Vazilip, nā Lūkiniʻāina Lūkini me nā kumukūʻai a me nā loiloi

- ʻO ka hypercholesterolemia mua o nā ʻano IIa a me IIb, e komo pū ana me ka polygenic hypercholesterolemia, he hepolyoliona he hemozygous ʻōwili a me ka hyperlipidemia i hui ʻia. Hoʻohana ʻia ka lāʻau lapaʻau e like me ka monotherapy i nā hihia i nele ka ʻai a me nā ʻano lāʻau ʻē aʻe.

- ka hōʻemi o ka maʻi cardiovascular a me ka morbidity i nā poʻe maʻi me nā hōʻike o ka maʻi o nā maʻi cardiovascular atherosclerotic a i ʻole ka maʻi diabetes, me nā pae kolamu maʻamau a hoʻokiʻekiʻe ʻia paha a ma ke ʻano hana hou e hoʻoponopono ai i nā mea pilikia ʻē aʻe a me ka maʻi cardioprotective.

Kūkākūkā e pili ana i ka lāʻau Vasilip i nā moʻolelo o nā makuahine

. ^ E Ha yM. Māhuahua ʻo Tformin i nā momona fibrinolytic o ke koko ma ka paʻa ʻana i kahi kiko-type plasminogen activator inhibitor. "ʻ saidlelo ʻia ʻo G e hoʻonui ʻia ka kolamu. Inā ʻaʻole e emi, a laila ʻo Vasilip. He nui hoʻi koʻu koko - hemoglobin-154.

. ^ E Ha yM. Inā ʻoe e lawe i ka paʻakikī o Oksilik, ʻaʻole ia e hoʻemi i ka nui, akā e loaʻa iā ʻoe ka hoʻāʻo iā l-thyroxine Metformin i mea e hoʻomaʻamaʻa ai i ka ʻaila metabolism a me ka hoʻohana ʻana i ka glucose. ʻAʻole nō ʻo Vasilip i hoʻopakele iaʻu - ua inu wau iā Roxer no nā mahina he 3. ʻO kēlā mau ʻano o nā pēpē, ma ke ʻano o yarins, jannins a me diana - e hōʻohi wale nei i kou mau ʻihi, akā ʻaʻole ia e pili i ke kiʻekiʻe kiʻekiʻe o LH, ʻoiai ka mea i loaʻa ka prolactin OKe, ʻo ia hoʻi ka nui)) ) Pono ʻāpono ʻo Utrozhestan e palau inā ʻaʻole pono hoʻokahi, ʻaʻohe ʻelua. Nā kaola mau i ka hoʻomaka mua o ka mana glutamic i ʻekolu mau manawa i ka lā ma kahi papa mai 5 a 15 DC + foil + iodine, a mai 16 a 2.

2. Nā ʻōmole

E like me nā ʻōlelo i hoʻohālikelike ʻia, vasilip:

• nā maʻi āpau ʻē aʻe i ka hana ikaika,
• ka hana hoʻonui nui o ka transaminases o nā kumu ʻike ʻole,
• ua hoʻohana me ka vasilip a me nā pale,
• hypersensitivity o nā mea i kūkulu ʻia o ka lāʻau lapaʻau,
• hapai.

Hoʻomaopopo ʻia ka hoʻomaʻemaʻe e hoʻohana i ka lāʻau lapaʻau i nā ʻoihana aʻe:

• i mua o ka mōʻaukala o ka maʻi maʻa,
• me nā hana koʻikoʻi ikaika o ka ʻoihana endocrine,
• me nā maʻi metabolic
• me nā maʻi ʻino, no ka laʻana, me ka sepsis,
• me ka hypotension arterial (kaomi ma luna o ke kahua paʻa)
• me nā pōʻino a me nā hōʻiliʻili o nā ʻano kumu like ʻole,
• me kahi palapala e kū ʻole ʻole i ka epilepsy,
• me ka myopathy (i kapa ʻia ʻole ka maʻi, ka hoʻomau ʻia o ka maʻi ʻōlaʻi, a ma ka hopena o ke ʻano o ka metabolism ma loko o nā kōpio o ka ʻiʻo).
• i ka wā o ka hōʻiliʻili o ka maʻi,
• me ka hana ino ana i ka wai inu wai.

3. Nā hopena maikaʻi

Hiki i Vasilip ke kau i nā hopena maikaʻi ʻole i ka kino o ke kanaka, ka mea maʻamau i ka mea:

Anemia, acute renal gagal, palpitations, hoʻemi i ka hana moʻo wahine ke loaʻa.

4. Ke ʻano o ka hoʻokele o ka lāʻau lapaʻau

Lawe ʻia ka Vasilip i ka maʻi, a hiki ke kau ʻia ke ʻano ma muli o nā hōʻike a me ke ʻano o ka maʻi mai 5 a 80 mg (ʻoi paha ka nui o ka nui e hoʻohana ʻia no ka mālama ʻana i ka hypercholesterolemia koʻikoʻi a i ʻole he ke kōpaʻa koʻikoʻi o ka hoʻopiʻi ma ka hana paʻa o ka papa o ka puʻuwai.

Kahi ʻia ka lōʻihi o ka hoʻokomo ʻana e ke kauka hele mai. ʻO ka dosis maʻamau he 10 mg o hoʻokahi mahele i kēlā me kēia lā, a e like me nā hōʻike ʻana ma kēia ʻano he nui i hoʻonui ʻia ʻo 2-8 mau manawa.

E hoʻololi i ka nui o nā lāʻau lapaʻau ma mua o 1 mau manawa i ka mahina.

5. Ka Hoʻohui Pūleʻa

1. Hiki i kēia lāʻau lapaʻau ke hoʻoikaika i ka hopena o nā anticoagulants, ʻaʻole hiki i nā mea hoʻowalewale.
2. Hoʻonui ia i ke kao o Digoxin i loko o ke koko, no laila, pono nā poʻe maʻi me nā lāʻau e nānā ʻia e nā kauka.

ʻO ka hoʻokele waʻa me ka cytostatics a me nā mea antifungal (ketoconazole, Itraconazole), fibrates, nā koina kiʻekiʻe o ka waikawa nikotinic, immunosuppressants, a me ka inhibitor protease e hoʻonui nui i ka hopena o ka rhabdomyolysis.

6. Hāpiha

Aia kahi mau mea e oi aku i ka hopena o Vasilip, eia naʻe, ʻaʻole lākou i hopena i nā hopena koʻikoʻi a me nā hōʻino koʻikoʻi. ʻOiai ʻo kēia, inā kahi overdose o ka lāʻau lapaʻau, pono pono e lawe i ka enterosorbents a holoi i ka ʻōpū, a me ke nānā aku ʻana i nā ʻōnaehana o ke kino, ʻo ia hoʻi, no ka ʻōpio a me nā aʻa.

7. E hoʻokuʻu i ke ʻano a me ke ola noho

ʻO ka lāʻau lapaʻau e hana ʻia e ka ʻoihana lāʻau lapaʻau ma ke ʻano o nā papa i kau ʻia i nā kiʻi ʻoniʻoni ma waho.

Hiki i hoʻokahi papa pākē i nā ʻokoʻa like ʻole - 10 mg, 20 mg, 40 mg.

I ka pā - 14 a 28 mau ʻāpana.

ʻO 3 mau makahiki kahi e noho ai ke ola o Vasilip.

Nā analog e pili ana i ka lāʻau lapaʻau Vasilip:

I loko o ke pūnaewele kūʻai olakino, kūʻai ʻia ka lāʻau lapaʻau ma nā kumukūʻai i lalo aʻe (ma muli o ke ʻano)

• i Lūkia - mai 328 a 587 mau rubles,
• i Ukraine - mai 82 a 148 hryvnias.

ʻO nā mea maʻi i lawe i kēia lāʻau lapaʻau ka mea i kahaki i ka kolamu o ke koko, amelioration o ke kūlana maʻamau, a me ka hana lōʻihi o ka lāʻau.

Eia naʻe, hōʻike kēia i kahi hōʻike o nā hopena maikaʻi ʻole e nalowale ma hope o ka pau ʻana o ka lawe ʻana iā Wazilip. Hiki iā ʻoe ke heluhelu i ka kikoʻī o nā loiloi o nā mea maʻi i hoʻohana iā Vazilip ma ka hope o ka ʻatikala.

11. Nā ʻōlelo ʻikepili kūikawā

1. Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me Vazilip, pono ʻoe e hana i kahi hoʻopaʻa noiʻi o nā ʻōhua hana o ka ate a nānā hou aku i ka hana o nā transaminases o kēlā me kēia 1.5-2 mahina. ʻO nā maʻi e loaʻa ana i ka simvastatin i kēlā me kēia lā ma kahi kikoʻī (80 mg) i nānā pinepine ʻia no ka hana o ka ate - hoʻokahi mau manawa i kēlā me kēia ʻekolu mahina. Me ka hoʻonui ʻana o ka hana o nā transaminases, hoʻopau ʻia ke ʻano ʻo Vasilip.
2. ʻO nā mea maʻi me ka myasthenia gravis, myalgia, a i ʻole me ka hana nui i hoʻonui ʻia ʻo ka CPK therapy me ka lāʻau lapaʻau i nīnau ʻia ua paʻa.
3. ʻAʻole ʻōlelo ʻia ʻo Simvastatin inā aia he ʻeha o ka rhabdomyolysis a i ʻole ka hopena ʻole (ma muli o ka hypotension arterial, maʻi ʻehaʻeha, hōʻeha hōʻeha metabolic, ʻeha).
4. Hoʻokomo nā mea i loko o Vasilip i ka hiki ʻana o ke kōpune, no laila, pono e haʻalele ʻia ka lāʻau lapaʻau no ka mālama ʻana i nā wahine hāpai. Inā hele a hānau ka wā hāpai i ka wā me ka Vazilip, a laila pau ka lāʻau.
5. Mālama ʻia ka lāʻau lapaʻau ma ka monotherapy a me ka hoʻohui pū ʻana me ka sequestrants o nā waikawa bile.
6. ʻO kahi kūlana kūpono no ke ʻano ʻo Vasilip ʻo ka mea maʻi ma ka ʻai cholesterol.
7. Inā pau ka wai o kēia manawa, pono ʻoe e lawe i nā hopena hou aʻe o ka lāʻau lapaʻau i ka hiki koke ʻole me ke kali ʻole.
8. Ma ka hihia o ka ʻeha ʻole i hoʻopili ʻia i loko o nā ʻōpū, ʻoi aku ka mea maʻi e kūkākūkā hou me ke kauka.

ʻO ka hana lāʻau lapaʻau ma ka lāʻau

ʻO ka hana ikaika o Vasilip he hopena lipid-hoʻohaʻahaʻa a hoʻohaʻahaʻa i ka cholesterol i loko o ke koko koko. Loaʻa ka lāʻau lapaʻau i ka maʻi puʻukui coronary, me ka hoʻēmi ʻana i ka hopena o ka myocardial infarction. Hoʻoulu ka hopena therapeutic o ka hoʻohana ʻana o vasilip i nā manawa he ʻelua pule, a ʻo ka nui ka nui ma hope o ka malama o ka hoʻohana ʻana i kēlā me kēia lā.

Eia kekahi, ʻo Vasilip, e like me nā loiloi, he hopena anti-atherosclerotic hoʻi, e hoʻopili ai i nā ʻāpana o ke koko a me nā paia kīʻaha koko.

Ma ke ʻano ka mea i hoʻolālā ʻia

Loaʻa Vasilip i ke ʻano o nā papa kiʻi ʻoniʻoni keokeo i loaʻa nā kinipōpō, 10, 20 a me 40 mg o ka mana simvastatin ikaika. 7 papa i kahi blister.

Inā pono, hiki ke hoʻololi ʻia ka lāʻau lapaʻau me kekahi o nā mea o Vazilip - simpleacor, avestatin, holvasim, atherostat, simvakard, actalipid, zokor, simgal, vasilip, zorstat, aries, simvor, simvagheksal, simvalimit, simvastatin, simlo, amiard or zovatin.

ʻAʻole hiki iā ʻoe ke koho

Wahi a nā ʻōlelo aʻo, ua contraindicated ʻo Vasilip no ka hoʻohana ʻana me:

• ʻO nā maʻi o ka puʻuwai ma ke ʻano ikaika, a me ka hoʻomau mau ʻana i ka hana o nā transaminases hepatic o ka etiology ʻike ʻole,
• ʻO ka hoʻokele ʻana me ka likitors o ka isoenzyme CYP3A4, e komo ana i ka erythromycin, itraconazole, clarithromycin, ketoconazole, inhibitor HIV protease, nefazodone a me telithromycin,
• Hypersensitivity i nā māhele o Vasilip.

Eia kekahi, ʻo ka lāʻau lapaʻau, e like me Vazilip analogues, ʻaʻole pono e hoʻohana i ka wā hapai, ma lalo o kona mau makahiki 18, i ka wā lactation, i ka wā e hoʻolālā ana i ka hāpai a i ʻole nā ​​mea i manaʻo ʻia.

Hoʻohana ʻia ʻo Vasilip me ka akahele:

• He mōʻaukala mahele o ka puʻuwai,
• ʻO ka endocrine endocrine a me ka hopena metabolic,
• ʻO nā maʻiʻeha koʻikoʻi, e komo pū me sepsis,
• Hipotina arterialia,
• Nā ʻeha
• ʻO ka epilepsy paʻa,
• Myopathy
• Hoʻopuka kūlia kaʻaila,
• Hoʻopau i ka waiʻona, ka mea ma mua o ka hoʻomaka ʻana i nā lāʻau lapaʻau,
• Lactase nele
• ʻO ka hemahema o nā electrolyte,
• ʻO Galactosemia aiʻole glucose-galactose malabsorption syndrome,
• ʻO ka hoʻokele māmā me ka cyclosporine, fenofibrate, gemfibrozin, verapamil, nicotinic acid, amiodarone, diltiazem a me ka wai huaʻala.

Ke ʻano o nā noi a vasilip

Wahi a nā ʻōlelo aʻoaʻo, lawe lima ʻia Vasilip i ke ahiahi, hiki i ka hopena hoʻohālikelike ʻia i ka maʻi mai ka 5 mg a hiki i ka 80 mg ka nui, ka mea i lawe wale ʻia me ka hypercholesterolemia koʻikoʻi a i ʻole kahi pilikia kiʻekiʻe o nā pilikia cardiovascular. ʻO ka lōʻihi o ka hoʻohana ʻana i ka vasilip e hoʻoholo kūʻokoʻa ʻia e ke kauka hele mai.

ʻO ka mea maʻamau, ma ka mālamaʻana i ka hypercholesterolemia, lawe ʻia ʻo Vasilip i 10 mg hoʻokahi manawa, e like me nā hōʻike ʻana, hiki ke hoʻonui ʻia i loko o ka hopena therapeutic 2 a i ʻole 4 mau manawa. Wahi a nā loiloi, e kūleʻa ana ʻo Vasilip i ka nānā ʻana i kahi kīʻaha hypocholesterol maʻamau i ka manawa o ka manawa mālama.

Me ka homozygous herpone hypercholesterolemia, ua koho ʻia ʻo Vasilip i ka 40 mg hoʻokahi i ke ahiahi a i ʻole 80 mg o ka lāʻau lapaʻau, kahele ʻia i 3 mau pākahi, i hui pū ʻia me nā maʻi hypolipidemic hou.

Me ka pilikia nui o ka hoʻomohala ʻana i ka maʻi naʻau coronary, lawe ʻia ʻo Vasilip i ka 20-40 mg i kēlā me kēia lā e like me ke kuhikuhi ʻana. Hiki iā ʻoe ke hoʻololi i ka kaumaha o ka lāʻau lapaʻau ʻaʻoleʻoi aku ma mua o hoʻokahi mahina.

Wahi a nā loiloi, kūpono ʻo Vasilip ma ka monotherapy a me ka hui pū me ka colestyramine, amiodarone, colestipol, gemfibrozil, cyclosporine a me nā fibrates a i ʻole ka nikotinic acid.

Ke hoʻohana nei iā Vasilip, ʻaʻole i ʻōlelo ʻia e hoʻopau i kahi nui (ʻoi aku ma mua o 1 lita) o ka wai ʻai.

Nā hopena hopena o vasilip

Wahi a nā loiloi, ʻaʻole alakaʻi ʻo Vasilip i ka hoʻomohala ʻana i nā hopena pili, i hōʻike ʻia e:

• ʻO ka pancreatitis, ka ʻeha o ka ʻōpū, constipation, nausea, flatulence, jaundice, dyspepsia, helehelena, ʻeha a me ka hepatitis,
• Paresthesia, peripheral neuropathy, blurred vision, convulsions, dizziness, asthenia, headache, insomnia a me ka pale hewa ʻana o nā ʻano naʻau,
• ʻO Rhabdomyolysis, myopathy, nā ʻōpū o ka kalamo a me ka myalgia,
• ʻO ka ʻōpū, ka alopecia, a me ka pruritus,
• ʻO ka ʻōpū, ka like me ka lupus like like, eosinophilia, nāwaliwali loa, ka angioedema, dermatomyositis, keʻala, ka piʻi ʻana o ka ESR, urticaria, polymyalgia rheumatism, vasculitis, thrombocytopenia, arthralgia, photosensitivity, flushing o ka maka a me ka pōkole o ka hanu,
• ʻAi ʻole ka hopena o ka renal, palpitations, anemia, a hoʻohaʻahaʻa i ka potency.

Vasilip - Nā ʻikepili e pili ana iā Vasilip

ʻO Vasilip kekahi lāʻau lapaʻau mai ka pūʻulu o nā statins, ʻo ia hoʻi nā lāʻau lapaʻau e hiki ke hoʻohaʻahaʻa i ka kolamu ma ke koko o ke kanaka. Hana ʻia ia ma ke kumu o simvastatin - kahi waiwai i loaʻa mai nā mea hana maoli kūlohelohe (mau huaʻai).

E like me nā mākaukau like, hiki i kekahi ke haʻi, no ka laʻana, ʻo Atoris, ka mea e pili ana i ka atorvastatin - he ʻano synthetic. Ua ʻike ʻia ka hopena o ka vasilip (i ka wā o ka mālama koko koko) i ʻelua mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana. Loaʻa ka hopena kiʻekiʻe o ka lāʻau ma hope o hoʻokahi mahina - hoʻokahi a me ka hapa.

Pehea ka hopena o ka lilo ʻana o ka cholesterol a me nā momona ʻē aʻe (ʻo ka triglycerides a pēlā aku) e pono ai ke nānā pinepine ʻana ma o ka hāʻawi ʻana i ke koko "no ka biochemistry". Hiki ke loaʻa nā hōʻailona no ke koho ʻana iā Vasilip a me nā ʻano hoʻoilina o ka hypercholesterolemia.

Eia kekahi, ʻo ka pale a me ka mālama ʻana i ka atherosclerosis, ka maʻi puʻuwai coronary, a me nā maʻi ʻē aʻe o ka maʻi i hoʻopili ʻia e nā momona koko e hiki ke kākoʻo ʻia e ka hoʻohana ʻana i kēia lāʻau.

Loaʻa ka Vasilip i ka ʻaoʻao pā. ʻO kahi kumuhana nui loa no ka koho lōlō ʻana o kahi mahele, i wehewehe ʻia e ka ʻōlelo a ka lāʻau lapaʻau. Hoʻomaka me ka hapa liʻiliʻi o Vazilip, pono ke mākaʻikaʻi ke kauka i ka pauku metabolic o ka mea maʻi a hana i nā loli i ka wā i koho ʻia (hoʻonui i ka momona) ʻaʻole i hoʻokahi manawa i hoʻokahi mahina.

Ma ka hoʻohālike, pono ka mea maʻi e hoʻopili i kahi meaʻai kūikawā, inā ʻaʻole he loiloi statin e nalo wale ana i ke ʻano.

Pono ke kauka kauka ʻo Vasilip i ka nānā pono ʻana i ka maʻi o ka mea maʻi a me ka olakino olakino, ʻike i nā lāʻau āna e lawe ai, a me ke ʻano o kona ʻano. Ke nānā nei i kā lākou hopena ma ke ʻano o ka manawa.

Ua hoʻohālikelike ʻia ka Vasilip i nā maʻi o nā keiki, ka ate, ka lihilahi ʻana o ke kanaka, ka hāpai ʻana a me ka lactation, nā keiki a me nā ʻōpio. Inā hoʻohana ka wahine i kēia lāʻau lapaʻau, pono ʻo ia e pale pono iā ia iho mai ka hapai ʻole ʻia. Inā hoʻolālā ka mea maʻi e hānai i kahi keiki, ʻaʻole ʻo ia e lawe iā Vasilip.

Nā hopena hopena o vasilip

Me ka hoʻohana pono ʻana i ka lāʻau lapaʻau, ka ʻike pono ʻana i ke ʻano o ke koko a me ka hana o nā ʻōnaehana kino nui, ka hōʻike ʻana i nā hōʻailona ʻole i makemake ʻole ʻia ua "lula" (ʻo ia hoʻi, hoʻokahi hihia i hoʻokahi tausani a ʻumi tausani mau maʻi ʻo ka lāʻau Vasilip).

ʻO ke aikamu, ʻōnaehana mikina, pili paha nā ʻōpū. No ka laʻana, nā hihia o ka ate kapili, nā hōʻeha, nā ʻōpū o ke aʻalolo, nā mea pili a me nā mea ʻē aʻe.

Hiki i ke ʻano o Allergic ʻano like ʻole - mai nā rashes maʻalahi i ka maʻi intolerance koʻikoʻi.

ʻO nā papa Vasilip: mau hōʻailona no ka hoʻohana ʻana, nā loiloi hoʻomanawanui

ʻO Vasilip kahi lāʻau i pili i ka hui lipid-lowing.ʻO ke kumu nui o kāna hana ka mea e lana nei i ka hoʻohaʻahaʻa ʻana i ka pae o nā lipids (nāʻu) i loko o ke koko. Loaʻa ʻia nā Vasilip i ke ʻano o nā papa keʻokeʻo i loko o kahi membrane kiʻi, kahi pōʻai, convex iki ma nā ʻaoʻao ʻelua.

ʻO ka mea hana nui a kēia lālā ʻo ia ka simvastatin. Loaʻa pū kekahi i nā mea waiwai'ē aʻe e like me ka lactose monohydrate, pregelatinized starch, anhydrous citric acid, vitamin C, mais starch, magnesium stearate a microcrystalline cellulose. I ka papa ʻaina iho ma ka talc, propylene glycol, hypromellose a me ka titanium dioxide.

ʻO ke ʻano o ka lāʻau lapaʻau he ʻelua mau ʻano - 20 a 40 mg kēlā me kēia.

Ke hana o ka hana a vasilip

No ka mea ʻo Vasilip no nā lāʻau lapaʻau lipid-ʻohi, kūpono ke ʻano o ka hana. ʻO ka mea mua, ʻo vasilip i hōʻemi i ka kahe ʻana o ka kolamu ma ka koko. ʻElua mau ʻano o ka cholesterol - "hewa" a "maikaʻi". ʻO "Bad" ka lipoproteins haʻahaʻa haʻahaʻa, a ʻo ka "maikaʻi" ka lipoproteins density kiʻekiʻe.

He hopena ʻo Vasilip i ka hoʻomaka mua ʻana o ka pae cholesterol. Hoʻopili ia i ka hoʻololi ʻana o HMG-CoA (hydroxymethylglutaryl coenzyme A) i ka waila mevalonic. Ke hele nei kēia loli ma lalo o ka mana o ka enzym HMG-CoAreductase.

ʻO ka hopena o Vasilip i kahi pōʻino i kēia enima, ma muli o ke ʻano maʻalahi o ka cholesterol. Hoʻopilikia ka lāʻau lapaʻau i ka kolamu, aia i ke kino.

E hōʻemi ana i ka nui o ka kolamu e pili pū ana me ka lipoproteins low haʻahaʻa, a ke hōʻemi nei hoʻi i ka neʻe o ka triglycerides.

ʻO kēia mau mea o kahi ʻano lipid ke kuleana no ka hoʻokumu ʻana i nā plas atherosclerotic i ka lumen o nā ona. Akā hoʻonui ka lāʻau i ka nui o ka cholesterol "maikaʻi" - pili i nā lipoproteins density kiʻekiʻe. ʻO ka pae o ka apolipoprotein B, kahi protein protein kūikawā hou e kuleana no ka lawe ʻana i ke kolamu ma o ke kino, ua hōʻemi ʻia nō hoʻi.

Hoʻopili iki i ka hoʻemi ʻana i ka pae o kekahi mau ʻano o lipids, ʻo ka mea nui o ka Vasilip e hoʻopilikia i ka paia vascular a me ke koko ponoʻī.

ʻO nā mea koko e like me macrophages, ka mea e alakaʻi nei i ka hana o ka hoʻopiʻi ʻana i ka mālama kolesterol, hoʻoneʻe ʻia e ka lāʻau lapaʻau, a luku ʻia nā pōpoki.

Eia nō hoʻi, ʻo ke kāpaeʻana i nā mea i kapa ʻia ʻo isoprenoids, nona ke kuleana no ka ulu ʻana o nā pū i ka muscular membrane o nā kīʻaha koko, ua hoʻohaʻahaʻa iki ʻia, no ka mea ʻaʻole e palalulu ka pā o ka moku, ʻaʻole ʻoloka nā lumen. A ma laila, kahili maikaʻi ʻo Vasilip i nā kīʻaha koko a hoʻomaikaʻi i ke kahe koko.

ʻO nā hiʻohiʻona o nā pharmacokinetics o vasilip

Ua nānā ʻia ʻo Vasilip. He mea maikaʻi loa ia ma ka pā o ka ʻili liʻiliʻi.

ʻO ka ʻike nui loa o ka lāʻau lapaʻau ka mea e nānā ʻia ai i hoʻokahi i ʻelua mau hola ma hope o kāna lawelawe ʻana, akā ma hope o nā hola 12 he emi ia i ka 10%. Hiki ke kiʻi i ka lāʻau lapaʻau me ka meaʻai, ʻaʻole naʻe kēia e hopena.

Pēlā nō, ʻaʻole ia e hōʻiliʻili i loko o ke kino me ka hoʻohana mau ʻana. Hoʻopaʻa loa ka lāʻau i nā protein koko, aneane 100%.

Hoʻololi ʻia ʻo Vasilip i kahi pūnaehana ikaika i loko o ke akeo. ʻO kēia pūhui ua kapa ʻia ʻo ia he beta hydroxy acid. Lawe ʻia kāna ʻōpio (kina.) Ma o ka ʻōpū nui. Hoʻokomo ʻia ka lāʻau lapaʻau i ke ʻano o nā metabolites (nā huahana hoʻololi).

Hoʻopili ʻia kahi hapa o ia mea e nā keiki, akā he hana ʻole o ka pūnao e waiho i loko o nā keiki.

Nā hōʻailona a me nā contraindications no ke hoʻohana

Hoʻomaʻamaʻa pinepine nā kauka i nā vasilip no kahi maʻi e like me ka atherosclerosis. He mea maʻamau loa ia no ka hypercholesterolemia haʻahaʻa a i ʻole ka dyspidemia i hui ʻia (kahi hana ʻole o ka ratio o nā lipids koko) i hui pū ʻia me ka hana kino kino, ke kaumaha ʻana o ka kaumaha, ma hope o ke kīpē paʻa, a i ʻole ka hopena o nā lāʻau lapaʻau.

ʻO kekahi hōʻailona hou aku ʻo ka maʻi homozygous herpaio hoʻohālikelike. He kūlohelohe, i ka ʻaukā, nā meaʻai a me ka hoʻokomo o nā lāʻau lapaʻau anti-atherosclerotic e pono ai e hahai.

Ua ʻōmapa ʻia ʻo Vasilip no ka pale ʻana i nā maʻi o ka pūnao cardiovascular me ka atherosclerosis i ʻole a he maʻi diabetes paha, ʻoiai ke kiʻekiʻe ka hōʻeha ʻana o ka puʻuwai, ʻeha a me nā ʻano like ʻole vascular.

A ʻo ka mea hope loa, ua hoʻokiʻekiʻe ʻia ka kolamu ma ka hōʻa ʻole o kekahi hōʻike.

Vasilip contraindicated i nā kūlana e like me:

• maʻi pūpū o ka ʻāʻī a i ʻole ke kaha kaha ʻana,
• hoʻonui hoʻonui lōʻihi i nā enzymes pepeke me kahi kumu ʻole paʻa.
• hapai a me lactation,
• makahiki ʻokoʻa
• maʻi kūlohelohe i simvastatin a i ʻole kekahi mau mea o ka lāʻau.

Pono e mālama pono i nā mea maʻi i loaʻa i kēia mau maʻi a i ʻole kekahi mau kūlana kikoʻī:

1. Me ka inu nui ʻana i ka waiʻona.
2. I mua o nā maʻi e hoʻopiʻi i ka ate.
3. ʻO ka heleʻana o nā hoʻonāʻana o nā electrolyte ma ke kino.
4. ʻO nā hōʻino koʻikoʻi o ka ʻoihana endocrine a me ka metabolism.
5. ʻO ke kahe mau ana me ka neʻe (hypotension).
6. Lesikui Septic o ke kino.
7. ʻO nā maʻi o ka ʻōnaehana kūʻai.
8. Epilepsy ʻokoʻa.
9. ʻO ka hoʻokele nui a me ka hōʻeha traumatic.
10. ʻO ka hapa o ka lactase, kahi enzyme e wāwahi i ka lactose (ʻo ka waiū waiū).
11. ʻO ka paleʻana i nā kaʻina o ka hoʻopiliʻana o ka lactose.

Nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau

Ma mua o ka hoʻohana pono ʻana i ka lāʻau lapaʻau, pono ʻoe e kamaʻilio me kāu kauka e pili ana i ka inu pono ʻana iā ʻoe a e kamaʻāina ma ka palapala. ʻO ka hoʻoponopono kaulike maʻamau e lawe i hoʻokahi papa a i ʻole hoʻokahi papa i hoʻokahi manawa i ka wā e moe ai.

A paipai ʻia e lawe i ka lāʻau lapaʻau i ka pō, no ka mea, i ka pō, ke hoʻokau ʻia nei ke ʻano o ka nui o ka cholesterol, a e ʻōlelo hou ʻia ka hopena o ka lāʻau. Hoʻomaka ma kahi hoʻomaka me kahi hapa o 10 mg. ʻO ka dosis ʻokoʻa loa ka 80 mg i kēlā me kēia lā.

Ua kuhikuhi ʻia no nā poʻe maʻi me nā ʻōmaʻomaʻo holomua o nā maʻi, me ka hopena kiʻekiʻe hoʻi i nā hoʻopiʻi mai ka naʻau a me nā kīʻaha koko. ʻO ke ʻano i koi ʻia ma ka hapa he nui ke koho ʻia i loko o hoʻokahi mahina.

Koho ʻia ka lōʻihi o ke ʻano o ka mālama ʻana i kēlā me kēia maʻi i kēlā me kēia kauka.

No ka mea e hoʻomanaʻo ana ʻo ka lawe ʻana iā Wazilip, i ka mea maʻi i ke kīkī o ka maʻi e pono ai ʻo ia. I kekahi mau hihia, ua kuhikuhi pū ʻia nā lāʻau lapaʻau hou-lipid.

No nā mea maʻi me ka maʻi e like me ka hypercholesterolemia, hoʻomaka ka mālamaʻana i kahi kinikona o 10 mg, akā hiki ke hoʻonui ʻia i 40 mg e loaʻa ai kahi hopena hou aʻe.

No ka ʻano hoʻoilina o kēia maʻi, ua hoʻokaʻawale ʻia ʻo Vazilip i ʻekolu mau manawa inā e kuhikuhi ʻia ka nui o ka nui (80 mg), a i ʻole 40 mg o ka lāʻau lapaʻau i kauoha ʻia i hoʻokahi lā ma mua o ka hiamoe.

ʻO Vasilip ka hopena i makemake ʻia i ka hoʻohana hoʻokahi a i hui pū ʻia me nā mea hana anti antololesterolemus, inā paha, me nā kuʻuna a me ke ohe bile. ʻO kēia mau lāʻau e like me colestyramine, colestipol.

Me ka hoʻohana pū ʻana o ka cyclosporine, gemfibrozil, waikika nicotinic a me nā lāʻau laʻa mai ka hui o fibrates, hoʻomaka lākou me kahi wai lāʻau o 5 mg, a me ka nui o ka mea i hāʻawi ʻia he 10 mg.

I kēia hihia, ʻaʻole ʻoe e hoʻonele i kēia pākuʻi.

Inā lawe ka mea maʻi i nā lāʻau lapaʻau e kūʻē i ka arrhythmia a me ke koko o ke koko nui, e like me Amiodarone a me Verapamil, a laila ʻaʻole nui ka nui o ka maʻi o Vasilip i ka 20 pākahi i kēlā me kēia lā, no ka mea, ʻaʻole paʻa ka hoʻomau.

Inā ʻeha kahi kanaka i kahi ʻeha ikaika o ka hina ʻana, ma ke ʻano o ka filtration glomerular ʻaʻole iʻoi aku ma mua o 30 ml / min., A laila ua kuhikuhi ʻia ʻo Vasilip i loko o kahi kuʻuna o ka nui ma mua o ka 10 mg i hoʻokahi lā. Pono e hoʻonui maikaʻi ʻia ka ʻona, a ma ia ʻano ka mea e ʻike mau ai ka mea maʻi.

E hoʻokuʻu i ke ʻano a me ka ʻano

Hoʻohana ʻia ʻo Vasilip i ke ʻano o nā papa keʻokeʻo (7 pcs. In blister), kahi i hoʻohui ʻia me ke membrane kiʻi.

Nā ʻōkuhi no ka hoʻohana ʻana iā Vasilip (ke ʻano a me ka helu ana)

Hoʻolālā ʻia nā papa papa no ka hoʻokele waha, ma ke ahiahi.

Hoʻololi ʻia ka lāʻau i ʻōlelo ʻia e 5 mg a 80 mg i kēlā me kēia lā i ke ahiahi. ʻO ka pilina mua o ka lāʻau lapaʻau he 10 mg. Pono e neʻe ʻia nā hoʻololi i nā dosis no ka liʻiliʻi he 4 mau hebedoma.

ʻO ka pae pae kiʻekiʻe e loaʻa ai i kēlā me kēia lā kahi 80 mg. Ua hoʻohālikelike ʻia i nā maʻi wale nō me ka pilikia nui o nā hoʻopiʻi o ka maʻi cardiovascular a iʻole ka hypercholesterolemia koʻikoʻi.

Hoʻoholo ʻia ka lōʻihi o ka lawe ʻana i nā papa e ka neʻe i ke kauka i ka ʻokoʻa.

ʻO ka Hypercholesterolemia

I ka manawa holoʻokoʻa o ka mālama ʻana, pono ka mea maʻi ma muli o kaʻai hypocholesterol maʻamau. ʻO ka ʻōmato hoʻomaka e hoʻomaka ʻia no nā mea maʻi me ka hypercholesterolemia he 10 mg. No ka loaʻa o ka emi ʻana ma ka LDL-C, hiki ke hoʻomaka ka lāʻau lapaʻau mai 20 a 40 mg i kēlā me kēia lā (hoʻokahi mau manawa i ke ahiahi).

I ka poʻe maʻi me ka homozygous hernary hypercholesterolemia, ke kūkaʻi o kēlā me kēia lā he 40 mg i ke ahiahi a i ʻole 80 mg i loko o 3 mau kīnā (20 mg i ke kakahiaka, 20 mg i ke ahiahi a me 40 mg i ke ahiahi).

Kāohi pilikia Cardiovascular

I nā maʻi me ka ʻole a hyperlipidemia paha, me ka nui o ka lāʻau nui o ka puʻuwai coronary, ʻo nā pōkole pono o ka lāʻau lapaʻau he 20 a 40 mg i kēlā me kēia lā. No laila, ʻo ka ʻōlelo hoʻomaka ʻia e hele ai i 20 mg i kēlā me kēia lā.

Pono e hoʻololi ʻia nā loli i nā wā he 4 o nā pule. Inā pono, hiki ke hoʻonui ʻia i kēia maʻa i 40 mg no ka lā.

Inā emi mai ka ʻike o LDL ma mua o 75 mg / dl (1.94 mmol / L), ʻoi loa ka nui o nā kolamu ma mua o 140 mg / dl (3.6 mmol / L), pono ke hōʻemi ʻia ka ʻona.

Hoʻolālā hoʻohui

Hoʻohana ʻo Vasilip i ka hui pū me ka bile acid sequestrants a i ʻole monotherapy. I nā mea maʻi e loaʻa ana ka mālama ʻana me ka gemfibrozil, cyclosporine, ka acid nikotinic a i ʻole nā ​​fibrates (ʻoi aku ma mua o 1 g i kēlā me kēia lā), ʻo ka hopena mua loa he 5 mg. ʻO ka lā helu ʻokoʻa loa i kēlā me kēia lā o ka lāʻau lapaʻau he 10 mg. ʻAʻole ʻōlelo ʻia nā hoʻonui hou aʻe.

I ka poʻe maʻi i ka manawa like i ka verapamil a amiodarone, ʻo ka nui o ka lā o ka lā lapaʻau ʻaʻole pono e ʻoi aku ma mua o 20 mg.

Lapaʻau lāʻau

ʻO Simvastatin - ka waiwai ikaika o Vasilip, he mākana lipid ka mea i loaʻa mai synthetically mai ka huahana fermentation Aspergillus terreus.

Ma hope o ka lawelawe waha, simvastatin, kahi mea lactone kahe ʻole, ka mea e pau ai i ka hydrolysis i loko o ke kao, me ka hoʻokumu ʻana i ke ʻano o nā ʻano like o acid-hydroxy acid o ka mea. ʻO ia ka metabolite koʻikoʻi a loaʻa iā ia ka hana inhibitory kiʻekiʻe e kūʻē iā HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) -reductase, he enzyme e kuhi ana i ka synthesis o ke ola (mua a me ka hopena koʻikoʻi) o ka cholesterol.

ʻO ka maikaʻi o ka simvastatin i ka hōʻemi ʻana i ka plasma o ka nui o ka kolamu, ka nui o ka kolamu, ka kolamu LDL, ka haʻahaʻa haʻahaʻa lipoprotein kūloko, triglycerides a me ka haʻahaʻa lipoprotein kūloko haʻahaʻa, a hoʻonui i ka kolamu HDL (kiʻekiʻe lipoprotein cholesterol) density) i loko o ke kaila plasma i loko o nā mea maʻi me ka heterozygous familial / non-familial hypercholesterolemia a hyperlipidemia i hui ʻia a i nā hihia inā hoʻonui ʻia ka nui o ka plasma o ke kolamu ma ke koko i waena o ka mea s ka hemahema a me ke koho ʻana i kahi mea ʻaʻai hoʻokahi lawa ʻole. Kuhi ʻia ka hopena therapeutic nānā i loko o 14 mau lā o ka lawe ʻana i simvastatin, ka nui loa i loko o nā wiki he 4-6 mai ka hoʻomaka ʻana o ka hoʻohana. Me ka hoʻomau mau ʻia, hoʻomau ka hopena. ʻO ka plasma o ka cholesterol o ka kolamu ma hope o ka hoʻopaʻa ʻana i ka hoʻohana ʻana i ka simvastatin i ke koko ka mea i hoʻi i kona waiwai ponoʻī, i ʻike ʻia ma mua o ka hoʻomaka o ka mālama ʻana.

ʻO ka metabolite aktif o ka simvastatin kahi mea pale paʻa o ka HMG-CoA reductase (kahi enzyme e hoʻomaʻamaʻa nei i ka hopena o ke ʻano o ka mevalonate mai HMG-CoA). Eia naʻe, ke alakaʻi ʻana i nā dute therapeutic o ka waiwai, ʻaʻole ia e alakaʻi i ka hoʻopau ʻana i ka hoʻoneʻe hou o HMG-CoA, e mālama ana i ka hana o ka nui o ka mevalonate ponoʻala. I manaʻo ia ʻaʻole pono ka hoʻohana ʻana o vasilip i ka ʻohi ʻana o nā maʻi paʻakiki i loko o ke kino, ʻoiai ʻo ka hoʻomaka mua ʻana o nā mea kanu o ke kolamu o ka hoʻololi ʻana o ka HMG-CoA i mevalonate. Eia kekahi, aia ka wikiwiki o ka metabolism wikiwiki o HMG-CoA i ka acetyl-CoA, ka mea i hoʻopili ʻia i nā hana biosynthesis he nui i ke kino.

He kolamu mua o Cholesterol ma o nā pauna āpau o ka hāmeʻa, a ʻaʻole i mālama ʻia ka hopena hopena o ka simvastatin ma steroidogenesis. Ma ke ʻano ʻaʻole i alakaʻi ʻo Vasilip i ka hoʻonui ʻana i ka lithogenicity o ka hua bile, ʻaʻole maopopo ka hopena i ka piʻi ʻana o ka manawa o ka cholelithiasis.

Kōkua ʻo Simvastatin i ka hoʻohaʻahaʻa ʻana i nā kiʻekiʻe kiʻekiʻe a me ka maʻamau o ka kolamu LDL i ka plasma koko. ʻO ke kikowaena o LDL e hele mai mai VLDL (haʻahaʻa haʻahaʻa lipoproteins liʻiliʻi). Lawe ʻia ka catabolism LDL me ke kōkua o ka mea hoʻokipa LDL kiʻekiʻe. ʻO ka hoʻokūkū no ka hoʻohaʻahaʻa i ka neʻe o ka kolamu LDL i ka plasma koko ma hope o ka lawe ʻana i simvastatin ma muli o ka emi ʻana o ka neʻe o ka plasma o ka kolamu VLDL i loko o ke koko a me ka hoʻōla ʻana o nā LDL receptors. Ma muli o kēia, aia ka emi ʻana o ka hoʻokumu a hoʻonui i ka catabolism o ka LDL cholesterol. I ka wā o ka maʻi me ka simvastatin, ʻo ke kaʻe o ka plasma o apolipoprotein B (apo B) i loko o ke koko me ka hoʻohaʻahaʻa nui. No ka mea, ʻo kēlā me kēia pālolo LDL loaʻa i ka molekahi apo B kahi, a me ka nui o nā apo B ka mea i loaʻa i nā lipoproteins ʻē aʻe, hiki iā ia ke manaʻo i ka simvastatin, i ka hoʻopiʻi ʻana i ka nalowale o ka kolamu ma nā mea maʻamau o ka LDL, e kōkua i ka hōʻemi o ka hoʻokaʻina plasma o nā kolo LDL i ka koko.

Hoʻonui hoʻi ʻo Simvastatin i ka popo ʻana o HDL cholesterol a hōʻemi i ke kaohi ʻana o TG i ka plasma koko. Ma muli o kēia pilina, ua hoʻemi ʻia ka LDL-C / HDL-C a me HDL / HDL-C.

Me ka maʻi puʻuwai coronary (maʻi o ka naʻau coronary) a me ka maka mua o ka nui o ka kolamu o 212-30 30 mg / dL (5.5 a 8 mmol / l), kōkua ʻo simvastatin e hōʻemi i ka hopena o ka make maʻamau, mai ka make mai ka maʻi ʻeha coronary, a me ka ʻike o ka nonfatal i hōʻoia ʻia i ka myocardial infarction. Eia kekahi, hōʻemi ka waiwai i ka hopena o ka pono no ka hōʻiho ʻana no ka hoʻihoʻi ʻana i ke kahe koko coronary (no ka laʻana, ka coronary artery bypass grafting a percutaneous transluminal coronary angioplasty). E kū'ē i ke kua o ka maʻi mellitus o ka maʻi mellitus, ua emi ka hopena o ka ʻike ʻana i nā hoʻopiʻi coronary nui. Eia kekahi, i ka wā o simvastatin therapy, ʻoi ka hopena o ka hoʻomohala ʻana i nā maʻi cerebrovascular fatal / non-fatal (e komo pū me nā hōʻeha a me nā maʻi cerebrovascular transient).

Aia ke hōʻike nei i ka hopena o ka simvastatin i nā mea maʻi me ka / ʻaʻohe hyperlipidemia, e hōʻemi nui nei i ka hoʻomohala ʻana i ka maʻi naʻau coronary ma muli o ka concomitant diabetes mellitus, kahi mōʻaukala o nā maʻi a me nā maʻi maʻi vascular.

Me ka hoʻohana ʻana o Vasilip i kahi lā i kēlā me kēia lā he 40 mg, ka pakanui holoʻokoʻa, nui ka hopena o ka make e pili ana i ka maʻi ʻōpū coronary, ka hopena o ka hoʻopiʻi coronary nui (me ka nonalial myocardial infarction a i ʻole e pili ana i ka maʻi ʻeha coronary), ke ʻano no ka hoʻōla ʻana no ka hoʻihoʻi hou ʻana i ke kahe coronary (komo me ka coronary artery bypass grafting and percutaneous transluminal angioplasty), a me ke kahe koko o peripheral a me nā ʻano ʻē aʻe o ka non-coronary revascularization, ka hopena o ka ʻeha, ʻo ka piʻi o ka homaʻi ʻana no ka se puʻuwai paʻakikī.

ʻO ka hopena o ka hoʻopiʻi nui o ka vascular / coronary e hoʻemi ʻia i nā mea maʻi me ka / me ka ʻole o ka maʻi artery coronary, me ka poʻe maʻi me ka maʻi maʻi peripheral, diabetes mellitus, a i ʻole nā ​​ala cerebrovascular. Ma ka maʻi mellitus, kōkua ʻo Vasilip i ka hoʻēmi ʻana i ka hōʻeha o nā maʻi vascular koʻikoʻi, me ka hoʻoluhi ʻia ʻana o ka hōʻuluʻulu ʻana no ka hōʻili ʻana o nā pākīwī o lalo, ka hoʻihoʻi hou ʻana o ka kahe koko peripheral, a me ka hanana i nā ʻōpala trophic.

Wahi a ka angiography coronary, hoʻomōlohelohe ka hoʻomalu simvastatin i ka holomua o ka atherosclerosis coronary a me ka ʻike hou ʻana o nā pūnaewele hou o ka atherosclerosis a me nā haʻalulu holoʻokoʻa hou, ʻo nā mea maʻi e loaʻa ana i ka maʻi maʻamau e hōʻike i ka hoʻomau mau ʻana o ka loina atherosclerotic o ka ʻalani coronary.

Lapaʻau lāʻau

ʻO Simvastatin he lactone hāpau ʻole. Hoʻololi koke ka waiwai i ka waiwai me kona hoʻololi ʻana i ka waila simvastatin β-hydroxy (L-654.969), kahi mea pale paʻa o ka HMG-CoA reductase. ʻO nā metabolitori nui o ka simvastatin i loko o ke kaila koko he β-hydroxyacid o simvastatin (L-654.969) a me kāna 6'-exomethylene, 6'-hydroxy a me 6'-hydroxymethyl derivatives.

ʻO ka ʻikepili no ka hōʻike ʻike nui ʻana o nā haʻawina pharmacokinetic āpau o nā metabolites acid β-hydroxy (neʻe ikaika) a me nā mea hoʻomau a me nā ākea (ʻāpono paʻa āpau) i hoʻokumu ʻia ma ke ʻano o ka hydrolysis kahi paʻa o ka HMG-CoA reductase. I ka hoʻonā ʻana o simvastatin i ke kaila koko, ua hoʻoholo ʻia nā ʻano ʻelua o nā metabolites.

Hōʻike ka Hydrolysis o simvastatin i ka manawa mua o ka hele ʻana ma o ka ate, no laila, he kaola plasma haʻahaʻa o nā simvastatin i loli ʻole i ka koko o ke kanaka e nānā ʻia (14 C huaʻōlelo simvastatin + 14 C huaʻōlelo simvastatin) i loaʻa i 4 mau hola. A laila ma waena o 12 mau hola e hoʻohaʻahaʻa ia i ka 10% o ka nui o ka nui. ʻOiai ke kūpono o ka nui o nā pakano therapeutic i hoʻihoʻi ʻia mai ka simvastatin mai 5 a 80 mg i kēlā me kēia lā, ke ʻano o ka linear o ka pānaʻi AUC (ʻo ka wahi ma lalo o ka kukuna-manawa o ka metabolite) i nā kahe nui o ke koko i mālama ʻia me ka piʻi ʻana o nā dosis i ka 120 mg.

Ma kahi o 85% o ka loaʻa i kā simvastatin e hoʻopili ʻia. ʻO ka ʻai (e like me ke ʻano o ka pāʻai hypocholesterol maʻamau) ma hope o ka lawe ʻana i ka simvastatin ʻaʻole i hoʻopilikia i ka profile pharmacokinetic o ka lāʻau.

Hoʻoholo ʻia ka ʻike kiʻekiʻe o ka simvastatin i loko o ka palu (hoʻohālikelike i nā kiko ʻē aʻe).

ʻO ka paʻa ʻana i ka ʻōnaehana lela o ka metabolite ikaika o ka simvastatin L-654.969 he 60% i nā kāne.

ʻO ka hiki ʻana o ka komo ʻana o ka waiwai ma o ka lolo-lolo a me nā mea hematoplacental e hoʻopaʻa ʻia ʻole ʻia.

ʻO Simvastatin i ka wā o ka hele mua ma ka atea ka mea e hoʻoneʻe ʻia, ma hope o ka hana a ka huina o nā mea a me nā metabolites e hana me ka bile.

Ke lawe nei i 100 mg o simvastatin 14 C, hōʻiliʻili ka mea i hōʻailona ʻia i loko o ke koko koko, me nā feces (e pili ana i 60%) a me ka urine (ma kahi o 13%). I loko o nā feces, i kapa ʻia nā simvastatin e hōʻike ʻia e nā huahana metabolic o simvastatin, kahi i hoʻopili ʻia i loko o ka bile, a i kapa ʻia ka simvastatin hōʻailona ʻia. ʻOi aku ma mua o ka 0.5% o ka loaʻa i nā mea i hāʻawi ʻia i loaʻa i loko o ka urine ma ke ʻano o nā metabolite ikaika o ka waiwai. I loko o plasma, 14% a me 28% o AUC ma muli o ka pale o ke ākea a me nā mea paʻa āpau o ka HMG-CoA reductase, kahi. Hōʻike kēia i nā huahana metabolic nui o simvastatin i ka hana a i ʻole nāwaliwali pale o ka HMG-CoA reductase.

Kuhi hewa ka nui o ka laina o ka AUC i ka nui o ke kahe o ke koko me ka hoʻonui ʻana i nā pupu ma ka palena o 5-120 mg ʻaʻole i mālama ʻia. Me ka helu manawa hoʻokahi a i hoʻākāka mau ʻia ai ka simvastatin, hōʻike ʻia ka lāʻau pharmacokinetic i ka loaʻa ʻole o ka hōʻiliʻili ʻana o nā waiwai i nā ʻili i ka hihia o ka hana mau.

Ke hana ʻole nui o ka renal (i nā mea maʻi me ka hana ʻana o ka creatinine o 10 mg i kēlā me kēia lā, inā pono, e kau ʻia ke ʻano me ka mālama ʻana,

Vasilip, nā ʻōlelo e pili ana i ka hoʻohana ʻana: ke ʻano a me ka helu ʻana

Hoʻolilo ʻia nā papa Vasilip i ka maʻamau, 1 ka manawa i kēlā lā, i ke ahiahi. Hoʻololi ʻia ka nui i kēlā me kēia lā i kēlā me kēia 5 mg a 80 mg.

ʻO ka pinepine, ʻo ka lāʻau lapaʻau i kuhikuhi ʻia i loko o kahi hoʻomaka o 10 mg. Pono e hoʻololi ʻia nā hoʻololi ʻana me kahi kekeʻe o 4 mau hebedoma. Hoʻolako ʻia ka lōʻihi o kēlā me kēia lā (80 mg) no nā mea maʻi me ka hypercholesterolemia koʻikoʻi a he pilikia nui paha o ka hoʻomohala ʻana i nā hoʻopiʻi cardiovascular. ʻO ka lōʻihi ka vasilip e hoʻoholo kūʻokoʻa ʻia e ke kauka hele mai.

I ka holo ʻana o ka manawa holoʻokoʻa, pono ka mea maʻi e hahai i kaʻai hypocholesterol maʻamau. ʻO ka papa hoʻomaka ʻia e 10 mg. I mea e wehe maʻalahi ai i ka pae o ka LDL-C (ma mua o 45%), hoʻomaka ʻoe e lawe iā Vasilip me 20-40 mg hoʻokahi manawa i ka lā, i ke ahiahi.

ʻO nā mea maʻi me ka hypercholesterolemia hoʻoilina homozygous e kono ʻia e lawe i 40 mg hoʻokahi manawa i ka lā, i ke ahiahi. Hiki ke hoʻohana i loko o 3 mau dosa - i ke kakahiaka a me ke ahiahi, 20 mg a me 40 mg o ke ahiahi. Noi ʻia ʻo Vasilip no kēlā mau maʻi i hui pū ai me nā ʻoihana lipid-hoʻohaʻahaʻa ʻē aʻe (no ka laʻana, ʻo LDL apheresis).

I ka paleʻana o ka maʻi cardiovascular:

Me ka pilikia nui o ka hoʻomohala ʻana i ka maʻi naʻau coronary (me a ʻole ʻole hyperlipidemia), 20-40 mg o Vasilip i kuhikuhi ʻia i kēlā me kēia lā. ʻO ka dosis mua he 20 mg, kahi hoʻonui e hoʻonui ʻia i ka wai me kahi manawa o 4 mau hebedoma. ʻO ka pae ʻauʻau nui loa ʻo kēlā me kēia lā he 40 mg. I ka emi ʻana o ka LDL liʻiliʻi ma mua o 75 mg / dl (1.94 mmol / L), ʻoi ka nui o nā waihona kolamu ma lalo o ka 140 mg / dl (3.6 mmol / L), pono ke hōʻemi ʻia ka dosage.

Ma ke kūleʻa ʻo Vasilip i ka monotherapy a i ʻole like me nā sequestrants o nā hua bile (no ka laʻana, colestipol a me colestyramine). I nā mea maʻi e loaʻa ana ka mālama ʻana me ka gemfibrozil, cyclosporine, nā fibrates a i ʻole ka nikotinic acid (ʻoi aku ma mua o 1 g i kēlā me kēia lā), e ʻōlelo ʻia e hoʻomaka i ka maʻi me 5 mg i kēlā me kēia lā, ʻo ka nui loa he nui o nā lā he 10 mg. I loko o kēlā mau kūlana, ʻaʻole i ʻōlelo ʻia kahi hoʻonui hou aʻe.

I nā maʻi e loaʻa ana i nā verapamil a i ole amiodarone, ʻaʻole pono ka nui o ka vasilip i kēlā me kēia lā he 20 mg.

I nā maʻi me ka pilikia ʻole o ka renal (CC ma mua o 30 ml / min), pono i kēlā me kēia lā ʻo Vasilip i ʻōlelo ʻia i kēlā me kēia lā e pono ka nui o 10 mg. Inā pono ʻoe e hoʻonui i ka maʻa, e pono ana ka mālama mālama maʻi.

ʻO nā maʻi me ka hala ʻole o ka hoʻololi ʻana a me ka poʻe ʻelemakule, ʻaʻole pono ka hoʻoponopono o ka lāʻau.

ʻŌpū a me ka lactation

ʻAʻole kuhikuhi ʻia ʻo Vasilip i ka wā hāpai / lactation.

Ke ulu mai ka wā hāpai, hiki ke hoʻopau koke i ka hoʻohana ʻana i ka simvastatin. ʻO nā wahine o ka hānau keiki ʻana, hiki ke koho ʻia ʻo Vasilip i nā hihia wale nō kahiʻuʻuku ka liʻiliʻi. ʻO ka lāʻau lapaʻau i ka wā hāpai a hiki ke alakaʻi i ka emi o ka neʻe ʻana o ka mevalonate (kahi hana mua i ka biosynthesis cholesterol) i ka pūpū. Manaʻo ʻia ʻo Atherosclerosis he maʻi maʻi mau, a ʻo ka hoʻoneʻe ʻana i nā lālani lipid-hoʻohaʻahaʻa i ka wā hapai ʻaʻole koʻikoʻi ka hopena o nā hopena lōʻihi e pili ana i ka hypercholesterolemia mua. I kēia hiʻohiʻona, ʻaʻole pono nā simvastatin e kuhikuhi i nā wahine hāpai ʻia, makemake e lilo a i manaʻo paha ua hāpai lākou. Pono e hoʻokuʻu iki i ka maʻi ʻo Vasilip no ka lōʻihi o ke hāpai ʻana a i ʻole ke nānā ʻana i ka wā hapai, a pono ʻia e ʻo ka wahine ponoʻī no ka make ʻana o ka wahine ma mua.

ʻAʻohe mea hōʻoia e hōʻoia ai a hōʻole ʻole i ka excretion o simvastatin a me nā metabolites me ka umauma waiū.

Nā kumukūʻai no vasilip i nā lāʻau lapaʻau ma Moscow

Hoʻohui hui like ʻole:

• inhibitor ikaika o ka isoenzyme CYP3A4 (itraconazole, telithromycin, ketoconazole, posaconazole, clarithromycin, voriconazole, erythromycin, HIV protease inhibitors, boceprevir, nefazodone, telaprevir e loaʻa ana i ka hoʻonui ʻia ʻana o nā huaʻoniʻu.
• gemfibrozil, danazol a cyclosporine.

Hōʻike nā kauka e pili ana i nā vasilip

Aia kahi manawa i nā kauka he nui (ʻaʻole ka lāʻau lapaʻau!) Kuhi ʻia ʻo 10 mg o vasilip i lilo i mea ola maikaʻi loa no nā maʻi e pili ana i ka atherosclerosis. Ua hala kēia manawa. ʻAʻole noonoo ʻia ka simvastatin i kekahi ʻano i ke ʻano he lāʻau lapaʻau e hiki ai iā ʻoe ke hoʻokō i nā pae kūlohelohe pono kūpono o ka kolamu a me nā lipids ʻē aʻe.

No laila, inā ke kauka nei ke kauka i ka simvastatin (me ka vasilip), ʻaʻole wau maopopo maoli i ke kumu no ka nānā ʻole ʻana i nā statins hou i kahi mana ikaika a me nā mea palekana.

ʻO ka manawa e poina iā simvastatin. A ma ke ala, he aha kēia kuhihewa ʻole pono e lawe ʻia ai nā statins i nā hebedoma liʻiliʻi? Lawe ʻia lākou i mau makahiki a me ʻumi makahiki, a ʻo kēlā me kēia makahiki o ka hoʻopiʻi ʻana e lawe mai i nā pono keu aku i nā mea maʻi, a me nā ʻoihana lāʻau lapaʻau, ʻoiaʻiʻo nō.

Hōʻike ke kōkua maʻi Vasilip

Lawe au i ka "Vasilip" 10 mg mau mau no ka papa 1 i ke ahiahi, lawe au i nā hoʻokolohua no ka cholesterol i kēlā me kēia ʻekolu mahina. Maikaʻi ʻia ka hopena. ʻAʻohe hana hōʻahewa ʻole e huli i kahi pahu kūʻai o nā home. Pii aku la o Kololeka, a hoi aku i ka "Vasilip". Me kahi penikala, kūʻai ke kūʻai aku, akā ʻoi aku ka ʻoi aku o ke ola.

"Ua ʻōlelo ʻia ʻo" Vasilip "iaʻu e kaʻu mea iʻai no ka mea momona, ma hope o ka kūkā ʻana me ke kauka, ua hui pū me kaʻu mea ʻai. ʻO ka pīhoihoi, ua hopena ka hopena, ʻoiai ʻaʻole wau i maopopo loa e kōkua ke kīpē! Lawe ʻo 5-6 mau pule, ʻaʻohe manawa! Mālama i ka koloka haʻahaʻa i loko o ke koko, ʻo ia ke kumu.

Lapaʻau

Hoʻololi nui ka Simvastatin i ka ʻike o ka apolipoprotein B, a hoʻonui pinepine i ke kao o HDL-C a me ka hoʻohaʻahaʻa haʻahaʻa plasma o TG. I ka hopena o kēia mau hopena o ka simvastatin, ka laha o ka nui o Chs i ka nui Chs-HDL a me Chs-LDL i Chs-HDL i ka hoʻemi ʻana.

ʻO ka hopena antiatherosclerotic o simvastatin he hopena o ka hopena o ka lāʻau lapaʻau ma luna o nā paia o nā kīʻaha koko a me nā ʻike koko. Hoʻololi ʻo Simvastatin i ka metabolism o macrophages, ke kāohi nei i ka hoʻōla ʻana o nā makcrophages a me ka luku ʻana i nā pā plika atherosclerotic. Mālama ka lāʻau i ka synthesis o isoprenoids, ʻo ia nā mea ulu i ka hoʻomaʻū ʻana o nā ahe o nā io o nā palahalaha o nā kīʻaha o ke koko. Ma lalo o ka hopena o ka simvastatin, e hoʻonui ai ka hoʻonui ʻana i ka hilinaʻi o ka endothelium.

Hoʻopilikia ka hopena therapeutic ma hope o 2 mau pule, ʻo ka hopena kiʻekiʻe e nānā ʻia ma hope o ka 4 mau hebedoma o ka mālama ʻana.

Hoʻohui

ʻO ka hoʻohana like ʻana o simvastatin me nā fibrates, ka acid nicotinic (ʻoi aku ma mua o 1 g / lā) e hoʻonui i ka pilikia o ka hoʻomohala ʻana i ka myopathy, ʻo ia hoʻi ʻo rhabdomyolysis (me ka hoʻohana pū ʻana me ka fenofibrate, ʻaʻohe i piʻi ka hopena o ka hoʻomohala ʻana i ka myopathy hoʻohālikelike i ka monotherapy me kēlā me kēia lāʻau hoʻokaʻawale).

ʻO ka hoʻohana kūpono me ka gemfibrozil hiki ke alakaʻi i ka hoʻonuiʻana i ka kao o simvastatin i loko o ka serum.

CYP3A4 inhibitors cytochrome (itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors a kanefazodone), ka mea i hoʻopili i ka hoʻokahuli o ka metabolic o simvastatin i ka ate, hoʻonui i ka pilikia o ka myopathy a me rhabdomyolysis i ka wā o ka maʻi me ka simvastatin. Hoʻohui like a hoʻohana me kēia mau lāʻau.

Me ka makaʻala, pono e kuhikuhi i ka manawa like me nā mea paʻa o ka CYP3A4 ikaika: cyclosporine, verapamil a diltiazem. ʻO ka makeʻana o kēlā me kēia lā o simvastatin i ka wā e lawe ana iā ia me ka cyclosporine, ʻaʻole pono e hoʻonui i ka 10 mg. ʻO ka laima o ka simvastatin i kēlā me kēia lā me ka hoʻohana ʻana i ka amiodarone a i ʻole verapamil ʻaʻole iʻoi aku ma mua o 20 mg, a me ka 40 mg me ka hoʻohana pono ʻana o ka diltiazem, ke ʻole ka maikaʻi o ka pōmaikaʻi e pili ana i ka hiki ke hiki mai i ka myopathy a me ka rhabdomyolysis.

ʻO Simvastatin ma kahi o 20-40 mg / lā i loko o nā mea hana a me nā poʻe maʻi me ka hypercholesterolemia potentiates i nā hopena o ka Coumarin anticoagulants (e.g. warfarin), ma ka hoʻonui pinepine i ka manawa prothrombin, MHO. No laila, i nā mea maʻi e lawe ana i ka anticoagulants Coumarin, pono ka manawa prothrombin a me MHO ma mua o ka hoʻomaka ʻana i ka therapy simvastatin, i ka wā mua o ka mālama ʻana, i ka wā e hoʻololi ai i ka ʻano o ka simvastatin a i ʻole ke hoʻokuʻu i ka lāʻau. Ma ka hiki ʻana i kahi hōʻailona mau o ka manawa prothrombin a me MHO, pono e nānā pono ʻia nā pale ma nā wahi i makemake ʻia no nā mea maʻi e loaʻa ana i ka lāʻau anticoagulant. ʻAʻole hoʻoiho ka lāʻau simvastatin i nā loli i ka manawa prothrombin i ke kahe a me ke koko i ka poʻe maʻi ʻaʻole lawe i nā anticoagulants.

Hoʻopili ka wai hua ʻai i ka hana o CYP3A4. Ke hoʻoluhi nui nei i ka nui o ka wai o ka hua kō (ʻoi aku ma mua o 1 lita no ka lā) a me ka simvastatin e alakaʻi i ka nui o ka neʻe o ka plasma o ka waikawa simvastatin. No laila, i ka wā o ka mālama ʻana me ka simvastatin, pono e ʻalo ʻia ka wai kōlepa.

Nā ʻōkuhi no ka hoʻohana ʻana i ka vasilip (ka ʻaina a me ka paukū)

No nā mea i kuhikuhi iā Vasilip, ʻo nā ʻōlelo aʻo no ka hoʻohana ʻana i ka ʻike e lawe ʻia ana ʻiʻo, i ke ahiahi, 1 i keia la.

ʻO ka maʻa maʻamau o kēlā me kēia lā he 5-80 mg. Ma ke kānāwai, kuhikuhi ʻia ka 10 mg. Pono ka hoʻoponopono ʻana o ka dosis me ka liʻiliʻi ma waena o 4 mau hebedoma. ʻAʻole pono nā dosis o kēlā me kēia lā e ʻoi aku ma mua o 80 mg. Hoʻolaha wale ʻia ka nui loa ka nui o ka poʻe me ka maʻi kaumaha hypercholesterolemia a i ʻole e loli 'ana i ka hanana nā hoʻopiʻi paʻakikī. ^ E Ha yM. Nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana iā Vazilip e hōʻike ana i ke ʻano o ka mālama ʻana e nā loea i kēlā me kēia hihia pākahi, ma muli o nā mea e hōʻike ʻia no ka hoʻohana ʻana a pehea e hoʻomanawanui ai ka mea maʻi i ka lāʻau.

Ma na koi o hypercholesterolemia pono e hana i nā mea maʻamau kaʻai ʻai hypocholesterol i ka wā mālama. ʻO ka maʻi kumu ma mua o ka hapanui he 10 mg. No ka hōʻemi nui ʻana LDL cholesterol hiki ke hoʻomaka ka papa me ka 20-40 mg / lā.

I ʻO ka maʻi homozygous hoʻoili koʻikoʻi hana pinepine iā 40 mg a i ʻole 80 mg i kēlā me kēia lā, akā i ʻekolu inikua (maʻamau ʻo 20 mg i ke kakahiaka a i ke ahiahi a me kekahi 40 mg o ke ahiahi). Hoʻouna ia e hoʻohui i nā lāʻau me kekahi lehelehe-liphoʻāla.

I mea e pale ai i ka hoʻomohala ʻana o ka maʻi cardiovascular ma ka poʻe i ka nui o ka pilikia Maʻi maʻi Ischemic koho ma 20 a 40 mg / lā. ʻO ke ʻano o ka lāʻau lapaʻau, koho ʻia ʻo ia iho inā hoʻemi ʻia ke pae LDLemi iho ma 75 mg / dl a huʻeluʻi kolaneemi malalo o 140 mg / dl.

Hiki ke hoʻohana ʻia ʻo Vasilip sequestrants o nā hua bile. ^ E Ha yM. ʻO ka maʻi maʻi e hoʻomaʻamaʻa ʻia nā huaʻai a i ʻole nikotinic acid, e lawe i kahi hoʻomaka mua o 5 mg. ʻAʻole pono ʻoi loa ka nui o ka lā ma mua o 10 mg. A i hui pū ʻia me nā Amiodarone a i ʻole Verapamil mai oi aku i kahi pōkole o 20 mg.

Me ka eha nā mālamalama maikaʻi ʻole ʻoi aku ka maikaʻi ma mua o ka momona ʻana o 10 mg / lā. Inā pono ke hoʻonui i ka dosis, pono e nānā mau ʻia ke kūlana o ka mea maʻi.

ʻO nā pilikia ʻē aʻe:

• gemfibrozil a me nā mea āpau (ʻaʻole i waiho i ka fenofibrate), waikawa fusidic: hoʻonui nui aʻe o ka hoʻomohala ʻana i ka myopathy,
• amiodarone, lomitapide, nā mea ʻohi līlī līlī lūlū (verapamil, diltiazem a i ʻole amlodipine), ka waikika nikotinic i loko o nā lipid e hōʻemi iho nei i ka wai (liʻiliʻi ma ka 1000 mg i kēlā lā): hoʻonui nui i ka ulu ʻana i ka myopathy / rhabdomyolysis,
• nā mea hōʻeha hōʻemi o ka CYP3A4 isoenzyme (e.g., dronedarone, ranolazine): hoʻonui nui aʻe o ka ulu ʻana i ka myopathy, hiki i ka hopena o Vasilip ke hoʻemi ʻia.
• OATP1B1 inhibitors protein protein: hoʻonui i ka plasma plasma o ka waila simvastatin hydroxy acid a me ka hopena o ka hoʻomohala ʻana i ka myopathy,
• colchicine (i loko o nā mea maʻi me ka hiki ʻole o ka pilikia): hoʻonui i ka makaʻala o ka hoʻomohala ʻana i ka myopathy a me ka rhabdomyolysis, me ka hoʻohui hoʻohui e pono ai ka mālama pono ʻana i nā maʻi.
• anticoagulants kūlike (dermarin derivatives): he hoʻonui i ka manawa prothrombin, i wehewehe ʻia e MHO (internationalization ratio ratio), ʻae ʻia ka waiwai o ka hōʻailona ma mua o ka hoʻomaka ʻana o ka hopena me ka simvastatin, a laila ua hoʻoholo pinepine ʻia i ka manawa mua o ka mālama ʻana, ka mea e ʻae ai i ka hoʻokaʻawale ʻana i nā loli nui i ka MHO. Ma hope o ka hiki ʻana i kahi hōʻailona mau o ka manawa prothrombin, pono e hoʻoholo ʻia i loko o nā manawa i kauoha ʻia no ka nānā ʻana i nā maʻi e loaʻa ana i ka terapi anticoagulant. I nā hihia no ka hoʻololi ʻana i ka hapa o ka simvastatin a i ʻole ka huki ʻana, ua ʻōlelo pū ʻia ka nui o ka helu ʻana i kēia hōʻailona. I ka poʻe maʻi i lawe ʻole i ka anticoagulants, ʻo ka maʻi me ka simvastatin me ke ʻano o ke koko a i ʻole nā ​​loli i ka manawa prothrombin i pili, ʻaʻole pili.
• kahe wai ʻona (ma ka nui helu): hoonui ka hana plasma o ka HMG-CoA reductase inhibitors.

Vasilip analogues i: Zocor, Zocor Forte Simvor, Simvakard, Simvastol, Simla, simvastatin Zentiva, SimvaGEKSAL, Zovatin, Levomir, Simvalimit, Aktalipid, Sinkard, Aterostat, Zorstat, Simvakol, Simplakor, simvastatin, Holvasim, simvastatin-Verein, Simvastatin- Chaikafarma, Simvastatin-SZ, Simvastatin Alkaloid, Aries, Simvastatin Pfizer.

Kahawai

No laila, ʻaʻole pono e hoʻohana ʻo simvastatin e nā wahine hāpai a me nā wahine e ʻimi nei e hāpai i ka hāpai a i ʻole ke kānalua.
ʻO ka ʻae ʻana o ka simvastatin e pono ke hoʻokuʻu ʻia no ka manawa holoʻokoʻa a hiki i kona hōʻoia ke ʻāpua ʻole ka wahine (e ʻike i ka ʻāpana "Contraindications").
Hoʻohana ʻia ka hoʻohana ʻana o simvastatin i nā wahine i ka wā lactation.
ʻAʻole ʻike ʻia inā hoʻokomo ʻia ka simvastatin a i ʻole nā ​​metabolites i ka waiū umauma. ʻO ka nui ʻana o nā lāʻau lapaʻau i loko o ka waiū umauma a aia paha he hopena kūpono loa, ʻo nā wahine e lawe i ka simvastatin e ho'ōki i ka hana ʻana i ka umauma. (E nānā i ka ʻāpana "Contraindications").