Medication

Simvastatin

Structure

Tablet contains active ingredient Simvastatin. Dosages of the active substance: 10, 20, 40, 80 mg. Auxiliary components: titanium dioxide, citric acid, povidone, lactose, hypromellose, calcium stearate, corn starch, ascorbic acid, talc, macrogol, butylhydroxyanisole.

Release form

Simvastatin is available in tablet form. Tablets can be packed in plastic cans, blisters of 10, 15, 30 pieces.

Pharmachologic effect

Hypolipidemic drug.The active ingredient is produced synthetically by fermentation of Aspergillus terreus. The active substance is an inactive lactone, which, as a result of hydrolysis in the human body, becomes a hydroxy acid derivative. The main metabolite inhibits a specific enzyme that catalyzes the formation of mevalonate from HMG-CoA. This reaction underlies early synthesis. cholesterol, which allows Simvastatin to prevent the accumulation of toxic forms of sterols. HMG-CoA can easily be metabolized to acetyl-CoA, which is actively involved in many synthesis processes in the human body.

While taking Simvastatin, the level decreases triglycerides, total cholesterol, "bad" and "very bad" cholesterol (LDL and VLDL). The effect of the drug appears after 15 days of treatment, and becomes noticeable by laboratory parameters after 1-1.5 months. The cholesterol-lowering effect persists throughout the course of treatment. After discontinuation of therapy, the level of cholesterol gradually returns to its original level.

Pharmacodynamics and pharmacokinetics

Simvastatin has a high absorption rate. The maximum concentration is recorded after 1.5-2.5 hours, but after 12 hours it decreases by 90%. In plasma proteins, the active component is able to bind to 95%. For simvastatin with metabolism a peculiar effect of the "first pass" is characteristic in the hepatic system, when, as a result of hydrolysis, an active derivative, beta hydroxy acid, is formed. The main route of excretion is through the intestines. In an inactive form, 10-15% of the active substance is excreted through the renal system.

Indications for use of simvastatin

What are the pills from? A medication is prescribed to lower cholesterol with hypercholesterolemia and coronary artery disease hearts. The main indications for the use of Simvastatin:

  • primary hypercholesterolemia (types: IIa and IIb) in the absence of the effect of diet therapy and other non-drug methods (weight loss, adequate physical activity) and people at high risk of developing atherosclerosis coronary in nature;
  • a combined form of hypercholesterolemia and hypertriglyceridemia with diet inefficiency and adequate physical exertion;
  • prevention myocardial infarction;
  • cardiovascular risk reduction (stroketransient ischemic attack);
  • risk reduction after revascularization;
  • preventing the progression of atherosclerosis of the heart vessels.

Contraindications

  • myopathy and other diseases of the skeletal muscles;
  • increased ALT, AST;
  • individual hypersensitivity;
  • pronounced pathology of the hepatic system;
  • age limit - up to 18 years.

Relative contraindications in which simvastatin is prescribed with caution:

  • immunosuppressive therapy after organ transplantation;
  • alcohol abuse
  • arterial hypotension;
  • water-electrolyte imbalance;
  • severe pathology of the endocrine system;
  • metabolic changes;
  • epilepsy;
  • traumatic and surgical interventions.

Side effects

Digestive tract:

  • pancreatitis
  • flatulence;
  • epigastric pain;
  • constipation
  • increase in CPK, ALT, AST;
  • vomiting
  • diurena syndrome;
  • nausea.

Nervous system:

  • blurry vision;
  • migraine headache;
  • asthenic syndrome;
  • paresthesia;
  • dizziness;
  • violation of taste perception;
  • muscle cramps;
  • insomnia;
  • peripheral neuropathy.

Immunopathological reactions and allergic responses:

  • tides;
  • vasculitis;
  • angioedema;
  • thrombocytopenia;
  • rheumatic polymyalgia;
  • eosinophilia;
  • lupus-like syndrome;
  • photosensitivity;
  • hives;
  • fever;
  • increase in ESR;
  • hyperemia of the skin;
  • arthritis, shortness of breath.

Musculoskeletal system:

  • muscle cramps;
  • myopathy
  • severe weakness;
  • rhabdomyolysis;
  • myalgia.

Dermatological reactions:

  • dermatomyositis;
  • itchy skin;
  • alopecia.

Other reactions:

  • decreased potency;
  • acute renal failure with rhabdomyolysis;
  • heart palpitations;
  • anemia.

With the manifestation of other negative reactions during treatment, the help of a specialist and self-medication withdrawal of Simvastatin is recommended.

Instructions for use (Method and dosage)

Before prescribing statins, cholesterol is reduced by a special hypocholesterol diet. With inefficiency, Simvastatin is additionally prescribed. Instructions for use of simvastatin: 1 time per day, 1 tablet at night, washed down with water. Do not associate medication with food intake. The daily dose depends on cholesterol and lipid profile (10 to 80 mg). It is better to start cholesterol lowering therapy with small doses, gradually increasing the amount of simvastatin every 4 weeks, monitoring laboratory parameters. In most cases, a good effect is recorded at a dose of 20 mg per day.

Patients with a hereditary (homozygous) form of hyperlipidemia are prescribed 40 mg once a day or 80 mg in 3 doses (20 mg in the morning and in the afternoon, 40 mg in the evening). With coronary heart disease, the daily dose varies in the range of 20-40 mg. With simultaneous therapy with fibrates, Gemfibrozil, Danazolum, Cyclosporinum, Natsinom it is recommended to take no more than 10 mg of simvastatin daily. At receptionVerapamil and Amiodarone daily take no more than 20 mg of statin.

Overdose

Specific symptoms are not described. Treatment: administration of enterosorbents, syndromic therapy. Recommended control of hepatic indices, KFK. With the development of renal failure, myopathy with rhabdomyolysis, sodium bicarbonate and a diuretic drug are prescribed intravenously. Hemodialysis can be carried out according to indications. Against the background of rhabdomyolysis, hyperkalemia is recorded, which requires intravenous infusion calcium gluconate, calcium chloride, insulin with glucose.

Interaction

The following medications can cause myopathy:

  • Nefazodon;
  • HIV protease inhibitors;
  • Erythromycin;
  • high doses nicotinic acid;
  • antimycotic drugs (Itraconazole, Ketoconazole);
  • fibrates;
  • immunosuppressants;
  • Telithromycin;
  • Clarithromycin

High dosages of simvastatin and co-administration Danazole and Cyclosporin may lead to rhabdomyolysis. The drug is able to potentiate the effect of oral forms of anticoagulants (Warfarin, Fenprokumon), increase the risk of bleeding. Medication Increases Concentration Digoxin.

Terms of sale

You can purchase without a prescription form.

Storage conditions

Dry place. The manufacturer recommends observing the temperature range of 15-25 degrees.

Shelf life

2 years.

Special instructions

The first days of therapy may be accompanied by an increase in ALT, AST, bilirubin. Regular ultrasound monitoring is recommended (when taking 80 mg every 3 months). An increase in liver enzymes by 3 times is an indication for stopping treatment. Following a hypocholesterol diet can achieve the best results. It is recommended to refuse grapefruit juice during treatment. The medication is not used for hypertriglyceridemia 1.4 and 5 types. The drug can provoke myopathy, which leads to renal failure and rhabdomyolysis. The medication is effective both in monotherapy and in joint treatment with bile acid sequestrants.

Simvastatin analogs (substitutes)

Matches for ATX Level 4 code:AkortaAtomaxLipitorPravastatinSimvastolAriesSimgalTulipLovastatinLiptonormRosulipZokorRosartTevastorLiprimarAtorisVasilipRosucardRoxerRosuvastatin

Structural analogues of simvastatin:

  • Vasilip;
  • Simgal;
  • Atherostat;
  • Zokor;
  • Aries

In pregnancy (and lactation)

Simvastatin is contraindicated in gestation of pregnancybecause able to cause various developmental abnormalities in newborns. During treatment, the use of contraception. There is no data on the penetration of the active substance into breast milk. However, it is important to remember that there is a high risk of the effects of simvastatin on the health of the child.

Reviews about Simvastatin (opinion of doctors, patients)

Reviews about Simvastatin on the forums are different. Patients confirm that the medication really lowers cholesterol, but at the same time they describe various negative reactions against the background of the entire course of hypocholesterol therapy. Patients suffering from chronic pancreatitis note an increase in the frequency of exacerbations during treatment. With prolonged therapy, there is a change in the lipid profile for the better.

Doctors reviews are shared. Some believe that the drug belongs to the "old guard" and has outlived itself, given the severity of adverse reactions, and the appearance on the pharmaceutical market Atorvastatin and Rosuvastatinthat relate to the drug of a new generation. Others note that the medication successfully lowers cholesterol and serves as an excellent means of preventing atherosclerosis.

Simvastatin price, where to buy

The price of pills for cholesterol depends on the manufacturer, sales region, dosage. The price of Simvastatin 40 mg varies in the range of 200-600 rubles.

  • Online Pharmacies in Russia
  • Online pharmacies in UkraineUkraine

ZdravCity

  • Simvastatin tab. n / a captive. 10mg No. 30Ozone LLC82 rub.order
  • Simvastatin tab p / o captive. 20mg No. 30 Vertex AO 270 RUB order
  • Simvastatin tab. p.p.o. 10mg n30 Vertex AO 178 rub.order
  • Simvastatin-ALSI tab. n / a captive. 10mg No. 30ALSI Pharma ZAO65 rub.order
  • Simvastatin tab. po about 20mg n20Hemofarm226 rub.order

Pharmacy Dialog

  • Simvastatin tablets 40mg No. 30108 rub.order
  • Simvastatin (tab.p / o 20mg No. 30) 258 rubles.order
  • Simvastatin tablets p / o 10mg No. 3063 rub.order
  • Simvastatin (tab p / o 10mg No. 30) 182 rubles to order
  • Simvastatin tablets 20mg No. 28295 rub. Order

Eurofarm * 4% discount on the promotional code medside11

  • Simvastatin-Vertex 10 mg No. 30 tablet Ozone LLC201 rub.order
  • Simvastatin 20 mg No. 30 tabOZON, OOO47 rub.order
  • Simvastatin-Vertex 20 mg No. 30 tabl Verteks ZAO273 rub.order
  • Simvastatin zentiva 20 mg No. 28 tab.Zentiva k.s. 325 rub.order
  • Simvastatin 40 mg No. 30 tab. North Star CJSC 129 rubles order
show more

Pharmacy24

  • Simvastatin 40 Ananta 40mg No. 28 tablets Marxans Pharma Ltd.India105 UAH order
  • Simvastatin Ananta 20 mg N28 tablets Marxans Pharma Ltd.India55 UAH
show more

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