Vazilip, analogues na kwayoyi na Rasha tare da farashin da sake dubawa

- hypercholesterolemia na farko na nau'ikan IIa da IIb, gami da polygenic hypercholesterolemia, heterozygous hereditary hypercholesterolemia da hade hyperlipidemia. Ana amfani da miyagun ƙwayoyi azaman monotherapy a lokuta inda rage cin abinci da sauran hanyoyin magani ba su isa ba.

- rage yawan mace-mace da cututtukan zuciya a cikin marasa lafiya tare da alamun bayyanar cututtuka na cututtukan cututtukan zuciya na cututtukan ƙwayoyin cuta na cututtukan ƙwaƙwalwar ƙwayar cuta ko ciwon sukari, tare da matakan al'ada ko haɓaka cholesterol kuma a matsayin ƙarin gwargwado don daidaita sauran abubuwan haɗari da cututtukan zuciya.

Tattaunawa game da maganin Vasilip a cikin bayanan iyaye mata

. Tformin yana inganta yanayin halittar fibrinolytic na jini ta hanyar dakatar da nau'in plasminogen mai kunna nama wanda yake hanawa. "G ya ce ya kamata cholesterol din ya ragu. Idan bai ragu ba, to Vasilip. Ni ma ina da jini sosai - haemoglobin-154. Na riga na auna daga kwayoyin.

. Idan kun ɗauki hadadden Oksilik, ba zai rage shi da yawa ba, amma kuna da damar gwada l-thyroxine Metformin an wajabta muku don hanzarta haɓakar metabolism da amfani da glucose, kalmominku game da Vasilip tabbaci ne cewa waɗannan kwayoyi ba su da alaƙa da nasu - wannan shine kwarewar sirri. Vasilip bai taimaka min ba - na sha Roxer na tsawon watanni 3. Irin wannan nau'in cokes, a cikin hanyar yarinyas, jannins da diana - kawai lalata ƙwayoyin ku, amma kada ku shafi babban matakin LH, yayin da prolactin ɗinku yayi kyau, wanda ke nufin da yawa)) ) Ya kamata Utrozhestan ya bugu akai-akai kuma kada ya daina idan ya cancanta daya, ba biyu. Bitamin yana kasancewa koyaushe a cikin farkon kashi na glutamic acid sau uku a rana akan kwamfutar hannu daga 5 zuwa 15 DC + foil + aidin, kuma daga 16 zuwa 2.

2. Contraindications

Dangane da umarnin, vasilip yana contraindicated a:

• cututtukan hanta daban-daban a cikin aiki,
• haɓaka ayyukan hanta transminases na asalin da ba a sani ba,
• amfani da vasilip da hanawa,
• rashin hankali ga abubuwan da ke haɗuwa da miyagun ƙwayoyi,
• ciki.

Anyi taka tsantsan don amfani da maganin a cikin waɗannan lambobin:

• a gaban tarihin cutar hanta,
• tare da mummunan take hakkin tsarin endocrine,
• tare da cuta na rayuwa
• tare da ciwo mai tsanani, alal misali, tare da sepsis,
• tare da jijiyoyin jini (matsin lamba sama da tsayayyen tsari),
• tare da raunin da rauni da dama asali,
• tare da nau'in cututtukan da ba a sarrafawa ba,
• tare da myopathy (abin da ake kira na kullum, cututtukan ƙwayar tsoka a cikin kullun, wanda yanayin metabolism a cikin ƙwayoyin tsoka ke da rauni),
• yayin ayyukan tiyata,
• tare da zagi da giya.

3. Rashin sakamako

Vasilip yana iya yin amfani da abubuwan da ba a so a jikin ɗan adam, waɗanda suka fi yawa daga cikinsu sune:

Cutar cutar sankara, rashin kumburin koda, bugun kirji, raguwar aikin jima'i ba su da yawa.

4. Hanyar gudanar da magani

Ana ɗaukar maganin Vasilip a baki, kuma za'a iya saita sashi gwargwadon alamun da kuma ƙayyadadden cutar daga 5 zuwa 80 MG (ana amfani da mafi yawan ƙwayoyi don magance hypercholesterolemia ko gaban haɗarin haɗari na rikitarwa a cikin aikin haɗin gwiwar tsarin jijiyoyin jini.

An wajabta tsawon izinin shiga ne ta kowane likita. Tsarin gargajiya shine 10 MG na kwaya guda na yau da kullun, kuma bisa ga alamu na musamman wannan an ƙara yawan wannan sau 2-8.

Canja kashi na maganin ba fiye da 1 lokaci na wata daya.

5. Rarraba Magunguna

1. Wannan magani na iya haɓaka sakamakon maganin rashin daidaituwa, wanda zai iya haifar da zub da jini.
2. Yana ƙara maida hankali ga Digoxin a cikin jini, sabili da haka, marasa lafiya da ke da irin wannan ilimin suna buƙatar likitoci su duba su.

Gudanar da sabis na lokaci daya tare da cytostatics da wakilai na antifungal (ketoconazole, Itraconazole), fibrates, babban allurai na nicotinic acid, immunosuppressants, da inhibitors na protease yana ƙara haɗarin rhabdomyolysis.

6. Yawan zubar da ciki

Akwai maganganun da suka wuce adadin Vasilip, duk da haka, ba su haifar da mummunan sakamako da mummunar keta ba. Duk da wannan, idan akwai batun yawan ƙwayar ƙwayar cuta, yana da buƙatar ɗaukar enterosorbents kuma kurkura ciki, ana bada shawarar saka idanu akan tsarin jiki, musamman ga kodan da hanta.

7. Sakin tsari da rayuwar shiryayye

Magungunan masana'antar suna samar da magungunan a cikin nau'ikan allunan da ke rufe fim a waje.

Tabletaya daga cikin kwamfutar hannu guda ɗaya na iya zama magani daban-daban - 10 mg, 20 mg, 40 mg.

A cikin kunshin - guda 14 ko 28.

Rayuwar shiryayye na Vasilip shine shekaru 3.

Mashahurai analogues ga miyagun ƙwayoyi Vasilip:

A cikin cibiyar sadarwar kantin magani, ana sayar da maganin a farashin da ke gaba (ya dogara da kashi):

• a Rasha - daga 328 zuwa 587 rubles,
• a cikin Ukraine - daga hryvnias na 82 zuwa 148.

Marasa lafiya waɗanda suka ɗauki wannan magani sun lura da raguwa a cikin cholesterol jini, rashin lafiya na janar yanayin, da kuma tsawan matakin maganin.

Koyaya, wannan yana nuna alamun sakamako mara illa wanda ya lalace bayan ƙarshen shan Wazilip. Kuna iya karanta dalla-dalla game da sake dubawar marasa lafiya da suka yi amfani da Vazilip a ƙarshen labarin.

11. Umarni na musamman

1. Kafin fara magani tare da Vazilip, kuna buƙatar gudanar da nazarin dakin gwaje-gwaje na alamomin aikin hanta da ƙarin sa ido kan ayyukan ƙwayar hanta kowane watanni 1.5-2. Marasa lafiya waɗanda ke karɓar simvastatin kullun a mafi girman kashi (80 MG) ana kulawa da su don aikin hanta - sau ɗaya a kowane watanni uku. Tare da karuwa a cikin ayyukan transaminases, an soke maganin cutar Vasilip.
2. Marasa lafiya tare da myasthenia gravis, myalgia, ko kuma tare da alamun karuwar ayyukan aikin jiyya na CPK tare da maganin da ke cikin tambaya an dakatar da su.
3. Ba a ba da shawarar Simvastatin ba idan akwai haɗarin rhabdomyolysis ko gazawar renal (saboda hauhawar jijiya, matsanancin ciwo, matsanancin tashin hankali, raunin da ya faru).
4. Abubuwan da ke cikin Vasilip suna da tasiri ga ci gaban tayin, saboda haka, ya kamata a cire maganin don maganin mata masu juna biyu. Idan ciki ya faru a lokacin jiyya tare da Vazilip, to an dakatar da maganin.
5. Magungunan suna da tasiri duka biyu a cikin maganin tauhidin da kuma a hade tare da jerin abubuwan acid.
6. Halin da ake buƙata don maganin Vasilip shine mai haƙuri yana kan abinci na cholesterol.
7. Idan an rasa kashi na yanzu, kuna buƙatar ɗaukar kashi na gaba na magani da wuri-wuri ba tare da yin shakka ba.
8. Game da ciwo wanda ba a bayyana shi ba a cikin tsokoki, ana ba da haƙuri ga likita da gaggawa.

Aikin magani na magani

Maganin aiki mai aiki na Vasilip yana da tasiri mai rage rage kiba kuma yana rage cholesterol a cikin jini. Magungunan suna da tasiri a cikin cututtukan zuciya, saboda yana rage haɗarin infitar fitsari. Sakamakon warkewa na amfani da vasilip yana haɓakawa na tsawon makonni biyu, kuma mafi girman yana faruwa bayan wata daya na yau da kullun.

Bugu da kari, Vasilip, bisa ga sake dubawa, shima yana da tasirin anti-atherosclerotic, yana shafar bangarorin jini da ganuwar jini.

Ta wace hanya ake samar

Vasilip yana samuwa a cikin nau'i mai farin allunan da aka saka a cikin fim wanda ya ƙunshi 10, 20 da 40 mg na simvastatin abu mai aiki. Allunan guda 7 a cikin boro.

Idan ya cancanta, ana iya maye gurbin miyagun ƙwayoyi tare da ɗayan analogues na Vazilip - simplacor, avestatin, holvasim, atherostat, simvakard, actalipid, zokor, simgal, vasilip, zorstat, aries, simvor, simvagheksal, simvalimit, simvastatin, simlo, sincard ko zovatin.

Lokacin da baza ku iya nadawa ba

Dangane da umarnin, Vasilip yana contraindicated don amfani tare da:

• Cutar cututtukan hanta a cikin aiki mai aiki, har ma tare da ci gaba mai yawa a cikin ayyukan hepatic transaminases na etiology da ba a sani ba,
• Amfani da kwanciyar hankali tare da CYP3A4 isoenzyme inhibitors, ciki har da erythromycin, itraconazole, clarithromycin, ketoconazole, masu hana HIV kariya, nefazodone da telithromycin,
• Hypersensitivity zuwa abubuwan da aka gyara na Vasilip.

Hakanan, magungunan, kamar su Vazilip analogues, bai kamata a yi amfani dashi ba yayin daukar ciki, a karkashin shekara 18, lokacin lactation, lokacin da ake shirin daukar ciki ko idan ana zargin.

Ana amfani da Vasilip tare da taka tsantsan a:

• Tarihin cutar hanta,
• Mai tsananin endocrine da cuta na rayuwa,
• Mai tsananin ciwo cututtuka, gami da sepsis,
• Ciwon jijiyoyin jini,
• Raunin da ya faru
• Cututturar da ba a sarrafawa,
• Cutar zuciya
• Tsarin tiyata mai zurfi,
• Almubazzaranci, musamman kafin farawa,
• Rashin bacci
• Mai tsananin rashin daidaituwa na lantarki,
• Galactosemia ko glucose-galactose malabsorption syndrome,
• Gudanar da lokaci ɗaya tare da cyclosporine, fenofibrate, gemfibrozin, verapamil, acid nicotinic, amiodarone, diltiazem da ruwan 'ya'yan itace innabi.

Hanyar aikace-aikacen vasilip

Dangane da umarnin, ana ɗaukar Vasilip ta baki sau ɗaya da maraice, kashi gwargwadon cutar na iya bambanta daga 5 MG zuwa matsakaicin 80 MG, wanda aka ɗauka kawai tare da mummunan hypercholesterolemia ko babban haɗarin cututtukan zuciya. Tsawon likitan da ke halartar shi yana yanke hukunci ne daban-daban.

Yawancin lokaci, a cikin maganin hypercholesterolemia, ana ɗaukar Vasilip 10 MG sau ɗaya, bisa ga alamun, ana iya ƙara yawan warkewa sau 2 ko 4. Dangane da sake dubawa, Vasilip yana da tasiri yayin lura da daidaitaccen tsarin abinci na hypocholesterol a duk lokacin magani.

Tare da hyzycholesterolemia na homozygous, Vasilip an wajabta 40 MG sau ɗaya da maraice ko 80 MG na miyagun ƙwayoyi, ya kasu kashi uku, a hade tare da sauran hanyoyin maganin cututtukan jini.

Tare da babban haɗarin haɓakar cututtukan zuciya, Vasilip ana ɗaukar 20-40 MG kowace rana bisa ga umarnin. Kuna iya canza kashi na maganin ba fiye da sau ɗaya a wata ba.

Dangane da sake dubawa, Vasilip yana da tasiri duka a cikin monotherapy kuma a hade tare da colestyramine, amiodarone, colestipol, gemfibrozil, cyclosporine da sauran fibrates ko acid nicotinic.

Lokacin amfani da Vasilip, ba a ba da shawarar cinye mai yawa (fiye da lita 1) na ruwan 'ya'yan itacen innabi ba.

Sakamakon sakamako na vasilip

Dangane da sake dubawa, Vasilip ba sau da yawa yakan haifar da ci gaban sakamako, wanda ke bayyana kamar:

• Ciwan huhu, ciwon ciki, maƙarƙashiya, tashin zuciya, rashin jin daɗi, jaundice, dyspepsia, amai, gudawa da hepatitis,
• Paresthesia, neuropathy na waje, hangen nesa mai iya gani, bugun zuciya, matsananciyar damuwa, asma, ciwon kai, rashin bacci da cin zarafin dandano,
• Rhabdomyolysis, myopathy, ƙwayar tsoka da myalgia,
• Fata na gaggawa, alopecia, da pruritus,
• Arthritis, lupus-like syndrome, eosinophilia, rauni mai rauni, angioedema, dermatomyositis, zazzabi, ƙaruwar ESR, urticaria, polymyalgia rheumatism, vasculitis, thrombocytopenia, arthralgia, photoensitivity, fulawar fuska da gazawar numfashi,
• M gazawar na koda, palpitations, anemia, da kuma rage karfin.

Vasilip - Yin bita game da Vasilip - Farashin Vasilip

Vasilip wani magani ne daga rukuni na statins, wato, magungunan da zasu iya rage cholesterol a cikin jinin mutum. An yi shi ne akan tushen simvastatin - wani abu ne da aka samo daga kayan albarkatun ƙasa (namomin kaza).

Kamar yadda shirye-shiryen makamancin wannan, mutum zai iya ambaci, alal misali, Atoris, wanda ya dogara da atorvastatin - abu mai haɓaka. Tasirin vasilip ya zama sananne (a lokacin sarrafa jini) makonni biyu bayan fara magani. Ana lura da tasirin miyagun ƙwayoyi bayan wata daya - ɗaya da rabi.

Yadda aka samu nasarar rage kwarin cholesterol da sauran kitsen (triglycerides da sauransu) ya zama dole don duba lokaci-lokaci ta hanyar bayar da gudummawar jini “don nazarin halittun”. Abubuwan da ke nuna alama don nishaɗin Vasilip na iya samun duka biyu da kuma hanyoyin gado na hypercholesterolemia.

Kari akan haka, yin rigakafi da magani na atherosclerosis, cututtukan zuciya da sauran cututtukan jijiyoyin jiki wanda ya haɗu da kitsen jini zai iya kuma yakamata a tallafa musu ta amfani da wannan maganin.

Ana samun Vasilip a cikin kwamfutar hannu. Kyakkyawan tsarin makirci don zaɓin hankali na kashi, wanda aka bayyana ta hanyar koyarwar miyagun ƙwayoyi. Farawa tare da mafi ƙarancin Vazilip, likita ya kamata ya kula da yanayin metabolic na mai haƙuri koyaushe kuma ya kawo canje-canje a alƙawarin (ƙara yawan kashi) ba sau ɗaya a wata.

A cikin layi daya, mai haƙuri dole ne ya bi wani abincin na musamman, in ba haka ba statin far zai rage ma'anarsa.

Likita ya tsara Vasilip kuma yakamata ya tantance lafiyar mai hanta da lafiyar koda, gano irin magungunan da yake dauka, menene salon rayuwarsa ... A takaice dai, statins, dukda cewa zasu iya canza yanayin da kwalara sosai, yakamata a tsara shi da taka tsantsan, Da alhakin duba tasirin su akan lokaci.

Vasilip yana contraindicated a cikin cututtuka na kodan, hanta, mutum rashin haƙuri, ciki da kuma lactation, yara da matasa. Idan uwargida ta yi amfani da wannan magani, ya kamata ta kiyaye kanta a hankali daga cikin cikin da ba a shirya ba. Idan mai haƙuri ya yi shirin yin juna biyu, to kada ta ɗauki Vasilip.

Sakamakon sakamako na vasilip

Tare da ingantaccen amfani da magani, saka idanu akan yanayin jini da kuma aiki da tsarin manyan sassan jikin mutum, an bayyana bayyanar alamun da ba a sonsu a matsayin “mafi wuya” (wato shari’a daya ga dubu daya zuwa dubu goma na cutar ta Vasilip).

Narkewa, tsarin juyayi, tsokoki na iya shafa. Misali, cututtukan cututtukan hanta, ciwon kai, raunin jiki, damuna da sauransu.

Bayyanar bayyanar cututtuka na iya zama dabam - daga rashes mai laushi zuwa matsanancin rashin haƙuri na rashin lafiya.

Allunan maganin Vasilip: alamomi don amfani, sake dubawa na mara haƙuri

Vasilip magani ne wanda ke cikin rukunin masu rage kiba.Babban ma’anar aikin sa shine ya kasance yana nufin rage matsayin lipids (fitsari) a cikin jini. Vasilip yana samuwa a cikin nau'i na farin allunan a cikin membrane fim, zagaye, dan kadan convex a garesu.

Babban sinadaran aiki na wannan wakili shine simvastatin. Hakanan ya ƙunshi ƙarin abubuwa irin su lactose monohydrate, sitaci pregelatinized, sittin acid na anhydrous, bitamin C, sitaci masara, magnesium stearate da celclostse microcrystalline. Shellwanin kwamfyutar da kanta ta ƙunshi talc, propylene glycol, hypromellose da titanium dioxide.

Yawan sashi na miyagun ƙwayoyi ya kasance nau'i biyu - 20 da 40 MG kowane.

Hanyar aikin vasilip

Tunda Vasilip yana cikin magungunan rage yawan lipid, tsarin aikinsa ya dace. Da farko dai, vasilip yana rage rage yawan tasirin cholesterol a cikin jini. Akwai nau'ikan cholesterol guda biyu - “mara kyau” da “kyau”. "Mara kyau" yana da karancin wadataccen lipoproteins, kuma "mai kyau" shine wadataccen lipoproteins mai yawa.

Vasilip yana da tasiri a farkon matakin samuwar cholesterol. Ya ƙunshi canzawar HMG-CoA (hydroxymethylglutaryl coenzyme A) zuwa mevalonic acid. Wannan canjin yana faruwa a ƙarƙashin ƙarfin enzyme HMG-CoAreductase.

Vasilip yana da tasiri mai banƙyama ga wannan enzyme, sakamakon abin da cholesterol kawai baya samar. Hakanan kwayar tana shafar cholesterol, wacce ta riga ta zama a jiki.

Yana rage yawan ƙwayar cholesterol da ke hade da ƙarancin lipoproteins mai yawa, sannan kuma yana rage haɗuwar triglycerides.

Wadannan abubuwa ne na dabi'ar samarda kyautuka wadanda sune ke da alhakin haifar da tarin atherosclerotic plaques a cikin lumen arteries. Amma miyagun ƙwayoyi suna ƙara adadin "mai kyau" cholesterol - hade da babban lipoproteins mai yawa. Hakanan an rage girman matakin apolipoprotein B, furotin na musamman wanda ke da alhakin jigilar cholesterol a jiki baki daya.

Baya ga rage matakin wasu nau'in lipids, babban abu mai aiki na Vasilip yana shafar bangon jijiyoyin jini da jinin kansa.

Abubuwan jini kamar macrophages, waɗanda ke jagorantar rawa wajen ƙirƙirar adana cholesterol, miyagun ƙwayoyi suna hana su, kuma filayen da kansu sun lalace.

Hakanan, aikin abubuwan da ake kira isoprenoids, wanda ke da alhakin haɓakar sel a cikin ƙwayar murjiyoyin jijiyoyin jini, an sami raguwa sosai, saboda bangon jirgin ba ya yi kauri, kuma lumfashinsa ba ya kumbura. Hakanan kuma, Vasilip yana dirar jini sosai kuma yana inganta hawan jini.

Siffofin likitan magunguna na vasilip

Vasilip yana cikin ciki. An sha sosai a jikin bangon karamin hanji.

Ana lura da mafi girman yawan maganin a cikin sa'o'i biyu zuwa biyu bayan gudanarwarsa, amma bayan sa'o'i 12 yana ragewa zuwa 10%. Ana iya ɗaukar magani tare da abinci, wannan ba zai tasiri tasirinsa ba.

Hakanan, baya tara cikin jiki tare da amfani da tsawan lokaci. Magungunan suna ɗaure sosai zuwa sunadarai na jini, kusan 100%.

An canza Vasilip zuwa wani fili mai aiki a cikin hanta. Wannan fili ana kiranta beta hydroxy acid. Excaukar aikinsa (kawarwa) yana gudana ta cikin babban hanji. An cire maganin a cikin hanyar metabolites (samfuran juyawa).

Smallan karamin sashi yana kodan kodan, amma wani sashi mai aiki da ke fita ya fita ta hannun kodan.

Manuniya da contraindications don amfani

Sau da yawa likitoci suna yin allurar vasilip don cuta kamar atherosclerosis. Hakanan yana da matukar amfani ga hypercholesterolemia na farko ko cakuda dyspidemia (rikicewar rabo daga lipids na jini daban) a cikin haɗuwa tare da aikin jiki na yau da kullun, asarar nauyi, bin wani abincin da aka kafa, ko kuma rashin sakamakon sauran magunguna.

Wata alama kuma shine maganin hyzycholesterolemia na homozygous. A zahiri, a layi daya, yakamata a bi tsarin abincin da kuma sauran magungunan anti-atherosclerotic.

Hakanan an wajabta maganin Vasilip don rigakafin cututtukan cututtukan zuciya tare da atherosclerosis da ke ciki ko ciwon sukari, tunda akwai babban haɗarin bugun zuciya, bugun jini da cututtukan jijiyoyin jiki daban-daban.

Thearshe na ƙarshe shine yana ɗaukar cholesterol a cikin rashin bayyanar cututtuka.

Vasilip yana cikin yanayi kamar:

• cutar hanta a cikin babban mataki ko a cikin aiki na aiki,
• karuwar dogon enzymes na hanta ba tare da wani dalili ingantacce ba,
• ciki da lactation,
• karamin shekaru
• halayen rashin lafiyan da suka shafi simvastatin ko duk wasu abubuwan haɗin maganin.

Ya kamata a saka kulawa ta musamman ga waɗancan marasa lafiya waɗanda ke da cututtukan da suke biye ko wasu takamaiman yanayi:

1. Tare da yawan shan barasa.
2. A gaban cututtuka da suka shafi hanta.
3. Kasancewar rashin daidaituwa na jiki.
4. Violationsayyadaddun ƙetarewar tsarin endocrine da metabolism.
5. Rage matsin lamba (hypotension) koyaushe.
6. Cututtukan raunuka na jiki.
7. Cututtuka na tsarin tsoka.
8. Ciwon mara.
9. Babban tiyata ko rauni.
10. Rashin lactase, enzyme wanda ke rushe lactose (sukari madara).
11. Take hakkin da aiwatar da sha daga lactose.

Umarnin don amfani da miyagun ƙwayoyi

Kafin kowane amfani da miyagun ƙwayoyi, ya kamata ku nemi shawara tare da likitan ku game da yadda za ku sha shi daidai a gare ku kuma ku sami masaniya da tattaunawar. Tsarin kula da lafiya shine a ɗauki ɗaya ko fiye da allunan sau ɗaya a rana a lokacin bacci.

An bada shawara don shan maganin da dare, saboda a cikin dare, ana aiwatar da kira mafi girma na cholesterol, kuma tasirin maganin ya zama mafi ma'ana. Yawancin lokaci fara da kashi na 10 MG. Matsakaicin izini na kashi ɗaya shine 80 MG kowace rana.

An wajabta shi ga marasa lafiya da cututtukan cututtukan haɓaka, kazalika da haɗarin rikice rikice daga zuciya da jijiyoyin jini. An zaɓi kashi da ake buƙata a mafi yawan lokuta an zaɓi tsakanin wata daya.

Zaɓin lokacin aikin yana zaɓa daban ga kowane mara lafiya ta hanyar halartar likit.

Ya kamata a tuna cewa lokacin shan Wazilip, mai haƙuri daban-daban yana da abincin da dole ne ya lizimta shi. A wasu halaye, ana kuma tsara wasu magunguna masu rage rage kiba.

Ga marasa lafiya da cuta irin su hypercholesterolemia, farawa ya fara ne da kashi 10 MG, amma ana iya ƙara zuwa 40 MG don cimma sakamako mafi ma'ana.

Don nau'in gado na wannan cuta, an rarraba Vazilip zuwa sau uku idan an tsara mafi girman kashi (80 MG), ko kuma an ba da 40 MG na miyagun ƙwayoyi sau ɗaya a rana kafin lokacin kwanciya.

Vasilip yana da tasirin da ake so duka a amfani guda kuma cikin haɗuwa tare da sauran wakilai na maganin asticholesterolemic, musamman, tare da masu bin bile acid. Wadannan kwayoyi irin su colestyramine, colestipol.

Tare da yin amfani da cyclosporine, gemfibrozil, acid nicotinic ko kwayoyi daga rukuni na fibrates, suna farawa da kashi 5 MG, kuma matsakaicin izini shine 10 MG.

A wannan yanayin, bai kamata ku wuce wannan maganin ba.

Idan mai haƙuri ya ɗauki ƙwayoyi a kan arrhythmia da hauhawar jini, kamar Amiodarone da Verapamil, to, kashi na Vasilip ya zama bai wuce 20 MG kowace rana ba, tunda ba a tabbatar da daidaituwarsu.

Idan mutum yana fama da matsanancin mataki na lalacewa na koda, wanda a cikin ƙirar fillo ɗin duniya ba ta wuce mil 30 / min., Sannan an wajabta Vasilip a cikin adadin da bai wuce 10 MG kowace rana ba. Ya kamata a ƙara yawan ƙwayar sosai a hankali, kuma a wannan yanayin ya kamata a kula da mai haƙuri koyaushe.

Formaddamar da tsari da abun da ke ciki

Ana samar da Vasilip a cikin nau'i mai farin allunan (7 inji mai kwakwalwa. A cikin bolaji), waɗanda aka rufe su da membrane fim.

Umarnin don amfani da Vasilip (hanya da sashi)

Allunan an yi su ne don gudanar da maganin baka, sau ɗaya da maraice.

Yawan shawarar da aka ba da shawarar sun bambanta daga 5 MG zuwa 80 MG sau ɗaya kowace rana da maraice. Maganin farko na maganin shine 10 MG. Ya kamata a aiwatar da canje-canje na tsaka-tsaki na ƙarancin makonni 4.

Matsakaicin izini na yau da kullun ya kai 80 MG. An wajabta shi kawai ga marasa lafiya waɗanda ke da haɗarin rikice-rikice na jijiyoyin jini ko babban hypercholesterolemia.

Tsawon lokacin shan allunan an ƙaddara ta wurin halartar likitocin daban daban.

Hypercholesterolemia

A duk tsawon lokacin jiyya, dole ne mai haƙuri ya bi tsarin abinci na hypocholesterol. Thewarin da aka bada shawarar farawa ga marasa lafiya da hypercholesterolemia shine 10 MG. Don samun raguwa mafi ma'ana a cikin LDL-C, ana iya fara amfani da maganin daga 20 zuwa 40 MG kowace rana (sau ɗaya da maraice).

A cikin marasa lafiya tare da hyzycholesterolemia na homozygous, kashi na yau da kullun shine 40 MG a maraice ko 80 MG a cikin allurai uku (20 mg da safe, 20 mg da yamma da 40 mg da yamma).

Rashin Cutar zuciya

A cikin marasa lafiya da ko ba tare da hyperlipidemia ba, tare da haɗarin cutar cututtukan zuciya, ingantattun magunguna sune 20 zuwa 40 MG kowace rana. Saboda haka, shawarar fara farawa ya kai 20 MG kowace rana.

Ya kamata a aiwatar da canje-canje na allurai a cikin tsaran makonni 4. Idan ya cancanta, ana iya ƙara kashi 40 zuwa 40 a kowace rana.

Idan abun cikin LDL bai wuce 75 mg / dl (1.94 mmol / L), yawan abubuwan cholesterol bai wuce 140 mg / dl (3.6 mmol / L) ba, yakamata a rage kashi.

Gudanar da aikin kwantar da hankali

Vasilip yana da tasiri a haɗe tare da bile acid sequestrants ko a cikin monotherapy. A cikin marasa lafiya da ke karbar magani tare da gemfibrozil, cyclosporine, nicotinic acid ko wasu fibrates (fiye da 1 g kowace rana), kashi na farko shine 5 MG. Matsakaicin izinin maganin yau da kullun shine 10 MG. Ba a bada shawarar karuwa da kashi daya ba.

A cikin marasa lafiya lokaci guda suna ɗaukar verapamil ko amiodarone, kashi na yau da kullum na miyagun ƙwayoyi bai kamata ya wuce 20 MG ba.

Pharmacodynamics

Simvastatin - abu mai aiki na Vasilip, wakili ne na rage kiba, wanda aka samu ta hanyar kayan aikin Aspergillus terreus.

Bayan gudanarwar baka, simvastatin, wanda yake shi ne lactone mara aiki, ana yin gwajin hydrolysis a cikin hanta, tare da samar da tsari mai dacewa na β-hydroxy acid na abu. Babban metabolite ne kuma yana da babban aiki mai hana mutum aiki da HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) -reductase, enzyme wanda ke ɗaukar kwayar halitta (farko da mafi mahimmancin mataki) na cholesterol.

Ingancin simvastatin a rage yawan tasoshin plasma na jimlar cholesterol, yawan kumburi, LDL cholesterol, low low lipoprotein cholesterol, triglycerides da low low yawa na lipoprotein cholesterol, da kuma ƙara HDL cholesterol (babban lipoprotein cholesterol) yawa) a cikin jini na plasma a cikin marasa lafiya da heterozygous familial / ba dangi na hypercholesterolemia ko hadewar hyperlipidemia a cikin lokuta yayin da yawan ƙwayar plasma na cholesterol a cikin jini na daga cikin abubuwan S hadarin da yin nishaɗin abinci ɗaya bai isa ba. Ana lura da tasirin warkewa a cikin kwanakin 14 na shan simvastatin, mafi girman a cikin makonni 4-6 daga farkon amfani. Tare da ci gaba da jiyya, sakamakon ya ci gaba. Yawan plasma na cholesterol bayan dakatar da amfani da simvastatin a cikin jini ya koma darajar sa ta asali, wanda aka lura kafin fara magani.

Tsarin aiki mai aiki na simvastatin shine takamaiman mai hana HMG-CoA reductase (wani enzyme wanda ke ɗaukar amsawar samuwar mevalonate daga HMG-CoA). Koyaya, gudanar da magungunan warkewar abubuwan bai haifar da cikakkiyar hanawa na rage girman HMG-CoA ba, ta hakan ne yake iya samar da adadin mevalonate na kayan tarihi. An yi imanin cewa yin amfani da vasilip kada ya haifar da tarin ƙwayoyin cutar mai guba a cikin jikin mutum, tunda farkon matakin ƙirar halitta na cholesterol shine sauyawar HMG-CoA zuwa mevalonate. Bugu da ƙari, akwai haɓakaccen haɓakar metabolism na HMG-CoA zuwa acetyl-CoA, wanda ke shiga cikin ayyukan biosynthesis da yawa a cikin jiki.

Cholesterol tsari ne na gaba na dukkanin kwayoyin halittun steroid, kuma ba a lura da sakamakon asibiti na simvastatin akan steroidogenesis ba. Tun da Vasilip ba ya haifar da karuwa a cikin lithogenicity na bile, sakamakonsa game da karuwar haɗarin cholelithiasis ba zai yiwu ba.

Simvastatin yana taimakawa rage yawan haɓaka da al'ada na LDL cholesterol a cikin jini na jini. Samuwar LDL ta fito ne daga VLDL (lipoproteins mai yawa sosai). LDL catabolism ana aiwatar dashi musamman tare da taimakon babban mai karɓar LDL mai karɓa. Hanyar rage yawan kwantar da hankali na LDL cholesterol a cikin jini na jini bayan shan simvastatin na iya zama saboda duka raguwa a cikin ƙwayar plasma na ƙwayar VLDL cholesterol a cikin jini da kunnawa masu karɓa na LDL. Saboda wannan, akwai raguwa a cikin samuwar da kuma ƙara yawan catabolism na LDL cholesterol. Lokacin yin jiyya tare da simvastatin, ƙwayar plasma na apolipoprotein B (apo B) a cikin jini kuma yana raguwa sosai. Tunda kowane ƙwayar LDL tana ɗauke da ƙwayar apo B guda ɗaya, kuma ana samun ƙananan apo na B a cikin sauran lipoproteins, ana iya ɗauka cewa simvastatin, ban da haifar da asarar cholesterol a cikin ƙwayar LDL, yana taimakawa rage ƙwayar plasma na yada ƙwayar LDL a cikin jini.

Simvastatin shima yana kara maida hankali ne ga HDL cholesterol kuma yana rage yawan TG a cikin jini na jini. Sakamakon wannan alaƙar, LDL-C / HDL-C da HDL / HDL-C suna raguwa.

Tare da cututtukan zuciya da jijiyoyin zuciya (cututtukan zuciya) da farawa na jimlar kwayar cutar 212-309 mg / dL (5.5 zuwa 8 mmol / l), simvastatin yana taimakawa rage haɗarin mace-mace gaba ɗaya, mace-mace daga cututtukan zuciya, da kuma haɗarin rashin ƙwaƙwalwar ƙwayar cuta marasa ƙarfi. Hakanan, sinadarin yana rage yiwuwar buƙatar ayyukan tiyata don dawo da hawan jini na ƙwayar cuta (alal misali, jijiyoyin jijiyoyin zuciya jijiyar buguwa ko ƙwayar jijiyoyin jijiyoyin bugun zuciya). A ƙarshen asalin ciwon sukari mellitus, da yiwuwar bayyanar manyan rikicewar jijiyoyin jiki yana raguwa. Haka kuma, yayin aikin simvastatin, hadarin kamuwa da cututtukan cututtukan cututtukan mahaifa (wadanda suka hada da bugun jini da cututtukan cututtukan jijiyoyin jiki) suna raguwa sosai.

Akwai shaidar ingancin simvastatin a cikin marasa lafiya da / ba tare da hyperlipidemia ba, waɗanda ke cikin haɗarin haɓaka cututtukan zuciya na zuciya sakamakon kamuwa da cututtukan ƙwaƙwalwa na mellitus, tarihin bugun jini da sauran cututtukan jijiyoyin bugun gini.

Tare da yin amfani da Vasilip a cikin kashi 40 na yau da kullun na 40 MG, yawan mace-mace, haɗarin mutuwa yana da alaƙa da cututtukan zuciya na zuciya, haɗarin manyan rikice-rikice na ciki (ciki har da rashin lalacewar myocardial infarction ko mutuwa da ke da alaƙa da cututtukan zuciya), buƙatar buƙatun ayyukan tiyata don dawo da hawan jini na jini an rage su. (gami da aikin jijiyoyin zuciya jijiya grafting da percutaneous transluminal angioplasty), da kuma zubar jini na gefe da sauran nau'ikan farfadowa na jijiyoyin zuciya, hadarin bugun jini, yawan bugun asibiti don se bugun zuciya.

An rage yiwuwar manyan cututtukan jijiyoyin jiki / na jijiyoyin jini a cikin marasa lafiya da / ba tare da cututtukan jijiyoyin zuciya ba, ciki har da marasa lafiya da cututtukan jijiyoyin jiki, ciwon sukari na mellitus, ko cututtukan cerebrovascular. A cikin ciwon sukari na mellitus, Vasilip yana taimakawa rage haɗarin mummunan rikice-rikice na jijiyoyin jiki, gami da buƙatar ayyukan tiyata don yankewar ƙananan ƙarshen, dawo da hawan jini na yanki, da kuma faruwar cututtukan trophic.

Dangane da cututtukan jijiyoyin zuciya, simvastatin farji yana rage jinkirin ci gaban cututtukan ƙwayoyin cuta na atherosclerosis da kuma bayyanar da sabbin wuraren atherosclerosis da kuma sabon tasirin, yayin da marasa lafiya ke samun daidaitaccen aikin nuna alamun ci gaba na cutar atherosclerotic na cututtukan jijiyoyin zuciya.

Pharmacokinetics

Simvastatin shine lactone mara aiki. Abubuwa da sauri hydrolyzes, tare da juyawa zuwa ga simvastatin β-hydroxy acid (L-654.969), wanda yake shi ne mai hana inhibition na HMG-CoA reductase. Babban metabolites na simvastatin a cikin plasma shine β-hydroxy acid na simvastatin (L-654.969) da abubuwan 6'-exomethylene, 6'-hydroxy da 6'-hydroxymethyl.

Tabbatarwa don ƙididdigar ƙididdigar yawan nazarin duka magunguna na β-hydroxy acid metabolites (inhibitors na aiki) da masu hana aiki / latent inhibitors (duk masu hana ruwa gudu) waɗanda aka kafa sakamakon hydrolysis shine hanawar HMG-CoA reductase. Lokacin da ake shigar da simvastatin a cikin jini na jini, ana ƙaddara nau'ikan metabolites biyu.

Hydrolysis na simvastatin yana faruwa yawancin lokaci yayin farkon hanyar ta hanta, sabili da haka, ana lura da ƙaramin plasma na simvastatin mara canzawa a cikin jinin mutum (14 C wanda aka yiwa simvastatin + 14 C wanda aka yiwa simvastatin metabolites) a cikin sa'o'i 4. Sannan a cikin awanni 12 yana ragewa da sauri zuwa kusan 10% na matsakaicin darajar. Duk da gaskiyar cewa adadin maganin warkewa na simvastatin yana daga 5 zuwa 80 MG kowace rana, yanayin layi na bayanin martaba na AUC (yankin da ke ƙarƙashin tsarin lokaci-lokaci) na aikin metabolites mai aiki a cikin jimlar yawan jini yana lura da karuwar allurai zuwa 120 mg.

Kimanin kashi 85% na kashin simvastatin an karɓa. Cin abinci (a matsayin wani ɓangare na daidaitaccen tsarin abinci na hypocholesterol) nan da nan bayan shan simvastatin ba ya shafar bayanin martaba na magani.

An ƙaddara mafi girman yawan simvastatin a cikin hanta (idan aka kwatanta da sauran kyallen takarda).

Natsuwa a cikin tsarin kewaya na aiki na metabolite na simvastatin L-654.969 shine kashi 60% cikin maza).

Ba a yi nazarin yiwuwar shigarwar cikin abu ta hanyar kwakwalwar jini da shingen jini ba.

Simvastatin yayin farkon hanta ta hanta yana metabolized, daga baya an cire kayan kuma abubuwan sa suna faruwa tare da bile.

Lokacin ɗaukar 100 MG na simvastatin 14 C, abu mai alama ya tara a cikin jini na jini, da feces (kusan 60%) da fitsari (kusan 13%). A cikin feces, ana sa wa simvastatin mai alama wakilcin samfuran samfuran simvastatin, waɗanda aka fesa a cikin bile, kuma ba a sanye su da simvastatin ba. Kasa da kashi 0,5% na abubuwanda aka yarda da abubuwan da aka yiwa alama ana samo su a cikin fitsari azaman metabolites mai aiki na abu. A cikin plasma, 14% da 28% na AUC yana faruwa ne saboda masu hana aiki kuma duk masu hana HMG-CoA reductase bi da bi. Wannan yana nuna yawancin samfuran metabolism na simvastatin marasa aiki ne ko rauni masu hanawa na HMG-CoA reductase.

Ba a lura da karkatacciyar karkatuwa game da daidaito tsakanin kungiyar ta AUC a yawan zubar jini tare da karuwar allurai a cikin kashi 5-120 mg. Tare da ɗayan guda ɗaya da maimaita kullun na simvastatin, sigogi na pharmacokinetic sun nuna rashi tarin tara abu a cikin kyallen takaddama yayin amfani da maimaituwa.

A cikin gazawar koda mai rauni (a cikin marasa lafiya tare da sharewar 10 na kwayar 10 a rana, idan ya cancanta, an wajabta maganin ta hankali,

Vasilip, umarnin don amfani: hanyar da sashi

Ana ɗaukar allunan Vasilip a baki, sau 1 a rana, da yamma. Shawarwarin da aka ba da shawarar yau da kullun sun bambanta daga 5 MG zuwa 80 MG.

Mafi sau da yawa, ana sanya magani a cikin kashi na farko na 10 MG. Dole ne a aiwatar da canje-canje na sashi tare da tazara tsakanin aƙalla makonni 4. Matsakaicin adadin yau da kullun (80 MG) ana bada shawara ne kawai ga marasa lafiya da mummunar cutar hypercholesterolemia ko kuma babban haɗarin haɓaka rikitarwa na zuciya. Tsawon likitan likitan mata an yanke shi ne daban-daban ta hanyar likitocin da ke halartar taron.

A duk tsawon lokacin da ake amfani da shi, dole ne mai haƙuri ya bi tsarin abinci na hypocholesterol. Yawan shawarar farawa shine 10 MG. Don ƙarin bayyananniyar matakin LDL-C (fiye da 45%), zaku iya fara shan Vasilip tare da 20-40 MG sau ɗaya a rana, da maraice.

An ba da shawarar marasa lafiya tare da maganin hyzycholesterolemia na homozygous don ɗaukar 40 MG sau ɗaya a rana, da maraice. Zai yuwu a yi amfani da allurai 3 - da safe da yamma, 20 MG da 40 MG da yamma. Ana ba da shawarar Vasilip ga irin waɗannan marasa lafiya a hade tare da sauran hanyoyin rage ƙwayar lipid (alal misali, LDL apheresis).

A cikin rigakafin cututtukan zuciya:

Tare da babban haɗarin kamuwa da cututtukan zuciya na zuciya (tare da ko ba tare da hyperlipidemia ba), an tsara 20-40 na Vasilip kowace rana. Kashi na farko shine 20 MG, karuwa a cikin kashi ya kamata ya faru tare da tazara tsakanin aƙalla makonni 4. Matsakaicin adadin yau da kullun shine 40 MG. Lokacin da abun ciki na LDL ya zama ƙasa da 75 mg / dl (1.94 mmol / L), yawan abubuwan cholesterol bai wuce 140 mg / dl (3.6 mmol / L) ba, ya kamata a rage yawan sashi.

Vasilip yana da tasiri a cikin monotherapy ko kuma a lokaci guda tare da jerin abubuwan bile acid (alal misali, colestiram da colestyramine). A cikin marasa lafiya da ke karbar magani tare da gemfibrozil, cyclosporine, sauran fibrates ko nicotinic acid (fiye da 1 g kowace rana), ana ba da shawarar farawa tare da 5 MG kowace rana, matsakaicin adadin yau da kullun shine 10 MG. A irin waɗannan yanayi, ba a shawarar ƙarin kara kashi ba.

A cikin marasa lafiya da suke karɓar verapamil ko amiodarone, kashi na yau da kullun na vasilip bai wuce 20 MG ba.

A cikin marasa lafiya da mummunan gazawar renal (CC kasa da 30 ml / min), shawarar da aka bayar na yau da kullun na Vasilip bai wuce 10 MG ba. Idan kana buƙatar ƙara yawan kashi, ana buƙatar kulawa da kulawa da hankali.

Marasa lafiya tare da gazawar ƙarancin ɗan ƙasa da tsofaffi ba sa buƙatar daidaita sashi.

Haihuwa da lactation

Ba a sanya allurar a lokacin daukar ciki / lactation ba.

Lokacin da ciki ya faru, ya kamata a dakatar da amfani da simvastatin nan da nan. Matan da suka isa haihuwa, Vasilip za a iya rubutasu ne kawai a lokutan da yiwuwar samun juna biyu yayi kankanta. Magungunan shan magani a lokacin daukar ciki na iya haifar da raguwa a cikin taro na mevalonate (wani tsinkaye a cikin cholesterol biosynthesis) a cikin tayi. Atherosclerosis ana ɗaukarsa cuta ce ta jiki, kuma yawanci karɓar magunguna masu rage ƙwayar lipid a lokacin daukar ciki baya tasiri sosai game da haɗarin da ke tattare da cutar rashin ƙarfi na lokaci mai tsawo. Dangane da wannan, bai kamata a sanya simvastatin ga mata masu juna biyu ba, masu son yin juna biyu ko zargin cewa suna da juna biyu. Yakamata a dakatar da maganin tiyata a duk tsawon lokacin daukar ciki ko har sai an gano ciki, kuma yakamata a yiwa matar da kanta gargadi game da hadarin da ke tattare da tayin.

Babu wata shaidar da ta tabbatar ko musanta fitar da sinadarin simvastatin da metabolites dinsa da madara.

Farashi don vasilip a cikin kantin magunguna a Moscow

Abubuwan haɗin gwiwa:

• masu hana ƙarfi na CYP3A4 isoenzyme (itraconazole, telithromycin, ketoconazole, posaconazole, clarithromycin, voriconazole, erythromycin, HIV masu hana masu cutar HIV, boceprevir, nefazodone, telaprevir dauke da haɗarin cutar da ita, an:
• gemfibrozil, danazol ko cyclosporine.

Likitoci sun sake dubawa game da vasilip

Akwai lokacin da likitoci da yawa (ba magani ba!) Ana ɗaukar 10 mg na vasilip don zama ingantaccen magani ga cututtukan da ke hade da atherosclerosis. Wannan lokaci ya wuce. Simvastatin a cikin kowane nau'i ba a ɗaukarsa azaman magani wanda zai ba ku damar cimma mahimman matakan zamani na cholesterol da sauran lipids.

Don haka, idan likita yanzu yana rubuta simvastatin (ciki har da vasilip), Ni kaina ban fahimci dalilin da ya sa ya yi watsi da ƙarin gumakan zamani ba tare da ingantaccen tasiri da waɗanda ke da aminci.

Lokaci ya yi da za a manta game da simvastatin. Kuma ta hanyar, menene wannan rashin fahimta cewa gumaka bai kamata a ɗauki fiye da makonni ba? An ɗauke su tsawon shekaru da shekarun da suka gabata, kuma kowane ƙarin shekara ta shigo yana kawo ƙarin fa'ida ga marasa lafiya, da kamfanonin magunguna, ba shakka, suma.

Vasilip haƙuri sake dubawa

Ina ɗaukar "Vasilip" 10 mg koyaushe don kwamfutar hannu 1 da yamma, Ina ɗaukar gwaje-gwaje don cholesterol sau ɗaya a kowane watanni uku. Sakamakon yana da kyau kwarai da gaske. Akwai wani yunƙurin da baiyi nasara ba don canzawa zuwa takwarancin gida mai rahusa. Cholesterol ya tashi, ya koma "Vasilip". Tare da fensho, siye yana da tsada, amma lafiyar ta fi tsada.

Mai ba ni shawarata na ya shawarce ni "Vasilip" don asarar nauyi, bayan tattaunawa da likita, sai na haɗo tare da rage cin abinci. Abin mamaki, sakamakon ya kasance tabbatacce, ko da yake ban tabbata gaba ɗaya cewa shafuka zasu taimaka ba! An ɗauki makonni 5-6, ba ƙari! Kwayoyin suna rage cholesterol a cikin jini, wannan shine dalilin da yasa irin wannan sakamako!

Pharmacology

Simvastatin kuma yana rage mahimmancin abubuwan apolipoprotein B, a matsakaici yana kara maida hankali ne akan HDL-C da rage yawan ƙwayoyin plasma na TG. Sakamakon wadannan tasirin simvastatin, yawan jimlar Chs zuwa duka Chs-HDL da Chs-LDL zuwa Chs-HDL yana raguwa.

Sakamakon antiatherosclerotic na simvastatin sakamako ne sakamakon tasirin magani a jikin bangon jijiyoyin jini da abubuwan haɗin jini. Simvastatin yana canza metabolism na macrophages, yana hana kunna macrophages da lalata filayen atherosclerotic. Magungunan yana hana kwayar halitta mai suna isoprenoids, waɗanda sune abubuwan haɓakawa a haɓaka ƙwayoyin tsoka mai santsi na jijiyoyin jini. Karkashin tasirin simvastatin, haɓaka endothelium da ke dogara da jijiyoyin jini yana inganta.

Sakamakon warkewa yana faruwa bayan makonni 2, ana lura da mafi girman sakamako bayan makonni 4-6 na magani.

Haɗa kai

Yin amfani da simvastatin tare da fibrates, nicotinic acid (fiye da 1 g / rana) yana ƙara haɗarin haɓakar cutar mahaifa, gami da rhabdomyolysis (tare da amfani da lokaci guda tare da fenofibrate, babu wata shaida ta haɓakar haɗarin cutar myopathy idan aka kwatanta da monotherapy tare da kowane magani daban).

Amfani da haɗin gwiwa tare da gemfibrozil na iya haifar da karuwa a cikin yawan simvastatin a cikin serum.

CYP3A4 cytochrome inhibitors (itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, masu hana HIV kariya da nefazodone), suna haɗuwa da haɓaka metabolism na simvastatin zuwa hanta, ƙara haɗarin cutar rashin hankali da rhabdomyolyatin yayin jiyya tare da simv. Amfani da kwanciyar hankali tare da waɗannan magunguna yana karɓa.

Tare da taka tsantsan, ya zama dole a rubuto lokaci guda tare da ƙarancin masu hana CYP3A4 mai ƙarfi: cyclosporine, verapamil da diltiazem. Aikin yau da kullun na simvastatin yayin shan shi tare da cyclosporine bai kamata ya wuce 10 MG ba. Aiki na yau da kullun na simvastatin tare da gudanarwa na lokaci guda na amiodarone ko verapamil bai kamata ya wuce 20 MG ba, kuma 40 MG tare da kulawa na lokaci guda na diltiazem, sai dai idan an sa rai sosai a fili ya wuce haɗarin haɓakar cutar myopathy da rhabdomyolysis.

Simvastatin a kashi 20-40 mg / rana a cikin masu ba da agaji da marasa lafiya tare da hypercholesterolemia potentiates sakamakon coumarin anticoagulants (misali warfarin), musamman karuwa a cikin prothrombin lokaci, MHO. Sabili da haka, a cikin marasa lafiya da ke shan maganin anticoagulants na coumarin, lokacin prothrombin da MHO ya kamata a ƙaddara su kafin fara aikin simvastatin, a farkon lokacin jiyya, lokacin canza kashi na simvastatin ko dakatar da magani. Bayan isa mai nuna tabbataccen lokacin prothrombin da MHO, yakamata a ƙara sa ido a cikin tsaka-tsakin da aka ba da shawarar ga marasa lafiya da ke karɓar maganin anticoagulant. Yin maganin Simvastatin baya haifar da canje-canje a cikin lokacin prothrombin da haɗarin zub da jini a cikin marasa lafiya ba shan magungunan anticoagulants.

Ruwan innabi ya hana ayyukan CYP3A4 aiki. Yawancin ruwan 'ya'yan itacen innabi guda (fiye da lita 1 a rana) kuma simvastatin yana haifar da ƙaruwa mai yawa a cikin ƙwayar plasma na simvastatin acid. Sabili da haka, yayin jiyya tare da simvastatin, ya kamata a guje wa ruwan 'ya'yan itacen innabi.

Umarnin don amfani da vasilip (hanya da sashi)

Ga waɗanda aka rubuta Vasilip, umarnin yin amfani da rahoton cewa an karɓa baki, da yamma, lokaci 1 a rana.

Yawancin yau da kullun shine 5-80 MG. A matsayinka na mai mulki, an tsara 10 MG. Dole a aiwatar da gyaran sashi na karamin lokaci tsakanin makonni 4. Aikin yau da kullun kada ya zama ya wuce 80 MG. Ana amfani da mafi girman sashi ne kawai ga mutanen da ke da rauni hypercholesterolemia ko kara yiwuwar faruwar hakan rikitarwa na zuciya. Umarnin don amfani da Vazilip ya ba da rahoton cewa ƙwararren likita ya ƙaddara ta hanyar kwararru a kowane yanayi daban-daban, gwargwadon menene alamun amfani da yadda mai haƙuri yake haƙuri da maganin.

Idan akwai wani hypercholesterolemia Dole a gudanar da al'ada Abincin hypocholesterol a lokacin jiyya. Sigar farko a cikin mafi yawan lokuta shine 10 MG. Don ƙarin raguwa mai mahimmanci LDL cholesterol ana iya fara karatun tare da 20-40 mg / day.

A Hyzycholestus hypercholesterolemia yawanci shan 40 MG ko 80 MG kowace rana, amma a cikin allurai uku (yawanci 20 mg da safe da yamma da kuma wani 40 mg da yamma). Zai bada shawara a hada maganin tare da wani ragewan lipidyana nufin.

Don hana ci gaban cututtukan zuciya a cikin mutane masu haɗarin gaske Ciwon zuciya na Ischemic wajabta daga 20 zuwa 40 MG / rana. Sashi na miyagun ƙwayoyi, wanda aka zaɓa daban-daban, an rage idan matakin LDLkasa da 75 mg / dl da jimlar cholesterolkasa da 140 mg / dl.

Za'a iya amfani da Vasilip a tare tare da jerin bile acid. Marasa lafiya suna cikin jiyya fibrates ko nicotinic acid, ɗauki matakin farko na 5 MG. Matsakaicin adadin yau da kullun kada ta fi 10 MG. Kuma idan aka hada shi Amiodarone ko Verapamil kada ku wuce sashi na 20 MG.

Tare da mai tsanani na gazawar zai fi kyau kada ku wuce kashi 10 na MG / rana. Idan haɓaka yawan sashi har yanzu wajibi ne, dole ne a kula da yanayin haƙuri koyaushe.

Sauran mu'amala da miyagun ƙwayoyi:

• gemfibrozil da sauran fibrates (ban da fenofibrate), fusidic acid: haɓakar yiwuwar haɓakar ciwon zuciya,
• amiodarone, lomitapide, jinkiri mai hana tashar alli (verapamil, diltiazem ko amlodipine), nicotinic acid a cikin rage ƙarancin liba (aƙalla 1000 MG kowace rana): haɓaka yiwuwar haɓaka myopathy / rhabdomyolysis,
• matsakaici mai hanawa na CYP3A4 isoenzyme (misali, dronedarone, ranolazine): yana iya ƙaruwa da yiwuwar kamuwa da ciwon sanƙuwar zuciya, ana iya rage kashi na Vasilip,
• OATP1B1 masu hana protein gina jiki: karuwar yawan plasma na simvastatin hydroxy acid da kuma yiwuwar bunkasa cutar mahaifa,
• colchicine (a cikin marasa lafiya tare da gazawar koda): ƙarancin haɗarin haɓakawa da rhabdomyolysis, haɗuwa gaba ɗaya yana buƙatar kulawa da hankali ga marasa lafiya
• anticoagulants kai tsaye (abubuwan da aka kirkiro coumarin): karuwa a cikin lokacin prothrombin, wanda aka ayyana shi a matsayin MHO (ƙaddarawar ƙayyadaddun ƙasashen duniya), ana sarrafa ƙimar ma'anar kafin farawa tare da simvastatin, to, an ƙaddara shi sau da yawa a cikin lokacin farawa, wanda ke ba da damar cire manyan canje-canje a MHO. Bayan ya kai ga tabbataccen lokaci na prothrombin, ya kamata a aiwatar da ƙarin ƙaddararsa a tsaka-tsakin shawarar da aka ba da shawarar kula da marasa lafiya da ke karɓar maganin anticoagulant. A cikin yanayin canza sashi na simvastatin ko bayan an cire shi, ana kuma shawarar yin amfani da ma'auni na yau da kullun wannan alamar. A cikin marasa lafiya waɗanda ba su shan maganin anticoagulants, ba da magani tare da simvastatin tare da bayyanar zub da jini ko canje-canje a cikin lokacin prothrombin ba su da alaƙa,
• ruwan 'ya'yan innabi (a manyan girma): karuwar aikin plasma na HMG-CoA reductase inhibitors.

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

Ciki

Don haka bai kamata mata masu juna biyu da matan da ke kokarin yin juna biyu su yi amfani da simvastatin ba ko kuma suke zargin suna da juna biyu.
Amincewa da simvastatin ya kamata a dakatar da shi tsawon tsawon ciki ko har sai an tabbatar cewa mace bata da ciki (duba sashe na "Contraindications").
Yin amfani da simvastatin a cikin mata yayin shayarwa yana contraindicated.
Ba'a san ko simvastatin ko metabolites dinsa ya wuce cikin madara ba. Tunda kwayoyi da yawa sun shiga cikin madarar nono kuma akwai yiwuwar mummunan sakamako masu rauni, mata masu shan simvastatin su daina shayar da nono. (Dubi sashin "Contraindications").