Novo-Simvastatin

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Novo-Simvastatin uses

• Pharmacological action
• Pharmacokinetics
• Why is Novo-Simvastatin prescribed?
• Dosage and administration
• Novo-Simvastatin side effects, adverse reactions
• Novo-Simvastatin contraindications
• Using during pregnancy and breastfeeding
• Special instructions
• Novo-Simvastatin drug interactions
• Novo-Simvastatin reviews

Pharmacological action

Novo-Simvastatin is a hypolipidemic agent from a group of statins, an inhibitor of HMG-CoA reductase. This medication is a prodrug because it has in its structure the closed lactone ring which is hydrolyzed after intake.

Lipid-lowering effect of statins is associated with lower levels of total cholesterol by LDL-C. Reducing cholesterol is dose-dependent and is not linear but exponential. Statins do not affect the activity of lipoprotein and hepatic lipase, have no significant effect on the synthesis and catabolism of free fatty acids, thats why their effect on TG levels again and indirectly through their main effects on reducing LDL-C.

According to the controlled studies of Novo-Simvastatin increases HDL-C to 14%.

In addition to the hypolipidemic actions Novo-Simvastatin has beneficial effects in endothelial dysfunction, on the vascular wall, the state of atheroma, improves blood rheology, have antioxidant, antiproliferative properties. There is evidence that Novo-Simvastatin improves endothelial function within 30 days of therapy.

Novo-Simvastatin therapy was accompanied by a decrease in the incidence of cardiovascular disorders, regardless of baseline LDL-C.

Pharmacokinetics

After oral administration Novo-Simvastatin is well absorbed from the gastrointestinal tract (average 85%). C_max is reached after 4 h. Taking Novo-Simvastatin just before eating with low fat does not affect its the pharmacokinetic parameters.

During a "first pass" through the liver Novo-Simvastatin biotransformed to form active beta-metabolites. The plasma protein binding is 95%.

The concentration of the active metabolite of Novo-Simvastatin in human systemic circulation is less than 5%.

Excreted in unchanged form and as metabolites, mainly in the bile - 60-85%, 10-15% - in the form of inactive metabolites are excreted by the kidneys.

Why is Novo-Simvastatin prescribed?

Primary hypercholesterolemia with the ineffectiveness of diets, combined hypercholesterolemia and hypertriglyceridemia.

Dosage and administration

The dosing regimen of Novo-Simvastatin is individual. The initial dose is 5-20 mg. If necessary the dose is increased every 4 weeks. Novo-Simvastatin is taken 1 time / day in the evening. The maximum dose is 40 mg / day.

For patients receiving immunosuppressive drugs, the recommended starting dose is 5 mg; the maximum dose is 5 mg / day.

In severe renal insufficiency, the initial dose is 5-10 mg / day.

Novo-Simvastatin side effects, adverse reactions

Digestive system: constipation, diarrhea, loss of appetite, flatulence, nausea, abdominal pain, pancreatitis, increased ALT, AST, GGT, ALP.

CNS and peripheral nervous system: headache, dizziness, muscle cramps, paresthesia, peripheral neuropathy.

Cardiovascular system: possible transient hypotension.

Musculoskeletal system: myalgia, myopathy, rhabdomyolysis, increased CPK.

Allergic reactions: seldom - angioedema, lupus like syndrome, vasculitis, thrombocytopenia, eosinophilia, ESR increase, arthritis, rash, fever, shortness of breath.

Dermatological reactions: photosensitivity, skin rash, itching, redness of skin, alopecia.

Other: anemia.

Novo-Simvastatin contraindications

An active pathological process in the liver, persistent elevation of transaminases, pregnancy, lactation, hypersensitivity to Novo-Simvastatin.

Using during pregnancy and breastfeeding

Novo-Simvastatin is contraindicated in pregnancy and lactation.

Category effects on the fetus by FDA - X.

Special instructions

With careful use Novo-Simvastatin in patients with liver disease, with chronic alcoholism, with hypotension, reduced or increased tone of skeletal muscle of unknown etiology, epilepsy, severe renal insufficiency.

Before and during treatment it is necessary to monitor liver function.

Patients receiving anticoagulant coumarin derivatives, before and during treatment with Novo-Simvastatin should monitor the prothrombin time.

Novo-Simvastatin therapy should be discontinued if a significant increase in CK activity or suspected myopathy, the development of acute or severe illness when any risk factors predisposing to renal failure due to rhabdomyolysis.

It is not recommended to use Novo-Simvastatin concurrently with immunosuppressants, fibrates, nicotinic acid, antifungal azole derivatives drugs.

Safety and efficacy of Novo-Simvastatin in a pediatric practice are not established. It is not recommended to use this medication for children.

Novo-Simvastatin drug interactions

Simultaneous administration of Novo-Simvastatin with: