabadwayo, chifukwa chake, mankhwalawa sayenera kuperekedwa pochizira amayi apakati. Ngati kutenga pakati kumachitika panthawi ya mankhwala ndi Vazilip, ndiye kuti mankhwalawo amasiya.
5. Mankhwala amagwira onse mu monotherapy komanso osakanikirana ndi bile acids.
6. Vuto lofunikira la mankhwala a Vasilip wodwala ali pachakudya cha cholesterol.
7. Ngati mulibe mlingo wa mankhwalawa, muyenera kumwa mankhwalawa posachedwa popanda kutero.
8. Ngati pakumva ululu wosadziwika m'mitsempha, wodwala amalimbikitsidwa kufunsa dokotala.

Pharmacological zochita za mankhwala

The yogwira Vasras ali lipid-kutsitsa kwenikweni ndipo amachepetsa mafuta m'thupi m'madzi a m'magazi. Mankhwala amagwira mtima matenda a mtima, chifukwa amachepetsa chiopsezo cha myocardial infarction. Zomwe achire amagwiritsidwa ntchito ngati vasilip amakula kwakanthawi kwa milungu iwiri, ndipo kuchuluka kwake kumachitika pakatha mwezi umodzi wogwiritsidwa ntchito tsiku ndi tsiku.

Kuphatikiza apo, Vasilip, malinga ndi ndemanga, amakhalanso ndi anti-atherosulinotic athari, yokhudza zigawo zamagazi ndi makoma amitsempha yamagazi.

Kodi zimapangidwa bwanji

Vasilip amapezeka mu mawonekedwe a mapiritsi oyera okhala ndi mafilimu okhala ndi 10, 20 ndi 40 mg ya yogwira mankhwala simvastatin. Mapiritsi 7 pachimake.

Ngati ndi kotheka, mankhwalawa akhoza kuthandizidwa ndi imodzi mwa fanizo la Vazilip - Simpacor, avestatin, holvasim, atherostat, simvakard, actalipid, zokor, simgal, vasilip, zorstat, aries, simvor, simvagheksal, simvalimit, simvastatin, simlo, sincard kapena zovatin.

Pomwe simungathe kusankha

Malinga ndi malangizo, Vasilip adalembedwa kuti agwiritse ntchito ndi:

• Matenda a chiwindi mu gawo yogwira, komanso kuwonjezereka kwa ntchito ya hepatic transaminases ya etiology yosadziwika,
• Kugwiritsa ntchito limodzi ndi CYP3A4 isoenzyme zoletsa, kuphatikiza erythromycin, itraconazole, clarithromycin, ketoconazole, HIV protease inhibitors, nefazodone ndi telithromycin,
• Hypersensitivity pamagawo a Vasilip.

Komanso, mankhwalawa, monga ma Vazilip analogues, sayenera kugwiritsidwa ntchito panthawi yomwe ali ndi pakati, zaka zakubadwa 18, pamene mkaka wa m'mawere, mukakonzekera kutenga pakati kapena ngati akuwakayikira.

Vasilip amagwiritsidwa ntchito mosamala mu:

• Mbiri ya matenda a chiwindi,
• Mavuto akulu a endocrine ndi metabolic,
• Matenda owopsa, kuphatikizapo sepsis,
• Maganizo ankhondo,
• Kuvulala
• Khunyu yosalamulirika,
• Myopathy
• Zowonjezera kuchitidwa opaleshoni,
• Mowa, makamaka musanayambe mankhwala,
• Lactase akusowa
• Mulingo wamphamvu wamagetsi,
• Galactosemia kapena glucose-galactose malabsorption syndrome,
• Munthawi yomweyo makonzedwe a cyclosporine, fenofibrate, gemfibrozin, verapamil, nicotinic acid, amiodarone, diltiazem ndi madzi a mphesa.

Njira ntchito vasilip

Malinga ndi malangizo, Vasilip amatengedwa pakamwa kamodzi m'madzulo, mlingo kutengera matendawa umatha kuchoka pa 5 mg mpaka 80 mg, womwe umangotengedwa ndi hypercholesterolemia yayikulu kapena chiwopsezo cha matenda amtima. Kutalika kwa ntchito ya vasilip kumatsimikiziridwa payekha ndi dokotala wopita.

Nthawi zambiri, pochiza hypercholesterolemia, Vasilip amatengedwa 10 mg kamodzi, monga momwe zikuwonekera, njira yochizira imatha kuchuluka 2 kapena 4. Malinga ndi ndemanga, Vasilip ndiwothandiza pamene akuwona zakudya za hypocholesterol nthawi yonse ya chithandizo.

Ndi homozygous cholowa hypercholesterolemia, Vasilip amapatsidwa 40 mg kamodzi madzulo kapena 80 mg ya mankhwalawa, ogaŵikana 3 Mlingo, kuphatikizapo hypolipidemic mankhwala.

Pokhala ndi chiopsezo chachikulu chotenga matenda a mtima, Vasilip amatengedwa 20-40 mg patsiku malinga ndi malangizo. Mutha kusintha mankhwalawa osapitirira kamodzi pamwezi.

Malinga ndi ndemanga, Vasilip imagwira ntchito yonse mu monotherapy komanso kuphatikiza ndi colestyramine, amiodarone, colestipol, gemfibrozil, cyclosporine ndi ena michere kapena nicotinic acid.

Mukamagwiritsa ntchito Vasilip, sikulimbikitsidwa kuti muzidya madzi ambiri (oposa lita imodzi) a madzi a mphesa.

Zotsatira zoyipa za vasilip

Malinga ndi ndemanga, Vasilip nthawi zambiri samatsogolera pakupanga zotsatira zoyipa, zomwe zimawoneka ngati:

• Pancreatitis, kupweteka kwam'mimba, kudzimbidwa, mseru, kugona mosachedwa, jaundice, dyspepsia, kusanza, kutsekula m'mimba ndi chiwindi,
• Paresthesia, zotumphukira neuropathy, kusawona bwino, kugundana, chizungulire, asthenia, kupweteka mutu, kusowa tulo komanso kuphwanya kwamvekera kwa kukoma,
• Rhabdomyolysis, myopathy, minofu kukokana ndi myalgia,
• Zotupa pakhungu, alopecia, ndi pruritus,
• Nyamakazi, lupus-like syndrome, eosinophilia, kufooka kwambiri, angioedema, dermatomyositis, kutentha thupi, kuchuluka kwa ESR, urticaria, polymyalgia rheumatism, vasculitis, thrombocytopenia, arthralgia, photosensitivity, kuzizira kwa nkhope komanso kufupika.
• Pachimake aimpso kulephera, palpitations, kuchepa magazi, ndi kuchepa potency.

Vasilip - Ndemanga za Vasilip - Mtengo wa Vasilip

Vasilip ndi mankhwala ena ochokera ku gulu la ma statins, ndiye kuti, mankhwala omwe amatha kutsitsa cholesterol m'magazi a anthu. Amapangidwa pamaziko a simvastatin - chinthu chomwe chimapezeka kuchokera ku zinthu zachilengedwe (bowa).

Monga kukonzekera komweko, wina angatchule, mwachitsanzo, Atoris, yomwe idakhazikitsidwa ndi atorvastatin - chinthu chopangidwa. Mphamvu ya vasilip imayamba kuonekera (pakumayang'aniridwa ndikuwongolera magazi) masabata awiri atayamba chithandizo. Kuchuluka kwa mankhwalawa kumawonedwa pakatha mwezi umodzi ndi theka.

Kuchepetsa bwino kwa kuchuluka kwa cholesterol ndi mafuta ena (triglycerides ndi zina zotero) kumachepetsedwa ndikofunikira kuti nthawi ndi nthawi mupereke magazi “mwa biochemistry”. Zizindikiro za Vasilip zitha kupezedwa komanso kukhala ndi cholowa cha mitundu ina ya hypercholesterolemia.

Kuphatikiza apo, kupewa komanso kuchiza matenda a atherosulinosis, matenda a mtima, komanso mavuto ena amitsempha omwe amayenda ndi mafuta am'magazi amatha ndipo ayenera kuthandizidwa ndikugwiritsa ntchito mankhwalawa.

Vasilip amapezeka piritsi. Chiwembu chofunikira kwambiri pakusankha pang'onopang'ono kwa mlingo, womwe umafotokozedwa ndi malangizo a mankhwala. Kuyambira ndi mlingo wocheperako wa Vazilip, adotolo amayenera kuwunika momwe wodwala alili komanso asinthe nthawi yoikidwiratu (kuwonjezera mlingo) osapitiliza kamodzi pamwezi.

Mofananamo, wodwalayo ayenera kutsatira zakudya zapadera, apo ayi mankhwala a statin angotaya tanthauzo lake.

Dotolo wofotokozera Vasilip amayeneranso kuwunika wodwala matenda a chiwindi ndi impso, kudziwa zomwe amamwa, zomwe ali ndi moyo wake ... Mwanjira ina, ma statins, ngakhale amatha kusintha kwambiri cholesterol, ayenera kuthandizidwa mosamala kwambiri, Kuwona momwe zikuwonekera pakapita nthawi.

Vasilip ali wodziwika matenda a impso, chiwindi, tsankho, pakati ndi kuyamwa, ana ndi achinyamata. Ngati mayi amagwiritsa ntchito mankhwalawa, ayenera kudziteteza mosamala ku mimba yosakonzekera. Ngati wodwalayo akufuna kubereka, sayenera kutenga Vasilip.

Zotsatira zoyipa za vasilip

Pogwiritsa ntchito mankhwalawa moyenera, kuwunika kwa nthawi yayitali momwe magazi alili komanso kugwira ntchito kwa machitidwe oyamba a thupi, mawonekedwe awonetsero osafunikira amafotokozedwa kuti "osowa" (ndiye kuti, mlandu umodzi wani mpaka 10,000 miliyoni wa chithandizo cha Vasilip).

Chimbudzi, dongosolo lamanjenje, minyewa ingakhudzidwe. Mwachitsanzo, milandu ya kusokonezeka kwa chiwindi, kupweteka mutu, kupweteka kwa minofu, kukokana ndi zina zotero.

Mawonekedwe a mziwopsezo amatha kukhala osiyana - kuchokera ku totupa tofiyira mpaka mankhwala osapatsa chidwi.

Mapiritsi a Vasilip: zikuwonetsa kugwiritsa ntchito, kuwunika kwa odwala

Vasilip ndi mankhwala osokoneza bongo omwe amatsitsa lipid.Tanthauzo lalikulu la chochitikacho ndikuti likufuna kutsitsa mulids (mafuta) m'magazi. Vasilip amapezeka mwa mawonekedwe a mapiritsi oyera mu membrane wa filimu, ozungulira, pang'ono pang'onopang'ono mbali zonse ziwiri.

Chofunikira chachikulu chaantchitoyi ndi simvastatin. Mulinso zinthu zina monga lactose monohydrate, pregelatinized starch, anhydrous citric acid, vitamini C, starch chimanga, magnesium stearate ndi microcrystalline cellulose. Chipolopolo cha piritsi palokha chimakhala ndi talc, propylene glycol, hypromellose ndi titanium dioxide.

Mlingo wa mankhwalawa ndi wa mitundu iwiri - 20 ndi 40 mg uliwonse.

Limagwirira ntchito vas vas

Popeza Vasilip ndi wa mankhwala ochepetsa lipid, momwe amagwirira ntchito ndioyenera. Choyamba, vasilip imachepetsa kuchuluka kwa mafuta m'thupi m'magazi. Pali mitundu iwiri ya cholesterol - "yoyipa" ndi "yabwino". "Choipa" ndi lipoproteins yotsika pang'ono, ndipo "chabwino" ndi lipoprotein yapamwamba.

Vasilip imakhudzanso gawo loyambirira la mapangidwe a cholesterol. Zimaphatikizapo kutembenuka kwa HMG-CoA (hydroxymethylglutaryl coenzyme A) kukhala mevalonic acid. Kusintha uku kumachitika mothandizidwa ndi enzyme HMG-CoAreductase.

Vasilip imakhumudwitsa enzyme iyi, chifukwa chomwe cholesterol imangokhala. Mankhwalawa amakhudzanso cholesterol, yomwe ili kale m'thupi.

Amachepetsa kuchuluka kwa cholesterol yogwirizana ndi otsika osalimba lipoprotein, komanso amachepetsa ndende ya triglycerides.

Ndizinthu zamtundu wa lipid zomwe ndizomwe zimayambitsa mapangidwe a atherosulinotic ku lumen ya mitsempha. Koma mankhwalawa amachulukitsa cholesterol "yabwino" - yolumikizana ndi lipoproteins yapamwamba. Mlingo wa apolipoprotein B, puloteni yapadera yonyamula mafuta omwe amayendetsa mafuta m'thupi monse, amachepetsedwa.

Kuphatikiza pa kuchepetsa milingo yamitundu ina ya lipids, chinthu chachikulu cha Vasilip chimakhudza khoma la mtima ndi magazi omwe.

Zinthu zamagazi monga macrophages, zomwe zimatsogolera pakupanga kwa cholesterol amana, zimalepheretseka ndi mankhwalawo, ndipo zolembera zimawonongeka.

Komanso kapangidwe kazinthu zomwe zimatchedwa isoprenoids, zomwe zimapangitsa kukula kwa maselo am'mimba mwa ziwiya, zimachepetsedwa kwambiri, chifukwa chake khoma la zotengera silinatope, ndipo mawonekedwe awo samakhala ochepa. Kuphatikiza apo, Vasilip amapaka bwino mitsempha yamagazi ndikuyenda bwino kwa magazi.

Zambiri za pharmacokinetics za vasilip

Vasilip wameza. Imayamwa bwino kudzera pa khoma la matumbo aang'ono.

Kuchuluka kwa mankhwalawa kumawonedwa ola limodzi ndi awiri pambuyo pokhazikitsa, koma pambuyo maola 12 amatsikira mpaka 10%. Mankhwalawa amatha kumwa ndi chakudya, izi sizingakhudze zotsatira zake.

Komanso siziunjikira m'thupi pogwiritsa ntchito nthawi yayitali. Mankhwalawa amamangidwa kwambiri kuma protein a magazi, pafupifupi 100%.

Vasilip amasinthidwa kukhala othandizira m'chiwindi. Pulogalamuyi imatchedwa beta hydroxy acid. Kutulutsa kwake (kuchotsedwa) kumachitika kudzera m'matumbo akulu. Mankhwalawa amachotseredwa mu mawonekedwe a metabolites (zida zotembenuka).

Gawo lake laling'ono limachotsedwa impso, koma mawonekedwe ake osafunikira amapezeka kudzera mu impso.

Zizindikiro ndi contraindication kuti mugwiritse ntchito

Madokotala nthawi zambiri amapereka mankhwala a vasilip matenda monga atherosulinosis. Komanso ndizofala kwambiri kwa hypercholesterolemia kapena dyspidemia wosakanikirana (kuphwanya kuchuluka kwa milomo yosiyanasiyana yamagazi) molumikizana ndi zochitika zolimbitsa thupi, kuchepa thupi, kutsatira zakudya zomwe zakhazikitsidwa, kapena chifukwa cha mankhwala ena.

Chizindikiro chinanso ndi homozygous cholowa cholowa hypercholesterolemia. Mwachilengedwe, mofanananira, zakudya ndi kudya zina za anti-atherosulinotic mankhwala ziyenera kutsatiridwa.

Vasilip adapangidwanso kuti apewe matenda a mtima ndi matenda amtundu wa chifuwa kapena matenda ashuga, popeza pamakhala chiopsezo cha matenda amtima, minyewa komanso matenda osiyanasiyana a mtima.

Ndipo yomaliza imangokwezedwa cholesterol posakhalapo mawonetseredwe azachipatala.

Vasilip amatsatiridwa pazinthu monga:

• matenda a chiwindi mu siteji kapena pachimake,
• kuchuluka kwakanthawi kwa ma enzymes a chiwindi popanda chifukwa chokhazikika,
• Mimba ndi kuyamwa
• zaka zazing'ono
• thupi lawo siligwirizana ndi simvastatin kapena zina zilizonse za mankhwala.

Iyenera kuthandizidwa makamaka kwa odwala omwe ali ndi matenda otsatirawa:

1. Ndi kumwa kwambiri.
2. Pamaso pa matenda okhudza chiwindi.
3. Kupezeka kwa kusalinganika kwa electrolyte mthupi.
4. Zoyipa zazikulu za endocrine system ndi metabolism.
5. Nthawi zonse kuchepetsedwa kupanikizika (hypotension).
6. Zilonda zam'mimba za thupi.
7. Matenda a minofu.
8. Khunyu yopanda vuto.
9. Opaleshoni yayikulu kapena kuvulala koopsa.
10. Kupanda lactase, enzyme yomwe imaphwanya lactose (shuga ya mkaka).
11. Kuphwanya njira za mayamwidwe lactose.

Malangizo ogwiritsira ntchito mankhwalawa

Musanagwiritse ntchito mankhwalawa, muyenera kufunsa dokotala kuti amwe momwe angamwere bwino komanso kuti adziwe tanthauzo la zakumwa zake. Njira yodziwika bwino yoyenera kumwa mankhwalawa ndi kumwa mapiritsi kamodzi kapena kawiri pa tsiku asanagone.

Ndikulimbikitsidwa kumwa mankhwalawa usiku, chifukwa usiku, kaphatikizidwe wa cholesterol yambiri umachitika, ndipo zotsatira za mankhwalawo zimayamba kutchulidwa. Nthawi zambiri yambani ndi 10 mg. Mlingo wovomerezeka waukulu ndi 80 mg patsiku.

Amalembera odwala omwe ali ndi mitundu yapamwamba yamatenda, komanso pachiwopsezo cha zovuta zochokera mumtima ndi m'mitsempha yamagazi. Mlingo wofunikira nthawi zambiri amasankhidwa pakatha mwezi umodzi.

Kutalika kwa nthawi ya maphunzirowa amasankhidwa mosiyanasiyana kwa wodwala aliyense ndi madokotala.

Tiyenera kukumbukira kuti mukatenga Wazilip, wodwala payekha amakhala ndi zakudya zomwe ayenera kutsatira. Nthawi zina, mankhwala ena okhala ndi lipid amachepetsa.

Kwa odwala omwe ali ndi matenda monga hypercholesterolemia, chithandizo chimayamba ndi 10 mg, koma amatha kuchulukitsidwa mpaka 40 mg kuti akwaniritse tanthauzo lake.

Kwa mtundu wobadwa nawo wa matendawa, Vazilip imagawika katatu ngati mlingo wokwanira umaperekedwa (80 mg), kapena 40 mg ya mankhwalawa ndi mankhwala kamodzi tsiku limodzi asanagone.

Vasilip ali ndi kufunika komwe kumagwiritsidwa ntchito kamodzi komanso molumikizana ndi ma anticholesterolemic othandizira, makamaka, ndi bile acid sequestrants. Awa ndi mankhwala monga colestyramine, colestipol.

Pogwiritsa ntchito cyclosporine, gemfibrozil, nicotinic acid kapena mankhwala ena am'magulu ena a mafupawo, amayamba ndi 5 mg, ndipo mlingo wovomerezeka ndi 10 mg.

Pankhaniyi, simuyenera kupitilira muyeso uwu.

Ngati wodwala amwa mankhwala osokoneza bongo motsutsana ndi arrhythmia ndi kuthamanga kwa magazi, monga Amiodarone ndi Verapamil, ndiye kuti mlingo wa Vasilip suyenera kupitanso 20 mg patsiku, popeza kusakhazikika kwawo sikumakhazikika.

Ngati munthu akuvutika kwambiri ndi vuto la aimpso, momwe kuchuluka kwa kusefedwa kwa glomerular sikupitirira 30 ml / min., Ndiye kuti Vasilip amapatsidwa mlingo wosaposa 10 mg patsiku. Mlingo uyenera kuchuluka kwambiri, ndipo pankhaniyi wodwala ayenera kuyang'aniridwa pafupipafupi.

Kutulutsa mawonekedwe ndi kapangidwe kake

Vasilip amapangidwa mwanjira ya mapiritsi oyera (ma 7 ma PC. Mu chithuza), omwe amaphatikizika ndi nembanemba wamafilimu.

Malangizo ogwiritsira ntchito Vasilip (njira ndi Mlingo)

Mapiritsiwo amapangidwira kukonzekera pakamwa, kamodzi madzulo.

Mlingo woyenera umasiyanasiyana kuyambira 5 mg mpaka 80 mg kamodzi tsiku lililonse madzulo. Mlingo woyambirira wa mankhwalawa ndi 10 mg. Kusintha kwa Mlingo uyenera kuchitika pafupipafupi kwa masabata anayi.

Mulingo wovomerezeka tsiku lililonse umafikira 80 mg. Amangoperekedwa kwa odwala omwe ali ndi chiopsezo cha mtima wamtima kapena hypercholesterolemia yayikulu.

Kutalika kwa mapiritsi kumatsimikiziridwa ndi dokotala aliyense payekhapayekha.

Hypercholesterolemia

Munthawi yonse ya chithandizo, wodwalayo ayenera kutsatira zakudya zapamwamba za hypocholesterol. Mlingo woyambira wa odwala omwe ali ndi hypercholesterolemia ndi 10 mg. Kuti mupeze kuchepa kwambiri kwa LDL-C, mankhwalawa amatha kuyamba kuyambira 20 mpaka 40 mg patsiku (kamodzi madzulo).

Odwala omwe ali ndi homozygous cholowa hypercholesterolemia, tsiku lililonse mlingo ndi 40 mg madzulo kapena 80 mg mu 3 Mlingo wogawika (20 mg m'mawa, 20 mg masanawa ndi 40 mg madzulo).

Mtima Kupewa matenda

Odwala odwala kapena opanda hyperlipidemia, omwe ali ndi chiopsezo chachikulu cha matenda a mtima, mankhwala olimbitsa ndi 20 mpaka 40 mg patsiku. Chifukwa chake, mlingo woyambira umafika pa 20 mg patsiku.

Kusintha kwa Mlingo uyenera kuchitika pakadutsa masabata anayi. Ngati ndi kotheka, mlingo utha kuwonjezeka mpaka 40 mg patsiku.

Ngati zomwe zili LDL ndizochepera 75 mg / dl (1.94 mmol / L), zonse zomwe zimakhala m'mafuta a cholesterol ndizochepa kuposa 140 mg / dl (3.6 mmol / L), mlingo uyenera kuchepetsedwa.

Chithandizo chothandizirana

Vasilip imagwira bwino ntchito ndi bile acid sequestrants kapena monotherapy. Odwala omwe amalandira chithandizo ndi gemfibrozil, cyclosporine, nicotinic acid kapena ma fiber ena (oposa 1 g patsiku), koyamba mlingo ndi 5 mg. Mulingo wovomerezeka tsiku lililonse wa mankhwalawa ndi 10 mg. Kupitilira muyeso wa mankhwala osavomerezeka.

Odwala omwe amatenga verapamil kapena amiodarone, tsiku lililonse mankhwalawa sayenera kupitirira 20 mg.

Mankhwala

Simvastatin - yogwira Vasas, ndi lipid-kutsitsa wothandizidwa amapangidwa kuchokera ku nayonso mphamvu mankhwala Aspergillus terreus.

Pambuyo pakukonzekera pakamwa, simvastatin, yomwe imagwiritsa ntchito lactone, imadutsa hydrolysis mu chiwindi, ndikupanga mawonekedwe ofanana a β-hydroxy acid pazinthu. Ndi metabolite yayikulu ndipo imakhala ndi zochita zambiri motsutsana ndi HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) -reductase, enzyme yomwe imayambitsa kuphatikizira kwachilengedwe (gawo loyambirira komanso lofunikira kwambiri) la cholesterol.

Kuchita bwino kwa simvastatin pakuchepetsa kuchuluka kwa plasma ya cholesterol yathunthu, cholesterol yathunthu, mafuta a LDL cholesterol, otsika kachulukidwe lipoprotein cholesterol, triglycerides ndi kachulukidwe kochepa kwambiri ka lipoprotein cholesterol, ndikuwonjezera cholesterol ya HDL (high lipoprotein cholesterol) kachulukidwe) m'magazi am'magazi odwala a heterozygous achiberekero / osagwirizana a hypercholesterolemia kapena hyperlipidemia nthawi pamene kuchuluka kwa plasma ndende ya magazi m'magazi ndi chimodzi mwazinthu Chiwopsezo komanso kusankhidwa kwa chakudya chimodzi sikokwanira. Njira yowoneka bwino yochizira imawonedwa pakadutsa masiku 14 mutatenga simvastatin, yomwe ndi yayitali pakadutsa masabata 4-6 kuyambira pakuyamba kugwiritsa ntchito. Ndi mankhwala omwe akupitilira, zotsatira zake zimapitilira. Kuchulukana kwa plasma ya cholesterol ataletsa kugwiritsa ntchito simvastatin m'magazi amabwerera ku mtengo wake woyambirira, womwe unawonedwa asanayambike mankhwala.

Metabolite yogwira ya simvastatin ndi yoletsa yeniyeni ya HMG-CoA reductase (enzyme yomwe imapangitsa machitidwe a mapangidwe a mevalonate kuchokera ku HMG-CoA). Komabe, makonzedwe achire a thunthu samapangitsa kuti ziletso za HMG-CoA zibwezeretsedwe, potero kusungitsa kupanga kwachilengedwe kwofunikira kwambiri. Amakhulupirira kuti kugwiritsidwa ntchito kwa Wazilip sikuyenera kuchititsa kudziunjikira kwa mankhwala owopsa mthupi, popeza gawo loyambirira la cholesterol yachilengedwe ndi kutembenuka kwa HMG-CoA kukhala mevalonate. Kuphatikiza apo, pali kusintha kwachilendo kwa HMG-CoA kupita ku acetyl-CoA, komwe kumakhudzana ndi njira zambiri za biosynthesis m'thupi.

Cholesterol ndiwotsogolera mahomoni onse a steroid, ndipo zovuta zamankhwala za simvastatin pa steroidogenesis sizimawonedwa. Popeza Vasilip sikubweretsa kuwonjezeka kwa lithogenicity ya bile, zovuta zake pakuwonjezeka kwa cholelithiasis ndizokayikitsa.

Simvastatin imathandizira kuchepetsa kukhathamiritsa komanso kukhazikika kwa LDL cholesterol m'madzi am'magazi. Kapangidwe ka LDL kumachokera ku VLDL (lipotroteins otsika kwambiri). Catabolism ya LDL imachitika makamaka mothandizidwa ndi receptor yapamwamba ya LDL. Njira yochepetsera kuchuluka kwa cholesterol ya LDL m'magazi am'mimba mutatenga simvastatin imatha chifukwa cha kuchepa kwa plasma ndende ya VLDL cholesterol m'magazi ndi kutsegula kwa ma receptors a LDL. Chifukwa cha izi, pali kuchepa kwa mapangidwe ndikuwonjezereka kwa catabolism ya cholesterol ya LDL. Pochita mankhwala ndi simvastatin, kuchuluka kwa plasma ya apolipoprotein B (apo B) m'magazi kumatsikanso kwambiri. Popeza tinthu chilichonse cha LDL chili ndi molekyulu imodzi ya B, komanso zochepa za apo B zimapezeka m'm lipoprotein ena, zitha kulingaliridwa kuti simvastatin, kuwonjezera pakupangitsa cholesterol kuthengo la LDL, kumathandizira kuchepetsa kuchuluka kwa plasma kuzungulira tinthu ta LDL m'magazi.

Simvastatin imakulitsanso kuchuluka kwa cholesterol ya HDL ndikuchepetsa kuchuluka kwa TG m'madzi a m'magazi. Chifukwa cha ubalewu, LDL-C / HDL-C ndi HDL / HDL-C amachepetsa.

Ndi matenda a mtima (coronary mtima matenda) komanso koyamba cholesterol ya 212-309 mg / dL (5.5 mpaka 8 mmol / l), simvastatin imathandiza kuchepetsa chiopsezo cha kufa, kufa kwa matenda a mtima, komanso vuto la infratal lomwe limatsimikizira kupindika kwa mtima. Komanso, mankhwalawa amachepetsa mwayi wakufunika kwa njira zopangira opaleshoni kuti abwezeretse magazi (mwachitsanzo, coronary artery bypass grafting kapena percutaneous translateuminal coronary angioplasty). Poyerekeza ndi matenda am'mimba a shuga, kuthekera kwa mawonekedwe ofunikira amakono kumachepa. Kuphatikiza apo, pamankhwala othandizira a simvastatin, chiopsezo chotenga matenda oopsa a m'magazi (kuphatikizapo mikwingwirima ndi matenda osakhalitsa amisala) amachepetsa kwambiri.

Pali umboni wa mphamvu ya simvastatin mwa odwala omwe ali / opanda hyperlipidemia, omwe ali pachiwopsezo chachikulu chotenga matenda a mtima chifukwa cha matenda a shuga a mellitus, mbiri yokhudza matenda opha ziwopsezo ndi matenda ena a mtima.

Pogwiritsa ntchito Vasilip tsiku lililonse pamankhwala 40 mg, kufa kwathunthu, chiwopsezo cha kufa komwe kumayenderana ndi matenda a mtima, kuchepa kwa zovuta zazikulu zamkati (kuphatikiza osagwirizana ndi myocardial infarction kapena kufa komwe kumayenderana ndi matenda a mtima), kufunika kwa kuchitapo kanthu kwa opaleshoni yobwezeretsa magazi a coronary kumachepetsedwa (kuphatikiza ma coronary artery bypass grafting and percutaneous translateuminal angioplasty), komanso zotumphukira zamagazi ndi mitundu ina ya kusasinthika kwa coronary, chiwopsezo cha kugwidwa, pafupipafupi kuchipatala kwa se kulephera kwa mtima.

Kuopsa kwa zovuta zam'magazi / zam'mimba kumachepetsedwa mwa odwala omwe ali ndi / opanda matenda amitsempha yamagazi, kuphatikiza odwala omwe ali ndi vuto la zotumphukira zam'mitsempha, matenda a shuga, kapena cerebrovascular pathologies. Mu matenda a shuga, Vasilip amathandiza kuchepetsa chiopsezo cha zovuta zam'mimba, kuphatikizapo kufunika kwa kuchitapo kanthu pochita opaleshoni yam'munsi, kubwezeretsanso kwa zotumphukira zamagazi, komanso kupezeka kwa zilonda zam'mimba.

Malinga ndi coronary angiography, chithandizo cha simvastatin chimachepetsa kupitilira kwa coronary atherosulinosis ndi kuwonekera kwa malo onse atsopano a atherosclerosis ndi maumbidwe atsopano, pomwe odwala omwe amalandila chithandizo chokwanira adawonetsa kupita patsogolo kwa zotupa za mitsempha ya mitsempha.

Pharmacokinetics

Simvastatin ndi lactone wosagwira. Thunthu limatulutsa hydrolyzed mwachangu, ndikutembenuka kwake ku simvastatin β-hydroxy acid (L-654.969), yomwe ndi choletsa champhamvu cha HMG-CoA reductase. Ma metabolites apamwamba a simvastatin mu plasma yamagazi ndi β-hydroxyacid ya simvastatin (L-654.969) ndi 6'-exomethylene, 6'-hydroxy ndi 6'-hydroxymethyl.

Choyimira pakuwerengera kwamaphunziro onse a pharmacokinetic a β-hydroxy acid metabolites (inhibitors yogwira) ndi yogwira / latent inhibitors (zonse zoletsa) zomwe zimapangidwa chifukwa cha hydrolysis ndikoletsa kwa HMG-CoA reductase. Mukamamwa simvastatin m'madzi am'magazi, mitundu yonse ya metabolites imatsimikiza.

Hydrolysis ya simvastatin imachitika makamaka pakapita gawo loyambirira kudzera pachiwindi, motero, kuchuluka kwa plasma kosasinthika simvastatin m'magazi a anthu kumawonedwa (14 C yolembedwa simvastatin + 14 C yolembedwa simvastatin metabolites) imatheka mu maola 4. Ndipo mkati mwa maola 12 amatsika mofulumira mpaka pafupifupi 10% ya mtengo wapamwamba kwambiri. Ngakhale kuti kuchuluka kwamankhwala othandizira a simvastatin amachokera pa 5 mpaka 80 mg patsiku, mzere wofanana ndi mbiri ya AUC (dera lomwe lili munthawi ya kuponderezedwa) kwa metabolites yogwira m'magazi athunthu ndi milingo yowonjezereka mpaka 120 mg imawonedwa.

Pafupifupi 85% ya mlingo wovomerezeka wa simvastatin umayamwa. Kudya (monga gawo la zakudya zapamwamba za hypocholesterol) mutangomwa kumwa simvastatin sikukhudza mbiri ya mankhwalawa.

Zozama kwambiri za simvastatin zimatsimikizika m'chiwindi (poyerekeza ndi minofu ina).

The kuchuluka kwa zokhudza zonse kufalikira kwa yogwira metabolite wa simvastatin L-654.969 ndi 60% mwa amuna).

Kuthekera kwa kulowa kwa chinthu kudzera muubongo wamagazi ndi zotchinga za hematoplacental sikunaphunzire.

Simvastatin pakadutsa gawo loyambirira kudzera mu chiwindi limapukusidwa, chotsatira cha chinthucho ndi metabolites chimachitika ndi bile.

Mukatenga 100 mg ya simvastatin 14 C, cholembedwa chomwechi chimadziunjikira m'madzi am'magazi, komanso ndowe (pafupifupi 60%) ndi mkodzo (pafupifupi 13%). Mu ndowe, cholembedwa simvastatin imayimiridwa ndi metabolic zopangidwa ndi simvastatin, zomwe zimafotokozedwa mu ndulu, komanso zosasanjidwa zolembedwa simvastatin. Pansi pa 0,5% ya mlingo wovomerezeka wa zinthu zomwe amalembedwera umapezeka mkodzo mwa mawonekedwe a metabolites yogwira thunthu. Mu plasma, 14% ndi 28% ya AUC imachitika chifukwa cha zoletsa zomwe zimagwira komanso zoletsa zonse za HMG-CoA reductase, motsatana. Izi zikuwonetsa kuti zopangira metabolic za simvastatin ndizosagwira kapena zopanda zoletsa za HMG-CoA reductase.

Kupatuka kwakukulu kwa mzere wa AUC m'magazi athunthu ndi kuchuluka kwa Mlingo wa 5-120 mg sikumawonedwa. Ndi kubwereza kamodzi komanso mobwerezabwereza kwa simvastatin, magawo a pharmacokinetic adawonetsa kusapezeka kwa kudzikundikira kwa zinthu mu minyewa ngati mukugwiritsidwa ntchito mobwerezabwereza.

A kwambiri aimpso kulephera (odwala ndi creatinine chilolezo cha 10 mg pa tsiku, ngati n`koyenera, mankhwala zotchulidwa mosamala,

Vasilip, malangizo ogwiritsira ntchito: njira ndi mlingo

Mapiritsi a Vasilip amatengedwa pakamwa, 1 nthawi patsiku, madzulo. Mlingo wovomerezeka tsiku lililonse umasiyana kuchokera ku 5 mg mpaka 80 mg.

Nthawi zambiri, mankhwala zotchulidwa koyamba mlingo wa 10 mg. Kusintha kwa Mlingo uyenera kuchitika mosakhalitsa milungu inayi. Mulingo wambiri watsiku ndi tsiku (80 mg) umangolimbikitsidwa kwa odwala omwe ali ndi vuto lalikulu la hypercholesterolemia kapena chiopsezo chokhala ndi zovuta zamtima. Kutalika kwa vasilip kumatsimikiziridwa payekha ndi dokotala wopita.

Munthawi yonse ya chithandizo, wodwalayo ayenera kutsatira zakudya zapamwamba za hypocholesterol. Mlingo woyambira wabwino ndi 10 mg. Kuti muchepetse bwino mulingo wa LDL-C (wopitilira 45%), mutha kuyamba kutenga Vasilip ndi 20-40 mg kamodzi patsiku, madzulo.

Odwala omwe ali ndi homozygous cholowa hypercholesterolemia amalimbikitsidwa kutenga 40 mg kamodzi patsiku, madzulo. Ndizotheka kugwiritsa ntchito mu 3 Mlingo - m'mawa ndi masana, 20 mg ndi 40 mg madzulo. Vasilip amalimbikitsidwa kwa odwala oterewa kuphatikiza ndi mitundu ina yotsitsa lipid-mwachitsanzo, LDL apheresis).

Popewa matenda amtima:

Pokhala ndi chiopsezo chachikulu chotenga matenda a mtima (kapena opanda hyperlipidemia), 20-40 mg wa Vasilip amapatsidwa tsiku lililonse. Mlingo woyambirira ndi 20 mg, kuchuluka kwa mankhwalawa kuyenera kuchitika pakapita milungu inayi. Mlingo wambiri watsiku ndi tsiku ndi 40 mg. Zomwe LDL ili zosakwana 75 mg / dl (1.94 mmol / L), zonse zomwe zimakhala m'mafuta a cholesterol ndizochepa kuposa 140 mg / dl (3,6 mmol / L), mlingo uyenera kuchepetsedwa.

Vasilip imagwira ntchito monotherapy kapena nthawi imodzi ndi sequestrants ya bile acids (mwachitsanzo, colestipol ndi colestyramine). Odwala omwe amalandila chithandizo ndi gemfibrozil, cyclosporine, ma fiber ena kapena nicotinic acid (wopitilira 1 g patsiku), tikulimbikitsidwa kuti ayambe mankhwala ndi 5 mg patsiku, mlingo wambiri tsiku lililonse ndi 10 mg. Zikatero, palinso mlingo wina wowonjezera.

Odwala omwe amalandira onse a verapamil kapena amiodarone, mlingo wa tsiku ndi tsiku wa vasilip sayenera kupitirira 20 mg.

Odwala omwe ali ndi vuto lalikulu la impso (CC osakwana 30 ml / min), mlingo wa Vasilip wovomerezeka tsiku lililonse sayenera kupitirira 10 mg. Ngati mukufuna kuwonjezera mlingo, kuyang'aniridwa mosamala kuchipatala ndikofunikira.

Odwala omwe ali ndi vuto lowona aimpso komanso okalamba safuna kusintha kwa mlingo.

Mimba komanso kuyamwa

Vasilip pa nthawi yomwe ali ndi pakati / mkaka wa m`mawere sichikudziwika.

Mimba ikachitika, kugwiritsa ntchito simvastatin kuyenera kuyimitsidwa nthawi yomweyo. Amayi azaka zakubala, Vasilip amatha kutumikiridwa pokhapokha ngati mwayi wokhala ndi pakati ndi wochepa kwambiri. Kugwiritsa ntchito mankhwala osokoneza bongo pa nthawi ya pakati kungayambitse kuchepa kwa kuchuluka kwa mevalonate (cholowera mu cholesterol biosynthesis) mu mwana wosabadwayo. Atherosulinosis imadziwika kuti ndi matenda osachiritsika, ndipo nthawi zambiri kuchotsedwa kwa mankhwala ochepetsa mphamvu ya lipid pa nthawi yapakati sikukhudza kwambiri zoopsa zomwe zingachitike chifukwa cha nthawi yayikulu. Pankhani imeneyi, simvastatin sayenera kulembedwa kwa amayi omwe ali ndi pakati, akufuna kubereka kapena akuganiza kuti ali ndi pakati. Mankhwala a Vasilip amayenera kuyimitsidwa nthawi yonse yomwe ali ndi pakati kapena mpaka atapezeka kuti ali ndi pakati, ndipo mkaziyo ayenera kuchenjezedwa za ngozi yomwe ilipo kwa mwana wosabadwayo.

Palibe umboni wotsimikizira kapena kutsutsa mawonekedwe a simvastatin ndi ma metabolites ake ndi mkaka wa m'mawere.

Mitengo ya vasilip ku malo ogulitsa mankhwala ku Moscow

Kuphatikiza Kwotsimikizika:

• zoletsa zamphamvu za CYP3A4 isoenzyme (itraconazole, telithromycin, ketoconazole, posaconazole, clarithromycin, voriconazole, erythromycin, HIV protease inhibitors, boceprevir, nefazodone, telaprevir yomwe ili ndi cobicistat mankhwala owonjezera.
• gemfibrozil, danazol kapena cyclosporine.

Madokotala amawunika za vasilip

Panali nthawi yomwe madokotala ambiri (osati mankhwala!) Amawaganizira 10 mg ya vasilip kukhala yothandiza pochiza matenda omwe amaphatikizidwa ndi atherosulinosis. Nthawi iyi yapita kale. Simvastatin pamtundu uliwonse samatchulidwanso ngati mankhwala omwe amakupatsani mwayi wokwaniritsa cholesterol yamakono ndi lipids zina.

Chifukwa chake, ngati adotolo akufotokozera simvastatin (kuphatikizapo vasilip), sindikumvetsa chifukwa chake amanyalanyaza maumboni amakono ndi amphamvu komanso otetezeka.

Yakwana nthawi kuiwala za simvastatin. Ndipo ndi njira yanji, kodi ndi lingaliro lolakwika liti lomwe ma statins sayenera kumwedwa kwa masabata angapo? Amatengedwa zaka ndi makumi, ndipo chaka chilichonse chowonjezedwa chimalandila odwala, komanso makampani opanga mankhwala, nawonso.

Ndemanga yodwala ya Vasilip

Ndimatenga "Vasilip" 10 mg mosalekeza piritsi limodzi madzulo, ndimayesa mayeso a cholesterol kamodzi miyezi itatu. Zotsatira zake ndi zabwino. Panali kuyeserera kosakhoza kusintha kwa mnzake wotsika mtengo wanyumba. Cholesterol adalumphira, nabwerera "Vasilip". Ndi penshoni, kugula ndikokwera mtengo, koma thanzi ndiokwera mtengo.

"Vasilip" adalangizidwa ndi dokotala wanga wa zakudya kuti achepetse thupi, nditakambirana ndi dokotala, ndidadya limodzi. Modabwitsa, zotsatira zake zinali zabwino, ngakhale sindinali wotsimikiza kotheratu kuti ma tabuwo angathandize! Adatenga milungu 6,6, osatinso! Amatsitsa cholesterol m'magazi, ndichifukwa chake chotere!

Pharmacology

Simvastatin imachepetsa kwambiri zomwe zili apolipoprotein B, mokulira zimachulukitsa kuchuluka kwa HDL-C ndi kutsika kwa plasma kwa TG. Zotsatira zazotsatira za simvastatin, kuchuluka kwa ma Ch kwathunthu ku Chs-HDL ndi Chs-LDL mpaka Chs-HDL kumachepa.

Mphamvu ya antiatherosulinotic ya simvastatin ndi chifukwa cha zotsatira za mankhwalawa pazitseko zamitsempha yamagazi ndi zigawo zamagazi. Simvastatin amasintha kagayidwe ka macrophages, zoletsa kutsegulitsa kwa macrophages ndikuwonongeka kwa malo a atherosranceotic. Mankhwala amalepheretsa kapangidwe ka isoprenoids, omwe ali zinthu zomwe zimapangitsa kuti minyewa izikhala yosalala. Mothandizidwa ndi simvastatin, kuchuluka kwa mitsempha ya endothelium kumatheka.

The achire zotsatira zimachitika pambuyo 2 milungu, pazipita zotsatira amawona pambuyo 4-6 milungu chithandizo.

Kuchita

Kugwiritsa ntchito pamodzi kwa simvastatin ndi ma fibrate, nicotinic acid (yoposa 1 g / tsiku) kumakulitsa chiopsezo chotenga myopathy, kuphatikizapo rhabdomyolysis (ndikugwiritsa ntchito pamodzi ndi fenofibrate, palibe umboni wowonjezera chiopsezo cha myopathy poyerekeza ndi monotherapy ndi mankhwala aliwonse mosiyana).

Kugwiritsira ntchito limodzi ndi gemfibrozil kungayambitse kuchuluka kwa simvastatin mu seramu.

CYP3A4 cytochrome inhibitors (itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors ndi nefazodone), omwe akuphatikizidwa ndi kutembenuka kwa metabolic kwa simvastatin kupita ku chiwindi, kuonjezera chiopsezo cha myopathy ndi rhabdomyolamine panthawi yamankhwala. Kugwiritsa ntchito limodzi ndi mankhwalawa ndiwotsutsana.

Mosamala, ndikofunikira kupereka nthawi imodzi ndi zoletsa zopanda mphamvu za CYP3A4: cyclosporine, verapamil ndi diltiazem. Mlingo wa tsiku ndi tsiku wa simvastatin pamene mukumwa ndi cyclosporine sayenera upambana 10 mg. Mlingo wa tsiku ndi tsiku wa simvastatin wogwiritsidwa ntchito ndi amiodarone kapena verapamil sayenera kupitirira 20 mg, ndi 40 mg ndi ntchito yogwiritsidwa ntchito ndi diltiazem, pokhapokha ngati phindu lomwe likuyembekezeredwa limaposa chiwopsezo cha myopathy ndi rhabdomyolysis.

Simvastatin pa mlingo wa 20-40 mg / tsiku mu odzipereka komanso odwala omwe ali ndi hypercholesterolemia amatha zotsatira za coumarin anticoagulants (mwachitsanzo warfarin), makamaka kuwonjezeka kwa prothrombin nthawi, MHO. Chifukwa chake, mwa odwala omwe akutenga ma coumarin anticoagulants, nthawi ya prothrombin ndi MHO iyenera kutsimikizika musanayambe mankhwala a simvastatin, nthawi yoyambirira yamankhwala, posintha mtundu wa simvastatin kapena kusiya mankhwala. Mukafika pachizindikiro chokhazikika cha prothrombin nthawi ndi MHO, kuwunikira kowonjezereka kuyenera kuchitika pakadutsa komwe kulimbikitsidwa kwa odwala omwe amalandila mankhwala othandizira. Mankhwala a Simvastatin samapangitsa kusintha kwa prothrombin nthawi ndi chiwopsezo cha magazi kwa odwala osatenga anticoagulants.

Madzi a mphesa amaletsa ntchito ya CYP3A4. Kutenga nthawi imodzi madzi ambiri a mphesa (kuposa lita imodzi patsiku) ndi simvastatin kumabweretsa chiwopsezo chachikulu cha plasma ndende ya simvastatin acid. Chifukwa chake, pa mankhwalawa ndi simvastatin, msuzi wa mphesa uyenera kupewedwa.

Malangizo a vasilip (njira ndi Mlingo)

Kwa iwo omwe adasankhidwa Vasilip, malangizo ogwiritsira ntchito akunena kuti amatengedwa pakamwa, madzulo, 1 nthawi patsiku.

Mlingo wamba watsiku lililonse ndi 5-80 mg. Monga lamulo, 10 mg ndi mankhwala. Kusintha kwa Mlingo kuyenera kuchitika mosakhalitsa kwa masabata anayi. Mlingo wa tsiku ndi tsiku sayenera kupitirira 80 mg. Mlingo wambiri umangoperekedwa kwa anthu odwala kwambiri hypercholesterolemia kapena kuchuluka kwa zochitika mtima. Malangizo ogwiritsira ntchito Vazilip akuti mayendedwe amathandizidwa ndi katswiri aliyense payekhapayekha, kutengera zomwe zikuwonetsa ndi momwe wodwalayo amalolera mankhwalawo.

M'malo mwa hypercholesterolemia zofunika kuchita yachibadwa zakudya zama hypocholesterol pa mankhwala. Mlingo woyambirira nthawi zambiri ndi 10 mg. Kuchepetsa kwakukulu LDL cholesterol Maphunzirowa amatha kuyamba ndi 2040 mg / tsiku.

At homozygous cholowa hypercholesterolemia Nthawi zambiri amatenga 40 mg kapena 80 mg patsiku, koma pamiyeso itatu (nthawi zambiri 20 mg m'mawa ndi masana ndi 40 mg wina madzulo). Ndikofunika kuphatikiza mankhwalawa ndi ena lipid-kutsitsaamatanthauza.

Pofuna kupewa kukhazikika kwa matenda amtima mwa anthu omwe ali pachiwopsezo chachikulu Matenda a mtima wa Ischemic malangizo kuchokera 20 mpaka 40 mg / tsiku. Mlingo wa mankhwalawa, mosankhidwa payekha, amachepetsedwa ngati mulingo LDLzosakwana 75 mg / dl ndi cholesterol yathunthuochepera 140 mg / dl.

Vasilip angagwiritsidwe ntchito molumikizana ndi otsatizana a bile acid. Odwala omwe akalandira chithandizo mafupa kapena nicotinic acid, imwani mlingo woyambirira wa 5 mg. Pazipita mlingo tsiku lililonse sayenera kupitirira 10 mg. Ndipo akaphatikizidwa Amiodarone kapena Verapamil osapitilira muyeso wa 20 mg.

Ndi kwambiri kulephera kwa aimpso ndibwino osapitilira muyeso wa 10 mg / tsiku. Ngati kuwonjezereka kwa mlingo kumafunikirabe, mkhalidwe wa wodwalayo uyenera kuyang'aniridwa pafupipafupi.

Zokhudzana ndi mankhwala:

• gemfibrozil ndi ma fiber ena (kupatula fenofibrate), fusidic acid: mwayi wowonjezereka wa myopathy,
• amiodarone, lomitapide, slowly calcium blockers (verapamil, diltiazem kapena amlodipine), nicotinic acid mu lipid kutsitsa Mlingo (osachepera 1000 mg patsiku): mwayi wowonjezereka wa myopathy / rhabdomyolysis,
• zoletsa zolimbitsa za CYP3A4 isoenzyme (mwachitsanzo, dronedarone, ranolazine): kuwonjezereka kwa mwayi wokhala ndi myopathy, mlingo wa Vasilip ungachepe.
• OATP1B1 mayendedwe a mapuloteni otulutsa: kuchuluka kwa plasma ndende ya simvastatin hydroxy acid ndi mwayi wopanga myopathy,
• colchicine (odwala ndi aimpso kulephera): chiwopsezo cha myopathy ndi rhabdomyolysis, kuphatikiza pamafunika kuwunika odwala mosamala
• indico anticoagulants (coumarin derivatives): kuchuluka kwa nthawi ya prothrombin, kumatanthauzira kuti MHO (kuchuluka kwa mitundu yonse), kufunikira kwa chizindikirocho kumayendetsedwa isanayambike mankhwala ndi simvastatin, ndiye kuti imatsimikizika nthawi zambiri munthawi yoyambira yamankhwala, yomwe imalola kupatula kusintha kwakukulu mu MHO. Pambuyo pakufika pachizindikiro chokhazikika cha prothrombin nthawi, kutsimikiza kwake kuyenera kuchitika pang'onopang'ono komwe kulimbikitsidwa kuwunikira odwala omwe amalandila anticoagulant. Pankhani yosintha mlingo wa simvastatin kapena mutachoka, muyeso wokhazikika wa chizindikiro ichi umalimbikitsidwanso. Odwala omwe sanatenge anticoagulants, mankhwalawa opangidwa ndi simvastatin omwe akuwoneka kutuluka magazi kapena kusintha kwa prothrombin nthawi sikugwirizana,
• Madzi a mphesa (m'mavidiyo ambiri): kuchuluka kwa plasma ya HMG-CoA reductase inhibitors.

Mafanizo a Vasilip ndi awa: Zokor, Zokor Forte, Simvor, Simvakard, Simvastol, Simlo, Simvastatin Zentiva, SimvaHEXAL, Zovatin, Levomir, Simvalimit, Actalipid, Sinkard, Aterostat, Zorstat, Simvakolat, Simvastatin, Simvastatin, Simatin Chaikafarma, Simvastatin-SZ, Simvastatin Alkaloid, Aries, Simvastatin Pfizer.

Mimba

Chifukwa chake, simvastatin sayenera kugwiritsidwa ntchito ndi amayi apakati ndi amayi omwe akuyesera kuti akhale ndi pakati kapena akuganiza kuti ali ndi pakati.
Kuvomerezedwa kwa simvastatin kuyenera kuyimitsidwa kwa nthawi yonse yomwe ali ndi pakati kapena pokhapokha umboni wotsimikizira kuti mayiyo alibe pakati (onani gawo "Contraindication").
Kugwiritsa ntchito kwa simvastatin mwa akazi pa mkaka wa m`mawere kumatsutsana.
Sizikudziwika ngati simvastatin kapena ma metabolites ake amapita mkaka wa m'mawere. Popeza mankhwalawa ambiri amadutsa mkaka wa m'mawere ndipo amatha kutengera zovuta zina, amayi omwe amatenga simvastatin ayenera kusiya kuyamwitsa. (Onani gawo "Contraindication").