Simgal: malangizo ogwiritsira ntchito, analogi, mtengo, ndemanga

Amapezeka mu mawonekedwe a mapiritsi ozungulira, ophatikizidwa ndi film ndi chiopsezo mbali imodzi. Mapiritsi amatha kukhala 10 (kuwala kwapinki), 20 (pinki) kapena 40 mg (pinki yakuda). Mu chodzaza matuza 14 mapiritsi. Zithunzithunzi za zidutswa ziwiri kapena zisanu ndi chimodzi zimayikidwa m'makatoni.

Palinso mwayi wosakanizira m'mabotolo 28 mapiritsi, botolo lililonse limayikidwa m'bokosi lina.

Mankhwala

Pambuyo pakulowetsa, simvastatin imapukusidwa kuti ipange mphamvu yochokera ku HMG-CoA reductase. Zotsatira zake, ndende imachepa cholesterol kachulukidwe otsika pakuchepetsa kaphatikizidwe kake ndikukula mphamvu kwa mphamvu ya satana.

Mlingo wa apolipoprotein, triglycerides amachepetsedwa ndipo ndende imakwezedwa pang'ono cholesterol kukwera kwambiri. Zotsatira zake, chiŵerengero cha kutsika ndi kutsika kwa kupsinjika kwa lipoprotein kusintha.

Pharmacokinetics

Simvastatin imayamwa bwino mosasamala kanthu kuti imatengedwa yokha kapena nthawi imodzi ndi chakudya. Kuzindikira kwakukulu kumatheka pambuyo pa maola 1-2.

Kutembenuka ku mawonekedwe akugwira kumachitika m'chiwindi. Pafupifupi 5% ya mlingo womwe umatengedwa m'magazi a chiwindi chonse. Palibe kuchuluka kwa mankhwala komwe kumawonedwa.

Osachepera 95% ya simvastatin ndi metabolites yake yogwira imamangilira mapuloteni a plasma.

Kutupa kumachitika mkati mwa maola 96 ndi mkodzo (13%) ndi ndowe (60%).

Zizindikiro zogwiritsidwa ntchito

Zotsatira za mankhwala:

• mankhwalawa hypercholesterolemia (cholowa m'malo mwake, chachikulu), chosakanizika dyslipidemia,
• kupewa matenda a mtima odwala atherosulinosis silika matenda ashuga.

Contraindication

Amakwaniritsidwa kumwa mankhwalawa motere:

• kuchuluka kwa mankhwala zosakaniza
• yogwira matenda a chiwindi,
• kuchuluka kwa ma seramu transaminases,
• mimba,
• nyere,
• kugwiritsidwa ntchito kwa potent cytochrome CYPZA4 inhibitors (i.e. Erythromycin, Clarithromycin, Nelfinar, Itraconazole, Telithromycin, Nefazodon).

Zotsatira zoyipa

Wodwala m'modzi pa 100-1000 ali ndi zotsatirazi zosasangalatsa:

Osapitilira 1%, madandaulo otere akuti:

• kuchepa magazi,
• mutu,
• paresthesia,
• chizungulire,
• kukokana,
• zotumphukira polyneuropathy,
• zam'mimba komanso zopondera,
• kusanza,
• kupweteka m'mimba
• kapamba,
• chiwindi, jaundice,
• zotupa, kuyabwa,
• alopecia,
• myopathyminofu kukokana myositis,
• asthenia,
• matenda oopsa hypersensitivity (angioedema, vasculitis, nyamakazi, rheumatic polymyalgia, thrombocytopenia, zithunzi, eosinophilia, kupuma movutikira, kufooka),
• kuchuluka kwa transaminases, zamchere phosphatase.

Nthawi zina, njira yolankhulirana imayamba m'mapapu kapenakulephera kwa chiwindi.

Simgal, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Simgal imatengedwa pa mlingo wa 10-20 mg mpaka 80 mg patsiku. Nthawi zambiri, mlingo umodzi wa mankhwalawa umaperekedwa madzulo. Ndikofunika kuti musaziphatikize ndi chakudya.

Ngati mukufunika kugawa piritsi pakati, muyenera kudula ndi mpeni, osati kuthyola ndi manja anu.

Mlingowo umaperekedwa ndi adokotala, poganizira zinthu monga zaka za wodwalayo, matenda ake, momwe alili thupi, chikhalidwe cha mankhwala (monotherapy kapena kuphatikiza mankhwala ena).

Kuchita

Kugwiritsa ntchito pamodzi ndi mankhwala ena kungakhudze momwe thupi limagwirira kapena kagayidwe ka simvastatin:

• ndi Bosentan - kuchuluka kwa simvastatin ndi zotumphukira zake kumachepa, ndikofunikira kusintha mlingo woganizira kuchuluka kwa cholesterol,
• ndi Cyclosporine, Danazol, Gemfibrozil, Niacin, Amiodarone, Verapamil - Mlingo wa Simgal uyenera kuchepetsedwa kuti muchepetse chitukuko myopathies,
• ndi Erythromycin, Itraconazole, Ketoconazole, Fluconazole, Posaconazole, Clarithromycin, Telithromycin ndi zina zoletsa CYP3A4 zoletsa - kuphatikiza koletsedwa. Ngati mukufunikira kupita kuchipatala mwachangu ndi mankhwala omwe atchulidwa pamwambapa, Simgal imachotsedwa kwakanthawi.

Malangizo apadera

Popereka mankhwala, madokotala ayenera kukumbukira zina mwazomwe adauza wodwalayo:

• odwala onse omwe adalembedwa Simgal ayenera kuchenjezedwa za kufunika kopita kuchipatala chifukwa cha ululu kapena kufooka kwa minofu,
• masiku angapo asanafike opaleshoni yokonzekera, chithandizo cha simvastatin ziyenera kutha,
• musanayambe chithandizo, tikulimbikitsidwa kumayesedwa kuti muwone momwe chiwindi chimagwirira ntchito.
• ndizoletsedwa kumwa msuzi wa mphesa nthawi ya mankhwala a Simgal,
• Ndikulimbikitsidwanso kuti musamamwe mowa.

Mukamamwa mankhwala ndi achinyamata, sizinawakhudze kukula ndi kukulitsa kugonana. Zochita akadali achichepere sizinafufuzidwe.

Analogs of Simgal

Analogues a Simgal ndi mankhwala otere:

• Aldesta,
• Atrolin,
• Vabadin,
• Vasilip,
• Vasostat-Health,
• Vasta,
• Vastatin,
• Zokor,
• Zosta,
• Cardak,
• Simva Tad,
• Simvagexal,
• Simvakard,
• Simvacol,
• Simvalimite,
• Simvostat.

Kuphatikizika, mawonekedwe omasulidwa

Simgal ndi phale lophimba lomwe limafanana ndi mphodza mu mawonekedwe awo. Kuti mugwiritse ntchito mosavuta, imapezeka m'malo atatu: 10, 20, 40 mg, 28, 84 ma PC. Mtundu wa piritsi la Simgala umatengera kuzunzika kwa zinthu zomwe zimagwira: 10 mg - pinki yotumbululuka, 20 mg - pinki yakuya, 40 mg - pinki yakuda.

Kuphatikiza pa gawo lalikulu la simvastatin, kapangidwe kamankhwala kamaphatikizira butylhydroxyanisole, ascorbic acid, citric acid kuchokera ku starch, cellulose, mkaka wa shuga wa monohydrate, magnesium stearate, Opadry II.

Zotsatira za pharmacological

Simgal imalowa m'thupi la munthu. Kukhazikitsa kwake kumachitika m'chiwindi, momwe cholesterol imapangidwira. Kuchita ndi enzyme HMG-CoA reductase, imayimitsa kaphatikizidwe ka cholesterol yoyipa pakapangidwe kamene adayambitsa, mevalonic acid. Izi zimawonjezera kuchuluka, komanso zochita za LDL receptors. Thupi limakumana ndi izi mwa chiwonongeko chambiri cha cholesterol, lipoproteins zovulaza.

Mlingo wa lipoproteins zabwino (wokhala ndi kachulukidwe kokulirapo) ukuwonjezeka m'malo mwake. Kodi izi zimathandiza bwanji thupi kumenyana ndi atherosulinosis? Mafuta okhala ndi mapuloteni a kachulukidwe kochepa kwambiri ndi cholesterol amakonda kukhazikika pamakoma a mitsempha yamagazi. Izi zimapanga mapangidwe a atherosulinotic. HDL imathandizira kukhathamiritsa kwa cholesterol kuchokera kumisempha ya makoma amitsempha yamagazi, komanso zida zina za thupi.

Mankhwala amadziwika ndi mayamwidwe abwino. Chiwonetsero chachikulu kwambiri cha zinthu zofunikira za Simgal chimadziwika pambuyo pa mphindi 60-120. Mankhwalawa amachotsedwa m'thupi makamaka ndi ndowe, mkodzo. Kutha kwake kupitilira mkaka wa m'mawere sikunaphunzire.

Chakudya sichimakhudza kuyamwa kwa mapiritsi a Simgal. Chifukwa chake, malangizowo akuwonetsa kuti akhoza kumwedwa isanachitike, itatha kapena chakudya.

Simgal: Zizindikiro zogwiritsidwa ntchito

Malinga ndi malangizo ogwiritsira ntchito Simgal, amalembedwa kwa odwala omwe ali ndi kuphwanya kwapakati pa cholesterol metabolism, pamene kudya kamodzi sikokwanira. Komanso, mankhwalawa ndi gawo la zovuta kuchizira matenda omwe amayenda ndi mkodzo wamafuta. Ichi makamaka ndi matenda a mtima (CHD), matenda ashuga.

Mapiritsi a Simgal amawonetsedwa ngati chithandizo cha adjunct kwa hemaitary hypercholesterolemia, koma pokhapokha njira zazikulu zochizira (zakudya, zolimbitsa thupi, LDL plasmapheresis) sizokwanira kapena sizothandiza.

Njira ya ntchito, Mlingo

Malinga ndi malangizo a mapiritsi a Simgal, mlingo wa mankhwalawa umachokera pa 10 mpaka 80 mg / tsiku. Mankhwalawa amatengedwa kamodzi patsiku, nthawi yolonjezedwa ndi madzulo. Monga lamulo, kasamalidwe ka Simgal kamayamba ndi yaying'ono / zolimbitsa Mlingo wowonjezera pang'onopang'ono, ngati pakufunika kutero. Nthawi yocheperako yosinthira ndi masabata anayi. Mlingo wapamwamba kwambiri wa mankhwalawa umaperekedwa nthawi zina mukamamwa Mlingo wocheperako sugwira ntchito.

Lamulo lofunika kugwiritsa ntchito Simgal ndizakudya zomwe zimatsitsa cholesterol.

Ndi hypercholesterolemia, mapiritsi a Simgal amatengedwa pa mlingo wa 20 mg / tsiku. Zozungulira zapamwamba za mankhwalawa (40 mg / tsiku) zimayikidwa, ngati kuli koyenera, kuchepa kwambiri kwa cholesterol, LDL (oposa 45%). Kwa hypercholesterolemia yofatsa / yolimbitsa thupi, malangizowo amalola kugwiritsa ntchito mapiritsi a Simgal mu mlingo wochepetsedwa (10 mg / tsiku).

Ndi chiopsezo chachikulu cha matenda a mtima, mapiritsi a Simgal amawonetsedwa ngati mankhwala olumikizira pa 40 mg / tsiku. Kusintha kwa Mlingo kumachitika monga tafotokozera pamwambapa. Simgal imathandizira kusintha mafuta m'thupi, komanso zinthu zina zamafuta. Izi zili ndi phindu pochepetsa chiopsezo cha matenda amtima ndi kufa.

Akuluakulu omwe ali ndi heterozygous cholowa hypercholesterolemia, mankhwala ndi mankhwala 40 mg. Mapiritsi atatu ndi otheka mlingo wa 80 mg / tsiku: 20 mg m'mawa, 20 mg masanawa, 40 mg madzulo. Kwa anyamata azaka zapakati pa 10 mpaka 17, komanso atsikana omwe msambo wawo unayamba pafupifupi chaka chapitacho, Simgal imayikidwa muyezo wa 10 mg. Malinga ndi malangizo, mlingo waukulu kwa odwala achinyamata ndi 40 mg. Kafukufuku wokhudza zotsatira za mapiritsi a Simgal pa thupi la ana aang'ono sanachitike.

Gulu la mankhwala, mawonekedwe omasulira ndi mtengo wa mankhwalawo

Simgal ndi m'gulu la mankhwala a hypolipidemic - ma statins. Ndi olepheretsa kuwachotsa kwa HMG-CoA. INN yamankhwala awa ndi simvastatin (Simvastatin). Mankhwalawa amapezeka pokhapokha piritsi. Mapiritsiwa amasiyana pamtundu ndi mtundu wa chipolopolo, malinga ndi kuchuluka kwa gawo lalikulu mwa iwo - simvastatin:

• Mankhwala okhala ndi Mlingo wa 10 mg - kuwala kofiirira, kofinya mbali zonse ndi kuzungulira mawonekedwe,
• Mapiritsi omwe 20 mg ya mankhwala othandizira amakhala ozunguliridwa ndi apinki muutoto, komanso ali ndi gawo logawa mbali imodzi yammbali
• mankhwala omwe ali ndi chophatikiza 40 mg ndi khungu la pinki lakuda, lozungulira komanso lopanda gawo mbali imodzi.

Mankhwalawa amadzaza matuza a mapiritsi 14, komanso makatoni okhala ndi matuza awiri kapena 6. Mitengo ya Simgal m'dera la Russian Federation (Gome 1)

The zikuchokera lipid-kutsitsa mankhwala

Kuphatikiza pa simvastatin, mankhwalawa ali ndi zinthu zina zomwe zimathandizanso pakugwira mapiritsi. Zina mwa izo ndi:

• lactose
• MCC
• ascorbic acid
• kukhuthala
• magnesium wakuba,
• talc ndi citric acid,
• zigawo za opadry (pinki ndi zofiirira), zomwe ndi gawo la chipolopolo.

Zizindikiro ntchito mankhwala ndi contraindication

Simgal imagwiritsidwa ntchito makamaka pa pathologies ya mtima ndi kayendedwe ka magazi. Mankhwala wovomerezeka chifukwa cha matenda:

• ndi angina pectoris amachepetsa kupitirira kwa matenda, omwe amachepetsa chiopsezo cha kufa kwa anthu amisinkhu yosiyanasiyana omwe ali ndi matenda a mtima,
• ndi mtima ischemia, chiwopsezo cha matenda amtima chimachepa kangapo,
• imalepheretsa kupezeka kwamikwingwirizo chifukwa cha chotupa cha isorria kapena chithokomiro cha m'mimba,
• zochizira matenda a atherosclerosis komanso kupewa kutembenuka kwake kukhala mawonekedwe ovuta.

Mankhwala amagwiritsidwanso ntchito pochiza matenda osiyanasiyana a hypercholesterolemia:

• ndi heterozygous ndi homozygous hypercholesterolemia,
• ndi hyperlipidemia yoyambira ndi yosakanikirana,
• ndi chitukuko cha hypertriglyceridemia ndi dyslipidemia.

Kuphatikiza apo, mankhwalawa amathandizidwa kuti apangidwe ndi matenda a endocrine, omwe amayambitsa kukula kwa matenda a shuga, omwe amayamba limodzi ndi systemic atherosulinosis.

Zoyipa zomwe zimamwa mankhwalawa ndi:

• matenda a m'magazi a chiwindi omwe ali pachikulupo.
• ntchito kwambiri ya transaminase michere mu chiwindi, ndi kulephera chiwindi,
• kuyamba kwa impso,
• Simungathe kutenga statin panthawi yovomerezeka mwa azimayi, komanso panthawi yodyetsa mwana mkaka wa m'mawere,
• tsankho kwa thupi la chigawo chachikulu cha simvastatin kapena zinthu zina,
• Ndi zoletsedwa kupereka mankhwala kwa ana osakwana zaka 10.

Osamalamulira azimayi azaka zosabereka popanda chitetezo chokwanira mokwanira mwakukhazikika kwa mimba. Pankhani ya kutenga pakati pa mwana panthawi yochiritsira ya Simgal, ndikofunikira kusokoneza chithandizo ndi ma statins asanafike kumapeto kwa mimba. Ngati kuchotsedwa kwa mankhwalawo kumaopseza wodwala ndi chiopsezo cha kufa, ndiye kuti funso limatuluka.

Atsikana atha kutumikiridwa mankhwala atayamba msambo, ndipo anyamata azaka 10 zothana ndi vuto la homozygous Famer hypercholesterolemia.

Mlingo

Kugwiritsa ntchito mapiritsi ngati mankhwala omwe mumadzipangira nokha ndizoletsedwa, chifukwa ndi adokotala okha omwe amatha kusankha mlingo woyenera ndikujambulitsa njira yothandizira. Musaiwale kuti chithandizo chikuyenera kuchitika limodzi ndi zakudya zotsutsana ndi cholesterol.

Mlingo wa tsiku lililonse wa mankhwalawa ukhoza kukhala 10, 20 kapena 80 mg:

• Mlingo woyenera umaperekedwa nthawi zina komanso kuchipatala.
• Ndi hypercholesterolemia, tsiku lililonse 10 mg ndi mankhwala. Ndi ischemia ya mtima, mankhwala 20 mg ndi mankhwala, atherosulinosis, mlingo wa kumwa 20 mg mg.
• Mlingo wa mamiligalamu 5 umayikidwa mukamamwa ma statins ndi ma fibrate mu zovuta mankhwala.

Mankhwala oyamba amatha kumveka pambuyo pa masabata awiri. Kusintha kwa dozi kumatheka pokhapokha mutamwa mwezi umodzi, komanso munthawi imeneyi mutha kusintha mankhwala ndi analog.

Kuchita Simgal ndi mankhwala ena

Ndikofunikira kuyendetsa mosamalitsa kudya kwama statins ndi mankhwala ena. Malamulo oyendetsera mgwirizano:

• pa mankhwala a cyclosporine ndi ma statins, kuchuluka kwa simvastatin m'magazi kumawonjezeka kangapo. Chifukwa chake, kugwiritsa ntchito mitundu iwiriyi kwa mankhwala kumatsutsana,
• Malangizo apadera ndi malangizo

Kuti mupeze chithandizo choyenera, ndikofunikira kutsatira malamulo awa:

Pa gawo loyambirira la mankhwalawa, ndikofunikira kuwunika pafupipafupi ma hepatic transaminases. Kotala yoyamba ya maphunziro a mankhwalawa muyenera kuyang'ana ma enzyme masiku onse a 45, pambuyo pake muyenera kuyang'anira masiku 60 aliwonse a chaka chimodzi chomwa mapiritsi.

Ndi chithandizo chotalikirapo, kuchuluka kwa ma enzyme kuyenera kuwunikiridwa kamodzi pakadutsa masiku 180.

Zotsatira zoyipa za mankhwala ndi bongo

Simgal imakhala ndi zotsatilapo zambiri thupi la wodwalayo. Zina mwa izo ndi:

• kuchuluka kwamphamvu mwa amuna,
• kusokera mu ntchito ya impso ndi chiwindi,
• kuchuluka kwa aimpso transaminases,
• dyspepsia
• pachimake mawonekedwe a kapamba,
• mseru, kusanza, kutsekula m'mimba ndi kudzimbidwa,
• zotumphukira neuropathy,
• kukhumudwa
• kutopa kwa thupi,
• kugona ndi kugona,
• mutu
• kufooka kwa minofu,
• rhabdomyolysis ndi alopecia.

Palibe chithandizo chenicheni cha bongo. Mankhwalawa amangokhala chizindikiro komanso amatsuka m'mimba.

Zochizira hypercholesterolemia, dokotala amatha kusankha mtundu wa mankhwalawo. Mndandanda wamalingaliro a Simgal omwe ali ndi yogwira pophika simvastatin:

1. Simvakard ndi mankhwala opangidwa ku Czech omwe amakhala ndi mphamvu yambiri yochizira ndi zovuta zochepa pamthupi la wodwalayo.
2. Simvastatin Zenith ndi mankhwala achi Czech omwe amagwiritsidwa ntchito pochiza matenda a hypercholesterolemia a 2A ndi 2B malinga ndi Fredrickson pophatikiza zakudya za anticholesterol.
3. Simvastol ndi mankhwala aku Romania omwe ndi otsika mtengo kuposa mankhwala oyambira. Simvastol imatchulidwa ngati prophylaxis ya pathologies ya mtima ndi kayendedwe ka magazi.

Ndemanga za madotolo ndi odwala

Odwala ndi a mtima nthawi zambiri amasiya ndemanga zabwino za mankhwalawa. Amaona zabwino zakutsitsa cholesterol komanso chiopsezo chochepa cha matenda a mtima:

Ngati mulingo woyenera umasankhidwa ndi adotolo ndipo zakudya za cholesterol zimayang'aniridwa, kugwiritsa ntchito bwino kwa mankhwalawa kumawonjezeka ndi zovuta zochepa. Kugwiritsa ntchito Simgal piritsi, osati chiopsezo chokha cha matenda a sitiroko ndi mtima, komanso mtima wa mtima ndi tachycardia amachepa.

Gulu la mankhwala

Hypolipidemic othandizira. HMG-CoA reductase inhibitors. Nambala ya ATC C10A A01.

Mankhwalawa a hypercholesterolemia kapena dyslipidemia wosakanikirana monga cholumikizira ku chithandizo cha zakudya, pamene mankhwala othandizira pakudya kapena njira zina zomwe sizikuchitika pamankhwala (mwachitsanzo, masewera olimbitsa thupi, kuchepa thupi) sizothandiza.

Chithandizo cha homozygous cholowa cholowa hypercholesterolemia monga njira yofananira ndi mankhwala othandizira kudya komanso njira zina zochizira zomwe zimayang'ana kutsitsa lipids (mwachitsanzo, LDL plasmapheresis), kapena ngati njira izi sizikugwira ntchito.

Mtima Kupewa matenda

Kuchepetsa kufa ndi kusakhazikika kwa matenda amtima mwa odwala omwe ali ndi matenda atherosselotic kapena matenda a shuga, omwe amakhala ndi cholesterol wamba ngati mankhwala othandizira kukonza zina zowopsa ndi mitundu ina ya mankhwala a mtima.

Mlingo ndi makonzedwe

Asanayambe njira yothandizira achire komanso nthawi yonse ya chithandizo, wodwalayo ayenera kutsatira zakudya zapamwamba za hypocholesterol.

Mapiritsi a Simgal amatengedwa pakamwa kamodzi patsiku (madzulo), pokhapokha atalamula mwanjira ina. Mankhwala tikulimbikitsidwa kuti amwe padera ndi zakudya, kutsukidwa ndi madzi okwanira kapena madzi ena.

• Hypercholesterolemia: 10-80 mg wa simvastatin kamodzi patsiku (madzulo). Mlingo woyambayo ndi 10 mg, ndipo pazipita tsiku lililonse ndi 80 mg. Kusintha kwa mlingo uliwonse kumachitika pakadutsa milungu inayi. Mulingo woyenera wa mankhwalawa nthawi zambiri umapezeka mu Mlingo mpaka 20 mg patsiku,
• Homozygous cholowa hypercholesterolemia: 40 mg patsiku kamodzi (madzulo) kapena 80 mg m'magawo atatu ogawanika (20 mg m'mawa ndi masana, 40 mg madzulo),
• Matenda a mtima ndi chiwopsezo cha kukula kwake: 20-40 mg Simgal patsiku. Mlingo woyambirira ndi 20 mg patsiku. Kusintha kwa mlingo uliwonse kumachitika pakadutsa milungu inayi. Ngati ndi kotheka, mutha kuwonjezera mlingo mpaka 40 mg patsiku. Ndi cholesterol yonse ya 3.6 mmol / L, ndi lipoproteins yotsika ya 1,94 mmol / L, mlingo wa mankhwalawa uyenera kuchepetsedwa.

Okalamba okalamba omwe ali ndi vuto lochepa kwambiri laimpso safuna kusintha kwa mlingo kwa Simgal.

Kulephera kwa aimpso kulephera (kuperekera kwa creatinine zosakwana 30 ml / mphindi) kapena kugwiritsa ntchito munthawi yomweyo danazol, cyclosporine, nicotinic acid mu Mlingo woposa 1 g patsiku, gemfibrozil kapena ma fiber ena, muyezo wa simvastatin sayenera kupitilira 10 mg patsiku, ndipo mukagwiritsidwa ntchito limodzi ndi verapamil kapena amiodarone - 20 mg patsiku.

Mlingo ndi makonzedwe

Mulingo wambiri ndi 10-80 mg patsiku ngati kamwa limodzi madzulo. Ngati ndi kotheka, sinthani mlingo womwewo, pakadutsa masabata anayi, mpaka muyeso wa 80 mg pa tsiku, womwe umayenera kumwa madzulo. Mlingo wa 80 mg patsiku amalimbikitsidwa kwa odwala omwe ali ndi vuto lalikulu la hypercholesterolemia komanso chiopsezo cha zovuta zamtima. Ngati dokotala wakupatsani theka la piritsi, simungathe kuthyola piritsi ndi manja anu. Mapiritsi agawo ayenera kuchitika ndi mpeni.

Odwala ayenera kutumikiridwa zakudya zoyenera kutsitsa cholesterol, zomwe zimayenera kuchitika pakumwa ndi Simgal. Mlingo woyambira wokhazikika ndi 20 mg patsiku ngati gawo limodzi lamadzulo. Ngati kuchepa kwakukulu kwa cholesterol ya LDL kukufunika (oposa 45%), mlingo woyambirira ungakhale 40 mg patsiku ngati mlingo umodzi madzulo. Ngati ndi kotheka, kusintha kwa mlingo kumachitika monga tafotokozera pamwambapa. Odwala omwe ali ndi hypercholesterolemia yofatsa kapena yolimbitsa amatha kuikidwa koyamba mlingo wa 10 mg.

Homozygous cholowa hypercholesterolemia

Mlingo woyenera ndi 40 mg simvastatin patsiku madzulo kapena 80 mg patsiku

Mlingo 3 Mlingo wa 20 mg m'mawa, 20 mg masanawa ndi madzulo mlingo wa 40 mg. Simgal iyenera kugwiritsidwa ntchito ngati cholumikizira ku njira zina zamankhwala zothandizira kuchepetsa milingo ya lipid (mwachitsanzo, LDL plasmapheresis) kapena ngati chithandizo chotere sichikupezeka.

Mtima Kupewa matenda

Mlingo wa Simgal ndi 40 mg tsiku lililonse ngati gawo limodzi lamadzulo madzulo kwa odwala omwe ali pachiwopsezo chachikulu cha matenda a mtima (CHD, wokhala ndi kapena wopanda hyperlipidemia). Mankhwala osokoneza bongo amatha kuyambitsidwa nthawi yomweyo monga zakudya komanso masewera olimbitsa thupi. Ngati ndi kotheka, kusintha kwa mlingo kumachitika monga tafotokozera pamwambapa.

Simgal imathandizira mu mawonekedwe a monotherapy kapena kuphatikiza ndi mankhwala, kuwonjezera kukondoweza kwa bile acid. Mankhwala ayenera kumwedwa kuposa 2:00 asanafike kapena kuposa 4:00 pambuyo kugwiritsa ntchito mankhwala omwe amalimbikitsa kuphipha kwa bile acid.

Odwala omwe amatenga cyclosporine, danazole, gemfibrozil, mafupa ena (kupatula fenofibrate), kapena lipid-kutsitsa Mlingo (≥1 g / tsiku) la niacin molumikizana ndi Simgal, mlingo wa Simgal suyenera kupitilira 10 mg patsiku. Kwa odwala omwe amatenga amiodarone kapena verapamil nthawi yomweyo ndi Simgal, mlingo wa Simgal suyenera kupitilira 20 mg patsiku.

Palibe chifukwa chosintha kwa odwala omwe ali ndi vuto laimpso lokwanira. A kwambiri aimpso kulephera (creatinine chilolezo

Gwiritsani ntchito pa nthawi yoyembekezera kapena mkaka wa m'mawere

Simgal imaphatikizidwa pakatundu. Chitetezo cha mankhwalawa kwa amayi apakati sichinakhazikitsidwe. Palibe mayeso owongolera azachipatala omwe amachitidwa mwa amayi apakati. Pali malipoti angapo abambo obadwa mwatsopano mwa amayi akhanda omwe amayi awo adatenga ma HMG-CoA reductase inhibitors panthawi yoyembekezera. Komabe, popenda mayendedwe apakati mwa amayi pafupifupi 200 omwe amatenga simvastatin kapena HMG-CoA reductase inhibitor panthawi yoyambirira, zinapezeka kuti ma frequenti a anomgenes obadwa nawo anali ofanana ndi ma frequency omwe amawonekera ponseponse. Chiwerengerochi cha mimba chinali chokwanira kupatula

Kuchulukitsa-2,5 kapena kupitirira apo pamafupipafupi amasiyana pamalingaliro amodzi pafupipafupi. Ngakhale palibe umboni kuti kusasinthika kwa kusamvana kwa ana omwe amayi awo adatenga simvastatin kapena HMG-CoA reductase inhibitor sikusiyana ndi kuchuluka komwe kumachitika kawirikawiri, chithandizo cha amayi omwe ali ndi simvastatin amatha kuchepetsa fetal level of mevalonate, yomwe ili patsogolo pa cholesterol biosynthesis. Atherosulinosis ndi njira yovuta, ndipo, monga ulamuliro, kusiya kwa mankhwala opatsirana a lipid pa nthawi yapakati sikuyenera kukhudza kwambiri chiopsezo cha nthawi yayitali chokhudzana ndi hypercholesterolemia yayikulu. Pankhani imeneyi, sikulimbikitsidwa kugwiritsa ntchito Simgal panthawi yapakati, panthawi yakukonzekera, komanso ngati kutenga pakati kumangoyembekezeredwa. Chithandizo cha Simgal chiyenera kuyimitsidwa nthawi yayitali kapena pokhazikika kuti wodwala alibe pakati.

Sizikudziwika ngati simvastatin kapena ma metabolites amalowa mkaka wa m'mawere. Popeza kuchuluka kwa mankhwalawa kumadutsa mkaka wa m'mawere, komanso chifukwa choopsa chambiri, azimayi omwe amatenga Simgal amayenera kuyamwitsa.

Chitetezo ndi mphamvu ya simvastatin mu achinyamata (atsikana omwe amakhala ndi chaka chimodzi chakutha msambo) ndi anyamata azaka zapakati pa 10 mpaka 17 ndi heterozygous cholowa cholowa anazindikira mu kafukufukuyu. Mbiri ya zotsatira za odwala omwe amalandila simvastatin zinali zofanana ndi zomwe zimachitika kwa odwala omwe akutenga placebo. Mlingo woposa 40 mg sunaphunzitsidwe m'gulu ili la odwala. Phunziroli silinawonetse kukula ndi kukula kwa kugonana kwa achinyamata, komanso nthawi yakusamba kwa atsikana. Atsikana omwe amatenga simvastatin ayenera kulangizidwa za njira zakulera. Simvastatin sanaphunzitsidwe mwa odwala ochepera zaka 10, komanso mwa atsikana omwe sanayambebe kusamba.

Zolemba ntchito

Simvastatin, ngati zoletsa zina za HMG-CoA (hydroxymethylglutaryl-coenzyme A) kuchepetsa, nthawi zina zimatha kuyambitsa kukulitsa kwa myopathy, komwe kumadziwoneka mu mawonekedwe a kupweteka kwa minofu, kupweteka kapena kufooka, motsatana ndi kuchuluka kwa CPK kuposa

Nthawi 10 kuposa kuposa pamwambamwamba. Myopathy nthawi zina imawoneka mwa njira ya rhabdomyolysis kapena popanda kupweteka kwambiri kwa impso kulephera kwachiwiri kwa microalbuminuria. Pankhaniyi, kufa sikungachitike kawirikawiri. Chiwopsezo cha myopathy chikuwonjezereka chifukwa cha kuchuluka kwa kuchuluka kwa magazi m'magazi a zinthu zomwe zimakhumudwitsa motsutsana ndi HMG-CoA reductase.

Monga ndi zoletsa zina za HMG-CoA reductase, chiwopsezo chotenga myopathy / rhabdomyolysis chimadalira mlingo.

Kuyeza kwa CPK (CC) sikuyenera kuchitika pambuyo pogwira ntchito mwamphamvu kwambiri kapena pamaso pa chifukwa china chilichonse chokwanitsira CC, chifukwa izi zimasokoneza kutanthauzira kwa zomwe zidapezeka. Ngati milingo ya nambala yamilandu ikula kwambiri pamlingo woyambirira (> nthawi 5 pamwamba pamwambamwamba), ndikofunikira kuyesanso mkati mwa masiku 5-7 kuti mutsimikizire zotsatira.

Odwala onse omwe amayamba mankhwala ndi simvastatin kapena ndi kuchuluka kwa simvastatin ayenera kuchenjezedwa za chiopsezo chotenga myopathy ndi kufunsa kufotokozera kupweteka kwamtundu uliwonse, kufooka kapena kufooka.

Chenjezo umaperekedwa kuti apereke mankhwala kwa odwala omwe amakonda rhabdomyolysis. Kuti akhazikitse mtengo woyambira, kuchuluka kwa CC kuyenera kuwerengedwa musanalandire chithandizo pazinthu zotere:

• Ukalamba (> zaka 70).
• Matenda aimpso.
• Hypothyroidism yosalamulirika.
• Kuvulala kwa minofu ya m'mabanja kapena banja.
• Mbiri yokhala ndi poizoni wa minofu yoyambitsidwa ndi ma statins kapena fibrate.
• Mowa.

Zikatero, chiopsezo chokhudzana ndi chithandizo chamankhwala chiyenera kulemedwa ndi phindu lomwe lingakhalepo, ndikuwunika kuyang'anira kuchipatala. Ngati wodwala ali ndi mbiri yakusokonekera kwa minofu yolumikizidwa ndi ma statins kapena ma fiber, mankhwala ena a gululi ayenera kugwiritsidwa ntchito mosamala. Ngati milingo ya CC yachuluka kwambiri pamlingo woyambirira (> nthawi 5 kuposa msambo wopitilira), chithandizo sichiyenera kuyamba.

Wodwala akalandira chithandizo cha statin akayamba kupweteka minofu, kufooka, kapena kukokana, milingo ya CC iyenera kuyesedwa. Ngati, pakalibe mphamvu yayikulu yolimbitsa thupi, milingo iyi imachulukitsidwa kwambiri (> nthawi 5 kuposa msinkhu wapamwamba), chithandizo chikuyenera kusiyidwa. Ngati zizindikiro za minofu zimakhala zowopsa pamlingo kapena zimayambitsa kusasangalala tsiku ndi tsiku, ngakhale ngati kuchuluka kwa QC kuli kokwirikiza katatu kuposa msanga wabwinobwino, kuchuluka kwa seramu transaminase kumawonedwa mu ochepa odwala akuluakulu omwe amatenga simvastatin. Ndi kutha kapena kusiya kwa mankhwalawa, kuchuluka kwa ma transaminase mwa odwalawa, monga lamulo, pang'onopang'ono kubwerera pazotsatira zam'mbuyomu.

Musanayambe chithandizo, kenako, malinga ndi zizindikiro zamankhwala, ndikulimbikitsidwa kuti odwala onse awone ntchito ya chiwindi. Odwala omwe amawonjezera mlingo mpaka 80 mg amapatsidwa mayeso owonjezereka kuti awonjezere mlingo, miyezi 3 atatha kuchuluka kwa mlingo wa 80 mg, ndipo nthawi ndi nthawi (mwachitsanzo, kamodzi pa miyezi isanu ndi umodzi) pachaka choyamba chamankhwala. Chisamaliro chachikulu chiyenera kuperekedwa kwa odwala omwe kuchuluka kwawo kwa seramu transaminase kumawonjezeka. Mwa iwo, zitsanzozi zimayenera kubwerezedwa nthawi yomweyo, ndikuzichita pafupipafupi. Ngati milingo ya transaminase imakonda kukwera, makamaka ngati ikukula> katatu kuchulukirapo kuposa momwe imakhazikika komanso khola, muyenera kusiya kumwa simvastatin.

Chenjezo liyenera kuperekedwa kwa odwala omwe amamwa mowa wambiri.

Monga mankhwala ena ochepetsa lipid,

Malangizo ogwiritsira ntchito Simgala: njira ndi mlingo

Mapiritsi a Simgal amatengedwa pakamwa, kamodzi patsiku (kumadzulo), kutsukidwa ndi madzi ambiri.

Mlingo wovomerezeka wa mankhwalawa umasiyanasiyana mosiyanasiyana kwa 5-80 mg patsiku. Kusintha kwa Mlingo kumachitika pang'onopang'ono, ndi nthawi yosachepera mwezi umodzi. Mulingo wambiri watsiku ndi tsiku wa 80 mg umaperekedwa kwa okhawo omwe sanakwaniritse chithandizo chamankhwala akamamwa simvastatin pa mlingo wa 40 mg patsiku, komanso kwa iwo omwe amatenga Simtal diltiazem nthawi yomweyo. Odwala omwe atsala sayenera kumwa oposa 40 mg ya mankhwalawa patsiku.

Ndi hypercholesterolemia, koyamba tsiku lililonse la simvastatin ndi 10-20 mg. Ngati pakufunika kuchepetsa kuchuluka kwa osalimba a lipoproteins (LDL) ndi 45% kapena kuposerapo, muthanso kuwonjezera 20 mg mg tsiku lililonse.

Ndi homozygous cholowa hypercholesterolemia, Simgal imayikidwa pa mlingo wa 40 mg kamodzi patsiku kapena 80 mg patsiku mu katatu Mlingo (20 mg m'mawa ndi masana, ndi 40 mg madzulo).

Asanayambe chithandizo, wodwalayo amapatsidwa chakudya cha hypocholesterol, chomwe amayenera kutsatira nthawi yonse ya chithandizo.

Mu matenda a mtima, koyamba mlingo wa simvastatin ndi 20 mg kamodzi patsiku (madzulo), ngati kuli koyenera, mlingo umakulitsidwa mpaka 40 mg patsiku (pang'onopang'ono, masabata 4 aliwonse).

Ndi munthawi yomweyo kugwiritsa ntchito gemfibrozil, danazole, cyclosporine, ena mafupa (kupatula fenofibrate) ndi nicotinic acid tsiku lililonse mlingo wa 1 g, mlingo wa Simgal suyenera kupitilira 10 mg patsiku. Akaphatikizidwa ndi verapamil kapena amiodarone, Simgal 20 mg imayikidwa.

Simvastatin iyenera kumwedwa mosiyana ndi bile acid sequestrants (colestyramine ndi colestipol) - maola 2 asanagwiritse ntchito kapena maola 4 atatha kumwa mankhwalawa.

Okalamba odwala ndi odwala omwe ali ndiofatsa pang'ono komanso pang'ono aimpso amalephera kusintha. Kulephera kwambiri kwa aimpso, mlingo sioposa 10 mg patsiku, ndipo chithandizo chikuchitika moyang'aniridwa ndi dokotala.

Bongo

Ndi mankhwala osokoneza bongo osaneneka, zizindikiro zenizeni sizinalembetsedwe (milandu yambiri imadziwika pamene Simgal idakamwa pa 450 mg).

Mankhwalawa ndi amodzi: ndikofunikira kusanza ndikupatsa wodwalayo makala. Ngati ndi kotheka, mankhwala othandizira ndi mankhwala. Magawo a Serum creatine phosphokinase ndi ntchito ya impso ndi chiwindi iyeneranso kuyang'aniridwa.

Ndi chitukuko cha pachimake aimpso kulephera ndi zimachitika myopathy ndi rhabdomyolysis, mankhwala ayenera anasiya yomweyo ndi sodium bicarbonate mu mawonekedwe a kulowetsedwa kulowetsedwa ndi okodzetsa ayenera kuperekedwa kwa wodwala. Ngati ndi kotheka, hemodialysis imachitika.

Hyperkalemia, yomwe imayambitsidwa ndi rhabdomyolysis, imachotsedwa ndi kukhazikitsa kwa calcium gluconate kapena calcium chloride, kulowetsedwa kwa glucose ndi insulin, kugwiritsidwa ntchito kwa potaziyamu ion, komanso ovuta kwambiri, hemodialysis.

Mimba komanso kuyamwa

Simgal imapangidwa pakakhala pakati. Mwa ana omwe amayi awo adamwa mankhwalawo, amadziwikanso amatha (pamakhala zidziwitso zingapo).

Amayi amisinkhu yakubereka omwe amatenga simvastatin ayenera kugwiritsa ntchito njira zodalirika zolerera komanso kupewa kutenga pakati.

Ngakhale kuti deta pakugawidwa kwa simvastatin mkaka wa m'mawere sikupezeka, kugwiritsa ntchito Simgal panthawi yoyamwitsa sikulimbikitsidwa.

Kuyanjana kwa mankhwala osokoneza bongo

Chiwopsezo chotenga myopathy chikuwonjezereka ndikugwiritsa ntchito munthawi yomweyo Simgal ndi mankhwala antifungal, immunosuppressants, HIV proteinase inhibitors, cytostatics, Mlingo waukulu wa nicotinic acid, clarithromycin, nefazodone, gemfibrozil ndi ena mafupa (kupatula fenofibrate), erythromycin.

Ndi kuphatikiza kwa danazol, cyclosporine, verapamil, amiodarone, diltiazem kapena amlodipine wokhala ndi Mlingo waukulu wa simvastatin, mwayi wa rhabdomyolysis / myopathy ukuwonjezeka.

Simgal imapangitsa mphamvu ya anticoagulants osakhudzika ndikuwonjezera ngozi ya magazi, imawonjezera kuchuluka kwa plasma ya digoxin.

Pakumwa mankhwala a simvastatin, madzi ambiri a zipatso za mphesa ayenera kupewedwa.

Zofananira za Simgal ndi: Aterostat, Atrolin, Aldesta, Vazilip, Vasta, Vabadin, Vazostat-Health, Vastatin, Kardak, Zosta, Zokor, Simvageksal, Simvakol, Symvostat, Simvastatin, Simvastatin Zentiva, Simvakard, Simva Tad, Simva.

Mtengo wa Simgal m'masitolo ogulitsa mankhwala

Mtengo wa mankhwalawa umasiyanasiyana kutengera mlingo ndi ma CD. Mpaka pano, mitengo ya Simgal m'masitolo ndi motere:

• Mapiritsi 10 mg, 28 ma PC. mu phukusi - 217-224 rubles,
• Mapiritsi 10 mg, ma PC 84. mu phukusi - ma ruble 591-611,
• 20 mg mapiritsi, 28 ma PC. mu phukusi - 282- 392 ma ruble,
• 20 mg mapiritsi, 84 ma PC. mu phukusi - ma ruble 593-880,
• 40 mg mapiritsi, 28 ma PC. mu phukusi - ma ruble 584-650,
• mapiritsi 40 mg, 84 ma PC. mu phukusi - 1357 ma ruble.

Maphunziro: Rostov State Medical University, apadera "General Medicine".

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo ovomerezeka. Kudzipatsa nokha mankhwala kuopsa!

Asayansi ochokera ku Yunivesite ya Oxford adachita maphunziro angapo, pomwe adazindikira kuti zamasamba zimatha kukhala zovulaza ku ubongo wa munthu, chifukwa zimapangitsa kuchepa kwa unyinji wake. Chifukwa chake, asayansi amalimbikitsa kuti asachotsere konse nsomba ndi nyama muzakudya zawo.

Pakusuntha, thupi lathu limasiya kugwira ntchito. Ngakhale mtima umayima.

Kuphatikiza pa anthu, cholengedwa chimodzi chokha padziko lapansi - agalu, omwe ali ndi vuto la prostatitis. Awa ndi abwenzi athu okhulupilika kwambiri.

Ngati mungagwere kuchokera pabulu, mukulola khosi lanu kusiyana ndi kugwa kuchokera pa kavalo. Ingoyesani kutsutsa mawu awa.

Mu 5% ya odwala, antidepressant clomipramine amayambitsa kuphipha.

Caries ndimatenda ofala kwambiri padziko lonse lapansi omwe ngakhale chimfine sangathe kupikisana nawo.

Mimba ya munthu imagwira ntchito yabwino ndi zinthu zakunja komanso popanda chithandizo chamankhwala. Madzi am'mimba amadziwika kuti amasungunula ngakhale ndalama.

Nthawi yayitali yotsala ndiyotsika ndi yoyipa.

Malinga ndi kafukufuku, azimayi omwe amamwa magalasi angapo a mowa kapena vinyo pamlungu amakhala pachiwopsezo chotenga khansa ya m'mawere.

Kulemera kwaubongo wamunthu kuli pafupifupi 2% ya kulemera konse kwathupi, koma kumadya pafupifupi 20% ya mpweya womwe umalowa m'magazi. Izi zimapangitsa kuti ubongo wamunthu ukhale wovuta kwambiri kuwonongeka chifukwa cha kusowa kwa mpweya.

Ngati mumamwetulira kawiri kokha patsiku, mutha kutsitsa magazi ndikuchepetsa chiopsezo cha matenda a mtima ndi stroko.

Mankhwala akutsokomola "Terpincode" ndi amodzi mwa atsogoleri ogulitsa, ayi chifukwa cha mankhwala ake.

Kutentha kwambiri kwa thupi kudalembedwa ku Willie Jones (USA), yemwe adamulowetsa kuchipatala ndi kutentha kwa 46,5 ° C.

Matenda osowa kwambiri ndi matenda a Kuru. Oimira okha a fuko la Fore ku New Guinea amadwala naye. Wodwala amafa chifukwa cha kuseka. Amakhulupirira kuti chomwe chimayambitsa matendawa ndicho kudya ubongo wa munthu.

Amayi ambiri amatha kusangalala mwakuganizira za thupi lawo lokongola pakalilore kuposa kugonana. Chifukwa chake, akazi, yesetsani kuyanjana.

Malinga ndi ziwerengero, pafupifupi 80% ya akazi ku Russia amadwala bakiteriya. Monga lamulo, matenda osasangalatsa awa amatsatiridwa ndi kutuluka koyera kapena imvi.

Mankhwala

Mankhwala. Mutatenga simvastatin, yomwe ndi lactone yolimba, imagwiritsa ntchito hydrolysis kuti ipange yogwira β-hydroxy acid derivative, yomwe ndi cholepheretsa cha HMG-CoA reductase (3-hydroxy)

3-methylglutaryl-CoA reductase). Ma enzyme amenewa amathandizira kusintha kwa HMG-CoA kukhala mevalonate, komwe ndi gawo loyamba la cholesterol biosynthesis.

Simvastatin yawonetsedwa kuti ichepetse kuchuluka kwa cholesterol yoyenera komanso yokwezeka. LDL imapangidwa kuchokera ku low lowensens lipoproteins (VLDL), yomwe imalimbikitsa makamaka kukhudzana kwambiri ndi LDL receptor. Kupanga kwa LDL-kutsitsa mphamvu ya simvastatin kungaphatikizepo kuchepa konse kwa kuchuluka kwa VLDL cholesterol ndi kuphatikizidwa kwa LDL receptors, komwe kumabweretsa kuchepetsedwa kupanga ndikuwonjezera catabolism ya cholesterol ya LDL. Mankhwala a Simvastatin amathandizanso kuchepetsa kuchuluka kwa apolipoprotein B. Kuphatikiza apo, simvastatin imakweza pang'ono mafuta a cholesterol a HDL (lipotroteins yapamwamba) ndikuchepetsa mulingo wa triglycerides m'madzi a m'magazi. Chifukwa cha kusintha kumeneku, kuchuluka kwa cholesterol yathunthu yokhudza cholesterol ya HDL ndi cholesterol ya LDL polemekeza cholesterol ya HDL yatsika.

Zogulitsa. Simvastatin imagwira bwino ntchito ndipo imapatsidwa gawo lochulukirapo nthawi yoyamba kudzera m'chiwindi. Kuphatikizika kwa chiwindi kumatengera kutuluka kwa magazi m'chiwindi. Chiwindi ndi gawo lalikulu la mawonekedwe. Kutenga kwa β-hydroxy acid kumachokera m'magazi ambiri mutatenga simvastatin wocheperako kuposa 5% ya mlingo. Kuchuluka kwa plasma ndende kumafikiridwa

Maola 1-2 mutatha simvastatin. Kudya nthawi imodzi sikukhudza kuyamwa.

Kafukufuku wa pharmacokinetics a single and angapo Mlingo wa simvastatin adawonetsa kuti pambuyo pa dosing yambiri palibe kudzikundikira kwa mankhwalawa.

Kugawa. Kumangiriza kwa simvastatin ndi ma metabolites ake omwe amagwira ntchito kuma protein a plasma ndi> 95%.

Pomaliza Simvastatin ndi gawo lapansi la CYP3A4. Ma metabolites apamwamba ndi

β-hydroxy acid ndi ma metabolites ena anayi owonjezera. Pambuyo pakamwa poyatsira simvastatin, 13% ya chinthucho imachotsedwa mu mkodzo ndi 60% ndi ndowe mkati mwa maola 96. Kuchuluka kwa ndowe ndikufanana ndi mankhwala omwe amamwa mu ndulu, komanso mankhwala osasamba. Fundu za Pharmacokinetic zaphunziridwa mwa odwala akuluakulu. Zambiri za pharmacokinetic pakati pa ana ndi achinyamata palibe.

Basic zida zachilengedwe

Piritsi la 10 mg - mapiritsi ozungulira a biconvex, ophatikizidwa ndi film, pinki yopepuka

20 mg piritsi - mapiritsi ozungulira a biconvex, okhala ndi utoto wamtundu wa pinki wokhala ndi notch mbali imodzi,

40 mg piritsi - mapiritsi ozungulira a biconvex, wokutidwa ndi chipolopolo cha mtundu wakuda wa pinki wokhala ndi notch mbali imodzi.