Litaelo tsa tšebeliso ea lithethefatsi Simvagexal® le litlhahlobo mabapi le eona

Mofuta oa mantlha IIa le mofuta oa IIb hypercholesterolemia (ka ho hloleha ho phekola lijo ho bakuli ba nang le menyetla e eketsehang ea ho ba le coronary atherosranceosis), hypercholesterolemia le hypertriglyceridemia, hyperlipoproteinemia, e ke keng ea lokisoa ke lijo tse khethehileng le ketso ea 'mele.

Thibelo ea infraction ea myocardial (ho liehisa tsoelo-pele ea coronary atherosulinosis), stroke le mathata a nakoana a ho potoloha ha lisele.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

Ka hare, hang, ka shoalane. Ka hypercholesterolemia e bonolo kapa e leka-lekaneng, tekanyetso ea pele ke 5 mg, ka hypercholesterolemia e matla ka lethal dose ea pele ea 10 mg / ka letsatsi, ka kalafo e sa lekaneng, tekanyo e ka eketsoa (eseng pele ho libeke tse 4), lethal dose le leholo la letsatsi le letsatsi ke 80 mg.

Ka lefu la pelo le coronary, lethal dose la pele ke 20 mg (hang, ka mantsiboea), haeba ho hlokahala, tekanyetso e eketseha butle-butle libeke tse 40 ho isa ho 40 mg. Haeba mahloriso a LDL a le ka tlase ho 75 mg / dl (1.94 mmol / L), kakaretso ea k'holeseterole e ka tlase ho 140 mg / dl (3,6 mmol / L), tekanyo e lokela ho fokotsoa.

Bakeng sa bakuli ba nang le bothata ba ho phekola renal (CC ka tlase ho 30 ml / min) kapa ba amohela cyclosporine, fibrate, nicotinamide, lethal dose la pele ke 5 mg, lethal dose le phahameng la letsatsi ke 10 mg.

Ketso ea pharmacological

Setlhare se fokotsang lipid, se fumanehang ho tloha sehlahisoa sa belisoa Aspergillus terreus, ke lactone e sa sebetseng; e feta ka har'a hydrolysis 'meleng ho theha hydroxy acid e tsoang teng. Metabolite e sebetsang e hatella ho fokotsoa ha HMG-CoA, enzyme e thusang karabelo ea pele ea sebopeho sa mevalonate e tsoang HMG-CoA. Ho tloha ha ho fetoloa hoa HMG-CoA ho mevalonate ke bohato ba pele moqoqong oa k'holeseterole, ts'ebeliso ea simvastatin ha e bake ho bokellana ha "sterols" tse nang le chefo 'meleng. HMG-CoA e tšelisoa habonolo ho acetyl-CoA, e amehang lits'ebetsong tse ngata tsa mantlha 'meleng.

E fokotsa khatello ea kelello ea TG, LDL, VLDL le cholesterol e felletseng ho plasma (maemong a heterozygous malapa le mekhoa eo e seng ea lelapa ea hypercholesterolemia, e nang le hyperlipidemia e kopaneng, ha keketseho ea cholesterol e le sesosa sa kotsi). E eketsa khatello ea mahlakore a HDL mme e fokotsa tekanyo ea LDL / HDL le k'holeseterole e akaretsang / HDL.

Ho qala hoa ts'ebetso ke libeke tse peli kamora ho qala taolo, kalafo e phahameng ka ho fetisisa ke kamora libeke tse 4-6. Matla a phehella ka kalafo e tsoelang pele; ha kalafo e emisoa, litaba tsa cholesterol li khutlela boemong ba tsona ba pele (pele ho kalafo).

Litlamorao

Ho tsoa ho tsamaiso ea tšilo ea lijo: dyspepsia (ho nyekeloa, ho hlatsa, gastralgia, bohloko ba ka mpeng, ho sokela kapa ho ts'oaroa ke lefutso, hepatitis, jaundice, ts'ebetso e eketsehileng ea "transaminase" ea "sebete" le "alkaline" phosphatase, CPK, ka seoelo - pancreatitis e hlobaetsang.

Ho tsoa ho tsamaiso ea methapo ea kutlo le litho tsa methapo ea kutlo: asthenia, chizungu, hlooho ea hlooho, ho hloka boroko, ho tsitsipana, paresthesia, peripheral neuropathy, pono e fifalitsoeng, tatso e sa sebetseng.

Ho tsoa ts'ebetsong ea musculoskeletal: myopathy, myalgia, myasthenia gravis, ka seoelo rhabdomyolysis.

Litla-morao le mathata a amanang le immunopathological: angioedema, lupus-like syndrome, polymyalgia rheumatism, vasculitis, thrombocytopenia, eosinophilia, ESR, ramatiki, arthralgia, urticaria, photosensitivity, feberu, hyperemia ea letlalo.

Boitšoaro ba letlalo: Rash letlalo, ho hlohlona, ​​alopecia.

Tse ling: phokolo ea mali, palpitations, ho hloleha ha renal haholo (ka lebaka la rhabdomyolysis), ho fokotseha ha potency.

Litaelo tse khethehileng

Pele o qala kalafo, ho a hlokahala hore a etse tlhahlobo ea ts'ebetso ea sebete (ho lekola tšebetso ea "sebete" transaminases libeke tse ling le tse ling tse 6 bakeng sa likhoeli tse 3 tsa pele, ebe libeke tse ling le tse ling tse 8 bakeng sa selemo sa pele se tlang ebe hang kamora likhoeli tse ling le tse ling tse tšeletseng). Bakeng sa bakuli ba fumanang simvastatin ka tekanyetso ea letsatsi le letsatsi ea 80 mg, ts'ebetso ea sebete e hlahlojoa hang ka likhoeli tse tharo. Maemong moo tšebetso ea "sebete" transaminase e eketsehang (e fetang makhetlo a 3 tekanyetso e kaholimo), kalafo e felisitsoe.

Ho bakuli ba nang le myalgia, myasthenia gravis le / kapa ka keketseho e tšoaeang ea ts'ebetso ea CPK, kalafo ea lithethefatsi e emisoa.

Simvastatin (hammoho le li-inhibitors tse ling tsa HMG-CoA reductase) ha ea lokela ho sebelisoa ka kotsi e eketsehang ea rhabdomyolysis le ho se sebetse hantle ha mali (ka lebaka la ts'oaetso e matla ea methapo, hypotension ea methapo, ts'ebetso e kholo ea mokokotlo, khatello ea maikutlo le mathata a tebileng a metabolic).

Ho hlakoloa ha lithethefatsi tse fokotsang lipid nakong ea kemolo ha ho ame litlamorao tsa kalafo ea nako e telele ea hypercholesterolemia ea mantlha.

Ka lebaka la hore HMG-CoA reductase inhibitor inhibit cholesterol synthetic, le cholesterol le lihlahisoa tse ling tsa motsoako oa eona li bapala karolo ea bohlokoa ntlafatsong ea ngoana, ho kenyelletsa motsoako oa li-steroid le membrane ea sele, simvastatin e kanna ea ba le phello e mpe ho lesea ha le laeloa basali ba baimana ( basali ba lilemo tsa ho ba le bana ba lokela ho latela mehato ea ho thibela pelehi ka hloko). Haeba ho ima ho etsahala nakong ea kalafo, moriana o lokela ho emisoa, mme mosali a lemose ka kotsi e ka bang teng ho lesea.

Simvastatin ha e bontšoe maemong ao ho nang le mofuta oa I, IV, le V hypertriglyceridemia.

E sebetsa ka bobeli ka mokhoa oa monotherapy, mme e kopantsoe le li-sequestrants tsa bile acid.

Pele le nakong ea kalafo, mokuli o lokela ho ja lijo tse matlafatsang.

Bakeng sa ho lahleheloa ke tekanyetso ea hona joale, moriana o lokela ho nooa kapele kamoo ho ka khonehang. Haeba ke nako ea tekanyetso e latelang, u se ke oa eketsa habeli tekanyetso.

Bakeng sa bakuli ba nang le bothata bo matla ba ho phekola ba renal, kalafo e etsoa ka tlasa taolo ea ts'ebetso ea renal.

Bakuli ba eletsoa hore ba tlalehe bohloko ba mesifa bo sa hlalosoang, mokhathala, kapa bofokoli, haholo haeba bo tsamaisana le malaise kapa feberu.

Tšebelisano

E ntlafatsa phello ea li-anticoagulants tse sa tobang mme e eketsa monyetla oa ho tsoa mali.

E eketsa khatello ea "digoxin" serum ea mali.

Cytostatics, lithethefatsi tsa antifungal (ketoconazole, itraconazole), li-fibrate, litekanyetso tse phahameng tsa nicotinic acid, li-immunosuppressants, erythromycin, clarithromycin, li-inhibitors tsa protease li eketsa kotsi ea rhabdomyolysis.

Colestyramine le colestipol li fokotsa bioavailability (tšebeliso ea simvastatin e khonahala lihora tse 4 kamora ho nka meriana ena, ka phello e tlatsetsang).

Lipotso, likarabo, litlhahlobo mabapi le lithethefatsi Simvageksal

Tlhahisoleseling e fanoeng e reretsoe litsebi tsa bongaka le tsa meriana. Tlhahisoleseling e nepahetseng ka ho fetelletseng ka lithethefatsi e fumaneha litaelong tse tlamelletsoeng ke moqapi. Ha ho na tlhahisoleseling e thathamisitsoeng leqepheng lena kapa leha e le efe ea sebaka sa rona sa marang-rang e ka sebeletsang e le sebaka sa boipiletso ba motho ho setsebi.

Tšoaetso ea lithethefatsi

Tlhahiso ea Simvageksal e etsoa ke tšoenyeho ea Jeremane Hexal AG. Morero o ka sehloohong oa sethethefatsi sena ke ho fokotsa cholesterol ea mali, triglycerides le lipoprotein tse tlaase.

Moriana ona ke oa sehlopha sa meriana ea li-statin. E fumaneha ka ntho ea Aspergillus terreus, e leng sehlahisoa sa enzymatic. INN: Simvastatin. Ho khethoa ha Simvagexal joalo ka ngaka ho etsahala ha mokuli a supa:

• hypercholesterolemia ea mantlha le e kopaneng,
• hypertriglyceridemia.

Lintlha tsa foromo ea tokollo le litšenyehelo tsa lithethefatsi

Moriana ona oa fumaneha ka sebopeho sa letlapa. Tsena ke matlapa a ellipsoidal ka khetla ea 'mala o pinki kapa' mala oa lamunu (ho latela tekanyetso), o nang le notch e ikhethang le e fatiloeng. Tse latelang li na le litlhaku tse tharo tsa pele tse amanang le lebitso la moriana (SIM) le nomoro e bonts'ang boemo ba khatello ea ntho kapa joala bo sebetsang.

Ho fanoa ka lintlha tse mabapi le theko ea Simvagexal ea meriana ena Russia.

Simvagexal ke ea litokisetso tsa monocomponent mme e na le ntho e le 'ngoe e sebetsang - simvastatin. Khetla e koahelang letlapa e na le lintho tse sebetsang hantle. E na le starch, cellulose, butylhydroxyanisole E320, magnesium stearate, ascorbic acid le citric acid, 5 cps le 15 cps hypromellose, titanium dioxide, yellow le red oxide oxide.

Tlhahisoleseling ka pharmacodynamics le pharmacokinetics

Simvagexal ke moemeli ea fokotsang lipid. Ho kenella ha simvastatin ho tsamaisana le hydrolysis, e lebisang ho thehoeng ha hydroxy acid e tsoang teng.

Moriana o sebelisa li-triglycerides hantle, li-lipoprotein tse tlaase haholo le tse tlase haholo le cholesterol e felletseng. Ntle le moo, e kenya letsoho keketseho ea tekano e phahameng ea lipoprotein (HDL) le ho fokotseha ha tekanyo ea OH / HDL ho LDL / HDL.

U ka lebella phello ea ho nka meriana ena kamora matsatsi a leshome ho isa ho a mane ho tloha ho qala kalafo le Simvagexal. Phello e phahameng ea kalafo e fumanoa kamora khoeli kapa halofo le tšebeliso ea litafole tse sa feleng.

Lethathamo la lipontšo le li-contraindication

Litaelo tsa moriana li bonts'a hore li sebelisoa maemong a mabeli:

1. Haeba ho na le tlhokeho ea tokiso ea lihlahisoa tsa cholesterol le lipid metabolism.
2. Haeba ho na le kotsi ea mathata a amanang le ts'ebetso ea pelo, lefu la pelo, lefu la tsoekere, stroke le tse ling tsa pathologies tse amanang le lefu la pelo.

Moriana ona ke pheko e ntle e fuoang bakuli ba nang le hypercholesterolemia (lefutso le futsitsoeng) hammoho le methapo e mengata ea pelo. Sena sea hlokahala maemong a ha ho fetola lijo ho sa fane ka phello e ntle.

Kamora ho nka Simvagexal ke bakuli ba fumanoeng ba na le mathata mosebetsing oa pelo le methapo, ho latela se latelang:

• Phokotso ea lefu ka lebaka la lefu la pelo,
• Thibelo ea ho nyekeloa ke pelo, stroke,
• Phokotso ea monyetla oa ho phatloha ha methapo ea mali methapo,
• Ho thibela tlhokeho ea ts'ebetso ea ts'ebetso ea bongaka e etselitsoeng ho khutlisetsa phetisetso ea pheriferale,
• kotsi e fokolisitsoeng ea ho kena sepetlele ka lebaka la angina pectoris.

Har'a li-contraindication tsa kalafo le Simvagexal, ho na le:

bothata bo amanang le ho qaptjoa ha sele e khubelu ea mali (porphyria),

Bohlokoa! Moriana ona ha o khothalletsoe hore o sebelisoe ke basali nakong ea kemolo, hobane ho na le bopaki ba tšusumetso e mpe ho lesea, e lebisang ho nts'etsopele ea anomalies ho ngoana.

Basali ba lilemong tsa ho ba le bana ba rerileng ho emola le bona ba lokela ho qoba kalafo ka simvastine. Haeba ho ima ho etsahala ha o ntse o nka Simvagexal, o lokela ho emisa ho e sebelisa.

Ha ho na tlhahisoleseling ea hore na ntho ena e sebetsang ea sethethefatsi sena e ama lebese la matsoele joang. Nakong ea lebone, ho nka Simavhexal ha ho kgothaletswe.

Ho khethoa ha moriana ona ho bana le bacha ba ka tlase ho lilemo tse leshome le metso e robeli ho etsoa ka hloko e kholo ka lebaka la khaello ea ya data mabapi le polokeho le katleho ea Simvagexal e amanang le sehlopha sena sa bakuli.

Ho na le maemo ao ho ona moriana o laetsoeng ka hloko ka tekanyetso e tlase le ka tlhahlobo ea nako le nako ea lipalo tsa mali. Tsena li kenyeletsa:

• ho hloleha ho matla ha renal,
• mathata a endocrine
• monyetla oa lefu la tsoekere
• khatello ea kelello ea methapo
• tlhekefetso ea joala
• bakuli ba amanang le lilemo tse ka bang 65,
• Pheko e kopaneng le vithamine B3, fusidic acid, Amiodarone, Verapamil, Amlodipine, Dronedaron, Ranolazine.

Litšobotsi tsa moriana

Simvagexal, ho latela litaelo tsa tšebeliso e khomaretsoeng, e nkuoa hang ka letsatsi. Sena se lokela ho etsoa ka shoalane. Setlhare se hlatsuoa ka metsi haholo. Nako ea thuto ea kalafo e boletsoe ke ngaka. Ha ho khothalletsoe ho ikemela ka mokhoa o ikemetseng oa ho nka lethal dose le mofuta oa mofuta oa ho sebelisa moriana.

Haeba moriana o ne o lahliloe, moriana o ka nooa ka nako efe kapa efe e ngoe, o tlohella lethal dose e sa fetohe. Tekanyetso e ka sehloohong e behiloe ho latela boemo ba cholesterol e shebaneng nakong ea libeke tse 'ne.

Tekanyetso e tloaelehileng ke limiligrama tse 40 tsa simvagexal. E ka eketsoa ho li-milligram tse 80 ka letsatsi haeba ho na le kotsi ea pelo le mekhoa ea phekolo ha e sebetse ka ho lekana.

Bakuli ba nang le lefu la pelo ba fuoa mofuta oa li-milligram tse 20. Kamora khoeli, ha ho hlokahala, litekanyetso li eketsoa ho li-milligram tse 40. Ka ho fokotseha ha cholesterol e felletseng ho isa ho 3,8 mmol / litha kapa ka tlase, palo ea matlapa a nkiloeng e fokotsehile.

Lefu la pelo

Haeba mokuli a le kalafong e eketsehileng ka Cyclosporine, Nicotinamide kapa fibrate, joale lethal dose la mantlha le le phahameng ka ho fetisisa le fokotsoa ho limiligrama tse 5-10. Ho nkuoa mehato e ts'oanang ha ho fumanoa ho fola ho sa pheleng ha renal ho sa sebetseng.

Litla-morao tse ka bang teng le litla-morao tse ngata

Lethathamong la litlamorao tse ka bang teng tsa kalafo ea Simvagexal, o ka bona tse latelang:

1. Ho tsoa litsong tsa kutlo le ts'ebetsong ea methapo: ho ba teng ha lits'oants'o tsa mesifa ea mesifa, asthenic syndrome, kizunguoe, pono e foufetseng, paresthesia, mathata a tatso, ho opeloa ke hlooho, ho hlobaela ha boroko, ho senyeha ha methapo ea kutlo.
2. Ho tloha lehlakoreng la tšilo ea lijo: ho sokela, ho nyekeloa, ho nyekeloa, ho opeloa ke mpa, bohloko bo eketsehileng ba mpeng, ho eketseha ha khase, pancreatitis, mathata a ka mpeng, hepatitis.

Matšoao a khethehileng a ne a sa hlahisoa bakeng sa ho feta tekanyetso ea moriana (tekanyetso e kholo e lumelletsoeng e ne e le li-milligram tse 450).

Lethathamo la li-analogues

Har'a lihokelo tsa Simvagexal, tse nang le ntho e sebetsang ea simvastine, tse latelang li ka khetholloa:

Lithethefatsi tsa Hungary Simvastol.E fumaneha ka foromo ea letlapa ho litekanyetso tsa li-milligram tse 10 le 20. Sephutheloana sena se na le matlapa a 14 le 28. Sesebelisoa sena se na le phello e ts'oanang ho Simvagexal, lenane la matšoao le li-contraindication. Pele o nka moriana, mokuli o fuoa lijo tsa hypocholesterol.

Moriana o nooa hanngoe ka letsatsi mantsiboea. Tekanyetso ea letsatsi le letsatsi e khothalletsoang ke lingaka e fapana ho tloha ho 10 ho isa ho 80 milligrams, ho latela tlhahlobo ea mafu le boteng ba maloetse a kopaneng. Bakeng sa bakuli ba bangata, tekanyetso e nepahetseng e fanang ka phello e lakatsehang ea kalafo ke li-milligram tse 20. Litsenyehelo tsa lithethefatsi li tloha ho 169 ho isa ho li-ruble tse 300.

Har'a lithethefatsi tse ling tsa analogue ho khothalletsoa: Vazilip (Slovenia), Zokor (Netherlands), Simvalimit (Latvia), Simgal (Israel), Zorstat (Croatia), Avenkor (Russia), Simvastatin (Russia), Sinkard (India).

Moriana oa Simvagexal: matšoao a ts'ebeliso, li-analogues, litekolo

Ho tsoekere ea lefu la tsoekere, ho bohlokoa eseng feela ho lekanya tsoekere ea mali, empa le ho etsa liteko tsa cholesterol khafetsa. Haeba letšoao lena le fetisitsoe, ngaka e beha tlhahiso ea kalafo e khethehileng le kalafo ea lithethefatsi.

Setlhare se tsebahalang haholo bakeng sa hypercholesterolemia ke Simvagexal, e bua ka lithethefatsi tse fokotsang lipid tse nang le ntho e sebetsang ea simvastatin.

Matlapa a loketse kalafo ea bakuli ba fetang lilemo tse 18. U ka li reka k'hemisteng efe kapa efe ha u hlahisa lengolo la ngaka. Litekanyetso li beoa ke ngaka ka bonngoe, e shebane le nalane ea bongaka, boteng ba li-contraindication le mafu a manyane.

Moriana o sebetsa joang?

Litokisetso tse fumanehang ho sehlahisoa sa enzymatic Aspergillus terreus se theola litaba tsa plasma tsa triglycerides, lipoprotein tse tlase haholo le tse tlase, hape e eketsa litaba tsa lipoprotein tse phahameng.

Liphetho tse ntle tsa pele li ka bonoa matsatsi a 14 kamora ho qala kalafo. Phello e phahameng ea kalafo e fumanoa butle-butle, kamora khoeli le halofo.

Ho bohlokoa ho phethela tsela e behiloeng ea kalafo ho boloka maemo a tloaelehileng nako e telele.

Ngaka e u fa moriana haeba mokuli a na le:

• Hypercholesterolemia,
• Hypertriglyceridemia,
• Hypercholesterolemia e kopaneng.

Motsoako oa sebelisoa haeba lijo tse khethehileng li sa ka tsa thusa. Hape, ts'ebeliso ea litafole e lumelloa bakeng sa merero ea thibelo haeba ho na le kotsi ea infyo ea myocardial ka index ea cholesterol e fetang 5,5 mmol / litha.

Ntle le ntho e sebetsang ea simvastatin, matlapa a nang le sebopeho sa oval e tšoeu, e mosehla kapa e pinki e na le ascorbic acid, oxide ea tšepe, lactose monohydrate, starch ea poone, stearate ea magnesium, hypromellose, titanium dioxide.

Litaelo tsa tšebeliso ea lithethefatsi

Ho ea ka bukana e kentsoeng, o hloka ho nka Simvagexal ka shoalane hang ka letsatsi, ho nooa metsi a mangata. Nako ea kalafo e khethoa ke ngaka e eang, ho fetola litekanyetso ka mokhoa o ikemetseng mme kalafo ha e lumelloe.

Haeba tekanyetso ea hona joale e lahlehile, moriana o nooa neng kapa neng, ha litekanyetso li ntse li tšoana. Kamora ho hlahloba mokuli, ho ithuta nalane le liteko tsa bongaka, ngaka e etsa qeto ea hore na ho hlokahala matlapa a makae mohato oa pele oa kalafo.

Tekanyetso ea mantlha e thehiloe, e shebane le boemo ba cholesterol ea plasma, e fumanoeng kamora libeke tse 'ne.

1. Ka litekanyetso tse tloaelehileng, mokuli o nka 40 mg ka letsatsi. Bophahamo ba modumo ona bo ka eketseha ho isa ho 80 mg ka letsatsi moo ho nang le kotsi ea pelo le kalafo ha kalafo e sa sebetse.
2. Bakuli ba nang le lefu la pelo ba nka 20 mg ka letsatsi. Kamora khoeli, tekanyetso haeba ho hlokahala e eketseha ho 40 mg. Tabeng ea ho fokotseha ha cholesterol e felletseng ho isa ho 3,6 mmol / litha mme ka tlase, palo ea matlapa e fokotsehile.
3. Haeba motho a phekoloa ka ho eketsehileng ka cyclosporine, Nicotinamide kapa fibrate, lethal dose la letsatsi le letsatsi le ka holimo le lekaneng le ka lumelloa ho fihlela ho 5-10 mg. Mehato e ts'oanang e nkuoa haeba ho e-na le ho se sebetse hantle ha renal.

Ke mang ea kopantsoeng le kalafo ea lithethefatsi?

Ho bohlokoa ho ela hloko hore matlapa a na le li-contraindication tse ngata, ka lebaka leo, boikoetliso ha boa lokela ho etsoa. Pele o nka Simvagexal, o hloka ho bala litaelo tsa ho li sebelisa.

Theko ea lithethefatsi tse nang le litlhahlobo tse ntle ke li-ruble tse 140-600, ho latela sephutheloana. Ka k'hemisteng u ka fumana lipakete tsa 5, 10, 20, 30, 40 mg. Ho feta thupelong e tloaelehileng ea bongaka, ho kgothaletsoa ho reka matlapa a Hexal Simvagexal 20mg ka bongata ba li-pcs tse 30.

Setlhare sena se kopantsoe ha mokuli a le:

• ho hloleha ha sebete
• hypersensitivity ho likarolo tsa moriana,
• sensitivity to statins,
• myopathy
• tlolo ea sebopeho sa lisele tse khubelu tsa mali (porphyria).

U ke ke ua etsa kalafo haeba motho a sebelisa Itraconazole, Ketoconazole, lithethefatsi bakeng sa kalafo ea ts'oaetso ea HIV ka ho tšoana. Hape, matlapa a pakiloe ho basali baimana le ba anyang.

Ho lokela hore ho sebelisoe tlhokomeliso ha mokuli a sebelisa lino tse tahang hampe, a phekoloa ka li-immunosuppressants, a na le molumo oa mesifa o eketsehileng kapa o fokotsehileng, o na le lefu la ho akheha, lefu la sethoathoa haholo, khatello ea methapo ea mmele le mathata a mmele. Kalafo e etsoa har'a bakuli ba ka holimo ho lilemo tse 18.

Nakong ea kemolo, ho molemo ho hana lithethefatsi, hobane maemong a koetliso ea bongaka ho hlahisoa ho khethollo ho ngoana ka mor'a hore ho sebelisoe matlapa a tloaelehileng.

Litlamorao

Ha u fana ka kalafo ka lipilisi, ngaka e lokela ho etsa bonnete ba hore mokuli ha a noe meriana e meng. Mokuli le eena o lokela ho tsebisa ngaka hore na o se a ntse a e-noa lipilisi life. Sena sea hlokahala e le ho qoba tšebelisano e sa batleheng le lithethefatsi tse ling.

Haholo-holo, ka tšebeliso ea li-fibrate, cytostatics, litekanyetso tse phahameng tsa nicotinic acid, Erythromycin, liproteine ​​inhibitors, li-antifungal agents, li-immunosuppressants, Clarithromycin, rhabdomyolysis li ka nts'etsapele.

Ka lebaka la ho pepeseha ho hoholo ha li-anticoagulants tsa molomo, ho tsoa mali ho ka ba teng, ka hona o hloka ho lekola boemo ba mali ka hloko nakong ea kalafo. Simvagexal e boetse e eketsa litaba tsa plasma tsa digoxin. Haeba mokuli a kile a sebelisa cholestyramine le colestipol, matlapa a lumelloa ho nooa feela kamora lihora tse 'ne.

1. Litla-morao li bonahala ka tsela ea ho fokola ha mesifa, asthenic syndrome, ho tsekela, pono e fifalitsoeng, paresthesia, ho senyeha ha hlooho, hlooho e bohloko, ho hloka boroko, neuropathy ea pherekano.
2. Ho na le maemo a ho senyeha ha tsamaiso ea tšilo ea lijo, ho ruruha, ho nyekeloa le pelo, ho hlatsa, ho opeloa, bohloko ka mpeng, bolutu, pancreatitis, lets'ollo, hepatitis.
3. Maemong a sa tloaelehang, karabelo ea allergic e bonoa ka mokhoa oa ho hlohlona ha letlalo le lekhopho, polymyalgia rheumatism, thrombocytopenia, feberu, palo e matla ea erythrocyte sedimentation, urticaria, ho hema, eosinophilia, angioedema, hyperemia ea letlalo, vasculitis, ramatiki, lupus erythematosus.
4. Motho a ka ba le myalgia, myopathy, bofokoli bo akaretsang, rhabdomyolysis. Ka lebaka leo, potency e fokotseha, palpitations ea eketseha, anemia ea hlaha, le ho se sebetse hantle ha sebete.

Tabeng ea overdose, joalo ka molao, matšoao a itseng ha a hlahe, empa ho bohlokoa ho tlosa ntho e sebetsang e ngata 'meleng. Ho etsa sena, mokuli oa hlatsoa, ​​fana ka mashala a sebetsang. Nakong ea phekolo, ho hlokahala hore ho hlahlojoe boemo ba serum ba creatine phosphokinase, renal le hepatic.

Haeba u nka li-statin nako e telele, maemong a sa tloaelehang ho hlaha lefu la masapo la mahareng, le tsamaeang le ho khohlela ho omileng, ho mpefala ha boemo ka kakaretso, mokhathala o eketsehileng, ho theola boima ba 'mele le ho opeloa.

Litlhahiso tsa lingaka

Haeba motho nakong ea ts'ebetso ea kalafo a eketsa ts'ebetso ea moeine phosphokinase le mesifa ea mesifa e hlaha, ho hlokahala hore o tlohele ho ikoetlisa ka matla.

E boetse e lokela ho felisa lisosa tsa ts'ebetso ea enzyme e eketsehileng, e kenyang ho ba teng ha feberu, ho longoa, likotsi, hypothyroidism, ts'oaetso, chefo ea khase ea carbon diapo, polymyositis, dermatomyositis, joala le ts'ebeliso ea lithethefatsi. Haeba kamora sena ts'ebetso ea enzyme e ntse e eketseha, matlapa a Simvagexal a lokela ho tloheloa ka botlalo. Ho fapana le moo, o ka sebelisa li-analogues tse tsoang ho bahlahisi ba bang.

Pele a qala kalafo, ngaka e lokela ho etsa tlhahlobo ea mali bakeng sa ts'ebetso ea KFK. Ts'ebetso ena e lokela ho phetoa kamora likhoeli tse tharo. Tlhokomelo ea li-phosphokinase tsa ho tsofala ho batho ba tsofetseng le bakuli ba fumanoeng ba na le lefu la tsoekere le amanang le lefu la tsoekere, hypothyroidism, ts'ebetso ea renal e sa sebetseng e etsoa selemong.

Bakeng sa mofuta leha e le ofe oa lefu la tsoekere, ho hlokahala hore kamehla a etse tlhahlobo ea tsoekere ea mali, kaha setlhare se thusa ho eketsa tsoekere e ngata maling ka har'a plasma.

Bakuli ba bang ba ba le hyperglycemia, e hlokang meriana e khethehileng.

Empa lingaka ha li khothaletse ho emisa kalafo ka li-statin, hobane cholesterol e phahameng e ka baka mathata a tebileng ho li-diabetes haeba a sa phekoloe hantle.

Matlapa a lokela ho nkuoa ka hloko haeba mokuli a sebelisa joala hampe. Haeba ts'ebetso ea qoqotho e fokotseha, lefu la liphio, lefu le ka sehloohong le phekoloa pele, ka mor'a moo o ka qala ho theola khatello ea cholesterol maling.

Lithethefatsi tse tšoanang li kenyelletsa Zokor, Avestatin, Sinkard, Simgal, Vasilip, Aterostat, Zorstat, Ovenkor, Holvasim, Simplakor, Actalipid, Zovatin le ba bang.

Lijo ho theola k'holeseterole e ngata

Ntle le ho nka meriana, mokuli o tlameha ho latela lijo tsa hypocholesterol, tse amanang le ho ja lijo tse mafura a liphoofolo. Phepo e nepahetseng e ka ntlafatsa boemo ba methapo ea mali le ho tlosa li-plaque atherosranceotic.

Lijo tse thibetsoeng li kenyelletsa mafura a liphoofolo le a khathollang, botoro ea tlhaho, margarine, nama e mafura, lisoseji le lisoseji. Mokuli o lokela ho hana li-yolks tsa mahe, litapole tse halikiloeng, li-pancake, li-pastries le sec confery ea tranelate.

Hape, ho sa kenyele lisoso, lebese lohle, lebese le tlotsitsoeng, tranelate, tranelate e bolila, chisi e mafura e ea hlokahala lijong.

Ho khothalletsoa hore mokuli a hlatsoe lijana tse nang le soya, canola, mohloaare, sesame le oli e meng ea meroho, e nang le mafura a mangata a mafura a omega.

U hloka ho ja salmon, trout, mackerel le mefuta e meng ea litlhapi tse mafura, nama e halikiloeng, khoho le mohatla. Lijo tse joalo ke mohloli o motle oa protheine.

Lenaneo le na le lijo-thollo leha e le life tse phehiloeng metsing, bohobe bohle ba lijo-thollo, makhapetla a mangata a lijo-thollo, meroho le litholoana tse ncha.

Ka lefu la tsoekere la mofuta ofe kapa ofe, o ke ke oa sebelisa li-sweets, lipie, li-biscuits.

Lijo tsa kalafo tse nang le cholesterol e phahameng li na le melao e 'maloa ea motheo e lokelang ho lateloa. Lino tse tahang, kofi, tee e matla e kopantsoe ka ho felletseng, lijo tse monate le tse tsoekere li sebelisoa ka bongata.

Lijo li kenyelletsa meroho, litholoana, lihlahisoa tsa lebese tse mafura a fokolang. Lijo tse halikiloeng li nkeloa sebaka ke lijo tse phehiloeng le tse halloang. Li-broth tsa nama tse phehiloeng li jeoa li halikiloe ntle le mafura. Nama e entsoeng ka maiketsetso e tšeloa tafoleng ntle le letlalo, mafura ha a sebelisoe ha a pheha. Mahe a likhoho a jeoa ntle le li-yolks.

Lijo tse nang le phepo e nepahetseng li tla imolla cholesterol e ngata, li sireletse methapo ea mali le sebete. Matsatsing a pele a supileng, mokuli o ikutloa a le betere, kaha mokhoa oa ho silila o sa pepesele khatello ea maikutlo. Lijo tse joalo ha li na li-contraindication, kaha li leka-lekane, ka hona li ntle ho batho ba nang le lefu la tsoekere.

Mokhoa oa ho fetisa metabolism ea lipid e hlalositsoe videong ena.

Tšoaea tsoekere ea hau kapa khetha bong bakeng sa likhothaletso Ho Batla ha ho fumanoe ha ho batloa ha hoa fumanoa

SIMVAGEXAL

- hypercholesterolemia ea mantlha (mofuta IIa le IIb ho latela sehlopha sa Fredrickson) ka ho se sebetse hantle ha kalafo ea ho ja ka k'holeseterole e tlase le mehato e meng eo e seng ea meriana (ho ikoetlisa 'meleng le ho theola boima ba' mele) ho bakuli ba nang le kotsi e eketsehileng ea coronary atherossteosis, - hypercholesterolemia le hypertriglyceridemia ho ja le ho ikoetlisa, - IHD: thibelo ea bofokoli ba myocardial (thibelo ea bobeli ea infraction ea myocardial) ho bakuli ba nang le boemo bo eketsehang ba ho nka cholesterol (> 5.5 mmol / l).

Mofumahali

SuctionHo monya simvastatin ho phahame. Kamora ho kenella, Cmax ho plasma e fihlelloa kamora lihora tse 1,2-2,4 mme e fokotseha ka hoo e ka bang 90% kamora lihora tse 12.TsamaisoHo tlama liprotheine tsa plasma ke hoo e ka bang 95%.MetabolismE feta tlas'a "pele" ka har'a sebete. E hydrolyzed ho etsa metsoako e sebetsang, beta-hydroxyacids, le li-metabolites tse ling tse sebetsang le tse sa sebetseng le tsona li fumanoe.Ho tsalaT1 / 2 ea metabolites e sebetsang ke lihora tse 1.9. E hloekisoa haholo-holo ka li-futs (60%) e le metabolites. Hoo e ka bang 10-15% e epolloa ke liphio ka mokhoa oa metabolites o sa sebetseng.

Contraindication

- ho hloleha ha sebete, lefu la sebete le sa foleng, ho eketseha ho tsoelang pele hoa tšebetso ea phepelo ea hepatic ea etiology e sa tsejoeng, - porphyria, - myopathy, - tsamaiso e ts'oanang ea ketoconazole, itraconazole, lithethefatsi bakeng sa kalafo ea ts'oaetso ea HIV, - kutloelo-bohloko ea methapo ea lithethefatsi tse ling tsa statin palo (ho li-inhibitors tsa HMG-CoA reductase) nalaneng. tlhokomeliso lithethefatsi li lokela ho fuoa bakuli ba nang le joala bo sa foleng, bakuli kamora ho fetisoa hoa litho, ba ntseng ba phekoloa ka lithethefatsi tsa immunosuppressive (ka lebaka la kotsi e eketsehang ea rhabdomyolysis le ho se sebetse hantle ha mokokotlo), maemong a ka lebisang ho se sebetseng hantle ha renal, joalo ka khatello ea mali ea methapo, mafu a tšoaetsanoang haholo mafu a matla, mathata a tebileng a metabolic le endocrine, ho ferekana ho lekantsoeng ha metsi-electrolyte, ho kenella ka tšebetso (ho kenyeletsoa meno) kapa likotsi, ho bakuli ba nang le mesifa e fokolitsoeng kapa e eketsehang ea mesifa ea methapo ea etiology e sa tsejoeng, ka lefu la sethoathoa, bana le bacha ba ka tlase ho lilemo tse 18 (polokeho le katleho ha e so theoe).

Litaelo tsa ho sebelisoa

Fomu ea tokollo, sebopeho le sephutheloanaMatlapa a koahetsoeng 'mala o mosehla, oval, convex, e nang le notch ka lehlakoreng le leng le mantsoe a ngotsoeng "SIM 5" ka lehlakoreng le leng, ka kink - tšoeu.Baeti: starch, lactose monohydrate, cellcose ea microcrystalline, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, oxide ea tšepe e 10. - lithutsoana (3) - lipakete tsa karete.Matlapa a koahetsoeng 'mala o pinki, oval, convex, o nang le notch ka lehlakoreng le leng le mantsoe a ngotsoeng "SIM 10" ka lehlakoreng le leng, ka kink - tšoeu.Baeti: starch, lactose monohydrate, cellcose ea microcrystalline, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, iron oxide e khubelu, iron oxide e mosehla. 10 likhomphutha. - lithutsoana (3) - lipakete tsa karete.Matlapa a koahetsoeng 'mala o mosehla, oval, convex, e nang le notch ka lehlakoreng le leng le mantsoe a ngotsoeng "SIM 20" ka lehlakoreng le leng, ka kink - e tšoeu.Baeti: starch, lactose monohydrate, cellcose ea microcrystalline, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, iron oxide e khubelu, iron oxide e mosehla. 10 likhomphutha. - lithutsoana (3) - lipakete tsa karete.Matlapa a koahetsoeng e tšoeu kapa e batla e tšoeu, e oval, convex, e nang le notch ka lehlakoreng le leng le ngotsoeng "SIM 30" ka lehlakoreng le leng, ka kink - e tšoeu.Baeti: starch, lactose monohydrate, microcrystalline cellulose, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide. 10 likhomphutha. - lithutsoana (3) - lipakete tsa karete.Matlapa a koahetsoeng pinki, oval, convex, e nang le notch ka lehlakoreng le leng le mantsoe a ngotsoeng "SIM 40" ka lehlakoreng le leng, ka kink - tšoeu.Baeti: starch, lactose monohydrate, cellcose ea microcrystalline, butyl hydroxyanisole, ascorbic acid, citric acid monohydrate, magnesium stearate, hypromellose, talc, titanium dioxide, oxide e khubelu ea iron. - lithutsoana (3) - lipakete tsa karete.Sehlopha le litlhare: Hypolipidemic drugNgoliso No№:

Foromo ea litekanyetso

Matlapa a koahetsoeng ka filimi.

Letlapa le 1 le koahetsoeng ka filimi le na le:
Bohlokoa ba letlapa:ntho e sebetsang: simvastatin 5.00 mg / 10.00 mg / 20.00 mg / 30.00 mg / 40.00 mg Baeti: Pregelatinized starch 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 / 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 / 3.00 mg / 4.00 mg,
Shell: 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, dae ea oxide ea tšepe e 0.0043 mg / 0.0017 mg / 0.11 mg / - / -, dae e khubelu ea oxide - / 0.0043 mg / 0.026 mg / - / 0.14 mg.

Tlhaloso

Litafole tsa biconvex tse oval, tse koaheletsoeng filiming, tse nang le notch ka lehlakoreng le leng, 'me li ngotsoe ho tse ling ka likotsi tse peli. Karolo ea sefapano e tšoeu.
Karolo ea 5 mg: matlapa a mmala o bobebe oa 'mala o mosehla o ngotsoeng "SIM 5".
Karolo ea 10 mg: matlapa a mmala o pinki o bobebe ka mongolo o ngotsoeng "SIM 10".
Karolo ea 20 mg: matlapa a mmala oa lamunu a bobebe a ngotsoeng "SIM 20".
Tekanyetso ea 30 mg: Matlapa a 'mala o mosoeu kapa o batlang o le tšoeu o ngotsoe "SIM 30".
Karolelano ea 40 mg: matlapa a pinki a ngotsoeng "SIM 40"

Sebelisa nakong ea bokhachane le nakong ea ho anyesa

Ts'ebeliso ea moriana SimvAGEXAL ® nakong ea bokhachane e tiisitsoe.
Ka lebaka la hore HMG-CoA reductase inhibitors e sitisa motsoako oa k'holeseterole, 'me cholesterol le lihlahisoa tse ling tsa motsoako oa eona li bapala karolo ea bohlokoa ntlafatsong ea lesea, ho kenyelletsa motsoako oa li-steroid le li-membrane tsa sele, simvastatin e kanna ea ba le phello e mpe ho "fetus" ha e sebelisoa ho basali baimana ( basali ba lilemo tsa ho beleha ba lokela ho qoba ho ima). Haeba ho ima ho etsahala nakong ea kalafo, moriana o lokela ho emisoa, mme mosali o lokela ho lemosoa ka kotsi e ka bang teng ho lesea.
Ho felisoa ha lithethefatsi tse fokotsang lipid nakong ea kemero ha ho ame haholo litholoana tsa kalafo ea nako e telele ea hypercholesterolemia ea mantlha.
Ha ho na datha mabapi le ho lokolloa ha simvastatin ka lebese la matsoele, ka hona ha o sebelisa moriana nakong ea lebone, ho anyesa ho lokela ho emisoa.

Tekanyetso le tsamaiso

Pele a qala kalafo ka SimvAGEXAL ®, mokuli o lokela ho fuoa lijo tse tloaelehileng tsa hypocholesterolemic, tse lokelang ho lateloa nakong eohle ea kalafo.
Matlapa a SimvAGEXAL ® a nooa hang ka letsatsi, mantsiboea, ka metsi a mangata.
Litekanyetso tse khothalelitsoeng tsa letsatsi le letsatsi li tsoa ho 5 ho isa ho 80 mg.
Dose titration e lokela ho etsoa ka linako tse ling tsa libeke tse 4.
Tekanyetso ea 80 mg e ka sebelisoa feela ho bakuli ba nang le hypercholisterinemia e ngata le kotsi e phahameng ea lefu la pelo.
Bakuli ba nang le homozygous hypercholesterolemia: Tekanyetso ea letsatsi le letsatsi e khothalletsoang ke 40 mg ka letsatsi, hang ka shoalane. Tekanyetso ea 80 mg ka letsatsi e khothaletsoa ha feela phaello e reriloeng ea kalafo e feta kotsi e ka bang teng. Ho bakuli ba joalo, lithethefatsi SimvAGEXAL ® e sebelisoa hammoho le mekhoa e meng ea kalafo e fokotsang lipid (mohlala, LDL plasmapheresis) kapa ntle le kalafo e joalo, haeba e sa fumanehe.
Bakuli ba nang le lefu la pelo la ischemic kapa ba kotsing e kholo ea mathata a pelo le methapo
Tekanyetso ea mantlha ea SimvAGEXAL ® bakeng sa bakuli ba kotsing e kholo ea ho ba le lefu la pelo le kopane kapa ntle le hyperlipidemia (moo ho nang le lefu la tsoekere, histori ea lefu la stroke kapa lefu le leng la lefu la pelo), hammoho le bakuli ba nang le lefu la methapo ea methapo ea methapo ke 40 mg ka letsatsi .
Bakuli ba nang le hyperlipidemia ba se nang lintlha tse ka holimo tsa kotsi: Tekanyetso e tloaelehileng ea ho qala ke 20 mg hang hang ka letsatsi mantsiboea.
Bakeng sa bakuli ba nang le mahloriso a serum LDL e 45% e phahame ho feta e tloaelehileng, tekanyo ea pele e kanna ea ba 40 mg / ka letsatsi. Bakeng sa bakuli ba nang le hypercholesterolemia e bonolo le e leka-lekaneng, kalafo e nang le SimvAGEXAL ® e ka qala ka tekanyo ea pele ea 10 mg / ka letsatsi.
Pheko e lumellanang: SimvAGEXAL ® e ka sebelisoa ho monotherapy le ho kopantsoe le li-sequestrants tsa bile tsa acid.
Bakeng sa bakuli ba nkang fibrate ka nako e le ngoe, Ntle le fenofibrate, tekanyetso e phahameng ea letsatsi le letsatsi ea simvastatin ke 10 mg. Ts'ebeliso e kopanetsoeng le gemfibrozil e kopantsoe.
Ho bakuli ka nako e tšoanang ba nka verapamil, diltiazem, le dronedarone, Tekanyo e phahameng ea letsatsi le letsatsi ke 10 mg / ka letsatsi.
Bakeng sa bakuli ka nako e ts'oanang ba nka amiodarone, amlodipine, ranolazine, Tekanyo e phahameng ea letsatsi le letsatsi ea simvastatin ke 20 mg.
Bakuli ba nang le bothata bo sa foleng ba ho phekola ba le methapo: ho bakuli ba nang le bothata ba ho hlaphoheloa ha renal ha bobebe ho lekana (CC ho feta 30 ml / min) tokiso ea litekanyetso ha e hlokehe. Bakeng sa bakuli ba nang le bothata ba ho hlaba ka thata ba boima ba methapo e boima (CC ka tlase ho 30 ml / min) kapa ka nako e ts'oanang ba nka fibrate kapa nicotinic acid (ka tekanyo ea tse fetang 1 g / letsatsi), lethal dose la pele ke 5 mg mme palo e kholo ea letsatsi le letsatsi e amoheloang ke 10 mg.
Ho bakuli ba tsofetseng (ba fetang lilemo tse 65) tokiso ea tekanyetso ha e hlokehe.
Sebelisa ho bana le lilemong tsa bocha ba lilemo li 10-17 ka heterozygous Familyal hypercholesterolemia: Motsoako oa ho qala o khothalelitsoeng ke 10 mg ka letsatsi ka shoalane. Mokhoa o khothalelitsoeng oa litekanyetso ke 10 - 40 mg ka letsatsi, tekanyo e phahameng e khothalletsoang ea moriana ke 40 mg ka letsatsi. Khetho ea dose e etsoa ka bonngoe ho latela lipheo tsa kalafo.
Bakeng sa ho lahleheloa ke tekanyetso ea hona joale, moriana o lokela ho nooa kapele kamoo ho ka khonehang. Haeba ke nako ea ho nka tekanyetso e latelang, lethal dose ha ea lokela ho imena habeli.

Litla-morao

Ho latela Mokhatlo oa Lefatše oa Bophelo (WHO), litlamorao tse sa batleheng li thathamisoa ho latela khafetsa ea tsoelo-pele ea tsona: khafetsa (≥1 / 10), khafetsa (ho tloha ≥1 / 100 ho mafu a mali le tsamaiso ea methapo.
ka seoelo: anemia (ho kenyelletsa hemolytic), thrombocytopenia, eosinophilia.
Mathata a tsamaiso ea methapo
ka seoelo: ho tsekela, ho opeloa ke hlooho, paresthesia, peripheral neuropathy,
ka seoelo: likhathatso tsa boroko (ho hloka boroko, litoro tsa "bosiu"), khatello ea maikutlo, ho lahleheloa ke kelello kapa tahlehelo, pono e lerootho.
Mathata a tsamaiso ea phefumoloho, sefuba le methapo ea methapo
khafetsa: tšoaetso e phahameng ea phefumoloho
maqhubu a sa tsejoeng: mafu a lipakeng a lipakeng (haholo-holo ka tšebeliso e telele), bronchitis, sinusitis.
Mathata a pelo
khafetsa: fibrillation ea lefutso.
Mathata a amanang le ho ja
khafetsa: gastritis
ka seoelo: ho ruruha, bohloko ba ka mpeng, ho nyekeloa ke pelo, ho hlatsa, lets'ollo, lefutso, pancreatitis.
Ho tlosoa ha sebete le tsamaiso ea biliary
ka seoelo: hepatitis, jaundice,
ka seoelo: ho hloleha le ho se sebetse ha sebete ha sebete.
Ho senyeha ha letlalo le lisele tse poteletseng
ka seoelo: lekhopho la letlalo, ho hlohlona ha letlalo, alopecia, photosensitivity.
Ho senyeha ha litho tsa masapo le masapo
ka seoelo: myopathy * (ho kenyeletsa myositis), rhabdomyolysis (ntle le nts'etsopele ea ho hloleha ka boits'oaro bo matla), myalgia, mesifa crump, polymyositis,
ka seoelo: arthralgia, ramatiki,
maqhubu a sa tsejoeng: tendinopathy, mohlomong ka ropo ea tendon.
* Lithutong tsa bongaka, myopathy e ile ea bonoa khafetsa ho bakuli ba sebelisang simvastatin ka tekanyo ea 80 mg / ka letsatsi, ha e bapisoa le bakuli ba sebelisang lethal dose ea 20 mg / letsatsi (1.0% bapisoa le 0.02%, ka ho latellana).
Ho tlosoa ha liphio le pampitšana ea ho ntša metsi
maqhubu a sa tsejoeng: ho hloleha ha methapo ea matsoho (ka lebaka la rhabdomyolysis), ts'oaetso ea ts'oaetso ea moroto.
Tlolo ea botona le botšehali
maqhubu a sa tsejoeng: erectile dysfunction, gynecomastia.
Mathata le mathata a mangata setsing sa ente
ka seoelo: bofokoli bo akaretsang.
Litla-morao
ka seoelo: angioedema, polymyalgia rheumatica, vasculitis, erythrocyte sedimentation rate (ESR), litheolelo tse nepahetseng tsa lithibela-mafu tsa antinuclear, letlalo le sefahleho hyperemia, lupus syndrome, dyspnea, malaise ka kakaretso, khafetsa e sa tsejoeng: immuno-mediated necrotizing myopathy, necrolcine necroliminal necrolcine Ncrolcine Ncrolcine Ncrolcine ho kenyelletsa le lefu la Stevens-Johnson.
Lintlha le tsebiso ea laboratori
ka seoelo: ts'ebetso e eketsehileng ea "sebete" transaminases, CPK le alkaline phosphatase maling a mali, khafetsa ho sa tsejoeng: ho eketseha ha khatello ea hemoglobin, hyperglycemia.
Ha o sebelisa li-statins tse ling, liketsahalo tse latelang tse mpe li tlalehiloe:
• tahlehelo ea mohopolo
• Ho sitisoa ke kelello
• lefu la tsoekere. Khafetsa ea tsoelo-pele ea lefu la tsoekere e itšetlehile ka ho ba teng ha lintho tse ka bang kotsi (ho itima lijo ha tsoekere ea mali e fetang 5,6 mmol / L, index ea boima ba 'mele e fetang 30 kg / m kg, keketseho ea thyroglobulin (TG) plasma ea mali, nalane ea khatello ea mali).
Bana le bacha (ba lilemo li 10-17)
Ho latela lipatlisiso tse nkang selemo se le seng ho bana le lilemong tsa bocha (bashanyana ba sethaleng sa Tanner II le ka holimo le bonyane selemo ka mor'a ho ilela khoeli)) ea lilemo tse 10-17 ka heterozygous Famal hypercholesterolemia (n = 175), tšireletseho le boemo ba ts'ireletso sehlopheng sa simvastatin, boemo ba sehlopha sa placebo bo ne bo tšoana.
Liketsahalo tse atileng ka ho fetisisa tse tlalehiloeng e ne e le tšoaetso ea pampiri ea phefumoloho e kaholimo, hlooho, bohloko ba ka mpeng, le ho nyekeloa hoa pelo. Litlamorao tsa nako e telele ntlafatsong ea 'mele, ea kelello le ea thobalano ha e tsejoe. Hona joale (selemo se le seng ka mor'a kalafo) ho na le data e sa lekaneng ea polokeho.

Bongata

Ho fihla joale, ha ho tšoaea matšoao a khethehileng a lithethefatsi tse ngata (litekanyetso tse phahameng tsa 3.6 g) tse fumanoeng.
Phekolo: matšoao a kalafo. Motsoako o tobileng ha o tsejoe.

Ho sebelisana le lithethefatsi tse ling

Boithuto ba ho sebelisana le lithethefatsi tse ling bo ne bo etsoa feela ho batho ba baholo.
Litšebelisano tsa Pharmacodynamic
Ho sebelisana le lithethefatsi tse ling tse fokotsang lipid tse ka lebisang kotsing e kholo ea myopathy / rhabdomyolysis
Fibrate
Kotsi ea ho ba le myopathy, ho kenyelletsa le rhabdomyolysis, e eketseha nakong ea ts'ebeliso e tšoanang ea simvastatin e nang le fibrate.
Sebelisa hammoho gemfibrozil e lebisa keketseho ea plasma ea mahlakore a simvastatin, ka hona ts'ebeliso ea bona e kopaneng e kopantsoe.
Ha ho na bopaki ba kotsi e eketsehang ea myopathy ka tšebeliso ea nako e tšoanang ea simvastatin le tlatsa.
Likoloi tse Laoloang mabapi le Kamano le metsoako e meng ha ea etsoa.
Nicotinic acid
Ho na le litlaleho tse 'maloa tsa nts'etsopele ea myopathy / rhabdomyolysis ka tšebeliso e ts'oanang ea simvastatin le nicotinic acid ka lethal dose ea lipid e theohelang (ho feta 1 g / ka letsatsi).
Fusidic asiti
Kotsi ea ho ba le myopathy e eketseha ka tšebeliso e tšoanang ea fusidic acid e nang le li-statins, ho kenyelletsa le simvastatin. Haeba ho sa khonehe ka lebaka le itseng ho qoba tšebeliso ea nako e tšoanang ea simvastatin e nang le fusidic acid, ho kgothaletswa hore o nahane ka ho lieha kalafo ka simvastatin. Haeba ho hlokahala, ts'ebeliso ea bona ka nako e ts'oanang, bakuli ba lokela ho betoa leihlo.
Litšebelisano tsa Pharmacokinetic
Ho fanoa ka litlhahiso mabapi le tšebeliso ea lithethefatsi tse kenang.

Litšebelisano tsa lithethefatsi tse amanang le kotsi e eketsehang ea Myopathy / Rhabdomyolysis

Matla a lithethefatsi tse ling ho pharmacokinetics ea simvastatin
Li-inhibitors tse matla tsa isoenzyme CYP3A4
Simvastatin ke karoloana ea CYP3A4 isoenzyme. Li-inhibitors tse matla tsa CYP3A4 isoenzyme li eketsa kotsi ea myopathy le rhabdomyolysis ka ho eketsa ts'ebetso ea inhibitory ea HMG-CoA reductase ho plasma ea mali nakong ea kalafo le simvastatin. Li-inhibitors tse joalo li kenyelletsa itraconazole, ketoconazole, posaconazole, voriconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors (e.g. nelfinavir), boceprevir, telaprevir, hape le nefazodone.
Ts'ebeliso e ts'oanang ea simvastatin e nang le itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, le thibelo ea liprotheine tsa HIV (mohlala, nelfinavir), hammoho le nefazodone. Haeba ho sa khonehe ka lebaka le itseng ho qoba ts'ebeliso e kopaneng ea simvastatin le lithethefatsi tse kaholimo, kalafo e nang le simvastatin e lokela ho chechisoa morao ho fihlela qetellong ea thupelo ka meriana ena.
Simvastatin e lokela ho sebelisoa ka hloko ka li-inhibitors tse ling tse seng matla tsa CYP3A4: fluconazole, verapamil, kapa diltiazem.
Fluconazole
Ho tlalehiloe liketsahalo tse sa tloaelehang tsa rhabdomyolysis tse amanang le tšebeliso e tšoanang ea simvastatin le fluconazole.
Cyclosporin
Ts'ebeliso e tšoanang ea cyclosporine le simvastatin e tiisitsoe.
Danazole
Kotsi ea ho ba le myopathy / rhabdomyolysis e eketseha ka tšebeliso e tšoanang ea danazol, haholoholo le litekanyetso tse phahameng tsa simvastatin.
Amiodarone
Kotsi ea ho ba le myopathy le rhabdomyolysis e eketseha ka tšebeliso e tšoanang ea amiodarone e nang le litekanyetso tse phahameng tsa simvastatin. Lithutong tsa kliniki, nts'etsopele ea myopathy e fumanoe ho 6% ea bakuli ba sebelisang simvastatin ka lethal dose ea 80 mg hammoho le amiodarone. Ka hona, tekanyo ea simvastatin ha ea lokela ho feta 20 mg ka letsatsi ho bakuli ba sebelisang lithethefatsi ka amiodarone ka nako e le 'ngoe, haeba molemo oa kliniki o feta kotsi ea ho ba le myopathy le rhabdomyolysis.
Slow Calcium Channel blockers
Verapamil
Kotsi ea ho ba le myopathy le rhabdomyolysis e eketseha ka tšebeliso e tšoanang ea verapamil e nang le simvastatin ho litekanyetso tse kholo ho feta 40 mg. Tekanyetso ea simvastatin ha ea lokela ho feta 10 mg ka letsatsi ho bakuli ba sebelisang lithethefatsi ka nako e le ngoe le verapamil, haeba molemo oa kliniki o feta kotsi ea ho ba le myopathy le rhabdomyolysis.
Diltiazem
Kotsi ea ho ba le myopathy le rhabdomyolysis e eketseha ka tšebeliso e ts'oanang ea li-diltiazem le simvastatin ka lethal dose ea 80 mg. Ka tšebeliso e tšoanang ea simvastatin ka tekanyo ea 40 mg ka diltiazem, kotsi ea ho ba le myopathy ha ea ka ea eketseha. Motsoako oa simvastatin ha oa lokela ho feta 10 mg ka letsatsi ho bakuli ba sebelisang lithethefatsi tse nang le diltiazem ka nako e le 'ngoe, haeba molemo oa kliniki o feta kotsi ea ho ba le myopathy / rhabdomyolysis.
Amlodipine
Bakuli ba sebelisang amlodipine ka mokhoa o tšoanang le simvastatin ka lethal dose ea 80 mg ba kotsing e eketsehileng ea ho ba le myopathy. Ka tšebeliso e tšoanang ea simvastatin ka tekanyetso ea 40 mg le amlodipine, kotsi ea ho ba le myopathy ha ea ka ea eketseha. Ka tšebeliso e tšoanang ea simvastatin e nang le amlodipine, tekanyo ea simvastatin ha ea lokela ho feta 20 mg ka letsatsi, haeba molemo oa kliniki o feta kotsi ea ho ba le myopathy / rhabdomyolysis.
Lomitapid
Kotsi ea ho ba le myopathy / rhabdomyolysis e ka eketseha ka tšebeliso e tšoanang ea lomitapapide e nang le simvastatin.
Litšebelisano tse ling
Lero la morara
Jusi ea morara e na le karolo e le 'ngoe kapa ho feta e thibelang CYP3A4 isoenzyme mme e ka eketsa bongata ba plasma ea lithethefatsi tse entsoeng ka CYP3A4 isoenzyme. Ha ho nooa lero ka tekanyo e tloaelehileng (khalase e le 'ngoe ea 250 ml ka letsatsi), phello ena e nyane (keketseho ea 13% ts'ebetsong ea li-inhibitors tsa HMG-CoA, tse hakantsoeng ke sebaka se tlas'a khefu ea nako ea mahloriso) mme ha e na bohlokoa ba tleliniki. Leha ho le joalo, tšebeliso ea lero la morara ka bongata bo boholo (ho feta litara e le 'ngoe ka letsatsi) e eketsa haholo boemo ba ts'ebetso ea li-inhibitors tsa HMG-CoA nakong ea kalafo ka simvastatin. Ntlheng ena, ho bohlokoa ho qoba tšebeliso ea lero la morara ka bongata bo boholo.
Colchicine
Ho na le litlaleho tsa nts'etsopele ea myopathy / rhabdomyolysis ka ts'ebeliso e ts'oanang ea colchicine le simvastatin ho bakuli ba nang le bothata ba ho phekoloa ke methapo. Bakuli ba sebelisang lithethefatsi tsena ka nako e ts'oanang ba lokela ho ba tlasa taolo ea ngaka.
Rifampicin
Kaha rifampicin ke inducer e matla ea CYP3A4 isoenzyme, ho bakuli ba nkang moriana ona nako e telele (mohlala, kalafong ea lefuba), ho ka ba le khaello ea ts'ebeliso ea simvastatin (ho haella ho fihlella sepheo sa mahloriso a plasma cholesterol).
Litlamorao tsa simvastatin ho pharmacokinetics ea lithethefatsi tse ling
Simvastatin ha e thibele CYP3A4 isoenzyme. Ka hona, ho nahanoa hore simvastatin ha e ame khatello ea mali ea plasma ea lintho tse ntlafalitsoeng ke CYP3A4 isoenzyme.
Digoxin
Ho na le molaetsa oa hore ka tšebeliso e le 'ngoe ea digoxin le simvastatin, khatello ea plasma ea pele e eketseha hanyane, ka hona, bakuli ba nkang digoxin ba lokela ho betoa leihlo ka hloko, haholo qalong ea kalafo ea simvastatin.
Li-anticoagulants tse sa tobang
Litekong tse peli tsa tleleniki, e 'ngoe e kenyelletsa baithaopi ba phetseng hantle' me e 'ngoe e kenyelletsa bakuli ba nang le hypercholesterolemia, simvastatin ka lethal dose ea 20-40 mg / letsatsi ka tsela e ntlafatsang phello ea li-anticoagulants tsa coumarin. Tekanyo e tloaelehileng ea machabeng e tloaelehileng (INR) e eketsehile ho tloha 1.7-1.8 ho isa ho 2.6-3.4 ho baithaopi ba phetseng hantle le bakuli ka ho latellana. Ho bakuli ba sebelisang coumarin anticoagulants, nako ea prothrombin (PV) kapa INR e lokela ho khethoa pele ho kalafo mme, kamora moo, hangata e ikemiselitsoe mothating oa pele oa kalafo ka simvastatin ho netefatsa hore ha ho na liphetoho tse kholo ho PV / INR. Hang ha boleng bo tsitsitseng ba PV / INR bo se bo thehiloe, bo ka shebelloa ka linako tse ling bo khothalelitsoeng ho bakuli ba nkang li-cicoadulant tsa coumarin. Ka phetoho ea tekanyetso ea simvastatin, kapa tšitiso ea kalafo, khafetsa taolo ea PV / INR e lokela ho eketsoa. Ho ba teng ha madi kapa phetoho ea PV / INR ho bakuli ba sa sebeliseng li-anticoagulants ha e amane le tšebeliso ea simvastatin.

Simvagexal: hana hana ho cholesterol e phahameng

imvaghexal ke sethethefatsi sa hypolipidemic se thehiloeng ho simvastatin.

E sebelisetsoa ho phekola bakuli ba nang le lefu la pelo le coronary le hypercholesterolemia.

E laetsoe bakuli ba ka holimo ho lilemo tse leshome le metso e robeli, ntle le batho ba nang le litlolo tsa molao.

Simvagexal e ajoa tsoang litlhare tsa litlama meriana. Ka hona, pele u reka lithethefatsi, u lokela ho etela ngaka.

Ts'ebetso ea kopo

Nka Simvagexal kahare, 'me u noe metsi a mangata. Khafetsa ea tšebeliso - hang ka letsatsi. Nako e ratoang ea ho amoheloa ke mantsiboea. Nako ea kalafo e khethoa ka bonngoe.

Haeba tekanyetso ea hona joale e lahlehile, moriana o nooa hanghang. Leha ho le joalo, u se ke oa eketsa tekanyetso habeli haeba e le nako ea ho nka tekanyetso e latelang.

Tekanyetso ea pele ea kalafo ea hypercholesterolemia e khethoa ke ho teba ha lefu lena mme e fapana ho tloha ho 5 ho isa ho 10 mg / ka letsatsi. Tekanyetso e behiloe ho latela boemo ba cholesterol ea plasma e fumanoeng ka nako ea bonyane libeke tse 'ne.

Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 40 mg. Haeba mokuli a le kotsi ea pelo le kalafo e sa sebetse ka ho lekaneng, ngaka e ka eketsa lethal dose ho isa ho 80 mg / ka letsatsi.

Tekanyetso ea pele ea CHD ke 20 mg. Haeba ho hlokahala, e eketse ka 40 mg ka mor'a libeke tse 'ne. Tekanyetso ea lithethefatsi e ea fokotsoa haeba lihlahisoa tsohle tsa cholesterol li oela ka tlase ho 3.6 mmol / litha, mme se kahare ho LDL se ka tlase ho 1.94 mmol / litha.

Bakuli ka nako e tšoanang ba nka cyclosporine, nicotinamide kapa fibrate ba lokela ho fokotsa tekanyetso ea pele le e lekaneng ea letsatsi le letsatsi ea 5 le 10 mg, ka ho latellana. Ho joalo le ka batho ba nang le bothata bo sa foleng ba ho ba le methapo.

Litholoana tsa letsatsi le letsatsi tse khothalelitsoeng tsa kalafo ea immunosuppress ke 5 mg / letsatsi.

3. Moetso, foromo ea tokollo

Setlhare se na le simvastatin le metsoako e meng, joalo ka lactose monohydrate, ascorbic acid, magnesium stearate, talc, iron (III) oxide, starch ea poone, hypromellose, citric acid monohydrate, titanium dioxide, MCC.

Simvagexal e lokolloa ka mokhoa oa matlapa a oval convex ka koae e sa koaeloang, e koahetsoeng.

'Mala oa khetla e ka ba' mala o mosehla (5 mg), o mopinki o bobebe (10 mg), o 'mala oa lamunu (20 mg), o mosoeu kapa o mosoeu (30 mg), le pinki (40 mg). Ka lehlakoreng le leng la matlapa ho na le mantsoe a ngotsoeng "SIM 40", "SIM 30", "SIM 10", "SIM 20" kapa "SIM 5" (ho latela sebopeho sa tokollo).

5. Litla-morao

Nakong ea kemolo

Bakuli ba baimana ha baa lokela ho nka Simvagexal. Ho na le litlaleho tsa nts'etsopele ho masea a sa tsoa tsoaloa bao bo-mme ba nkileng simvastatin ea litlolo tse fapaneng.

Haeba mosali ea lilemong tsa ho ba le bana a nka simvastatin, o lokela ho qoba ho ima. Haeba ho ima ho etsahetse nakong ea kalafo, Simvagexal e lokela ho emisoa, mme mokuli o lokela ho lemosoa ka kotsi e ka bang teng ho lesea.

Ha ho na tlhahisoleseling mabapi le kabo ea karolo e sebetsang ka lebese la matsoele. Haeba u sa khone ho qoba ho khethoa ha Simvagexal ho mosali oa moimana, o lokela ho mo hopotsa ka tlhokeho ea ho emisa ho anyesa.

Boitlhokahalo bona bo amahanngoa le taba ea hore meriana e mengata e tlotsoa lebeseng, e eketsa monyetla oa ho ba le karabelo e matla.

7. Lipehelo le maemo a polokelo

Simvagexal e bolokoa lilemo tse tharo ka mocheso oa likhato tse 30 kapa tse lekanang le eona.

Litsenyehelo tse tloaelehileng tsa simvageksal ka liketane tsa limela tsa Russia ke 280 leq.

Ho batho ba tsoang Ukraine lithethefatsi li reka ka karolelano ea 300 UAH.

Lenane la li-analogane tsa Simvagexal le kenyelletsa lithethefatsi tse joalo ka Aterostat, Avestatin, Vazilip, Actalipid, Zokor, Vero-Simvastatin, Zorstat, Zovatin, Ariescor, Simvastatin, Simgal, Simvor, Simvastol, Holvasim, Sinkard, Simplakor le tse ling.

Litlhahlobo mabapi le lithethefatsi har'a lingaka le bakuli li ntle haholo. Ho ea ka bona, simvagexal e thusa ho fokotsa cholesterol le kotsi ea mathata a amanang le mosebetsi oa pelo.

Eya bofelong ba sengoloa ho bala maikutlo mabapi le Simvageksal. Hlalosetsa maikutlo a hau ka moriana oo haeba u tlameha ho o sebelisa kapa ho o fa bakuli. Sena se tla thusa baeti ba bang ba sebaka.

1. Qalong ea ho sebelisa moriana, serum transaminase ea khonahala (keketseho ea nakoana ea li-enzyme tsa sebete).
2. Simvagexal ha e nkuoe kotsing e kholo ea ho ba le mafu a kang ho se sebetse hantle ha renal, rhabdomyolysis.

Sivastatin, e etselitsoeng bakuli ba baimana, e ka ba le litlamorao tse mpe ho lesea (basali ba lilemo tsa ho beleha ba lokela ho qoba ho ima). Haeba ho ima ho etsahetse nakong ea kalafo, moriana o lokela ho emisoa, mme mokuli o lokela ho tsebisoa ka kotsi e ka bang teng ho lesea.

Na sengoloa seo se ne se thusa? Mohlomong leseli lena le tla thusa metsoalle ea hau! Ka kopo tlanya e 'ngoe ea likonopo:

Lebitso le sa nepahalang la machabeng:

Matlapa a koahetsoeng ka filimi.

Letlapa le 1 le koahetsoeng ka filimi le na le:
Ntho ea mantlha ea litafole: motsoako o sebetsang: simvastatin 5.00 mg / 10.00 mg / 2000 mg / 30.00 mg / 40.00 mg, ba fanang ka tsona: pregelatinized starch 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, cellcose ea microcrystalline 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
Shell: 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, dae e tšehali ea iron oxide 0,0043 mg / 0.0017 mg / 0.11 mg / - / -, dae e khubelu ea oxide - / 0.0043 mg / 0.026 mg / - / 0,14 mg.

Tlhaloso

Litafole tsa biconvex tse oval, tse koaheletsoeng filiming, tse nang le notch ka lehlakoreng le leng, 'me li ngotsoe ho tse ling ka likotsi tse peli. Karolo ea sefapano e tšoeu.
Karolo ea 5 mg: matlapa a mmala o bobebe oa 'mala o mosehla o ngotsoeng "SIM 5".

Karolo ea 10 mg: matlapa a mmala o pinki o bobebe ka mongolo o ngotsoeng "SIM 10".
Karolo ea 20 mg: matlapa a mmala oa lamunu a bobebe a ngotsoeng "SIM 20".
Tekanyetso ea 30 mg: Matlapa a 'mala o mosoeu kapa o batlang o le tšoeu o ngotsoe "SIM 30".

Karolelano ea 40 mg: matlapa a pinki a ngotsoeng "SIM 40"