Hypevas 20mg Ha Tay medicine for hypertonic blood cholesterol (6 blisters x 10 tablets)

Pravastatin is a competitive inhibitor with 3-hydroxy-3-methylglutaryl-coenzym (HMG -coA) reductase, preventing HMG-COA into Mevabonate, the precursor of cholesterol. Therefore, pravastatin inhibits cholesterol biosynthesis, reduces cholesterol in liver cells, increases the amount of LDL - cholesterol receptor and thereby increases the transport of LDL - cholesterol from circulation. In addition, Pravastatin also inhibits the synthesis of VLDL - cholesterol liver, VLDL - cholesterol will convert into LDL - cholesterol.

In normal doses, HMG - CoA Reductase is not completely inhibited, so there is still enough meevalonic acid for many other metabolic processes.

In both healthy people and patients with hypercholesterol, sodium pravastatin reduces total cholesterol, LDL-Cholesterol, Apolipoprotein B, VLDL-Cholesterol, Triglycerides and HDL-Cholesterol and Apoliprotein a.

Dynamic pharmacokinetics

Absorption: fast absorption drug and not affected by food. On average, 34% of oral doal dose is absorbed. Low bioavailability (17%) for first metabolism through strong liver (> 60%). Tmax from 1 to 1.5 hours, plasma concentrations are proportional to the dose,

Distribution: Pravastatin binds to plasma proteins about 55 - 60%. The distribution volume 0.5 /kg. A small amount of pravastatin excreted into breast milk. The drug has a rainwater body does not pass through the bloody barrier.

Metabolism: Metabolizes mainly through the liver into active and non -active substances.

Elimination: After drinking, 20% of the initial dose is eliminated in the urine and 70% in the feces, the exhaust time is from 1.5 to 2 hours.

Children: After taking the dose of 20 mg, cmax and AUC of Pravastatin in children are similar in adults.

Patients with liver failure: exposure to pravastatin and metabolites increased by 50% in patients with alcoholic cirrhosis compared to patients with normal liver function.

Patients with renal failure: Pharmacokinetics have not changed significantly in patients with mild renal impairment. However, in patients with average and severe renal failure, exposure to pravastatin and metabolites twice.

recommended dose for children from 8 to 13 years old is: 10 - 20 mg/day (no full study with a dose greater than 20 mg in this age group).

Dosage recommended for children from 14 - 18 years old is: 10 - 40 mg/day (without adequate research with a dose greater than 40 mg in this age group).

No research for children under 8 years old.

Elderly:

No need to adjust the dose except for patients at risk of muscle absence or some drug interactions and some special patients.

Patients with kidney failure or liver disease:

The recommended starting dose is 10 mg/day, monitoring and adjusting the dose if necessary.

Note:

Patients need to follow a standard, low-cholesterol diet, before taking HMG-CoA Reductase inhibitors and continue to maintain this diet during treatment.

Adjust the dosage of sodium pravastatin according to the needs and response of each person by increasing each other no less than 4 weeks apart, until reaching the desired LDL cholesterol level, or when the maximum dose is reached.

Because the synthesis of cholesterol in the liver occurs mainly at night, taking the drug in the evening will increase the effectiveness of the drug.

Mortish coordination: sodium pravastatin and bile acid -mounted resin (cholestyramin, colestipol) have a supplementary mechanism for each other; Combining these groups of drugs has a combination effect on LDL-cholesterol. When using sodium pravastatin along with bile acid -mounted plastic, such as cholestyramin, sodium pravastatin must be taken before 1 hour or after 4 hours of drinking plastic with bile acid to avoid clear interactions due to the drug attached to the plastic.

Restricting the combination of sodium pravastatin with other lipid medications because of its ability to increase muscle disease.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when using overdose? There is no special report on symptoms when overdose of pravastatin.

How to handle: There is no specific trial measure. If overdose occurs, symptomatic treatment and support treatment when necessary. Because the drug is strongly connected to plasma proteins, the color separation does not significantly increase the clearing cravastatin.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

Pravastatin has not been evaluated in patients with hypercholesteroline hypertension in genetics. This therapy is not suitable for hypercholesterolemia due to HDL-cholesterol hyperplation.

As other HMG-Coa Reductase inhibitors should not combine pravastatin with fibrat.

In children before puberty, it is necessary to carefully assess the benefits/risks before starting treatment.

Be careful when using pravastatin for patients with a history of liver disease or severe alcoholism.

Mechanical disorders: Like other HMG-CoA Reductase inhibitors (statin), pravastatin is related to muscle pain, muscle diseases and very rare, muscle pattern. Mechanical diseases must be considered in all patients using statins with unknown symptoms such as pain or mild pain, muscle weakness, or cramps. Before starting treatment: Precautions when used in patients with renal impairment, hypothyroidism, a history of muscle poisoning with statin or fibrat, a history of yourself or a family with genetic, or alcoholic muscle disorders.

Caution for patients with liver dysfunction: Pravastatin increases moderate transaminase levels. In most cases, transaminase concentration returns to its original value without having to stop treatment. Pay special attention if the patient has Transaminase concentration, Alanin Aminotransferase (ALT) and Aspartat Aminotransferase (AST) exceeding three normal limits, should stop treatment with Pravastatin.

Diabetes: Some evidence suggests that statin increases blood sugar in some patients. Patients at risk (such as hunger at 5.6 - 6.9 mmol/l, BMI> 30kg/m2, increased triglycerides, hypertension) should be monitored both in clinical and biochemical according to
treatment guidelines.

Need to do liver enzyme test before starting treatment with pravastatin and during treatment if clinically indicated.

Consider monitoring Creatin Kinase (CK) in the case:

Before treatment, CK tests should be conducted in the case of: impaired renal function, hypothyroidism, history of self or family with genetically diseases, a history of muscle disease due to statin or fibrat, a history of liver disease and/or drinking lots of alcohol, elderly patients (> 70 years old) are at risk of muscle driving, some special medical interactions and some special patients.

In these cases, the benefits/risks should be considered and clinical monitoring when treated with pravastatin. If ck> 5 times the normal limit above, do not start treatment with pravastatin.

During Pravastatin treatment, patients need to notify when there are symptoms of muscle pain, muscle stiffness, muscle weakness ... When there are these manifestations, patients need to test CK to take appropriate interventions.

Before starting treatment with sodium pravastatin, it is necessary to eliminate the causes of blood cholesterol (such as under-control diabetes, thyroid disobol, nephrotic syndrome, blood protein disorders, biliary liver disease, due to some other drugs, alcoholism) and need
total amount of cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerid.

Periodic lipid quantification and dosage adjustment to respond to the patient's drug with a dose adjustment distance of less than 4 weeks. The goal of treatment is to reduce LDL-Cholesterol so it is necessary to use LDL-cholesterol levels to start treatment and evaluation of treatment.

Only when LDL-cholestrol cannot be tested, will the total cholesterol use for treatment.

suspend or stop pravastatin therapy in any patient manifestation of acute and severe muscle disease or risk of acute renal impairment due to muscle pattern, severe acute bacterial infections, hypotension, surgery and large injuries, abnormalities in metabolism, hormonal, electrolytes or uncontrolled convulsions.

Only use pravastatin for women of reproductive age when they are certainly not pregnant and only in the case of hyperlestoly blood cholesterol very high without responding to other drugs.

Interstitial lung disease has been reported when using some statins, especially when long -term treatment. The manifestations may include shortness of breath, dry cough and general health impairment (fatigue, weight loss and fever). If the patient is suspected of developing interstitial lung disease, he should stop using statin.

excipients:

Lactose ingredients: Patients with rare genetic disorders in galactose tolerance, lactase deficiency lactase or glucose-galactose absorption disorders should not use this drug.

Tartrazin ingredients: can cause allergic reactions.

Using drugs for pregnant and lactating women

pregnancy:

Contraindicated use of pravastatin during pregnancy and should only be used for patients without intent on pregnancy and must notify potential risks. If the patient is planning to immediately notify the doctor and should stop the drug because of the potential risk for the fetus.

Breastfeeding period:

Small amount of pravastatin is excreted in breast milk, so pravastatin is contraindicated during breastfeeding.

The effect of the drug on driving and operating machinery

Pravastatin does not affect or affect the ability to drive and operate machinery. However, do not drive or operate machinery if dizziness and visual disorders during treatment.

Drug interaction

drug interactions may affect the activity of the drug or cause side effects. Should notify the doctor or pharmacist a list of drugs and functional foods you are using. Do not use or increase or decrease the dose of the drug without the guidance of a doctor.

Fibrat: Increased risk of muscle damage when used simultaneously with statin. Pravastatin combination should be avoided with Fibrat (Gemfibrozil, Fenofibrat), if needed together, it is necessary to monitor the patient's subclinical and ck.

cholestyramin/colestipol: simultaneously led to a reduction of about 40-50% of pravastatin's bioavailability, this is not meaningful when Pravastatin is taken 1 hour before or 4 hours after G Cholestyramin or 1 hour before taking Colestinol.

Bile acid -mounted resins can significantly reduce Prayusttan's bioavailability when taken with them, so the time to use these two drugs must be apart.

ciclosporin: simultaneously use pravastatin and ciclosporin, resulting in a vastatin phase 4 times and may be larger in some patients.

If being treated with Fusidi acid, patients need to suspend the use of bleach, because when the pravastatin is simultaneously with fusilic acid, it can lead to muscle weakness, muscle pain or muscle pattern.

Warfarin and other oral anticoagulants: Pravastatin can increase the effects of warfarin. Prothrombin must be determined before starting to use pravastatin and regularly monitoring in the early stages of treatment to ensure no change in prothrombin time.

Metabolic drugs by cytochrom P450: Pravastatin metabolism is negligible for a sieve by Cytochrom P450, so drugs metabolized by cytochrom P450 or cytochrom P450 inhibitors can add stable treatment with pravastatin without
significant changes in plasma concentration in plasma that see Other.

There is no significant drug interaction between pravastatin and many drugs, especially CYP3A4 inhibitors such as Diltiazem, Verapamil, Itrilenzol, Ketoconazol, Protease inhibitors, Grapefruit juice and CYP2C9 inhibitors (such as fluconazol).

Antyrin: simultaneously using pravastatin does not affect the clearance of antipipin.

erythromycin: Increase (70%) and cmax (121%) of pravastatin.

Clarithromycin: increase AUC (110%) and cmax (127%) of Privastatin.

Despite the small change, it is necessary to be careful when combining pravastatin with erythromycin or clarithromycin.

Other drugs: In interactive studies, the difference has no statistical significance of bioavailability has been reported when using simultaneously pravastatin with acetylsalicylic acid (Aspirin), antacids (oral an hour before taking pravastatin), nicotinic acid or
Probucol.

Increase the risk of muscle damage when using statin simultaneously with the following drugs:

Concomitance the use of statin lipid medications with HIV and hepatitis C (HCV) can increase the risk of muscle damage, the most serious is small muscle, kidney syndrome leading to kidney failure and can be fatal,

Pravastatin in collaboration with Clarunavir and Ritonavi: Unlimited dosage.

Pravastatin in collaboration with Lopinavir and Ritonavir: Unlimited dosage.

Although there is no clinical interaction studies in clinical interaction, there is no clinical significant interaction with clinical significance when taking pravastatin along with angiotensin medications, bet blockers: 1, channel blockers, diuretics and non -steroid anti -inflammatory drugs.

Cavalry of the drug: Due to no studies on the correspondence of the drug, not mixing this drug with other drugs.