Vazilip, li-analogues tsa Russia tsa lithethefatsi tse nang le litheko le litlhahlobo

- hypercholesterolemia ea mantlha ea mefuta IIa le IIb, ho kenyelletsa polygenic hypercholesterolemia, heterozygous hereditary hypercholesterolemia le hyperlipidemia e kopaneng. Setlhare se sebelisoa e le monotherapy maemong ao ho ja le mekhoa e meng ea kalafo e sa lekaneng.

- Phokotso ea lefu la pelo le morusu ho bakuli ba nang le lipontšo tsa kliniki ea lefu la pelo kapa lefu la tsoekere, ka litekanyetso tsa cholesterol tse tloaelehileng kapa tse phahameng joalo ka mohato o mong oa ho lokisa mabaka a mang a kotsi le kalafo ea pelo.

Puisano ea Vasista ea lithethefatsi litlalehong tsa bo-'mè

. Tformin e ntlafatsa thepa ea mali ea fibrinolytic ka ho hatella inhibitor ea mofuta oa lisele tsa mofuta oa "plasminogen activator inhibitor." G e boletse hore cholesterol e lokela ho fokotseha. Haeba e sa fokotsehe, ebe Vasilip. Le 'na ke na le mali a mangata - hemoglobin-154.

. Haeba u nka Oksilik e le thata, ha e e fokotsehe, empa u na le monyetla oa ho leka l-thyroxine Metformin bakeng sa hau ho potlakisa metabolism ea carbohydrate le ts'ebeliso ea tsoekere, mantsoe a hau mabapi le Vasilip ke bopaki ba hore meriana ena ha e amanang le bona - sena e ne e le boiphihlelo ba motho ka mong. Vasilip ha a ka a nthusa le nna - ke ile ka nwa Roxer ka likhoeli tse 3. Seipone se joalo, ka mokhoa oa yarins, jannins le diana - li senya feela mahe a hau, empa se se ke sa ama boemo bo phahameng ba LH, ha prolactin ea hau e nepahetse, e bolelang haholo)) ) Utrozhestan e lokela ho tahoa haholo mme e sa tlohele ho hlokahala e le 'ngoe, eseng tse peli .. Li-vithamine li lula li le sethaleng sa pele sa glutamic acid makhetlo a mararo ka letsatsi ho letlapa ho tloha ho 5 ho isa ho 15 DC + foil + iodine, le ho tloha ho 16 ho isa ho 2.

2. Contraindication

Ho latela litaelo, Vasilip e tšoaelitsoe:

• mafu a fapaneng a sebete a karolong e sebetsang,
• ts'ebetso e eketsehileng ea li-transaminase tsa sebete tse tsoang moetlo o sa tsejoeng,
• Tšebeliso e tšoanang ea li-vasilip le li-inhibitors,
• hypersensitivity ho likarolo tse etsang sehlahisoa,
• boimana.

Tlhokomeliso e eletsoa ho sebelisa moriana maemong a latelang:

• boteng ba nalane ea lefu la sebete,
• ka tlolo e matla ea tsamaiso ea endocrine,
• ka mathata a metabolic
• ka ts'oaetso e matla, ho etsa mohlala, ka sepsis,
• ka khatello ea methapo (khatello e kaholimo ho se tloaelehileng),
• ka likotsi le maqeba a tsoang litsong tse fapaneng.
• ka sebopeho se sa laoleheng sa sethoathoa,
• Le myopathy (eo ho thoeng ke e sa foleng, e tsoelang pele lefu la mesifa, leo metabolism ea mesifa ea mesifa e senyehileng),
• nakong ea ts'ebetso ea ho buoa,
• ka tlhekefetso ea lino tse tahang.

3. Litla-morao

Vasilip e khona ho fana ka litlamorao tse sa rateheng 'meleng oa motho, tseo boholo ba tsona e leng:

Ho hlobaetsana le lefu la sethoathoa, ho hloleha ha boits'oaro bo matla, ho se sebetse hantle ka thobalano, ho fokola hoa tšebetso ea thobalano.

4. Mokhoa oa tsamaiso ea lithethefatsi

Vasilip e nooa ka molomo, 'me lethal dose le ka beoa ho latela lipontšo le tekanyo ea lefu ho tloha ho 5 ho isa ho 80 mg (tekanyetso e phahameng e sebelisetsoa ho phekola hypercholesterolemia kapa boteng ba kotsi e kholo ea mathata a ts'ebetsong e hokahaneng ea methapo ea pelo.

Nako ea kamohelo e fanoa ka kotloloho ke ngaka e eang. Tekanyetso ea khale ke 10 mg ea lethal dose le le leng la letsatsi, 'me ho ea ka lipontšo tse khethehileng lethalamo lena le eketseha makhetlo a 2-8.

Fetola litekanyetso tsa moriana ha o sa feta nako e le 'ngoe ka khoeli.

5. Litšebelisano tsa lithethefatsi

1. Moriana ona o ka ntlafatsa litlamorao tsa li-anticoagulants tse sa tobang, tse ka bakang mali.
2. E eketsa khatello ea methapo ea Digoxin maling, ka hona, bakuli ba nang le kalafo e joalo ba hloka ho hlahlojoa ke lingaka.

Tsamaiso e ts'oanang ka li-cytostatics le li-anttifungal agents (ketoconazole, Itraconazole), li-fibrate, litekanyetso tse phahameng tsa nicotinic acid, li-immunosuppressants, le li-protease inhibitors li eketsa kotsi ea rhabdomyolysis.

6. Overdose

Ho na le linyeoe tsa ho fetisa lethal dose ea Vasilip, leha ho le joalo, ha lia ka tsa baka litlamorao tse mpe le tlhekefetso e kholo. Ntle le sena, haeba ho na le lithethefatsi tse ngata tse ngata, ho hlokahala hore u nke li-enterosorbents le ho hlatsoa mpa, mme ho khothalletsoa ho lekola litsamaiso tsa 'mele, haholo-holo bakeng sa liphio le sebete.

7. Fokotsa foromo le bophelo ba sehatsetsing

Setlhare sena se hlahisoa ke indasteri ea litlama ka mefuta ea matlapa a entsoeng ka filimi ka ntle.

Letlapa le le leng le ka ba litekanyetso tse fapaneng - 10 mg, 20 mg, 40 mg.

Ka paketeng - likotoana tse 14 kapa tse 28.

Bophelo ba sehatsetsing ba Vasilip ke lilemo tse 3.

Litšoantšiso tse tummeng tsa lithethefatsi Vasilip:

Ka marang-rang a litlama, lithethefatsi li rekisoa ka theko e latelang (ho latela lethal dose):

• Russia - ho tloha ho li-ruble tse 328 ho isa ho 587,
• naheng ea Ukraine - ho tloha ho 82 ho isa ho tse 148 h hpnias.

Bakuli ba ileng ba sebelisa moriana ona ba ile ba hlokomela ho fokotseha ha k'holeseterole ea mali, ho khahlisoa ke boemo bo akaretsang, le ketso ea nako e telele ea meriana.

Leha ho le joalo, sena se bontša pontšo ea litla-morao tse sa rateheng tse nyamela kamora ho fela ha ho nka Wazilip. U ka bala ka botlalo litlhahlobo tsa bakuli ba sebelisitseng Vazilip qetellong ea sengoloa.

11. Litaelo tse ikhethang

1. Pele o qala kalafo le Vazilip, o hloka ho etsa lipatlisiso tsa laboratori tsa matšoao a ts'ebetso ea sebete mme a tsoele pele ho lekola ts'ebetso ea transaminase ea sebete ka mor'a likhoeli tse 1.5-2. Bakuli ba fumanang simvastatin letsatsi le leng le le leng ka tekanyo e phahameng (80 mg) hangata ba beiloe leihlo bakeng sa ts'ebetso ea sebete - hang hang ka likhoeli tse tharo. Ka keketseho ea ts'ebetso ea li-transaminase, kalafo ea Vasilip e hlakotsoe.
2. Bakuli ba nang le myasthenia gravis, myalgia, kapa ba nang le ts'ebetso e eketsehileng ea kalafo ea CPK ka lithethefatsi tse ho buuoang ka bona baa emisoa.
3. Simvastatin ha e khothalletsoe haeba ho na le kotsi ea ho rhabdomyolysis kapa ho se sebetse hantle ha masapo (ka lebaka la hypotension ea methapo, ts'oaetso e matla ea pherekano, ho senyeha ho matla ha metabolic, likotsi).
4. Likarolo tsa Vasilip li ama nts'etsopele ea bokhachane, ka lebaka leo, lithethefatsi ha li na ho sebelisoa bakeng sa kalafo ea basali baimana. Haeba ho ima ho hlaha nakong ea kalafo le Vazilip, moriana o emisoa.
5. Setlhare sena se sebetsa ka kotloloho ho monotherapy hape se kopantsoe le li-acid tse 'moho.
6. Boemo bo hlokahalang bakeng sa kalafo ea Vasilip ke hore mokuli o lijong tsa k'holeseterole.
7. Haeba tekanyetso ea hona joale e lahlile, o hloka ho nka moriana o latelang oa meriana kapele kamoo ho ka khonehang ntle le ho o pheta.
8. Ha ho na le bohloko bo sa hlalosoang mesifa, mokuli o khothalletsoa ho etela ngaka ka potlako.

Ketso ea pharmacological ea moriana

Ntho e sebetsang ea Vasilip e na le phello e theolang lipid mme e theola cholesterol maling plasma. Setlhare se sebetsa hantle ho lefu la pelo, kaha se fokotsa kotsi ea ho tšoaroa ke myocardial infarction. Phello ea kalafo ea ts'ebeliso ea vasilip e fetoha nako e fetang libeke tse peli, 'me boholo bo fumaneha kamora khoeli ea tšebeliso ea letsatsi le letsatsi.

Ntle le moo, Vasilip, ho latela litekolo, e boetse e na le phello ea anti-atherosulinotic, e amang likarolo tsa mali le marako a methapo ea mali.

E hlahisoa ka sebopeho se joang

Vasilip e fumaneha ka mokhoa oa matlapa a koahetsoeng ka filimi e tšoeu e nang le 10, 20 le 40 mg ea simvastatin e sebetsang. Matlapa a 7 ka blister.

Haeba ho hlokahala, lithethefatsi li ka nkeloa sebaka ke e 'ngoe ea li-analogue tsa Vazilip - Simpacor, avestatin, holvasim, atherostat, simvakard, actalipid, chakor, simgal, vasilip, zorstat, aries, simvor, simvaghexal, simvalimit, simvastatin, simlo, sincard kapa zovatin.

Ha o sa khone ho khetha

Ho latela litaelo, Vasilip e ngolisitsoe hore e ka sebelisoa le:

• Maloetse a sebete a karolong e sebetsang, hammoho le keketseho e phehellang ts'ebetsong ea hepatic transaminases ea etiology e sa tsejoeng,
• Tšebeliso e kopanetsoeng le li-inhibitors tsa CYP3A4 isoenzyme, ho kenyelletsa erythromycin, itraconazole, clarithromycin, ketoconazole, li-protease inhibitors tsa HIV, nefazodone le telithromycin,
• Hypersensitivity ho likarolo tsa Vasilip.

Hape, sethethefatsi, joalo ka Vazilip analogues, ha sea lokela ho sebelisoa nakong ea bokhachane, ka tlase ho lilemo tse 18, nakong ea lebele, ha ho raloa moimana kapa haeba ho belaelloa.

Vasilip e sebelisoa ka hlokolosi ho:

• Nalane ea lefu la sebete,
• Mathata a tebileng a endocrine le metabolic,
• Tšoaetso e matla e matla, ho kenyeletsa le sepsis,
• Hlooho ea maikutlo
• Likotsi
• Ho akheha ho sa laoleheng,
• Myopathy
• Ho kenella ka mokhoa o pharaletseng
• Tšebeliso e mpe ea tahi, haholo pele a qala kalafo.
• Khaello ea Lactase
• Ho se leka-lekane ho matla ha motlakase,
• Galactosemia kapa glucose-galactose malabsorption syndrome,
• Tsamaiso e ts'oanang ka cyclosporine, fenofibrate, gemfibrozin, verapamil, nicotinic acid, amiodarone, diltiazem le lero la grapefruit.

Mokhoa oa ts'ebeliso ea vasilip

Ho ea ka litaelo, Vasilip e nkuoa ka molomo hang ka mantsiboea, tekanyetso ho latela lefu lena e ka fapana ho tloha ho 5 mg ho isa ho 80 mg, e nkiloeng feela ka hypercholesterolemia e mpe kapa kotsi e kholo ea mathata a pelo. Nako ea ts'ebeliso ea vasilip e khethoa ka bomong ke ngaka e eang.

Hangata, kalafong ea hypercholesterolemia, Vasilip e nkuoa 10 mg hang, ho ea ka lipontšo, lethal dose ea kalafo e ka eketseha makhetlo a 2 kapa a 4. Ho latela maikutlo, Vasilip e sebetsa ha ho ntse ho bolokoa mokhoa o tloaelehileng oa hypocholesterol nakong eohle ea kalafo.

Le homozygous hereditary hypercholesterolemia, Vasilip e beoa 40 mg hang hang ka mantsiboea kapa 80 mg ea moriana, o arotsoe ka litekanyetso tse 3, hammoho le kalafo e meng ea hypolipidemic.

Ka kotsi e kholo ea ho ba le lefu la pelo la coronary, Vasilip e nkuoa 20-25 mg ka letsatsi ho latela litaelo. O ka fetola tekanyetso ea moriana ha o sa feta hang ka khoeli.

Ho latela litekolo, Vasilip e sebetsa hantle ho li-monotherapy hape e kopana le colestyramine, amiodarone, colestipol, gemfibrozil, cyclosporine le li-fibrate tse ling kapa nicotinic acid.

Ha u sebelisa Vasilip, ha ho khothalletsoe ho sebelisa tekanyo e kholo (e fetang litara e le ngoe) ea lero la morara.

Litla-morao tsa vasilip

Ho latela maikutlo, Vasilip ha e lebise ho nts'etsopele ea litla-morao, tse hlahang e le:

• Pancreatitis, bohloko ba ka mpeng, ho sokela, ho nyekeloa, ho ruruha, jaundice, dyspepsia, ho hlatsa, lets'ollo le lefu la sebete.
• Paresthesia, peripheral neuropathy, pono e fifalitsoeng, ho tsitsipana, ho tsekela, ho ruruha, hlooho e bohloko, ho hloka boroko le tlolo ea maikutlo a tatso,
• Rhabdomyolysis, myopathy, mesifa mesifa le myalgia,
• Letlalo la letlalo, alopecia le pruritus,
• Ramatiki, lefu la lupus-kama, eosinophilia, bofokoli bo matla, angioedema, dermatomyositis, feberu, ho eketseha ha ESR, urticaria, polymyalgia rheumatism, vasculitis, thrombocytopenia, arthralgia, photosensitivity, flush ea sefahleho le ho hema hanyane,
• Ho hlobaela ha bohloko bo ka mpeng, ho hlaka, ho fokola hoa mali le phokotso ea potency.

Vasilip - Tlhahlobo mabapi le Vasilip - Theko ea Vasilip

Vasilip ke sethethefatsi se seng se tsoang sehlopheng sa li-statins, ke hore, lithethefatsi tse ka fokotsang cholesterol maling a motho. E entsoe motheong oa simvastatin - ntho e fumanoang linthong tsa tlhaho tse tala (li-mushroom).

Joaloka litokisetso tse tšoanang, motho a ka bua, ka mohlala, Atoris, e thehiloeng ho atorvastatin - ntho ea maiketsetso. Tšusumetso ea vasilip e totobala (nakong ea taolo ea mali ea laboratori) libeke tse peli kamora ho qala kalafo. Phello e phahameng ea lithethefatsi e bonoa ka mor'a khoeli - e le 'ngoe le halofo.

Ho atleha hakae ha karolelano ea cholesterol le mafura a mang (triglycerides le tse ling) e fokotseha nako le nako ho hlahloba ka ho fana ka mali "bakeng sa biochemistry". Matšoao a ho khethoa ha Vasilip a ka fumaneha le mefuta e futsitsoeng ea hypercholesterolemia.

Ntle le moo, thibelo le kalafo ea atherosulinosis, lefu la pelo le mathata a mang a methapo a tsamaeang le mafura a mangata a mali li lokela ho ts'ehetsoa ke ts'ebeliso ea sethethefatsi sena.

Vasilip e fumaneha ka foromo ea letlapa. Morero oa bohlokoa haholo bakeng sa khetho ea butle-butle ea lethal dose, e hlalosoang ke taelo ea moriana. Ho qala ka lethal dose le tlase la Vazilip, ngaka e lokela ho lula e lekola boemo ba metaboliki ba mokuli le ho etsa liphetoho likhethong (eketsa palo) ho feta hanngoe ka khoeli.

Ka tsela e tšoanang, mokuli o tlameha ho latela lijo tse khethehileng, ho seng joalo kalafo ea "statin" e tla lahleheloa ke moelelo.

Ngaka e hlalosang Vasilip o boetse o lokela ho lekola bophelo ba mokuli le liphio ka hloko, ho fumana hore na o sebelisa meriana efe, hore na o phela joang ... Ka mantsoe a mang, li-statins, leha li ka fetola maemo ka k'holeseterole, li lokela ho fuoa tlhokomelo e kholo. Ka mokhoa o nang le boikarabello, o tla bona hore na o sebetsa joang ha nako e ntse e feta.

Vasilip e kopantsoe le mafu a a liphio, sebete, ho se mamellane, moimana le ho nyeka, bana le bacha. Haeba mofumahali a sebelisa sethethefatsi sena, o lokela ho itšireletsa ka hloko ho ima e sa reroang. Haeba mokuli a rera ho ima ngoana, ha aa lokela ho nka Vasilip.

Litla-morao tsa vasilip

Ka tšebeliso e nepahetseng ea moriana, ho lekola boemo ba mali le ho sebetsa ha lits'ebetso tse kholo tsa 'mele, ponahatso ea matšoao a sa batleheng e hlalosoa e le "seoelo" (ke hore, nyeoe e le' ngoe ho tse likete tse sekete ho isa ho tse leshome tsa kalafo ea Vasilip).

Tšilo ea lijo, tsamaiso ea methapo, mesifa e ka ameha. Mohlala, linyeoe tsa ho senyeha ha sebete, ho opeloa ke hlooho, bohloko ba mesifa, mesifa le tse ling lia hlalosoa.

Lipontšo tsa lefu la ho kula li ka fapana - ho tloha ho makhopho a bonolo ho isa ho ho thata ho se mamelle lithethefatsi.

Litafole tsa Vasilip: matšoao a ts'ebeliso, litlhahlobo tsa mokuli

Vasilip ke sethethefatsi seo e leng karolo ea sehlopha se theolang lipid.Moelelo o ka sehloohong oa ketso ea ona ke hore e reretsoe ho theola boemo ba lipids (mafura) maling. Vasilip e fumaneha ka mokhoa oa matlapa a masoeu ka har'a membrane ea filimi, e chitja, e nang le mahlakore a mabeli butle.

Sesebelisoa sa mantlha sa moemeli enoa ke simvastatin. E boetse e na le lintho tse ling tse kang lactose monohydrate, setlolo sa pregelatinized, anhydrous citric acid, vithamine C, starch ea poone, magnesium stearate le microcrystalline cellulose. Khetla ea khalase ka boeona e na le talc, propylene glycol, hypromellose le titanium dioxide.

Tekanyetso ea lithethefatsi ke ea mefuta e 'meli - 20 le 40 mg ka' ngoe.

Mochini oa ts'ebetso oa vasilip

Kaha Vasilip ke ea lithethefatsi tse fokotsang lipid, ts'ebetso ea eona ea ts'ebetso e loketse. Pele ho tsohle, vasilip e fokotsa khatello ea k'holeseterole e maling. Ho na le mefuta e 'meli ea cholesterol - e "mpe" le e "ntle". “E mpe” ke lipoprotein tse tlaase tsa batho, 'me "botle" ke lipoprotein tse phahameng.

Vasilip e na le phello mohatong oa pele oa ho etsoa ha k'holeseterole. Ho kenyelletsa ho fetoloa ha HMG-CoA (hydroxymethylglutaryl coenzyme A) ho mevalonic acid. Phetoho ena e etsahala tlasa ts'usumetso ea enzyme HMG-CoAreductase.

Vasilip e na le phello e nyahamisang ho enzyme ena, ka lebaka leo k'holeseterole e seng feela. Setlhare sena se boetse se ama cholesterol, e seng e le 'meleng.

E fokotsa bongata ba k'holeseterole e amanang le lipoprotein tse tlaase, hape e fokotsa le khatello ea "triglycerides".

Ke lintho tsena tsa mofuta oa lipid o ikarabellang bakeng sa ho theha liathomo tsa atherosselotic ho lumen ea methapo. Empa moriana o eketsa palo ea "cholesterol" e ntle - e amanang le lipoprotein tse phahameng. Tekanyo ea apolipoprotein B, protheine e khethehileng e tsamaisang 'mele e tsamaisang' mele le eona ea fokotseha.

Ntle le ho fokotsa boemo ba mefuta e meng ea lipids, ntho ea mantlha e sebetsang ea Vasilip e ama lebota la vascular le mali ka boeona.

Lintho tse amanang le mali tse kang li-macrophages, tse tsamaisang karolo e ka sehloohong ho hlahiseng li-cholesterol deposits, li sitisoa ke ketso ea lithethefatsi, 'me li-plaque ka botsona li senngoe.

Hape, sebopeho sa lintho tse bitsoang isoprenoids, tse ikarabellang bakeng sa kholo ea lisele tsa sebopeho sa methapo ea likepe, se fokotseha haholo, ka lebaka leo lebota la lijana le sa tebang, le lumen ea tsona e sa patisane. Ho feta moo, Vasilip e hlapolla methapo ea mali hantle mme e ntlafatsa phallo ea mali.

Lintlha tsa pharmacokinetics tsa vasilip

Vasilip e kenelletse. E kenella hantle leboteng la mala a manyane.

Palo e phahameng ea lithethefatsi e bonoa hora e le 'ngoe ho isa ho tse peli ka mor'a ts'ebetso ea eona, empa kamora lihora tse 12 e fokotseha ho 10%. Moriana o ka nooa le lijo, sena se ke ke sa ama phello ea sona.

Hape, ha e ipokelletse 'meleng ka tšebeliso ea nako e telele. Setlhare se tlameletsoe ka thata liprotheine tsa mali, hoo e batlang e le 100%.

Vasilip e fetoha motsoako o sebetsang sebeteng. Khemero ena e bitsoa beta hydroxy acid. Tlhahiso ea eona (ho tlosa) e etsoa ka mpeng e kholo. Lithethefatsi li tlosoa ka mokhoa oa metabolites (lihlahisoa tsa phetoho).

Karolo e nyane ea eona e epolloa ke liphio, empa sebopeho se sa sebetseng sa komporo se tloha lipelong.

Matšoao le contraindication bakeng sa ts'ebeliso

Hangata lingaka li beha vasilip bakeng sa lefu le kang atherosclerosis. Ho boetse ho tloaelehile haholo bakeng sa hypercholesterolemia ea mantlha kapa dyspidemia (tlolo ea karolelano ea lipids tse fapaneng tsa mali) hammoho le ho ikoetlisa khafetsa ho ikoetlisa, ho theola boima ba 'mele, ho latela lijo tse thehiloeng, kapa ho sa sebetseng litlamorao tsa meriana e meng.

Letšoao le leng ke homozygous hereditary hypercholesterolemia. Ka tlhaho, ka mokhoa o tšoanang, ja le ho ja lithethefatsi tse ling tsa anti-atherosclerotic li lokela ho lateloa.

Vasilip e boetse e laetsoe bakeng sa thibelo ea mafu a pelo le methapo ea methapo ea methapo, hobane ho na le kotsi e kholo ea tlhaselo ea pelo, stroke le methapo e mengata ea methapo.

'Me ea ho qetela e mpa e le cholesterol e phahameng e le teng ha ho se liponahatso tsa bongaka.

Vasilip e kopantsoe le maemo a kang:

• lefu la sebete sethaleng kapa ka mafolofolo,
• keketseho ea nako e telele ea li-enzyme tsa sebete ntle le lebaka le tiisitsoeng,
• ho ima le ho nyekeloa,
• lilemo tse nyane
• ho kula ho sa tloaelehang ho simvastatin kapa likarolo tse ling tsa lithethefatsi.

Ho lebisoa tlhokomelo e khethehileng ho bakuli ba nang le mafu a latelang kapa maemo a itseng:

1. Ka ho nwa haholo.
2. Boteng ba maloetse a amang sebete.
3. Boteng ba khaello ea li-electrolyte 'meleng.
4. Tlolo ea bohlokoa ea tsamaiso ea endocrine le metabolism.
5. Kamehla khatello e fokolisitsoeng (hypotension).
6. Lisosa tsa mmele.
7. Mathata a tsamaiso ea mesifa.
8. Lefu la sethoathoa.
9. Ho buuoa ho hoholo kapa ho lemala hampe.
10. Ho haella ha lactase, enzyme e theohang lactose (tsoekere ea lebese).
11. Tlolo ea mekhoa ea ho monya lactose.

Litaelo tsa tšebeliso ea lithethefatsi

Pele o sebelisa litlhare tsena, u lokela ho buisana le ngaka ea hau ka hore na u ka e noesa joang ka nepo le hore u tloaelane le tumello. Mokhoa o tloaelehileng oa kalafo ke oa ho nka letlapa le le leng kapa ho feta hang ka letsatsi nakong ea ho robala.

Ho khothalletsoa ho nwa moriana bosiu, hobane bosiu, motsoako oa cholesterol e kholo o etsoa, ​​'me phello ea lithethefatsi e ba e boletsoeng le ho feta. Hangata qala ka tekanyetso ea 10 mg. Tekanyetso e kholo e lumelletsoeng ke 80 mg ka letsatsi.

E laetsoe bakuli ba nang le mefuta e tsoetseng pele ea maloetse, le ba kotsing e kholo ea mathata a tsoang pelong le methapong ea mali. Tekanyetso e hlokahalang maemong a mangata e khethoa nakong ea khoeli.

Nako ea kalafo e khethoa ka thoko ho mokuli e mong le e mong ke ngaka ea hae e eang.

Ho lokela ho hopoloa hore ha o nka Wazilip, mokuli ka bomong o na le lijo tseo a tlamehang ho li latela. Maemong a mang, lithethefatsi tse ling tse fokotsang lipid le tsona lia laeloa.

Bakeng sa bakuli ba nang le lefu le kang hypercholesterolemia, kalafo e qala ka lethalinyana la 10 mg, empa e kanna ea eketsoa ho 40 mg ho fihlela sephetho se boletsoeng haholoanyane.

Bakeng sa mofuta oa lefu lena, Vazilip e arotsoe makhetlo a mararo haeba ho fanoa ka tekanyetso e kholo (80 mg), kapa 40 mg ea moriana o fanoang hang ka letsatsi pele ho robala.

Vasilip e na le phello e lakatsehang ts'ebelisong e le 'ngoe le kopantsoeng le li-anticholesterolemic agents, haholoholo, le li-sequestrants tsa bile acid. Tsena ke lithethefatsi tse kang colestyramine, colestipol.

Ka tšebeliso e kopaneng ea cyclosporine, gemfibrozil, nicotinic acid kapa lithethefatsi tse tsoang sehlopheng sa li-fibrate, li qala ka lethal dose ea 5 mg, mme tekanyetso e kholo e amohelehang ke 10 mg.

Maemong ana, ha ua lokela ho feta tekanyetso ena.

Haeba mokuli a sebelisa lithethefatsi khahlanong le arrhythmia le khatello e phahameng ea mali, joalo ka Amiodarone le Verapamil, joale lethal dose la Vasilip ha lea lokela ho ba ka tlase ho 20 mg ka letsatsi, kaha ts'ebelisano ea bona ha e tiisoe ka botlalo.

Haeba motho a e-na le bothata bo matla ba ho se sebetse hantle ke lefutso, moo litheko tse fetotsoeng tsa glomerular li sa feteng 30 di ml / min. Ka mor'a moo, Vasilip e beoa lethal dose e seng ho feta 10 mg ka letsatsi. Tekanyetso e lokela ho eketsoa ka hloko haholo, mme maemong ana mokuli o lokela ho lula a beiloe leihlo.

Sokolla foromo le sebopeho

Vasilip e hlahisoa ka mokhoa oa matlapa a tšoeu (li-pcs tse 7. Ka blister), tse koahetsoeng ka membrane ea filimi.

Litaelo tsa ho sebelisa Vasilip (mokhoa le litekanyetso)

Matlapa a etselitsoe ho tsamaisoa ka molomo, hang ka shoalane.

Tekanyetso e khothalletsoang e fapana ho tloha ho 5 mg ho isa ho 80 mg hang hang ka letsatsi ka shoalane. Tekanyetso ea pele ea lithethefatsi ke 10 mg. Liphetoho tsa dose li lokela ho etsoa khafetsa bonyane libeke tse 4.

Phaello e lumellehang ea letsatsi le letsatsi e fihla ho 80 mg. E fuoa feela bakuli ba nang le kotsi e kholo ea mathata a pelo le pelo e matla kapa hypercholesterolemia.

Nako ea ho nka litafole e khethoa ke ngaka e eang ka bonngoe.

Hypercholesterolemia

Nakong eohle ea kalafo, mokuli o lokela ho latela lijo tse tloaelehileng tsa hypocholesterol. Motsoako oa ho qala oa bakuli ba nang le hypercholesterolemia ke 10 mg. Ho fumana phokotseho e boletsoeng haholoanyane ho LDL-C, kalafo e ka qala ho tloha ho 20 ho isa ho 40 mg ka letsatsi (hang ka shoalane).

Ho bakuli ba nang le homozygous hereditary hypercholesterolemia, lethal dose ea letsatsi le letsatsi ke 40 mg mantsiboea kapa 80 mg ho litekanyetso tse 3 tse arohaneng (20 mg hoseng, 20 mg thapama le 40 mg ka shoalane).

Thibelo ea Maloetse a amanang le pelo le pelo

Ho bakuli ba nang le hyperlipidemia kapa ba se nang hyperlipidemia, ba kotsing e kholo ea lefu la pelo ea methapo, litekanyetso tse sebetsang tsa lithethefatsi ke 20 ho isa ho 40 mg ka letsatsi. Ka hona, moriana o khothalletsoang oa ho qala o fihla ho 20 mg ka letsatsi.

Liphetoho tsa moriana li lokela ho etsoa hangata ka libeke tse 'ne. Haeba ho hlokahala, lethalinyana le ka eketsoa ho 40 mg ka letsatsi.

Haeba litaba tsa LDL li le ka tlase ho 75 mg / dl (1.94 mmol / L), tlhahiso ea k'holeseterole e ka tlase ho 140 mg / dl (3,6 mmol / L), tekanyo e lokela ho fokotsoa.

Pheko e lumellanang

Vasilip e sebetsa hantle hammoho le li-sequence tsa bile acid kapa ho monotherapy. Ho bakuli ba fumanang kalafo ka gemfibrozil, cyclosporine, nicotinic acid kapa li-fibrate tse ling (tse fetang 1 g ka letsatsi), tekanyo ea pele ke 5 mg. Tekanyetso e phahameng ea letsatsi le letsatsi ea lithethefatsi ke 10 mg. Ho eketsoa ha litekanyetso tse ling ha ho khothalletsoe.

Ho bakuli ka nako e tšoanang ba nka verapamil kapa amiodarone, tekanyetso ea letsatsi le letsatsi ea lithethefatsi ha ea lokela ho ba 20 mg.

Mofumahali

Simvastatin - ntho e sebetsang ea Vasilip, ke moemeli ea fokotsang lipid a fumanoang ka sehlahisoa sehlahisoa sa belisoa Aspergillus terreus.

Kamora ho tsamaisoa ka molomo, simvastatin, e leng lactone e sa sebetseng, e kenella ka har'a hydrolysis ka har'a sebete, ka sebopeho sa mokhoa o lumellanang oa β-hydroxy acid ea ntho. Ke metabolite e ka sehloohong 'me e na le ts'ebetso e phahameng khahlanong le HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) -reductase, enzyme e ts'oarisang synthetic ea biolo (karolo ea pele le ea bohlokoahali) ea cholesterol.

Ho sebetsa hantle ha simvastatin ho fokotsa khatello ea plasma ea cholesterol e felletseng, k'holeseterole e felletseng, cholesterol ea LDL, cholesterol e fokolang haholo, le troplycerides le cholesterol e tlaase haholo ea lipoprotein, le cholesterol e phahameng ea HDL letsoalo) ho plasma ea mali ho bakuli ba nang le heterozygous Familia / bao e seng ba lelapa bo amanang le hypercholesterolemia kapa hyperlipidemia maemong ha ho eketseha ha plasma ea cholesterol maling e le e 'ngoe ea mabaka. Kotsi le khetho ea lijo tse le 'ngoe ha ea lekana. Phello e hlokomelehang ea kalafo e bonoa matsatsing a 14 a ho nka simvastatin, e phahameng ka ho fetisisa nakong ea libeke tse 4-6 ho tloha ts'ebetsong. Ka kalafo e tsoelang pele, phello e phehella. Khokahano ea plasma ea cholesterol ka mor'a ho emisa ts'ebeliso ea simvastatin maling e khutlela boleng ba eona ba pele, bo ileng ba bonoa pele ho qala kalafo.

Metabolite e sebetsang ea simvastatin ke inhibitor e khethehileng ea HMG-CoA reductase (enzyme e tsosang karabelo ea ho thehoa ha mevalonate ho tloha HMG-CoA). Leha ho le joalo, taolo ea litekanyetso tsa kalafo ea ntho ena ha e lebise ho thibelo e felletseng ea phetoho ea HMG-CoA, ka ho etsa joalo e boloka tlhahiso ea palo e hlokahalang ea biologic. Ho lumeloa hore tšebeliso ea vasilip ha ea lokela ho baka ho bokellana ha li-sterols tse ka bang kotsi 'meleng, hobane mohato oa pele oa ts'ebetso ea likokoana-hloko tsa cholesterol ke phetoho ea HMG-CoA ho mevalonate. Ntle le moo, ho na le metabolism e potlakileng ea HMG-CoA ho acetyl-CoA, e amehang lits'ebetsong tse ngata tsa biosynthesis 'meleng.

Cholesterol ke selelekela sa li-hormone tsohle tsa steroid, 'me phello ea kliniki ea simvastatin ho steroidogenesis ha e bonoe. Kaha Vasilip ha e lebise keketseho ea lithogenicity ea bile, phello ea eona ea keketseho ea kholo ea cholelithiasis ha e na monyetla.

Simvastatin e thusa ho fokotsa ho tsitsisa ha cholesterol e phahameng le e tloaelehileng ka har'a plasma ea mali. Sebopeho sa LDL se tsoa ho VLDL (lipoprotein tse tlase haholo). Catabolism ea LDL e etsoa haholo ka thuso ea receptor e phahameng ea LDL. Mokhoa oa ho fokotsa khatello ea cholesterol ea LDL maling a mali kamora ho nka simvastatin e ka ba ka lebaka la ho fokotseha hoa khatello ea plasma ea cholesterol ea VLDL maling le ts'ebetsong ea li-receptor tsa LDL. Ka lebaka la sena, ho na le ho fokotseha ha sebopeho le ho eketseha ha catabolism ea cholesterol ea LDL. Nakong ea kalafo ka simvastatin, khatello ea plasma ea apolipoprotein B (apo B) maling le eona e fokotseha haholo. Kaha karolo e 'ngoe le e' ngoe ea LDL e na le molek'hule e le 'ngoe ea B, le palo e nyane eaapo B e fumaneha lipoprotein tse ling, ho ka nahanoa hore simvastatin, ntle le ho baka tahlehelo ea k'holeseterole likarolong tsa LDL, e thusa ho fokotsa khatello ea plasma ea ho potoloha hoa likaroloana tsa LDL maling.

Simvastatin e boetse e eketsa khatello ea cholesterol ea HDL hape e fokotsa khatello ea mali ea TG maling a mali. Ka lebaka la kamano ena, LDL-C / HDL-C le HDL / HDL-C li fokotsehile.

Ka lefu la pelo (coronary pelo lefu la pelo) le khatello ea mantlha ea cholesterol e ka bang 212-309 mg / dL (5.5 ho isa ho 8 mmol / l), simvastatin e thusa ho fokotsa menyetla ea ho shoa ka kakaretso, lefu la lefu la pelo le lefu le sa bonahaleng la lefu la pelo. Hape, ntho ena e fokotsa menyetla ea ho hloka ts'ebetso ea ho buoa ho khutlisetsa phallo ea mali (ka mohlala, coronary artery bypass grafting kapa percutaneous translateuminal coronary angioplasty). Khahlano le semelo sa lefu la tsoekere, ho khonahala hoa ponahalo ea mathata a maholo a khoheli ho fokotseha. Ho feta moo, nakong ea kalafo ea simvastatin, menyetla ea ho tšoaroa ke mafu a bolaeang a amanang le lefu la sethoathoa (ho kenyelletsa le marang-rang le mafu a amanang le lefu la sethoathoa) e fokotsehile haholo.

Ho na le bopaki ba katleho ea simvastatin ho bakuli ba nang le / ntle le hyperlipidemia, ba kotsing e kholo ea ho ba le lefu la pelo ka lebaka la lefu la tsoekere le amanang le lefu la tsoekere, nalane ea ho otla le mafu a mang a methapo.

Ka tšebeliso ea Vasilip ka tekanyetso ea letsatsi le letsatsi ea 40 mg, lefu le akaretsang, kotsi ea lefu e amanang le lefu la pelo, ho ba le mathata a maholo a kenyelletsang (ho kenyelletsa infarction ea lefu la pelo kapa lefu le amanang le lefu la pelo), tlhokeho ea ho kenella ts'ebetsong ea bongaka ho khutlisetsa phallo ea mali a coronary e fokotsehile (ho kenyelletsa le tsamaiso ea methapo ea methapo ea methapo ea methapo ea methapo ea kutlo, hammoho le phallo ea mali le mefuta e meng ea ho hlaseloa hape ho sa kopaneng, kotsi ea ho otloa, khafetsa le sepetlele bakeng sa se ho nyekeloa ke pelo.

Monyetla oa mathata a maholo a methapo ea pelo / "coronary" a fokotsehile ho bakuli ba nang le / ntle le lefu la mokokotlo oa mokokotlo, ho kenyelletsa le bakuli ba nang le lefu la methapo ea methapo, lefu la tsoekere kapa lefu la methapo ea methapo. Ho tsoekere ea lefu la tsoekere, Vasilip e thusa ho fokotsa kotsi ea mathata a tebileng a methapo, ho kenyelletsa le tlhoko ea ts'ebetso ea ho buuoa bakeng sa ho phumula likarolo tse tlase, ho khutlisetsa phallo ea mali a pharalletseng, le ho hlaha ha liso tsa trophic.

Ho ea ka coronary angiography, kalafo ea simvastatin e fokotsa tsoelo-pele ea coronary atherosclerosis le ponahalo ea libaka tse ncha tsa atherosclerosis le lits'oants'o tse ncha tsa kakaretso, ha bakuli ba fumanang kalafo e tloaelehileng ba bonts'a tsoelo-pele e tsitsitseng ea liso tsa methapo ea methapo ea methapo ea methapo ea kutlo.

Mofumahali

Simvastatin ke lactone e sa sebetseng. Ntho e potlakisa hydrolyzes, ka phetoho ea eona ea simvastatin β-hydroxy acid (L-654.969), e thibelang e ka fokotsang matla a HMG-CoA. Li-metabolites tse ka sehloohong tsa simvastatin ho plasma ke β-hydroxy acid ea simvastatin (L-654.969) le 6'-exomethylene, 6'-hydroxy le 6'-hydroxymethyl.

Mohlala oa tlhahlobo e lekanyelitsoeng ea lithuto tsohle tsa pharmacokinetic tsa β-hydroxy acid metabolites (li-inhibitors tse sebetsang) le li-inhibitors tse sebetsang / tsa morao-rao (li-inhibitors tsohle) tse thehiloeng ka lebaka la hydrolysis ke thibelo ea phokotso ea HMG-CoA. Ha o ja simvastatin ka plasma ea mali, mefuta e 'meli ea metabolites e ikemiselitse.

Hydrolysis ea simvastatin e etsahala haholo nakong ea karolo ea pele ho pholletsa le sebete, ka hona, ho na le mohopolo o fokolang oa plasma ea simvastatin e sa fetoheng maling a motho (14 C e ngotsoeng simvastatin + 14 C e ngotsoeng simvastatin metabolites) e fihlella ka lihora tse 4. Ebe nakong ea lihora tse 12 e fokotseha ka potlako ho isa ho 10% ea boleng bo phahameng. Leha ho na le taba ea hore tekanyetso ea litekanyetso tsa kalafo tse khothalelitsoeng tsa simvastatin e tsoa ho 5 ho isa ho 80 mg ka letsatsi, sebopeho sa nalane ea profinse ea AUC (sebaka se ka tlasa nako ea nako ea mahloriso) ea metabolites e sebetsang maling a phallang ka botlalo e bonoa ka tekanyetso e ntseng e eketseha ho isa ho 120 mg.

Hoo e ka bang 85% ea tekanyetso e amoheloang ea simvastatin e ananeloa. Ho ja (e le karolo ea phepelo e tloaelehileng ea hypocholesterol) hang kamora ho nka simvastatin ha ho ame boemo ba "drugacokinetic" ba lithethefatsi.

Likarolo tse phahameng tsa simvastatin li beoa ka har'a sebete (ho bapisoa le lisele tse ling).

Kholiseho tsamaisong ea metabolism ea metabolite e sebetsang ea simvastatin L-654.969 ke 60% ho banna).

Monyetla oa ho kenella ka hare ho ntho ka methapong ea mali le methapo ea hematoplacental ha o so ithute.

Simvastatin nakong ea karolo ea pele ea sebete e tšeloa matla, kamora 'metso ea ntho' me metabolite ea eona e etsahala ka bile.

Ha u nka 100 mg ea simvastatin 14 C, ntho e boletsoeng e bokellana ka plasma ea mali, hammoho le makhopho (a ka bang 60%) le moroto (hoo e ka bang 13%). Li-facks, tse bitsoang simvastatin li hlahisoa ke lihlahisoa tsa metabolic tsa simvastatin, tse ileng tsa epolloa ka har'a bile, le tse sa boleloang tse ngotsoeng simvastatin. Tlas'a 0,5% ea lethal dose le amoheloang la ntho e ngotsoeng e fumanoa moriring ka mokhoa oa metabolites ea ntho. Ka plasma, 14% le 28% ea AUC e bakoa ke li-inhibitors tse sebetsang le li-inhibitors tsohle tsa HMG-CoA reductase, ka ho latellana. Sena se bonts'a hore lihlahisoa tsa "metabolite" tsa simvastatin hangata ha li sebetse kapa li na le matla a fokotsang matla a HMG-CoA.

Ho kheloha ho hoholo ha moralo oa AUC ho phallo ea mali ka botlalo le tekanyetso e ntseng e eketseha ka bongata ba 5-120 mg ha e bonoe. Ka ho kenella ka nako e le 'ngoe le ho pheta-pheta ha simvastatin, litekanyetso tsa pharmacokinetic li bonts'itse ho ba sieo ha ho bokellwa ha thepa liseleng ho sebelisoa hangata.

Ho hloleha ho matla ha renal (ho bakuli ba nang le tumello ea creatinine ea 10 mg ka letsatsi, haeba ho hlokahala, kalafo e fanoa ka hloko.

Vasilip, litaelo tsa tšebeliso: mokhoa le litekanyetso

Matlapa a Vasilip a nooa ka molomo, nako e le 'ngoe ka letsatsi, ka shoalane. Motsoako oa letsatsi le letsatsi o khothalletsoang o fapana ho tloha ho 5 mg ho isa ho 80 mg.

Hangata, lithethefatsi li fanoa ka tekanyo ea pele ea 10 mg. Liphetoho tsa litekanyetso li lokela ho etsoa bonyane ha libeke tse 4. Tekanyo e phahameng ea letsatsi le letsatsi (80 mg) e khothalletsoa feela ho bakuli ba nang le hypercholesterolemia kapa kotsi e kholo ea ho ba le mathata a pelo. Nako ea vasilip e khethoa ka bomong ke ngaka e eang.

Nako eohle ea kalafo, mokuli o lokela ho latela lijo tse tloaelehileng tsa hypocholesterol. Motsoako oa ho qala o khothalelitsoeng ke 10 mg. Bakeng sa ho theola boemo ba LDL-C ka mokhoa o hlakileng haholoanyane (ka ho feta 45%), o ka qala ho nka Vasilip ka 20-25 mg hang ka letsatsi, mantsiboea.

Bakuli ba nang le homozygous hereditary hypercholesterolemia ba khothalletsoa ho nka 40 mg hang ka letsatsi, ka shoalane. Ho a khonahala ho sebelisa tekanyetso ea 3 - hoseng le thapama, 20 mg le 40 mg ka shoalane. Vasilip e khothalletsoa ho bakuli ba joalo hammoho le kalafo e meng e fokotsang lipid (mohlala, LDL apheresis).

Thibelo ea mafu a pelo le methapo:

Ka kotsi e kholo ea ho ba le lefu la pelo (le nang le hyperlipidemia), 20-40 mg ea Vasilip e beoa ka letsatsi. Tekanyetso ea pele ke 20 mg, keketseho ea tekanyetso e lokela ho hlaha nako le nako ea bonyane libeke tse 4. Tekanyo e phahameng ea letsatsi le letsatsi ke 40 mg. Ha litaba tsa LDL li le ka tlase ho 75 mg / dl (1.94 mmol / L), lihlahisoa tsa cholesterol kaofela ha li tlase ho 140 mg / dl (3,6 mmol / L), litekanyetso li lokela ho fokotsoa.

Vasilip e sebetsa hantle ho monotherapy kapa ka nako e ts'oanang le li-sequestrants tsa bile acid (mohlala, colestipol le colestyramine). Ho bakuli ba fumanang kalafo ka gemfibrozil, cyclosporine, fibrate tse ling kapa nicotinic acid (e fetang 1 g ka letsatsi), ho khothalletsoa ho qala kalafo ka 5 mg ka letsatsi, lethal dose le leholo la letsatsi ke 10 mg. Maemong a joalo, ha ho kgothaletswe keketseho e 'ngoe ea tekanyetso.

Ho bakuli ba fumanang verapamil kapa amiodarone, lethal dose la letsatsi le letsatsi la vasilip ha lea lokela ho feta 20 mg.

Bakeng sa bakuli ba nang le bothata bo matla ba ho lemala (CC ka tlase ho 30 ml / min), lethal dose le khothalletsoang la letsatsi le letsatsi la Vasilip ha lea lokela ho feta 10 mg. Haeba o hloka ho eketsa tekanyetso, ho hlokahala tlhokomelo e hlokolosi ea bongaka.

Bakuli ba nang le mathata a ho leka-lekanya a renal le maqheku ha ba hloke phetoho ea litekanyetso.

Bokhachane le pelehi

Vasilip nakong ea bokhachane / pelehi ha e khethoe.

Ha bokhachane bo etsahala, tšebeliso ea simvastatin e lokela ho emisoa hang-hang. Basali ba lilemo tsa ho ba le bana, Vasilip a ka fuoa feela maemong ao menyetla ea bokhachane e nyane haholo. Phekolo ea lithethefatsi nakong ea kemolo e ka lebisa ho fokotseha hoa khatello ea methapo ea methapo (cholesterol biosynthesis) ka popelong. Atherosclerosis e nkoa e le lefu le sa foleng, mme hangata ho tlosoa ha lithethefatsi tse fokotsang lipid nakong ea kemolo ha ho amehe haholo likotsi tsa nako e telele tse amanang le hypercholesterolemia ea mantlha. Tabeng ena, simvastatin ha ea lokela ho fuoa basali ba baimana, ba batlang ho ima kapa ho belaella hore ba imme. Phekolo ea Vasilip e lokela ho emisoa bakeng sa nako eohle ea kemolo kapa ho fihlela moimana a fumanoa, mme mosali ka boeena o lokela ho lemosoa ka kotsi e teng ho lesea.

Ha ho na bopaki bo netefatsang kapa bo sa pepeseheng bo pepesitsoeng ba simvastatin le metabolites ea eona ka lebese la matsoele.

Litheko tsa vasilip libakeng tsa polokelo ea meriana Moscow

Motsoako o kopantsoeng:

• li-inhibitors tse matla tsa CYP3A4 isoenzyme (itraconazole, telithromycin, ketoconazole, posaconazole ,cacithromycin, voriconazole, erythromycin, li-protease inhibitors tsa boceprevir, nefazodone, telaprevir e amanang le litlamorao tsa ts'oaetso ea ka ke ena: itraconazole, telaprevir.
• gemfibrozil, danazol kapa cyclosporine.

Lingaka li hlahloba mabapi le vasilip

Ho na le nako eo lingaka tse ngata (eseng meriana!) Li ileng tsa nka 10 mg ea vasilip e le kalafo e sebetsang bakeng sa mafu a amanang le atherosulinosis. Nako ena e felile. Simvastatin ka sebopeho sefe kapa sefe ha e sa nkoa e le lithethefatsi tse u lumellang ho fihlela maemo a hlokahalang a k'holeseterole le lipids tse ling.

Kahoo, haeba ngaka e se e fana ka taelo ea simvastatin (ho kenyeletsoa vasilip), ha ke utloisise hore na ke hobaneng ha a hlokomoloha lipalo tsa sejoale-joale tse nang le tšusumetso e matla le e sireletsehileng haholoanyane.

Ke nako ea ho lebala ka simvastatin. Mme ka tsela efe, ke khopolo efe e fosahetseng eo li-statins ha lia lokela ho nkuoa ho feta libeke tse 'maloa? Li nkuoa ka lilemo le mashome a lilemo, 'me selemo se seng le se seng sa ho amoheloa se tlisa melemo e eketsehileng ho bakuli, le likhamphani tsa meriana, le tsona.

Tlhahlobo ea mokuli ea Vasilip

Ke nka "Vasilip" mg ka makhetlo a 10 bakeng sa Letlapa le le leng mantsiboea, ke nka liteko tsa cholesterol hang ka likhoeli tse ling le tse ling tse tharo. Liphetho li ntle. Ho bile le boiteko bo sa atleheng ba ho fetohela ho molekane oa lapeng ea theko e tlase. Cholesterol o ile a tlolela holimo, a khutlela ho "Vasilip". Ka penshene, ho reka ho theko e boima, empa bophelo bo botle bo bitsa chelete e ngata haholo.

"Vasilip" e ile ea eletsoa ho nna ke setsebi sa ho ja ka ho fokotsa boima ba 'mele, ka mor'a ho buisana le ngaka, ke ile ka ja hammoho le lijo. Ho makatsang ke hore litholoana e bile tse ntle, leha ke ne ke sena bonnete ba hore li-tabo li tla thusa! Ba nkile libeke tse 5-6, hape! E tšela k'holeseterole e tlase maling, ke ka lebaka leo sephetho se joalo!

Thutela-litso

Simvastatin e boetse e fokotsa haholo litaba tsa apolipoprotein B, ka tsela e leka-lekaneng e eketsa khatello ea HDL-C le maemo a tlase a plasma ea TG. Ka lebaka la litlamorao tsena tsa simvastatin, karo-karolelano ea Chs ho kakaretso ea Chs-HDL le Chs-LDL ho Chs-HDL ea fokotseha.

Matla a antiatherosulinotic a simvastatin ke litholoana tse hlahisoang ke lithethefatsi maboteng a methapo ea mali le likarolo tsa mali. Simvastatin e fetola metabolism ea li-macrophages, e thibela ts'ebetso ea li-macrophages le timetso ea li-plagi tsa atherosselotic. Lithethefatsi li thibela tlholeho ea isoprenoids, e leng lintlha tsa kholo kholopanong ea lisele tse boreleli tsa mesifa ea mokokotlo oa methapo ea mali. Tlas'a tšusumetso ea simvastatin, ho atoloha ho itšetlehileng ka methapo ea mali hoa ntlafala.

Tšusumetso ea kalafo e etsahala kamora libeke tse peli, phello e phahameng e bonoa kamora libeke tse 4 tsa kalafo.

Tšebelisano

Tšebeliso e tšoanang ea simvastatin e nang le fiber, nicotinic acid (ho feta 1 g / letsatsi) e eketsa kotsi ea ho ba le myopathy, ho kenyelletsa le rhabdomyolysis (ka tšebeliso e tšoanang le fenofibrate, ha ho na bopaki ba kotsi e eketsehang ea myopathy ha e bapisoa le monotherapy le lithethefatsi tse ling ka thoko).

Tšebeliso e kopanetsoeng le gemfibrozil e ka lebisa hoketseho ea khatello ea simvastatin serum.

CYP3A4 cytochrome inhibitors (itraconazole, ketoconazole, erythromycin ,cacithromycin, telithromycin, HIV proteinase inhibitors le nefazodone), e kenang phetolelong ea metabolic ea simvastatin ho sebete, e eketsa kotsi ea myopathy le rhabdomyolysis nakong ea kalafo e nang le simvastatin. Ts'ebeliso e lumellanang le lithethefatsi tsena e hanyetsitsoe.

Ka tlhokomeliso, ho hlokahala ho fana ka nako e ts'oanang le li-inhibitors tse se nang matla tsa CYP3A4: cyclosporine, verapamil le diltiazem. Tekanyetso ea letsatsi le letsatsi ea simvastatin ha u ntse u e nka le cyclosporine ha ea lokela ho feta 10 mg. Tekanyetso ea letsatsi le letsatsi ea simvastatin ka tsamaiso e ts'oanang ea amiodarone kapa verapamil ha ea lokela ho feta 20 mg, le 40 mg ka tsamaiso e ts'oanang ea li-diltiazem, ntle le haeba phaello e lebelletsoeng e feta ka ho hlaka menyetla ea ho ba le myopathy le rhabdomyolysis.

Simvastatin ka tekanyo ea 20-40 mg / ka letsatsi ho baithaopi le bakuli ba nang le hypercholesterolemia ba hlahisa litlamorao tsa coumarin anticoagulants (e.g. warfarin), haholoholo keketseho ea nako ea prothrombin, MHO. Ka hona, ho bakuli ba nkang li-anticoagulants tsa coumarin, nako ea prothrombin le MHO li lokela ho ikemela pele li qala kalafo ea simvastatin, nakong ea pele ea kalafo, ha u fetola tekanyetso ea simvastatin kapa o tlohela moriana. Kamora ho fihlela letšoao le tsitsitseng la nako ea prothrombin le MHO, ho hlahlojoa ho eketsehileng ho lokela ho etsoa nako le nako ho khothalletsoang bakuli ba fumanang kalafo ea anticoagulant. Phekolo ea Simvastatin ha e bake liphetoho nakong ea prothrombin le kotsi ea ho tsoa mali ho bakuli ba sa nkeng li-anticoagulants.

Lero la morara le thibela tšebetso ea CYP3A4. Ho ja ka nako e le 'ngoe ea lero le leholo la morara (ho feta litara e le' ngoe ka letsatsi) le simvastatin ho lebisa keketseho e kholo khorong ea plasma ea simvastatin acid. Ka hona, nakong ea kalafo ka simvastatin, lero la morara le lokela ho qojoa.

Litaelo tsa ho sebelisoa ha vasilip (mokhoa le litekanyetso)

Bakeng sa ba abetsoeng Vasilip, litaelo tsa tšebeliso li tlaleha hore e nkuoe ka molomomantsiboea, nako e le 1 ka letsatsi.

Litekanyetso tse tloaelehileng tsa letsatsi le letsatsi ke 5-80 mg. E le molao, li-10 mg li beiloe. Phetoho ea litekanyetso e lokela ho etsoa kamora libeke tse 4. Tekanyetso ea letsatsi le letsatsi ha ea lokela ho ba ho feta 80 mg. Tekanyetso e phahameng e fuoa feela batho ba nang le boima hypercholesterolemia kapa monyetla o eketsehileng oa ketsahalo pelo le mathata a pelo. Litaelo tsa ts'ebeliso ea Vazilip li tlaleha hore tsela ea kalafo e khethoa ke setsebi maemong ka 'ngoe ka bomong, ho latela lipontšo tsa tšebeliso le hore na mokuli o mamella moriana joang.

Boemong ba hypercholesterolemia ho hlokahala hore o tsamaise lintho tse tloaelehileng hypocholesterol ja lijo nakong ea kalafo. Tekanyetso ea pele maemong a mangata ke 10 mg. Bakeng sa phokotso ea bohlokoa haholo LDL k'holeseterole thupelo e ka qala ka 20-40 mg / ka letsatsi.

Ho homozygous hereditary hypercholesterolemia hangata ho nka 40 mg kapa 80 mg ka letsatsi, empa ho litekanyetso tse tharo (hangata 20 mg hoseng le thapama le e 'ngoe 40 mg ka shoalane). Ho bohlokoa ho kopanya sethethefatsi sena le se seng lipid-lowingho bolela.

Ho thibela nts'etsopele ea lefu la pelo le batho ba kotsing e kholo Lefu la pelo ea Ischemic fana ka taelo ho tloha ho 20 ho isa ho 40 mg / ka letsatsi. Tekanyetso ea lithethefatsi, e khethiloeng ka bomong, ea fokotseha haeba boemo LDLka tlase ho 75 mg / dl le k'holeseterole e felletsengka tlase ho 140 mg / dl.

Vasilip e ka sebelisoa hammoho ka kopanelo li-sequestrants tsa li-acid acid. Bakuli ba ntseng ba phekoloa fibrate kapa asiti ea nicotinic, nka tekanyo ea pele ea 5 mg. Tekanyo e phahameng ea letsatsi le letsatsi ha ea lokela ho ba ho feta 10 mg. 'Me ha e kopantsoe le Amiodarone kapa Verapamil u se ke ua feta tekanyetso ea 20 mg.

Ka ho teba ho hloleha ha rems ho molemo hore o se ke oa feta tekanyetso ea 10 mg / ka letsatsi. Haeba keketseho ea litekanyetso e ntse e hlokahala, boemo ba mokuli bo lokela ho lula bo beiloe leihlo.

Ho sebelisana le lithethefatsi tse ling:

• gemfibrozil le li-fibrate tse ling (ntle le fenofibrate), fusidic acid: monyetla oa ho theha myopathy,
• amiodarone, lomitapide, butle-butle calcium blockers (verapamil, diltiazem kapa amlodipine), nicotinic acid e lipid e fokolisang tekanyetso (bonyane 1000 mg ka letsatsi): monyetla o eketsehileng oa ho nts'etsapele myopathy / rhabdomyolysis,
• li-inhibitors tse itekanetseng tsa CYP3A4 isoenzyme (mohlala, dronedarone, ranolazine): menyetla e eketsehang ea ho nts'etsapele myopathy, tekanyo ea Vasilip e ka fokotsoa,
• OATP1B1 liproteine ​​tse tsamaisang protheine: ho eketseha ha plasma ea simvastatin hydroxy acid le monyetla oa ho nts'etsapele myopathy,
• colchicine (ho bakuli ba nang le ho se sebetse hantle ha methapo): menyetla e eketsehileng ea ho ba le myopathy le rhabdomyolysis, ts'ebeliso e kopaneng e hloka ho lekola bakuli ka hloko
• anticoagulants e sa tobang (coumarin derivatives): keketseho ea nako ea prothrombin, e hlalosoang e le MHO (tekanyetso e tloaelehileng ea machaba), boleng ba letšoao bo laoloa pele ho qala kalafo ka simvastatin, joale e ikemiselitsoe hangata haholo nakong ea pele ea kalafo, e lumellang ho qhelela ka thoko liphetoho tse kholo ho MHO. Kamora ho fihlela letšoao le tsitsitseng la nako ea prothrombin, boikemisetso ba eona bo tsoetseng pele bo lokela ho etsoa nako le nako bo khothalletsoang ho lekola bakuli ba fumanang kalafo ea anticoagulant. Maemong a ho fetola tekanyetso ea simvastatin kapa ka mor'a ho tlohela, ho khothalletsoa tekanyo e tloaelehileng ea letšoao lena. Ho bakuli ba sa kang ba nka li-anticoagulants, kalafo e nang le simvastatin ka ponahalo ea ho tsoa mali kapa liphetoho tsa nako ea prothrombin e ne e sa amanngoe,
• lero la morara (ka bongata bo boholo): ts'ebetso e eketsehileng ea plasma ea HMG-CoA reductase inhibitors.

Litšoantšiso tsa Vasilip ke: Zokor, Zokor Forte, Simvor, Simvakard, Simvastol, Simlo, Simvastatin Zentiva, SimvaHEXAL, Zovatin, Levomir, Simvalimit, Actalipid, Sinkard, Aterostat, Zorstat, Simvakolat, Simvastatin, Simvastatin, Simatinv Chaikafarma, Simvastatin-SZ, Simvastatin Alkaloid, Aries, Simvastatin Pfizer.

Boimana

Ka hona, simvastatin ha ea lokela ho sebelisoa ke basali le basali baimana ba lekang ho ima kapa ba belaella hore ba imme.
Ho amoheloa ha simvastatin ho lokela ho emisoa bakeng sa nako eohle ea kemolo kapa ho fihlela ho na le bopaki ba hore mosali ha a imme (bona karolo "Contraindication").
Ts'ebeliso ea simvastatin ho basali nakong ea lactation e hatelloa.
Ha ho tsejoe hore na simvastatin kapa metabolites ea eona e fetela lebeseng la matsoele. Kaha lithethefatsi tse ngata li fetela lebeseng la matsoele mme ho na le monyetla oa hore ho be le karabelo e mpe e matla, basali ba nkang simvastatin ba lokela ho emisa ho anyesa. (Bona karolo "Contraindication").