Malangizo ogwiritsira ntchito mankhwalawa Simvagexal ® ndi ndemanga zake

Mtundu woyamba wa IIa ndi mtundu wa IIb hypercholesterolemia (wokhala ndi vuto lochiritsa pakudya kwa odwala omwe ali ndi chiopsezo chowonjezereka cha coronary atherosulinosis), hypercholesterolemia ndi hypertriglyceridemia, hyperlipoproteinemia, yomwe singathe kuwongoleredwa ndi zakudya zapadera komanso masewera olimbitsa thupi.

Kupewera kwa myocardial infarction (kuti muchepetse kupita patsogolo kwa matenda a coronary atherosulinosis), matenda a sitiroko ndi kusakhalitsa kwa matenda amitsempha yamagazi.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, kamodzi, madzulo. Ndi hypercholesterolemia yofatsa kapena yolimbitsa, mlingo woyambirira ndi 5 mg, ndi hypercholesterolemia yayikulu pamankhwala oyambira 10 mg / tsiku, ndi mankhwala osakwanira, mankhwalawa amatha kuchuluka (osapitirira masabata 4), mlingo waukulu wa tsiku ndi tsiku ndi 80 mg.

Ndi matenda a mtima a coronary, mlingo woyambirira ndi 20 mg (kamodzi, madzulo), ngati pakufunika, mlingo umakulitsidwa pang'onopang'ono sabata iliyonse 40 mpaka 40 mg. Ngati ndende ya LDL ndi yochepera 75 mg / dl (1.94 mmol / L), kuchuluka kwa mafuta m'thupi kumachepera 140 mg / dl (3,6 mmol / L), mlingo uyenera kuchepetsedwa.

Odwala omwe ali ndi vuto la aimpso kulephera (CC osakwana 30 ml / mphindi) kapena kulandira cyclosporine, fibrate, nicotinamide, mlingo woyambira ndi 5 mg, mlingo waukulu wa tsiku ndi tsiku ndi 10 mg.

Zotsatira za pharmacological

Mankhwala ochepetsa lipid omwe amapezeka kuti amapangidwa kuchokera ku mphamvu yampweya wa Aspergillus terreus ndi lactone wosagwira ntchito; amapita hydrolysis m'thupi kuti apange hydroxy acid. Metabolite yogwira imapunditsa kuchepa kwa HMG-CoA, ma enzyme omwe amathandizira pakuyamba kwa mapangidwe a mevalonate ku HMG-CoA. Popeza kutembenuka kwa HMG-CoA kukhala mevalonate ndi gawo loyambirira kapangidwe ka cholesterol, kugwiritsidwa ntchito kwa simvastatin sikumapangitsa kudzikundikira kwa ma sterols oopsa mthupi. HMG-CoA imapangidwa mosavuta ku acetyl-CoA, yomwe imakhudzidwa ndi njira zambiri zopangira thupi.

Amachepetsa kuchuluka kwa TG, LDL, VLDL ndi cholesterol yathunthu m'madzi am'magazi (hypercholesterolemia, yosakanikirana ndi hyperlipidemia, kuwonjezeka kwa cholesterol ndi chiopsezo). Kuchulukitsa ndende ya HDL ndikuchepetsa kuchuluka kwa LDL / HDL ndi cholesterol / HDL yathunthu.

Kukhazikika kwa masabata awiri pambuyo pa kuyambika kwa makonzedwe, chithandizo chokwanira kwambiri pambuyo pa masabata a 4-6. Zotsatira zake zimapitiliza ndi chithandizo chopitilira, pakutha kwa chithandizo, mafuta a cholesterol amabwerera pamlingo wawo woyambirira (chithandizo chisanachitike).

Zotsatira zoyipa

Kuchokera pamatumbo: dyspepsia (nseru, kusanza, m'mimba, kupweteka kwam'mimba, kudzimbidwa kapena kutsekula m'mimba, chiwindi, jaundice, kuchuluka kwa "chiwindi" transaminases ndi alkaline phosphatase, CPK, kawirikawiri - pachimake pancreatitis.

Kuchokera kwamankhwala amanjenje ndi ziwalo zam'magazi: asthenia, chizungulire, kupweteka mutu, kusowa tulo, kupweteka, paresthesias, zotumphukira zamitsempha, mawonekedwe osasinthika, kusokonekera kwa zomverera.

Kuchokera ku minculoskeletal system: myopathy, myalgia, myasthenia gravis, kawirikawiri rhabdomyolysis.

Thupi lawo siligwirizana ndi immunopathological: angioedema, lupus ngati matenda, polymyalgia rheumatism, vasculitis, thrombocytopenia, eosinophilia, kuchuluka kwa ESR, nyamakazi, arthralgia, urticaria, photosensitivity, fever, hyperemia ya pakhungu.

Dermatological zimachitika: zotupa pakhungu, kuyabwa, alopecia.

Zina: kuchepa kwa magazi m'thupi, palpitations, kulephera kwa impso (chifukwa cha rhabdomyolysis), kutsika kwa potency.

Malangizo apadera

Musanayambe chithandizo, ndikofunikira kuti muwoneke momwe chiwindi chimagwirira ntchito (kuwunika momwe "chiwindi" chikufikirira masabata 6 aliwonse kwa miyezi itatu yoyambirira, kenako milungu isanu ndi itatu ya chaka chotsalira, komanso kamodzi miyezi isanu ndi umodzi). Kwa odwala omwe amalandila simvastatin tsiku lililonse la 80 mg, chiwindi chimayang'aniridwa kamodzi miyezi itatu iliyonse. Milandu yomwe ntchito ya "chiwindi" transaminases imachulukana (kuchulukitsa katatu pazomwe zimachitika), chithandizo chimathetsedwa.

Odwala a myalgia, myasthenia gravis ndi / kapena kuwonjezeka kodziwika ka zochitika za CPK, mankhwala osokoneza bongo amayimitsidwa.

Simvastatin (komanso zoletsa zina za HMG-CoA reductase inhibitors) siziyenera kugwiritsidwa ntchito ndi chiwopsezo chowonjezeka cha matenda a rhabdomyolysis ndi kulephera kwa aimpso (chifukwa cha kufooka kwambiri, kuchepa kwa mitsempha, opaleshoni yayikulu, kuvulala kwambiri, komanso kuvulala kwambiri kwa metabolic.

Kuletsa lipid-kuchepetsa mankhwala panthawi yoyembekezera sikukhudza kwambiri zotsatira za chithandizo cha nthawi yayitali cha hypercholesterolemia.

Chifukwa chakuti HMG-CoA reductase inhibitors inhibit cholesterol synthesis, ndi cholesterol ndi zinthu zina zomwe zimapangidwa zimathandizira kwambiri kukulira kwa mwana wosabadwayo, kuphatikizapo kuphatikiza kwa ma steroid ndi nembanemba yama cell, simvastatin imatha kukhala ndi vuto pa mwana wosabadwayo azimayi a msinkhu wobereka azitsatira mosamala njira zakulera). Mimba ikachitika panthawi ya chithandizo, mankhwalawo ayenera kusiyidwa, ndipo mayiyo anachenjeza za ngozi yomwe ingakhalepo kwa mwana wosabadwayo.

Simvastatin siimawonetsedwa pomwe pali mtundu I, IV, ndi V hypertriglyceridemia.

Imagwira bwino onse mu mawonekedwe a monotherapy, komanso osakanikirana ndi bile acid.

Asanachitike komanso munthawi yamankhwala, wodwalayo ayenera kukhala ndi chakudya cha hypocholesterol.

Pakusowa mlingo womwe ulipo, mankhwalawa amayenera kumwedwa posachedwa. Ngati ili nthawi yotsatira, musangonenepa.

Odwala kwambiri aimpso kulephera, mankhwala ikuchitika motsogozedwa aimpso.

Odwala amalangizidwa kuti afotokozereni ululu wosaneneka wa minofu, kufooka, kapena kufooka, makamaka ngati kumayendera limodzi ndi malaise kapena kutentha thupi.

Kuchita

Imawonjezera mphamvu ya ma anticoagulants osawerengeka ndipo imawonjezera mwayi wokhetsa magazi.

Kuchulukitsa kuchuluka kwa digoxin mu seramu yamagazi.

Cytostatics, antifungal mankhwala (ketoconazole, itraconazole), ma fibrate, mlingo waukulu wa nicotinic acid, immunosuppressants, erythromycin, clarithromycin, proteinase inhibitors amawonjezera chiopsezo cha rhabdomyolysis.

Colestyramine ndi colestipol amachepetsa bioavailability (kugwiritsa ntchito simvastatin ndikotheka patatha maola 4 mutatha kumwa mankhwalawa, ndiwowonjezera).

Mafunso, mayankho, ndemanga pa mankhwala Simvageksal

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe aphatikizidwa ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.

Khalidwe la mankhwala

Kupanga Simvageksal kumachitika ndi nkhawa ya ku Germany Hexal AG. Cholinga chachikulu cha mankhwalawa ndikuchepetsa cholesterol yamagazi, triglycerides ndi lipoproteins yotsika.

Mankhwalawa ndi a gulu lama pharmacological a statins. Amapezeka kuchokera ku zinthu monga Aspergillus terreus, chomwe ndi michere ya enzymatic. INN: Simvastatin. Kusankhidwa kwa Simvagexal ngati dokotala kumachitika pamene wodwala azindikira:

• hypercholesterolemia yoyamba komanso yophatikiza,
• hypertriglyceridemia.

Zomwe zimachitika pa fomu yotulutsira komanso mtengo wake

Mankhwalawa amapezeka piritsi. Awa ndi mapiritsi a ellipsoidal mu chipolopolo cha mtundu wotuwa wa pinki kapena wa lalanje (kutengera mlingo), wokhala ndi notchi yapadera ndi zolemba. Otsirizawa ali ndi zilembo zitatu zoyambirira zokhudzana ndi dzina la mankhwalawo (SIM) ndi nambala yomwe ikuwonetsa kuchuluka kwa kuzungulira kwa chinthu chomwe chimagwira.

Zambiri za mtengo wamba wa Simvagexal wa mankhwalawa ku Russia zimaperekedwa patebulo.

Simvagexal ndi ya monocomponent yokonzekera ndipo imapangidwa chimodzi yogwira - simvastatin. Chipolopolo chomwe chimakwirira piritsi chimakhala ndi zinthu zothandiza. Amakhala ndi wowuma, cellulose, butylhydroxyanisole E320, magnesium stearate, ascorbic acid ndi citric acid, 5 cps ndi 15 cps hypromellose, titanium dioxide, chikasu ndi red iron oxide.

Zambiri pa pharmacodynamics ndi pharmacokinetics

Simvagexal ndi othandizira kutsitsa lipid. Iningion ya simvastatin imayendera limodzi ndi hydrolysis, zomwe zimapangitsa kuti pakhale mpweya wina wa hydroxy acid.

Mankhwalawa amachepetsa triglycerides, otsika kwambiri komanso ochepa otsika lipoproteins (LDL), komanso cholesterol yonse (OX). Kuphatikiza apo, zimathandizira kuwonjezeka kwa osachulukitsa lipoprotein (HDL) komanso kutsika kwa chiŵerengero cha OH / HDL mpaka LDL / HDL.

Mutha kuyembekezera zotsatira za kumwa mankhwalawa pakatha masiku khumi mpaka khumi ndi anayi kuyambira pomwe mudayamba kulandira mankhwala ndi Simvagexal. Kwambiri achire zotsatira zimatheka pambuyo mwezi kapena theka ndi kudya mapiritsi mosalekeza.

Mndandanda wazowonetsa ndi zotsutsana

Malangizo a mankhwalawa akuwonetsa kuti akuwonetsedwa kuti mugwiritse ntchito pawiri:

1. Ngati pakufunika kuwongolera mankhwala a cholesterol ndi lipid metabolism.
2. Ngati pali chiopsezo cha zovuta zokhudzana ndi mtima, matenda a mtima, matenda a shuga, stroke komanso matenda ena okhudzana ndi matenda amisala amadziwika.

Mankhwalawa ndi mankhwala othandizira omwe amalembedwa kwa odwala omwe ali ndi hypercholesterolemia (cholowa kapena cholowa), komanso osiyanasiyana a mtima. Izi ndizofunikira pokhapokha kusintha zakudya sizipereka phindu.

Mutatha kumwa Simvagexal ndi odwala omwe apezeka kuti ali ndi vuto la mtima ndi ziwalo, zotsatirazi zikuwoneka:

• Kuchepetsa imfa chifukwa cha matenda amtima,
• kupewa matenda amtima, minyewa,
• kuchepa kwamphamvu kwamitsempha yamagazi.
• popewa kufunikira kwa kuchitapo kanthu kwa opaleshoni yomwe imapangidwanso kuti ibwezeretsenso kwina.
• Kuchepetsa chiopsezo kuchipatala chifukwa cha angina pectoris.

Pakati pa contraindication pochiza ndi Simvagexal, pali:

vuto lomwe limadza chifukwa cha kupangika kwa maselo ofiira a m'magazi (porphyria),

Zofunika! Mankhwalawa ali osavomerezeka kuti agwiritsidwe ntchito ndi amayi panthawi yomwe ali ndi pakati, popeza pali umboni wa zovuta zake pa mwana wosabadwayo, zomwe zimapangitsa kuti pakhale zovuta pa mwana.

Amayi a msinkhu wobala mwana amene akukonzekera kubereka ayeneranso kupewa kulandira mankhwalawa ndi simvastine. Mimba ikachitika mukumwa Simvagexal, muyenera kusiya kugwiritsa ntchito.

Palibe chidziwitso pazomwe zimagwiritsidwa ntchito ndi mankhwalawa zimakhudza mkaka wa m'mawere. Pakati mkaka wa m'mawere, kutenga Simavhexal sikulimbikitsidwa.

Kukhazikitsidwa kwa mankhwalawa kwa ana ndi achinyamata ochepera zaka khumi ndi zisanu ndi zitatu kumachitika kwambiri.

Pali zochitika zina zomwe mankhwalawa amayikidwa mosamala muyezo wotsikirapo komanso kuyezetsa magazi pafupipafupi. Izi zikuphatikiza:

• kulephera kwambiri kwaimpso
• zovuta za endocrine
• mwayi wa matenda ashuga
• ochepa matenda oopsa
• uchidakwa
• okhudzana ndi zaka zaka 65,
• Mankhwala olumikizana ndi vitamini B3, fusidic acid, Amiodarone, Verapamil, Amlodipine, Dronedaron, Ranolazine.

Zolemba za mankhwala

Simvagexal, malinga ndi malangizo ogwiritsira ntchito matendawa, amatengedwa kamodzi patsiku. Izi zikuyenera kuchitika madzulo. Mankhwalawa amatsukidwa ndi madzi ambiri. Kutalika kwa njira ya achire ndi mankhwala ndi adokotala. Sitikulimbikitsidwa kuti musinthe mosiyanasiyana mankhwalawa komanso mtundu wa mankhwalawa.

Ngati mankhwalawo adaphonya, ndiye kuti mankhwalawo amatha kuledzera nthawi ina iliyonse, kusiya kumwa kosasinthika. Mlingo waukulu umakhazikitsidwa malinga ndi kuchuluka kwa cholesterol yomwe imapezeka pakadutsa milungu inayi.

Mlingo wokhazikika ndi mamiligalamu 40 a simvagexal. Itha kuwonjezereka mpaka ma milligram 80 patsiku ngati pali vuto la mtima komanso njira zochizira sizikugwira ntchito mokwanira.

Odwala omwe ali ndi vuto la mtima amapatsidwa mlingo wa mamiligalamu 20. Pakatha mwezi, ngati kuli kotheka, muyezo umachulukitsa mpaka 40 milligram. Ndi kuchepa kwa cholesterol yathunthu kupita ku 3.8 mmol / lita kapena kuchepera, kuchuluka kwa mapiritsi omwe adatengedwa amachepetsedwa.

Matenda a mtima

Wodwala akalandira chithandizo chowonjezereka ndi cyclosporine, Nicotinamide kapena ma fibrate, ndiye kuti mlingo woyambira ndi wokulirapo wa tsiku ndi tsiku umachepetsedwa kukhala mamililita 5 mpaka 10. Machitidwe omwewo amatengedwa ngati matenda a impso alephera.

Zotheka zoyipa ndi bongo

Pa mndandanda wazotsatira zoyipa kuchokera ku Simvagexal mankhwala, mutha kuwona izi:

1. Kuchokera kuzinthu zamanjenje ndi zamanjenje: kupezeka kwa kugwedezeka kwamatenda a minofu, asthenic syndrome, chizungulire, masomphenya osakhazikika, paresthesia, zovuta zamkamwa, kupweteka pamutu, kugona tulo, zotumphukira m'mitsempha.
2. Kuchokera kumbali ya chimbudzi: chimbudzi, kusanza, kupweteka pamimba, kuchuluka kwa chiwindi, kulenga phosphokinase (CPK), kuchuluka kwa kapangidwe ka mpweya, kapamba, matumbo, chiwindi.

Zizindikiro zapadera sizinakhazikike pochulukitsa mlingo wa mankhwalawa (mlingo woyenera wovomerezeka unali mamiligalamu 450).

Mndandanda wazofananira

Mwa mayendedwe a Simvagexal, omwe ali ndi yogwira mankhwala simvastine, izi zitha kusiyanitsidwa:

Mankhwala a ku Hungary Simvastol.Wopezeka mu mawonekedwe a piritsi pamtengo wa 10 ndi 20 mamililita. Phukusili lili ndi miyala 14 ndi 28. Chida ichi chili ndi kufanana kofanana ndi Simvagexal, mndandanda wazowonetsa ndi zotsutsana. Asanayambe kumwa mankhwalawa, wodwalayo amapatsidwa chakudya cha hypocholesterol.

Mankhwalawa amatengedwa kamodzi patsiku madzulo. Mlingo watsiku ndi tsiku womwe amalimbikitsidwa ndi madokotala umasiyana kuchokera pa 10 mpaka 80 mamiligalamu, kutengera ndi kupezeka kwa matenda komanso kupezeka kwa matenda olimba. Kwa odwala ambiri, mulingo woyenera kwambiri womwe umapereka chithandizo chofunikira ndi mamiligalamu 20. Mtengo wa mankhwalawa umachokera ku 169 mpaka 300 rubles.

Mwa zina mwa mankhwala analogue akutsimikiziridwa: Vazilip (Slovenia), Zokor (Netherlands), Simvalimit (Latvia), Simgal (Israel), Zorstat (Croatia), Avenkor (Russia), Simvastatin (Russia), Sinkard (India).

Mankhwala a Simvagexal: zikuwonetsa ntchito, analogi, ndemanga

Mu shuga mellitus, ndikofunikira kuti musamangoyesa shuga wamagazi, komanso kumangoyesa mayeso a cholesterol pafupipafupi. Ngati chizindikiro ichi chikuwonjezereka, adotolo amakupatsani zakudya zapadera zochizira komanso mankhwala.

Mankhwala odziwika kwambiri a hypercholesterolemia ndi Simvagexal, amatanthauza za lipid-kuchepetsa mankhwala omwe ali ndi yogwira mankhwala simvastatin.

Mapiritsiwa ndi oyenera kuthandizira odwala omwe ali ndi zaka zopitilira 18. Mutha kuzigula pa pharmacy iliyonse mukapereka mankhwala. Mlingowo umatsimikiziridwa ndi dokotala payekhapayekha, poganizira za mbiri yakale yakuchipatala, kupezeka kwa ma contraindication ndi matenda ang'onoang'ono.

Kodi mankhwalawa amagwira ntchito bwanji?

Kukonzekera komwe kumapangidwa kuchokera ku enzymatic product Aspergillus terreus kumatsitsa ma plasma omwe amakhala ndi triglycerides, otsika kwambiri komanso otsika kwambiri a lipoproteins, komanso kumawonjezera zomwe zili ndi kachulukidwe kakakulu ka lipoproteins.

Zotsatira zabwino zoyambirira zitha kuwoneka patadutsa masiku 14 chichitikireni chithandizo. Kwambiri achire zotsatira zimatheka pang'onopang'ono, patatha mwezi ndi theka.

Ndikofunika kumaliza njira yochiritsira yomwe mwalandira kuti ikhale yotalikilapo kwa nthawi yayitali.

Dokotalayo amakupatsani mankhwala ngati wodwala amuwonetsa:

• Hypercholesterolemia,
• Hypertriglyceridemia,
• Kuphatikiza hypercholesterolemia.

Mankhwala amagwiritsidwa ntchito ngati zakudya zapadera sizinathandize. Komanso, kugwiritsa ntchito mapiritsi kumaloledwa kuchitira zokhala ndi vuto ngati pali chiopsezo cha kulowetsedwa kwa myocardial ndi cholesterol index yoposa 5.5 mmol / lita.

Kuphatikiza pa yogwira chinthu simvastatin, mapiritsi okhala ndi mawonekedwe owoneka ngati oyera, achikasu kapena ofiira okhala ndi ascorbic acid, iron oxide, lactose monohydrate, starch ya chimanga, magnesium stearate, hypromellose, titanium dioxide.

Malangizo ogwiritsira ntchito mankhwalawa

Malinga ndi buku lofunikiralo, muyenera kumwa Simvagexal madzulo kamodzi patsiku, kumwa madzi ambiri. Kutalika kwa mankhwalawa kumatsimikiziridwa ndi adotolo, kudzisintha mosamala komanso mulingo saloledwa.

Ngati mlingo waposowa akusowa, mankhwalawa amatengedwa nthawi ina iliyonse, pamene mlingo umakhalabe womwewo. Pambuyo pofufuza wodwalayo, ndikuphunzira mbiri yakale yakuchipatala komanso mayeso, dokotalayo amasankha kuti ndi mapiritsi angati omwe amafunikira pakuyamba kwa chithandizo.

Mlingo waukulu umakhazikitsidwa, ndikuyang'ana kuchuluka kwa cholesterol, yomwe imapezeka pakadutsa milungu inayi.

1. Pa mlingo wokwanira, wodwala amatenga 40 mg patsiku. Voliyumu iyi imatha kuwonjezeredwa mpaka 80 mg patsiku pamaso pa vuto la mtima pamene chithandizo sichikugwira ntchito.
2. Odwala omwe ali ndi vuto la mtima amatenga 20 mg tsiku lililonse. Pakatha mwezi umodzi, mlingo ngati pakufunika ukuwonjezeka 40 mg. Pankhani ya kuchepa kwa cholesterol yathunthu mpaka 3,6 mmol / lita ndi pansi, kuchuluka kwa mapiritsi kumachepa.
3. Ngati munthu amathandizidwa ndi cyclosporine, Nicotinamide kapena ma fibrate, mlingo woyambira komanso wovomerezeka tsiku lililonse umachepetsedwa kukhala 5-10 mg. Zochita zofananira zimatengedwa ngati pali kulephera kwa impso.

Ndani amatsutsana ndi mankhwala

Ndikofunikira kudziwa kuti mapiritsi ali ndi ma contraindication angapo, chifukwa chake, kudzipiritsa nokha sikuyenera kuchitika. Musanatenge Simvagexal, muyenera kuwerenga malangizo kuti mugwiritse ntchito.

Mtengo wa mankhwala omwe ali ndi ndemanga zabwino ndi ma ruble 140-600, kutengera phukusi. Mu pharmac mungapeze mapaketi a 5, 10, 20, 30, 40 mg. Kuti muchite maphunziro ambiri, tikulimbikitsidwa kugula mapiritsi a Hexal Simvagexal 20mg mu 30 ma PC.

Mankhwala okhazikika ngati wodwala ali:

• kulephera kwa chiwindi
• Hypersensitivity pamagawo a mankhwala,
• chidwi ndi ma statins,
• myopathy
• kuphwanya mapangidwe a maselo ofiira a m'magazi (porphyria).

Simungathe kuchita mankhwala ngati munthu akutenga Itraconazole, Ketoconazole, mankhwala ochizira matenda a HIV limodzi. Komanso, mapiritsi amadzipanikiza azimayi oyembekezera komanso oyamwitsa.

Chenjezo liyenera kuchitika pamene wodwala agwiritsa ntchito zakumwa zoledzeretsa, amathandizidwa ndi immunosuppressants, amakhala ndi kachulukidwe kamisempha kapena minyewa yam'mimba, ali ndi vuto la khunyu, matenda opweteka kwambiri, matenda oopsa a m'magazi, matenda oopsa a endocrine komanso a metabolic. Mankhwalawa amachitidwa pakati pa odwala azaka zopitilira 18.

Pa nthawi yoyembekezera, ndibwino kukana mankhwalawa, chifukwa muzochitika zamankhwala zokhudzana ndi zovuta za mwana zimachitika pambuyo poti aledzeretse mapiritsi.

Zotsatira zoyipa

Popereka mankhwala ndi mapiritsi, dokotala ayenera kuonetsetsa kuti wodwala samamwa mankhwala ena. Wodwalayo, ayenera kudziwitsa adotolo za mankhwala omwe amamwa kale. Izi ndizofunikira popewa kuyanjana kosafunikira ndi mankhwala ena.

Makamaka, pogwiritsa ntchito ma fibrate, cytostatics, kuchuluka kwa nicotinic acid, Erythromycin, proteinase inhibitors, antifungal agents, immunosuppressants, Clarithromycin, rhabdomyolysis amatha.

Chifukwa chodziwikiratu kwa ma anticoagulants am'kamwa, magazi amatha kutuluka, motero muyenera kuyang'anitsitsa momwe magazi amathandizira pakumwa. Simvagexal imachulukanso zam'magazi za digoxin. Ngati wodwalayo agwiritsa kale cholestyramine ndi colestipol, mapiritsi amaloledwa kuti amwe pokhapokha maola anayi.

1. Zotsatira zoyipa zimawonetsedwa mu mawonekedwe a minofu kukokana, asthenic syndrome, chizungulire, masomphenya osawona, paresthesia, kukhumudwa kwa mutu, kupweteka mutu, kusowa tulo, zotumphukira neuropathy.
2. Pali milandu ya kugaya chakudya dongosolo, kudzimbidwa, nseru, dyspepsia, kusanza, kupweteka pamimba, flatulence, kapamba, kutsegula m'mimba, chiwindi.
3. Nthawi zina, sayanjana zimachitika mu mawonekedwe a kuyabwa ndi zotupa, polymyalgia rheumatica, thrombocytopenia, malungo, kuchuluka kwa erythrocyte sedimentation rate, urticaria, kufupika kwa mpweya, eosinophilia, angioedema, khungu hyperemia, vasculitis, nyamakazi, lupus erythematosus.
4. Munthu akhoza kukhala ndi myalgia, myopathy, kufooka kwathunthu, rhabdomyolysis. Zotsatira zake, potency imachepa, palpitations imawonjezeka, kuchepa kwa magazi m'thupi, komanso kulephera kwa chiwindi.

Ngati mankhwala osokoneza bongo, monga lamulo, zizindikiro zina sizimawoneka, koma ndikofunikira kuchotsa zochuluka zogwira ntchito m'thupi. Kuti muchite izi, wodwalayo amatsukidwa, apatseni makala oyambitsa. Mankhwala, ndikofunikira kuwunika momwe seramu imapangidwira phosphokinase, aimpso ndi kwa chiwindi ntchito.

Ngati mutenga ma statins kwa nthawi yayitali, nthawi zina nthenda yam'mapapo imayamba, yomwe imayendera limodzi ndi chifuwa chouma, chikuwonjezeka kwambiri, kutopa kwambiri, kuchepa thupi, komanso kuzizira.

Malangizo a Madokotala

Ngati munthu ali mkati mwa chithandizo akuwonjezera ntchito ya creatine phosphokinase ndi kukokana kwa minofu, ndikofunikira kusiya kulimbikira.

Ziyeneranso kuthetsa zomwe zimayambitsa ntchito ya enzyme yowonjezereka, yomwe imaphatikizapo kukhalapo kwa malungo, mabala, kuvulala, hypothyroidism, matenda, chifuwa cha kaboni dayosi, polymyositis, dermatomyositis, mowa ndi mankhwala osokoneza bongo. Zitatha izi ntchito ya enzyme ikupitilirabe, mapiritsi a Simvagexal ayenera kusiyidwa kwathunthu. M'malo mwake, mutha kugwiritsa ntchito fanizo kuchokera kwa opanga ena.

Asanayambe chithandizo, adokotala amayenera kukayezetsa magazi a KFK. Njirayi iyenera kubwerezedwa pambuyo pa miyezi itatu. Kuwunika kwa creatine phosphokinases mu okalamba ndi odwala omwe amapezeka ndi insulin amadalira matenda a shuga, hypothyroidism, matenda opatsirana aimpso amachitika chaka.

Kwa mtundu wina uliwonse wa matenda ashuga, ndikofunikira kumayesa mayeso a shuga wamagazi, chifukwa mankhwalawa amathandizira kuwonjezera kuchuluka kwa shuga mu plasma.

Odwala ena amakhala ndi hyperglycemia, yomwe imafuna mankhwala apadera.

Koma madokotala salimbikitsa kuti ayimitse chithandizo ndi ma statins, chifukwa cholesterol yokwezeka imatha kuyambitsa zovuta zambiri m'matenda a matenda ashuga ngati sanalandiridwe bwino.

Mapiritsi ayenera kumwedwa mosamala ngati wodwala akuledzera. Ngati kuchepa kwa chithokomiro, matenda a impso, matenda oyamba amathandizidwa pokhapokha pokhapokha mutayamba kuchepetsa kuchuluka kwa mafuta m'thupi m'magazi.

Mankhwala ofanana ndi awa akuphatikizapo Zokor, Avestatin, Sinkard, Simgal, Vasilip, Aterostat, Zorstat, Ovenkor, Holvasim, Simplakor, Actalipid, Zovatin ndi ena.

Zakudya kuti muchepetse cholesterol

Kuphatikiza pa kumwa mankhwala, wodwalayo ayenera kutsatira zakudya zama hypocholesterol, zomwe zimaphatikizapo kudya zakudya zochepa m'mafuta a nyama. Zakudya zoyenera zimatha kusintha mitsempha yamagazi ndikuchotsa mapangidwe a atherosrance.

Zakudya zoletsedwa ndizophatikiza nyama komanso mafuta osinthika, batala wachilengedwe, margarine, nyama yamafuta, masoseji, ndi masoseji. Wodwala ayenera kukana mazira, mazira okazinga, zikondamoyo, zophika ndi zonunkhira zonona.

Komanso, kupatula sauces, mkaka wonse, mkaka wokometsedwa, zonona, wowawasa zonona, tchizi mafuta ophikira ndizofunikira kuchokera pakudya.

Ndikulimbikitsidwa kuti wodwala azithira mbale ndi soya, canola, maolivi, sesame ndi masamba ena ammafuta, omwe ali ndi omega-mafuta atatu acids.

Muyenera kudya nsomba, nsomba, nsomba zazing'ono zam'madzi, mitundu ya nsomba, nkhuku, nkhuku. Zakudya zoterezi ndi gwero labwino kwambiri la mapuloteni.

Menyu mumakhala zamphesa zilizonse zophika pamadzi, buledi wa tirigu, tirigu wamitundu yambiri, masamba abwino ndi zipatso.

Ndi matenda a shuga amtundu uliwonse, simungagwiritse ntchito maswiti, ma pie, mabisiketi.

Zakudya zochiritsika zokhala ndi cholesterol yokwezeka zili ndi malamulo angapo omwe ayenera kutsatiridwa. Zakumwa zoledzeretsa, khofi, tiyi wamphamvu zimakhala zotsutsana kwathunthu, zakudya zotsekemera komanso zotsekemera zimagwiritsidwa ntchito pazochepa kwambiri.

Chakudyacho chimaphatikizapo masamba, zipatso, mkaka wopanda mafuta. Zakudya zophika zimasinthidwa ndi zakudya zowiritsa komanso zosafunikira. Msuzi wophika nyama umadyedwa osazola popanda mafuta. Nkhuku yokonzedwa yokonzeka imadyedwa patebulo popanda khungu, mafuta sagwiritsidwa ntchito pakuphika. Dzira la nkhuku limadyedwa popanda yolks.

Zakudya zopatsa thanzi zimachepetsa cholesterol yowonjezera, kuteteza mitsempha ya magazi ndi chiwindi. M'masiku asanu ndi awiri oyamba, wodwalayo akumva bwino, chifukwa m'mimba mulibe nkhawa. Zakudya zotere sizikhala ndi zotsutsana, monga momwe zimakhalira, ndizabwino kwa odwala matenda ashuga.

Momwe masinthidwe a metabolid a lipid akufotokozedwera mu kanema m'nkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda pamayendedwe Akusaka Osapezeka Kusaka sakupeza Kusaka sikupezeka

SIMVAGEXAL

- hypercholesterolemia yoyamba (mtundu IIa ndi IIb malinga ndi gulu la Fredrickson) ndi kusachita bwino kwa chithandizo chamankhwala chokhala ndi cholesterol yotsika komanso njira zina zosagwiritsa ntchito mankhwala (zolimbitsa thupi ndi kuchepa thupi) mwa odwala omwe ali ndi chiopsezo cha coronary atherossteosis, - kuphatikiza hypercholesterolemia ndi hypertriglyceridemia kudya ndi kuchita masewera olimbitsa thupi, - IHD: kupewa kulowetsedwa kwa myocardial (chitetezo chachiwiri cha infrction ya myocardial) mwa odwala omwe ali ndi msana kutulutsa cholesterol (> 5.5 mmol / l).

Pharmacokinetics

ZogulitsaMayamwidwe a simvastatin ndi okwera. Pambuyo pakulowetsa, Cmax mu plasma imafikiridwa pambuyo pafupifupi maola 1.3-2.4 ndipo imatsika pafupifupi 90% pambuyo maola 12.KugawaKulumikizana ndi mapuloteni a plasma kuli pafupi 95%.KupendaImachitika chifukwa cha "gawo loyamba" kudzera mu chiwindi. Ndi hydrolyzed kuti ipange yogwira mtima, beta-hydroxyacids, ndi ma metabolites ena ogwira ntchito nawonso apezeka.KuswanaT1 / 2 ya metabolites yogwira ndi maola 1.9. Imapukusidwa makamaka ndi ndowe (60%) monga metabolites. Pafupifupi 10-15% amachotseredwa ndi impso mu mawonekedwe a metabolites osagwira.

Contraindication

- Kulephera kwa chiwindi, matenda a chiwindi, pachimake, kupitilira kwa zochitika za hepatic transaminases of etiology osadziwika, - porphyria, - myopathy, - munthawi yomweyo makonzedwe a ketoconazole, itraconazole, mankhwala othandizira matenda a HIV, - kuchuluka kwa chidwi ndi zigawo zina za mankhwala a statin - mbiri (zoletsa za HMG-CoA reductase) mbiri. kusamala Mankhwala ayenera kuperekedwa kwa odwala omwe ali ndi uchidakwa wambiri, odwala atatha kumuwonjezera, omwe akuwathandizanso ndi mankhwala a immunosuppressive (chifukwa cha chiwopsezo cha rhabdomyolysis ndi kulephera kwa aimpso), mikhalidwe yomwe ingayambitse kulephera kwa aimpso, monga matenda oopsa, matenda oopsa, kusokonekera kwambiri kwa metabolic ndi endocrine, kusokonezeka koyenera m'madzi-electrolyte, kulowererapo kwa opaleshoni (kuphatikiza mano) kapena kuvulala kwa odwala omwe ali ndi minofu yafupika kapena yowonjezereka ya mafupa amkati a etiology osadziwika, okhala ndi khunyu, ana ndi achinyamata osakwana zaka 18 (chitetezo ndi mphamvu sizinakhazikitsidwe).

Malangizo ogwiritsira ntchito

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CDMapiritsi okhala ndi mbali chikasu chopepuka, chowaza, chokhala ndi notch mbali imodzi ndi cholembedwa "SIM 5" mbali inayo, pa kink - yoyera.Othandizira: starch, lactose monohydrate, microcrystalline cellulose, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, iron iron oxide. 10 ma PC. - matuza (3) - mapaketi a makatoni.Mapiritsi okhala ndi mbali pinki yoyera, chowolokera, chozungulira, cholembedwa mbali ina ndi cholembedwa "SIM 10" mbali inayo, pa kink - yoyera.Othandizira: starch, lactose monohydrate, microcrystalline cellulose, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, iron oxide ofiira, iron oxide chikasu. 10 ma PC. - matuza (3) - mapaketi a makatoni.Mapiritsi okhala ndi mbali lalanje, oval, convex, wokhala ndi notch mbali imodzi ndi cholembedwa "SIM 20" mbali inayo, pa kink - yoyera.Othandizira: starch, lactose monohydrate, microcrystalline cellulose, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, iron oxide ofiira, iron oxide chikasu. 10 ma PC. - matuza (3) - mapaketi a makatoni.Mapiritsi okhala ndi mbali yoyera kapena pafupifupi yoyera, chowonda, chozungulira, chokhala ndi notch mbali imodzi ndi mawu olembedwa "SIM 30" mbali inayo, pa kink - yoyera.Othandizira: starch, lactose monohydrate, microcrystalline cellulose, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide. 10 ma PC. - matuza (3) - mapaketi a makatoni.Mapiritsi okhala ndi mbali pinki, chowonda, chozungulira, cholembedwa mbali ina ndi cholembedwa "SIM 40" mbali inayo, pa kink - yoyera.Othandizira: starch, lactose monohydrate, microcrystalline cellulose, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, red iron oxide. 10 ma PC. - matuza (3) - mapaketi a makatoni.Zachipatala ndi gulu: Hypolipidemic mankhwalaKulembetsa No№:

Mlingo

Mapiritsi okhala ndi mafilimu.

Piritsi limodzi lachifundo 1
Pakatikati pa cholembapo:ntchito: simvastatin 5.00 mg / 10,00 mg / 20,00 mg / 30.00 mg / 40.00 mg zokopa: Pregelatinized wowuma 10,00 mg / 20.00 mg / 40.00 mg / 60.00 mg / 80.00 mg, lactose monohydrate 47.60 mg / 95.20 mg / 190.00 mg / 286.00 mg / 381 , 00 mg, microcrystalline cellulose 5.00 mg / 1000 mg / 2000 mg / 30.00 mg / 40.00 mg, butylhydroxyanisole 0.01 mg / 0.02 mg / 0.04 mg / 0.06 mg / 0,08 mg, ascorbic acid 1.30 mg / 2.50 mg / 5.00 mg / 7.50 mg / 10,00 mg, citric acid monohydrate 0,63 mg / 1.30 mg / 2.50 mg / 3.80 mg / 5.00 mg, magnesium stearate 0,50 mg / 1.00 mg / 2.00 mg / 3.00 mg / 3.00 mg / 4.00 mg,
Chigoba: hypromellose-5 cps 0.35 mg / 0.70 mg / 1.50 mg / 2.00 mg / 3.00 mg, hypromellose-15 cps 0.53 mg / 1.10 mg / 2.30 mg / 3, 00 mg / 4.50 mg, talc 0.16 mg / 0.32 mg / 0.69 mg / 0.90 mg / 1.40 mg, titanium dioxide (E171) 0.40 mg / 0.80 mg / 1 , 70 mg / 2.30 mg / 3.4 mg, utoto wachikasu wachitsulo 0.0043 mg / 0.0017 mg / 0.11 mg / - / -, utoto wofiira wa iron oxide - / 0.0043 mg / 0,026 mg / - / 0,14 mg.

Kufotokozera

Oval, mapiritsi a biconvex, wophatikizidwa ndi filimu, wokhala ndi notch mbali imodzi ndi wolemba mbali inayo, ndi ziwopsezo ziwiri mbali. Gawo la mtanda ndi loyera.
Mlingo 5 mg: mapiritsi amtundu wachikaso chopepuka ndi zolemba "SIM 5".
Mlingo 10 mg: mapiritsi amtundu wopepuka wa pinki wokhala ndi zolemba "SIM 10".
Mlingo 20 mg: mapiritsi amtundu wa lalanje owala ndi "SIM 20".
Mlingo wa 30 mg: Mapiritsi amtundu woyera kapena pafupi ndi mtundu wolembedwa "SIM 30".
Mlingo wa 40 mg: mapiritsi a pinki omwe amalemba "SIM 40".

Gwiritsani ntchito pa nthawi yoyembekezera komanso nthawi yoyamwitsa

Kugwiritsa ntchito mankhwala SimvAGEXAL ® pa nthawi ya pakati kumatsutsana.
Chifukwa chakuti HMG-CoA reductase inhibitors imalepheretsa kuphatikizika kwa cholesterol, ndi cholesterol ndi zinthu zina zamapangidwe ake zimathandizira kwambiri pakukula kwa mwana wosabadwayo, kuphatikizapo kaphatikizidwe ka ma steroid ndi nembanemba yama cell, simvastatin imatha kukhala ndi vuto pa mwana wosabadwayo azimayi a msinkhu wobereka ayenera kupewa kutenga pakati. Mimba ikachitika nthawi ya mankhwalawa, mankhwalawo ayenera kusiyidwa, ndipo mayiyo ayenera kuchenjezedwa za ngozi yomwe ingachitike kwa mwana wosabadwayo.
Kutha kwa mankhwala ochepetsa lipid pakuchepetsa sikumakhudza kwambiri zotsatira za chithandizo cha nthawi yayitali cha hypercholesterolemia.
Palibe chidziwitso pakutulutsidwa kwa simvastatin mkaka wa m'mawere, chifukwa mukamagwiritsa ntchito mankhwalawa panthawi yoyamwa, kuyamwitsa kuyenera kuyimitsidwa.

Mlingo ndi makonzedwe

Asanayambe chithandizo ndi SimvAGEXAL ®, wodwalayo ayenera kuthandizidwa kudziwa mtundu wa zakudya za hypocholesterolemic, zomwe ziyenera kutsatiridwa panthawi yonse ya chithandizo.
Mapiritsi a SimvAGEXAL ® amatengedwa kamodzi patsiku, madzulo, ndimadzi ambiri.
Mlingo wovomerezeka tsiku lililonse umachokera ku 5 mpaka 80 mg.
Mlingo kukhudzana ayenera kuchitika mwa 4 milungu.
Mlingo wa 80 mg ungagwiritsidwe ntchito kokha mwa odwala omwe ali ndi vuto lalikulu la mtima ndi chiopsezo cha mtima.
Odwala okhala ndi homozygous hypercholesterolemia: Mlingo wovomerezeka tsiku lililonse ndi 40 mg patsiku, kamodzi madzulo. Mlingo wa 80 mg patsiku umalimbikitsidwa pokhapokha ngati phindu la mankhwalawo liposa ngozi zomwe zingatheke. Mwa odwala, mankhwalawa SimvAGEXAL ® amagwiritsidwa ntchito limodzi ndi njira zina zochizira lipid-mwachitsanzo (LDL plasmapheresis) kapena popanda chithandizo chotere, ngati mulibe.
Odwala omwe ali ndi ischemic matenda a mtima kapena chiwopsezo cha mtima wamavuto
Mulingo woyambira wa SimvAGEXAL ® kwa odwala omwe ali pachiwopsezo chachikulu chotenga matenda a mtima kuphatikizika kapena popanda hyperlipidemia (pamaso pa matenda a shuga, mbiri ya matenda opha ziwalo kapena matenda ena am'mimba, mbiri ya matenda am'mitsempha yamagazi) ndi 40 mg tsiku lililonse .
Odwala omwe ali ndi hyperlipidemia omwe alibe izi: Mlingo woyambira wokhazikika ndi 20 mg kamodzi tsiku lililonse madzulo.
Odwala omwe ali ndi seramu LDL ndende yomwe imaposa 45% kuposa masiku onse, mlingo woyambirira ungakhale 40 mg / tsiku. Kwa odwala omwe ali ndi hypercholesterolemia yofatsa pang'ono, mankhwalawa omwe ali ndi SimvAGEXAL ® amatha kuyambitsidwa ndi mlingo woyambirira wa 10 mg / tsiku.
Chithandizo chothandizira: SimvAGEXAL ® ikhoza kugwiritsidwa ntchito limodzi mu monotherapy komanso kuphatikiza ndi bile acid sequestrants.
Kwa odwala omwe amatenga ma fiber nthawi yomweyo, kuwonjezera pa fenofibrate, mlingo woyenera wa tsiku ndi tsiku wa simvastatin ndi 10 mg. Kugwiritsa ntchito limodzi ndi gemfibrozil ndi kotsutsana.
Odwala nthawi yomweyo amatenga verapamil, diltiazem, ndi dronedarone, pazipita tsiku lililonse 10 mg / tsiku.
Kwa odwala omwewo amatenga amiodarone, amlodipine, ranolazine, mlingo waukulu wa tsiku lililonse wa simvastatin ndi 20 mg.
Odwala aakulu aimpso kulephera: Odwala mkhutu aimpso ntchito ofatsa kwambiri zolimbitsa (CC oposa 30 ml / mphindi) kusintha kwa mlingo sikofunikira. Odwala omwe ali ndi vuto laimpso kuwonda kwambiri (CC osakwana 30 ml / mphindi) kapena kumwa mafupa kapena nicotinic acid (pa mlingo woposa 1 g / tsiku), mlingo woyambirira ndi 5 mg ndipo mlingo wovomerezeka wa tsiku ndi tsiku ndi 10 mg.
Odwala okalamba (woposa zaka 65) kusintha kwa mlingo sikofunikira.
Gwiritsani ntchito ana ndi achinyamata a zaka 10 mpaka 17 ndi heterozygous Famer hypercholesterolemia: Mlingo woyambira wabwino ndi 10 mg tsiku lililonse madzulo. Mlingo wovomerezeka ndi 10 - 40 mg patsiku, mlingo woyenera kwambiri wa mankhwalawa ndi 40 mg patsiku. Kusankhidwa kwa Mlingo kumachitika aliyense payekha malinga ndi zolinga zamankhwala.
Pakusowa mlingo womwe ulipo, mankhwalawa amayenera kumwedwa posachedwa. Ngati nthawi yoti mutenge mlingo wotsatira, mankhwalawa sayenera kuwonjezeredwa.

Zotsatira zoyipa

Malinga ndi World Health Organisation (WHO), zotsatira zosafunikira zimagawidwa malinga ndi kuchuluka kwa chitukuko motere: pafupipafupi (≥1 / 10), nthawi zambiri (kuchokera ≥1 / 100 ku zovuta zamagazi ndi dongosolo la zamankhwala
osati kawirikawiri: kuchepa magazi (kuphatikizapo hemolytic), thrombocytopenia, eosinophilia.
Kusokonezeka kwamanjenje
osati kawirikawiri: chizungulire, kupweteka mutu, paresthesia, zotumphukira neuropathy,
kawirikawiri kusokonezeka kwa tulo (kugona tulo, "maloto" osoweka "), kukhumudwa, kukumbukira kapena kutaya, masomphenya opanda chiyembekezo.
Zovuta zamkati mwa kupuma, chifuwa ndi ziwalo zapakati
Nthawi zambiri: chapamwamba kupuma thirakiti matenda
maulendo osadziwika: interstitial m'mapapo matenda (makamaka kugwiritsa ntchito nthawi yayitali), bronchitis, sinusitis.
Mavuto a mtima
Nthawi zambiri: fibrillation ya atria.
Matenda am'mimba
Nthawi zambiri: gastritis
osati kawirikawiri: kudzimbidwa, kupweteka pamimba, kusanza, kusanza, kutsegula m'mimba, kunyansidwa.
Kuphwanya chiwindi ndi njira ziwiri
osati kawirikawiri: chiwindi, jaundice,
kawirikawiri kufooka kwa chiwindi ndi kopanda magazi.
Kusokonezeka kwa khungu ndi minofu yolowerera
osati kawirikawiri: zotupa pakhungu, kuyabwa kwa khungu, alopecia, photosensitivity.
Kusokonezeka kwa minofu ndi mafupa
osati kawirikawiri: myopathy * (kuphatikiza myositis), rhabdomyolysis (popanda kapena kutha kwa mphamvu yaimpso), myalgia, minofu kukokana, polymyositis,
kawirikawiri nyamakazi, nyamakazi,
maulendo osadziwika: tendinopathy, mwina ndi kupindika kwa tendon.
* M'maphunziro azachipatala, myopathy amawonedwa pafupipafupi mwa odwala omwe amagwiritsa ntchito simvastatin pa mlingo wa 80 mg / tsiku, poyerekeza ndi odwala omwe amagwiritsa ntchito mlingo wa 20 mg / tsiku (1.0% poyerekeza ndi 0.02%, motsatana).
Kuphwanya impso ndi kwamikodzo thirakiti
maulendo osadziwika: pachimake aimpso kulephera (chifukwa cha rhabdomyolysis), matenda a kwamikodzo.
Kuphwanya maliseche ndi nyamakazi
maulendo osadziwika: kukanika kwa erectile, gynecomastia.
Zovuta ndi zovuta zina pamalo a jakisoni
osati kawirikawiri: kufooka wamba.
Thupi lawo siligwirizana
osati kawirikawiri: angioedema, polymyalgia rheumatica, vasculitis, kuchuluka kwa erythrocyte sedimentation rate (ESR), zotupa zabwino za ma antinuclear antibodies, nkhope ya khungu hyperemia, lupus syndrome, dyspnea, malaise pafupipafupi, pafupipafupi osadziwika: immuno-mediated necrotizing myopathy kuphatikiza ndi matenda a Stevens-Johnson.
Zambiri zasayansi ndi zothandizira
osati kawirikawiri: kuchuluka kwa "chiwindi" transaminases, CPK ndi alkaline phosphatase m'magazi am'magazi, pafupipafupi osadziwika: kuchuluka kwa glycosylated hemoglobin, hyperglycemia.
Pogwiritsa ntchito ma statin ena, zochitika zotsatirazi zowonjezera zidalemba:
• Kuiwalika
• kuwonongeka kwazindikiritso
• matenda a shuga. Pafupipafupi chitukuko cha matenda a shuga zimatengera kukhalapo kwa zinthu zoopsa (kusala kudya kwa glucose wamagetsi opitilira 5.6 mmol / l, index index yaoposa 30 kg / m², kuchuluka kwa ndroglobulin (TG) mu plasma yamagazi, mbiri ya matenda oopsa.
Ana ndi achinyamata (wazaka 10 mpaka 17)
Malinga ndi kafukufuku wopitilira chaka chimodzi mwa ana ndi achinyamata (anyamata omwe ali pa gawo la Tanner II komanso pamwambapa ndi atsikana osachepera chaka chimodzi atapita msambo) azaka 10 mpaka 17 ndi heterozygous Famel hypercholesterolemia (n = 175), chitetezo ndi kulekerera pagulu la simvastatin, mawonekedwe a gulu la placebo anali ofanana.
Zochitika zomwe zimanenedweratu kwambiri zinali kupweteka kwam'mimba thirakiti, kupweteka mutu, kupweteka m'mimba, komanso nseru. Zotsatira za nthawi yayitali pakulimbitsa thupi, luntha, komanso kugonana sizikudziwika. Pakadali pano (chaka chimodzi chatha chithandizo) palibe chitetezo chokwanira.

Bongo

Mpaka pano, palibe zizindikiro zenizeni za mankhwala osokoneza bongo (mlingo waukulu wa 3,6 g) omwe adadziwika.
Chithandizo: symptomatic mankhwala. Mankhwala enieniwo sakudziwika.

Kuchita ndi mankhwala ena

Kuphunzira kwa kuyanjana ndi mankhwala ena kunachitika kokha mwa akulu.
Mapulogalamu a Pharmacodynamic
Kuchita ndi mankhwala ena ochepetsa lipid omwe angayambitse chiopsezo cha myopathy / rhabdomyolysis
Fibates
Chiwopsezo chotenga myopathy, kuphatikizapo rhabdomyolysis, chimawonjezeka panthawi yomwe mukugwiritsa ntchito simvastatin yokhala ndi ma fiber.
Kugwiritsa ntchito ndi gemfibrozil kumabweretsa kuwonjezeka kwa plasma ndende ya simvastatin, kotero kuphatikiza kwawo kumagwirizana.
Palibe umboni kuti chiwopsezo cha myopathy chimagwiritsidwa ntchito munthawi yomweyo simvastatin ndi fenofibrate.
Maphunziro Olamulidwa pa Kuyanjana ndi mafupa ena osati kuchitidwa.
Nicotinic acid
Pali malipoti ochepa okhudza kukula kwa myopathy / rhabdomyolysis ndi munthawi yomweyo kugwiritsa ntchito simvastatin ndi nicotinic acid mu lipid-kuchepetsa mlingo (woposa 1 g / tsiku).
Fusidic acid
Chiwopsezo chotenga myopathy chimawonjezeka ndi kugwiritsa ntchito pamodzi fusidic acid wokhala ndi ma statins, kuphatikizapo simvastatin. Ngati ndizosatheka pazifukwa zina kupewa kugwiritsa ntchito simvastatin munthawi yomweyo ndi fusidic acid, tikulimbikitsidwa kuti muganizire kuchedwetsa chithandizo ndi simvastatin. Ngati ndi kotheka, kugwiritsa ntchito kwawo munthawi yomweyo, odwala ayenera kuyang'aniridwa kwambiri.
Kuchita kwa Pharmacokinetic
Malangizo ogwiritsira ntchito mankhwala othandizira amaperekedwa pagome.

Kuyanjana Ndi Mankhwala Kumalumikizidwa ndi Chiwopsezo Chowonjezera cha Myopathy / Rhabdomyolysis

Zotsatira za mankhwala ena pa pharmacokinetics of simvastatin
Zoletsa zolimba za isoenzyme CYP3A4
Simvastatin ndi gawo la CYP3A4 isoenzyme. Mphamvu zoletsa zamphamvu za CYP3A4 isoenzyme zimawonjezera chiopsezo cha myopathy ndi rhabdomyolysis pakuwonjezera ntchito ya HMG-CoA reductase mu plasma yamagazi panthawi ya mankhwala a simvastatin. Zoletsa zoterezi zimaphatikizapo itraconazole, ketoconazole, posaconazole, voriconazole, erythromycin, clarithromycin, telithromycin, HIV proteinase inhibitors (mwachitsanzo nelfinavir), boceprevir, telaprevir, komanso nefazodone.
Kugwiritsa ntchito pamodzi kwa simvastatin ndi itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, HIVasease inhibitor (mwachitsanzo nelfinavir), komanso nefazodone. Ngati nkosatheka pazifukwa zina kupewa kugwiritsa ntchito simvastatin pamodzi ndi mankhwalawa, ndiye kuti chithandizo cha simvastatin chiyenera kuikidwa kaye mpaka kumapeto kwa chithandizo cha mankhwalawa.
Simvastatin iyenera kugwiritsidwa ntchito mosamala ndi zoletsa zochepa za CYP3A4 zoletsa: fluconazole, verapamil, kapena diltiazem.
Fluconazole
Nkhani zochepa za rhabdomyolysis zomwe zimagwiritsidwa ntchito munthawi yomweyo simvastatin ndi fluconazole zidanenedwapo.
Cyclosporin
Kugwiritsa ntchito munthawi yomweyo cyclosporine ndi simvastatin ndi zotsutsana.
Danazole
Chiwopsezo chokhala ndi myopathy / rhabdomyolysis chimawonjezeka ndi kugwiritsa ntchito nthawi yomweyo danazol, makamaka ndi Mlingo waukulu wa simvastatin.
Amiodarone
Chiwopsezo chokhala ndi myopathy ndi rhabdomyolysis chimawonjezeka ndi kugwiritsa ntchito nthawi yomweyo ya amiodarone wokhala ndi Mlingo waukulu wa simvastatin. M'maphunziro azachipatala, chitukuko cha myopathy chinapezeka 6% ya odwala omwe amagwiritsa ntchito simvastatin pa mlingo wa 80 mg molumikizana ndi amiodarone. Chifukwa chake, mlingo wa simvastatin sayenera kupitilira 20 mg patsiku la odwala omwe amagwiritsidwa ntchito ndi mankhwala a amiodarone nthawi yomweyo, ngati chithandizo cha chipatala chimaposa chiopsezo chokhala ndi myopathy ndi rhabdomyolysis.
Ochepetsa a calcium calcium blockers
Verapamil
Chiwopsezo chotenga myopathy ndi rhabdomyolysis chimawonjezeka ndi kugwiritsa ntchito nthawi yomweyo verapamil ndi simvastatin mu Mlingo woposa 40 mg. Mlingo wa simvastatin sayenera upambana 10 mg patsiku la odwala omwe amagwiritsa ntchito mankhwalawa nthawi yomweyo ndi verapamil, ngati chithandizo cha chipatala chimaposa chiopsezo chokhala ndi myopathy ndi rhabdomyolysis.
Diltiazem
Chiwopsezo chokhala ndi myopathy ndi rhabdomyolysis chimawonjezeka pamodzi ndi ntchito imodzi ya diltiazem ndi simvastatin muyezo wa 80 mg. Ndi kugwiritsa ntchito pamodzi kwa simvastatin muyezo wa 40 mg ndi diltiazem, chiopsezo chokhala ndi myopathy sichinawonjezeke. Mlingo wa simvastatin sayenera upambana 10 mg patsiku la odwala omwe amagwiritsidwa ntchito ndi mankhwala osokoneza bongo nthawi imodzi, ngati chithandizo cha chipatala chimaposa chiopsezo chokhala ndi myopathy / rhabdomyolysis.
Amlodipine
Odwala omwe amagwiritsa ntchito amlodipine mogwirizana ndi simvastatin pa mlingo wa 80 mg ali pachiwopsezo chotenga myopathy. Ndi kugwiritsa ntchito pamodzi kwa simvastatin muyezo wa 40 mg ndi amlodipine, chiopsezo chokhala ndi myopathy sichinawonjezeke. Pogwiritsa ntchito munthawi yomweyo simvastatin ndi amlodipine, mlingo wa simvastatin sayenera kupitilira 20 mg patsiku, ngati chithandizo cham'chipatala chimaposa mwayi wokhala ndi myopathy / rhabdomyolysis.
Lomitapid
Chiwopsezo chotenga myopathy / rhabdomyolysis chitha kuchuluka ndi munthawi yomweyo kugwiritsa ntchito lomitapide ndi simvastatin.
Zochita zina
Madzi a mphesa
Madzi a mphesa amakhala ndi chimodzi kapena zingapo zomwe zimalepheretsa mawonekedwe a CYP3A4 isoenzyme ndipo zimatha kuwonjezera kuchuluka kwa plasma kwa mankhwala omwe amapangidwa ndi CYP3A4 isoenzyme. Mukamamwa juwisi mwachizolowezi (chikho chimodzi cha 250 ml patsiku), izi ndizochepa (kuwonjezereka kwa 13% mu zochitika za HMG-CoA reductase inhibitors, zomwe zimayesedwa ndi dera lomwe lili pansi pa nthawi yokhazikika) ndipo zilibe chofunikira. Komabe, kumwa kwa msuzi wa mphesa m'miyeso yayikulu kwambiri (1 lita imodzi patsiku) kumakulitsa kuchuluka kwa ntchito ya HMG-CoA reductase inhibitors panthawi ya mankhwala ndi simvastatin. Pankhaniyi, ndikofunikira kupewa kumwa madzi a mphesa m'miyeso yayikulu.
Colchicine
Pali malipoti a chitukuko cha myopathy / rhabdomyolysis ndi munthawi yomweyo kugwiritsa ntchito kolchicine ndi simvastatin mwa odwala omwe amalephera impso. Odwala omwe amagwiritsa ntchito mankhwalawa nthawi yomweyo ayenera kuyang'aniridwa ndi dokotala.
Rifampicin
Popeza rifampicin imalimbikitsa kwambiri CYP3A4 isoenzyme, mu odwala omwe amamwa mankhwalawa kwa nthawi yayitali (mwachitsanzo, mankhwalawa amtundu wa chifuwa), akhoza kuchepa mphamvu pakugwiritsa ntchito simvastatin (kulephera kukwaniritsa chandamale cha m'magazi a cholesterol).
Zotsatira za simvastatin pa pharmacokinetics zamankhwala ena
Simvastatin sikuletsa CYP3A4 isoenzyme. Chifukwa chake, akuganiza kuti simvastatin siyikhudzanso kuchuluka kwa plasma ya zinthu zomwe zimapangidwa ndi CYP3A4 isoenzyme.
Digoxin
Pali uthenga kuti pogwiritsa ntchito munthawi yomweyo digoxin ndi simvastatin, kuchuluka kwa plasma koyamba kumawonjezeka pang'ono, chifukwa chake, odwala omwe akutenga digoxin amayenera kuyang'aniridwa mosamala, kumayambiriro kwa chithandizo cha simvastatin.
Zododometsa zachindunji
M'mayeso awiri azachipatala, imodzi yokhudzana ndi odzipereka athanzi ndipo ina imakhudza odwala omwe ali ndi hypercholesterolemia, simvastatin pa mlingo wa 20-40 mg / tsiku mochuluka momwe zotsatira za coumarin anticoagulants. Chiwerengero cha anthu wamba padziko lonse lapansi (UNR) chinakwera kuchoka pa 1.7-1.8 kufika pa 2.6-3.4 mwa odzipereka odzipereka komanso odwala. Odwala omwe amagwiritsa ntchito coumarin anticoagulants, nthawi ya prothrombin (PV) kapena INR iyenera kutsimikiziridwa musanalandire chithandizo ndipo, nthawi zambiri, nthawi zambiri amatsimikiza pa gawo loyambirira la chithandizo ndi simvastatin kuti awonetsetse kuti palibe kusintha kwakukulu mu PV / INR. Mtengo wokhazikika wa PV / INR ukakhazikitsidwa, imatha kuyang'aniridwa pakanthawi kovomerezeka kwa odwala omwe akutenga coumarin anticoagulants. Mukamasintha mlingo wa simvastatin, kapena kusokoneza chithandizo, pafupipafupi kuyang'anira PV / INR kuyenera kuchuluka. Kupezeka kwa magazi kapena kusintha kwa PV / INR mwa odwala osagwiritsa ntchito anticoagulants sikugwirizana ndi kugwiritsa ntchito simvastatin.

Simvagexal: nenani kwa cholesterol yayikulu

imvaghexal ndi hypolipidemic mankhwala ozikidwa pa simvastatin.

Amagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda a mtima komanso a hypercholesterolemia.

Amalembedwa kwa odwala azaka zopitilira khumi ndi zisanu ndi zitatu, kupatula anthu omwe ali ndi contraindication.

Simvagexal omwe amaperekedwa ku pharmacies ndi mankhwala. Chifukwa chake, musanagule mankhwala, muyenera kufunsa dokotala.

Njira yogwiritsira ntchito

Tengani Simvagexal mkati, ndikumwa madzi ambiri. Kugwiritsa ntchito pafupipafupi - kamodzi patsiku. Nthawi yomwe angafune kuti alowe ndi madzulo. Kutalika kwa chithandizo kumatsimikiziridwa payekhapayekha.

Ngati mankhwalawa akumanidwa, mankhwalawa amatengedwa nthawi yomweyo. Komabe, musamachulukitse mlingo wake ngati nthawi yakwana kumwa.

Mlingo woyambirira wochizira hypercholesterolemia amatsimikiza mwakuya kwa matendawa ndipo amasiyanasiyana kuyambira 5 mpaka 10 mg / tsiku. Mlingo umakhazikitsidwa potengera plasma ya cholesterol yomwe imapezeka pakadutsa masabata anayi.

Muyezo tsiku lililonse ndi 40 mg. Ngati wodwala ali ndi vuto la mtima ndipo chithandizo chake sichikugwira ntchito mokwanira, dokotala amatha kuwonjezera mlingo wa 80 mg / tsiku.

Mlingo woyamba wa CHD ndi 20 mg. Ngati ndi kotheka, wonjezerani mpaka 40 mg pakatha milungu inayi iliyonse. Mlingo wa mankhwalawa umachepetsedwa ngati zinthu zonse za cholesterol zikugwera pansi 3.6 mmol / lita, ndipo zomwe zili LDL ndizotsika 1.94 mmol / lita.

Odwala omwewo amatenga cyclosporine, nicotinamide kapena ma fiber ayenera kuchepetsa koyambira komanso koyenera tsiku lililonse kwa 5 ndi 10 mg, motero. Zomwezi zimaperekanso kwa anthu omwe ali ndi vuto laimpso.

Mlingo woyenera komanso wofunikira tsiku lililonse wa mankhwala a immunosuppress ndi 5 mg / tsiku.

3. Kuphatikizika, mawonekedwe omasulira

Mankhwalawa ali ndi simvastatin ndi zina zowonjezera, monga lactose monohydrate, ascorbic acid, magnesium stearate, talc, iron (III) okusayidi, wowuma chimanga, hypromellose, citric acid monohydrate, titanium dioxide, MCC.

Simvagexal imatulutsidwa ngati mapiritsi okhala ndi ovomerezeka ndi coaching, osaphimba.

Mtundu wa chipolopolo umatha kukhala wachikasu (5 mg), pinki yopepuka (10 mg), lalanje wowala (20 mg), yoyera kapena pafupifupi yoyera (30 mg), ndi yapinki (40 mg). Kumbali ina ya mapiritsi pali mawu akuti "SIM 40", "SIM 30", "SIM 10", "SIM 20" kapena "SIM 5" (kutengera mtundu wa kumasulidwa).

5. Zotsatira zoyipa

Pa nthawi yoyembekezera

Odwala omwe ali ndi pakati sayenera kutenga Simvagexal. Pali malipoti a chitukuko cha akhanda omwe amayi awo adatenga simvastatin zamatenda osiyanasiyana.

Ngati mayi wazaka zambiri amatenga simvastatin, ayenera kupewa kutenga pakati. Ngati kutenga pakati kumachitika pakumwa, Simvagexal iyenera kusiyidwa, ndipo wodwalayo ayenera kuchenjezedwa za chiwopsezo chomwe chingachitike kwa mwana wosabadwayo.

Palibe chidziwitso pakugawidwa kwa gawo lomwe limagwira ndi mkaka wa m'mawere. Ngati simungapewe kusankhidwa kwa Simvagexal kwa mayi woyembekezera, muyenera kumukumbutsa kufunika kosiya kuyamwitsa.

Kusamala kumeneku kumalumikizidwa ndikuti mankhwala ambiri amatsitsidwa mkaka, ndikuwonjezera mwayi wokhala ndi vuto lalikulu.

7. Malamulo ndi malo osungira

Simvagexal imasungidwa zaka zitatu pa kutentha kwa madigiri 30 kapena ofanana nayo.

Mtengo wapakati wa simvageksal mu Russian makemikari unyolo ndi 280 p.

Kwa anthu ochokera ku Ukraine mankhwalawa amatenga pafupifupi UAH 300.

Mndandanda wa mayendedwe a Simvagexal akuphatikizapo mankhwalawa monga Aterostat, Avestatin, Vazilip, Actalipid, Zokor, Vero-Simvastatin, Zorstat, Zovatin, Ariescor, Simvastatin, Simgal, Simvor, Simvastol, Holvasim, Sinkard, Simplakor ndi ena.

Ndemanga za mankhwala pakati pa madokotala ndi odwala ndizabwino kwambiri. Malinga ndi iwo, simvagexal imathandiza kuchepetsa cholesterol komanso chiopsezo cha zovuta zomwe zimakhudzana ndi ntchito ya mtima.

Pitani kumapeto kwa nkhaniyi kuti muwerenge ndemanga za Simvageksal. Fotokozani malingaliro anu okhudzana ndi mankhwalawo ngati mukufunika kumwa kapena kupereka mankhwala kwa odwala. Izi zithandiza alendo ena amtsamba.

1. Kumayambiriro kwa kumwa mankhwalawa, seramu transaminase ndiyotheka (kuwonjezeka kwapang'onopang'ono pamlingo wa michere ya chiwindi).
2. Simvagexal satengedwa pachiwopsezo chotenga matenda monga aimpso kulephera, rhabdomyolysis.

Sivastatin, yolembedwera odwala omwe ali ndi pakati, amatha kukhala ndi vuto limodzi pa mwana wosabadwayo (azimayi amsinkhu wobereka ayenera kupewa kutenga pakati). Ngati kutenga pakati kumachitika pakumwa, mankhwalawo ayenera kusiyidwa, ndipo wodwalayo adziwitsidwe za kuwopsa kwa mwana wosabadwayo.

Kodi nkhaniyo inali yothandiza? Mwina izi zithandiza anzanu! Chonde dinani chimodzi mwa mabataniwo:

Dzinalo Losasamala:

Mapiritsi okhala ndi mafilimu.

Piritsi limodzi lachifundo 1
Pulogalamu yamapiritsi: chopangira yogwira: simvastatin 5.00 mg / 1000 mg / 2000 mg / 30.00 mg / 40,00 mg, olemba: pregelatinized starch 10.00 mg / 2000 mg / 40.00 mg / 60.00 mg / 80.00 mg, lactose monohydrate 47.60 mg / 95.20 mg / 190.00 mg / 286.00 mg / 381.00 mg, microcrystalline cellulose 5.00 mg / 10.00 mg / 20.00 mg / 30.00 mg / 40.00 mg, butylhydroxyanisole 0,01 mg / 0,02 mg / 0,04 mg / 0,06 mg / 0,08 mg, ascorbic acid 1.30 mg / 2 , 50 mg / 5.00 mg / 7.50 mg / 10.00 mg, citric acid monohydrate 0,63 mg / 1.30 mg / 2.50 mg / 3.80 mg / 5.00 mg, magnesium stearate 0 50 mg / 1.00 mg / 2.00 mg / 3.00 mg / 4,00 mg
Phula: hypromellose-5 cps 0,35 mg / 0.70 mg / 1.50 mg / 2.00 mg / 3.00 mg, hypromellose-15 cps 0,53 mg / 1.10 mg / 2.30 mg / 3.00 mg / 4.50 mg, talc 0.16 mg / 0.32 mg / 0.69 mg / 0.90 mg / 1.40 mg, titanium dioxide (E171) 0.40 mg / 0.80 mg / 1.70 mg / 2.30 mg / 3.4 mg, utoto wachikasu wachitsulo wamkati 0.0043 mg / 0.0017 mg / 0.11 mg / - / -, utoto wofiira wa iron oxide - / 0.0043 mg / 0,026 mg / - / 0,14 mg.

Kufotokozera

Oval, mapiritsi a biconvex, wophatikizidwa ndi filimu, wokhala ndi notch mbali imodzi ndi wolemba mbali inayo, ndi ziwopsezo ziwiri mbali. Gawo la mtanda ndi loyera.
Mlingo 5 mg: mapiritsi amtundu wachikaso chopepuka ndi zolemba "SIM 5".

Mlingo 10 mg: mapiritsi amtundu wopepuka wa pinki wokhala ndi zolemba "SIM 10".
Mlingo 20 mg: mapiritsi amtundu wa lalanje owala ndi "SIM 20".
Mlingo wa 30 mg: Mapiritsi amtundu woyera kapena pafupi ndi mtundu wolembedwa "SIM 30".

Mlingo wa 40 mg: mapiritsi a pinki omwe amalemba "SIM 40".