Absorption of simvastatin high. After primobolan depot dosage oral administration the maximum plasma concentration is reached after about 1.3 – 2.4 hours, and reduced by 90% after 12 hours. Communication with the plasma proteins is approximately 95%. It is metabolized in the liver, it has the effect of “first pass” through the liver (hydrolyzed to form an active derivative: beta-hydroxyacids are found and other active and inactive metabolites). The half-life of the active metabolite is 1.9 hours. Excreted mainly via the intestine (60%) in the form of metabolites. About 10 – 15% is excreted by the kidneys in an inactive form.
- Primary Hypercholesterolemia (type IIa and IIb), when poor diet low in cholesterol and other non-drug interventions (exercise and weight reduction) in patients with an increased risk of coronary atherosclerosis;
- combined hypercholesterolemia and hypertriglyceridemia, uncorrectable special diet and physical activity;
- Homozygous Familial Hypercholesterolemia (as a supplement to the lipid-lowering therapy);
- secondary hyperlipidemia: hypercholesterolemia, hypertriglyceridemia (IV type, as an adjunct to diet), disbetalipoproteinemiya (III type in cases with inadequate diet), as well as mixed forms); Coronary heart disease:
- for the prevention of myocardial infarction, to reduce the risk of death, reducing the risk of cardiovascular events (stroke or transient ischemic attacks), slowing the progression of atherosclerosis of the coronary vessels, reducing the risk of revascularization procedures.Contraindications
- Hypersensitivity to simvastatin or to other components of the formulation;
- Hypersensitivity to other inhibitors of primobolan depot dosage reductase in the history;
- liver disease in the active phase, a persistent increase in activity of “liver” enzymes of unknown etiology;
- diseases of skeletal muscles (myopathy);
- age of 18 years (effectiveness and safety have been established);
- Hereditary lactose intolerance.Be wary appoint:
- patients who abuse alcohol;
- transplant patients undergoing immunosuppressive therapy (due to an increased risk of rhabdomyolysis and renal failure);
- in conditions that can lead to severe renal insufficiency, such as hypotension, acute infectious diseases heavy currents expressed metabolic and endocrine disorders, disorders of water and electrolyte balance, surgery (including dental), or injury;
- patients with low or high tone of the skeletal muscles of unknown etiology;
- epilepsy.Pregnancy and lactation
simvastatin contraindicated in pregnant women.
In view of the fact that inhibitors reductase inhibitors inhibit the synthesis of cholesterol and cholesterol and other products of its synthesis are essential in fetal development including synthesis of steroids primobolan and cell membranes, simvastatin may have adverse effects on the fetus. There are several reports of malformations in newborns whose mothers took simvastatin.
Therefore, women of childbearing age should avoid conception.
If during treatment with simvastatin pregnancies still occurred, the drug should be immediately canceled and the woman warned of the possible danger to the fetus.
Allocate data simvastatin in breast milk are not available. The appointment of simvastatin during lactation should be borne in mind that many drugs are excreted in breast milk, and there is a threat of severe reactions, so breast-feeding while receiving the drug should be discontinued.Dosage and administration
Before the treatment primobolan depot dosagepatient must assign a standard hypolipidemic diet, which should be respected during the entire course of treatment.
Sinkard recommended to be taken orally, 1 time per day in the evening, drinking plenty of water.
Time of the drug should not be linked with the meal.
Sinkarda recommended dose for the treatment of hypercholesterolemia varies from 10 to 80 mg 1 time per day in the evening. The recommended starting dose for patients with hypercholesterolemia is 10 mg.
The maximum daily dose – 80 mg.
Changes (selection) the dose should be performed at intervals of 4 weeks.
In case of missing the current drug dose must be taken as soon as possible. If it is time for your next dose, dose not double.
In most patients, the optimal effect is achieved while taking the drug at doses up to 20 mg per day.
Patients with Homozygous Familial Hypercholesterolemia The recommended daily dose Sinkarda is 40 mg 1 time per day in the evening or 80 mg . three doses (20 mg in the morning, 20 mg in the afternoon and 40 mg in the evening)
in the treatment of patients with coronary heart disease or a high risk of developing effective doses are 20-40 mg per day.
Therefore, the recommended starting dose in these patients – 20 mg per day.
The change (selection) of the dose should be performed at intervals of 4 weeks, if necessary dose can be increased to 40 mg per day. If the LDL content of less than 75 mg / dl (1.94 mmol / l), total cholesterol – less than 140 mg / dl (3.6 mmol / L), the dose should be reduced.
In elderly patients and in patients primobolan cycle with mild or moderate renal impairment changes medication dosage is necessary.
patients with chronic renal failure (creatinine clearance less than 30 mL / min) or receiving cyclosporin, danazol, gemfibrozil or other fibrates (except fenofibrate), niacin in lipid-lowering doses (> 1 g / day) in combination with simvastatin, the maximum recommended dose Sinkarda should not exceed 10 mg per day.
in patients taking amiodarone or verapamil primobolan depot dosage simultaneously with a maximum daily dose Sinkarda should not exceed 20 mg. In the case of the current dose skip the drug should be taken as soon as possible. If it is time for your next dose, do not double the dose.