Absorption primobolan steroid is high. After 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 with faeces (60%) in the form of metabolites. Approximately 10-15% is excreted by the kidneys in an inactive form.
- Primary hypercholesterolemia (IIa and type 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;
- The combined hypercholesterolemia and hypertriglyceridemia, is not correctable special diet and exercise.
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 primobolan steroid the risk of revascularization procedures.
- Hypersensitivity to simvastatin or to other components of the preparation (including hereditary lactose intolerance), as well as several other statin drugs (inhibitors MMC-CoA reductase) in history;
- Liver disease in the active phase, a persistent increase in activity of “liver” enzymes of unknown etiology;
- Diseases of the skeletal muscles (myopathy);
- Age 18 years (effectiveness and safety have been established).
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 can have adverse effects primobolan steroid on the fetus and is contraindicated in pregnant women. There are several reports of malformations in newborns whose mothers took simvastatin.
Women of childbearing age who take simvastatin should avoid conception. The use of simvastatin is not recommended in women of childbearing age, not using contraception. If during treatment pregnancy yet occurred, simvastatin should be discontinued, and the woman should be advised of the potential hazard to the fetus.
The data on the allocation of simvastatin in breast milk are not available. If necessary, simvastatin appointment 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 during treatment is not recommended.
Dosing and Administration
Prior to treatment with simvastatin patient must assign a standard hypolipidemic diet, which should be respected during the entire course of treatment.
Simvastatin is taken orally 1 time a day in the evening, drinking plenty of water.
Time of the drug should not be linked with the meal.
The recommended dose of simvastatin 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 most patients, the optimal effect is achieved by taking the drug at doses up to 20 mg per day.
In patients with homozygous familial hypercholesterolemia recommended daily dose of simvastatin 40 mg 1 time per day in the evening or 80 mg in three divided 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 at high risk effective doses of simvastatin are 20-40 mg per day. Therefore, the recommended initial dose in these patients – 20 mg per day. 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 content of less than 75 mg / dl (1.94 mmol / l), total cholesterol – less than 140 mg / dl (3, the dose should be reduced.
In elderly patients and in patients with mild or moderate renal impairment changes medication dosage is necessary.
patients with primobolan steroid chronic renal failure (creatinine clearance less than 30 mL / min) or receiving cyclosporin, danazol, gemfibrozil or other fibrates (except fenofibrate), nicotinic acid as lipid-lowering doses (≥ 1g / day) in combination with simvastatin, the maximum recommended dose of simvastatin should not exceed 10 mg per day.
in patients taking amiodarone or verapamil with simvastatin at the same time, the daily dose should not exceed 20 mg.
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