Lovastatin 20mg Domesco medicine prevents cardiovascular events (1 blister x 10 tablets)

Dosage form Box of 1 blister x 10 tablets
Specifications Lovastatin

Ingredient

Composition informationContent
Lovastatin20mg

Uses

indications

Lovastatin 20 mg is indicated in the following cases:

Cardiovascular prevention treatment:

  • Primary prophylaxis: In patients with LDL-Cholesterol (normal or medium high) and HDL-Cholesterol below average to reduce the risk of acute coronary artery (such as myocardial infarction, unstable angina), reduce the risk of coronary coronary regeneration surgery.
  • Blood lipid disorders:
  • hypercholesteroline blood cholesterol and mixed blood lipid disorders in adults (hyperlested family blood cholesterol and other causes) and in children over 10 years old (hyperlested family blood cholesterol and family history with cardiovascular disease without controlled by diet). Diseases (diabetes, cardiovascular disease, kidney transplantation, kidney syndrome due to hyperlipidemia, ileum surgery).

    • Pharmacology

    lovastatin are competitive inhibitors with hydroxymethyglutaryl coenzym (HMG - CoA) Reductase that prevent HMG - CoA into Meevalonate, the precursor of cholesterol, Lovastatin inhibit cholesterol, reduce cholesterol bioscle Hepatic cells, stimulating LDL receptors (low density lipoprotein) and thereby increasing LDL transport from blood. The final result of these biochemical processes is to reduce cholesterol levels in plasma. At normal doses, HMG - CoA Reductase is not completely inhibited, so there is still enough meevalonic acid for many metabolic processes.

    Lovastatin reduces LDL levels very effectively, lowering LDL cholesterol from 25% to 45% depending on the dose, increasing the concentration of HDL cholesterol (lipoprotein has a high density) from 5% to 15% and thus lowering LDL/HDL and global cholesterol ratio/HDL. Lovastatin also reduces plasma triglycerides at a lower level (10% to 30%) by increasing the clearance of VLDL (Lipoprotein very low density) residual thanks to LDL receptors.

    The treatment response can be seen within 1-2 weeks after starting the drug and usually reaches up to 4-6 weeks. Maintain maintenance during long -term treatment. In clinical studies, Lovastatin evidence significantly reduces coronary artery events, all cardiovascular events have the total number of deaths in people with coronary artery disease (with a history of angina or acute myocardial infarction) and people with plasma cholesterol 5.5 mmol/liters or higher.

    Lovastatin also plays a prophylactic role (acute 1) coronary artery disease in patients with cholesterol patients at high risk of coronary artery events.

    pharmacokinetics

    absorption:

    Lovastatin absorbs rapidly, is a precursor of the substance that has a strong initial metabolism to become an active metabolic substance, taking drugs when hungry, the concentration of metabolites is active in serum only two -thirds of concentration when taking the drug at full. Low bioavailability because of its first strong metabolism in the liver (> 60%).

    Distribution:

    The peak concentration of serum activity is within 1-4 hours. Link about 95% with plasma protein.

    Metabolism - excretion:

    Lovastatin passes through the bloody barrier. Metabolic mainly in Qan (> 70%), much elimination through stool, 10% elimination through the kidneys.

    Before taking Lovastatin 20mg Domesco medicine prevents cardiovascular events (1 blister x 10 tablets)

    How to use

    Take oral use.

    Should drink in the evening with meals to absorb maximum.

    Dosage

    Normal adult dose: Start 20 mg/time, every day, at dinner. Adjust the dose of 4 Tuan once, if necessary and if tolerated. Maintenable dose of 20 - 80 mg, taken once a day or 2 times, at meals.

    The maximum dose must not exceed 80 mg/day.

    Do not use more than 20 mg of lovastatin/day when used simultaneously with Danazol, Diltiazem, Verapamil.

    Do not use more than 40 mg of lovastatin/day when used with amiodaron.

    * The recommendation to start treatment with the lowest dose has the drug, then if necessary, can adjust the dose according to the needs and response of each person by increasing the dose each spaces no less than 4 weeks apart and must monitor the harmful reactions of the drug, especially the harmful reactions to the muscle system.

    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 do

    do when using overdose? No patient has special symptoms and all patients recover without sequelae. If overdose occurs, symptomatic treatment and support when necessary. Because the drug is strongly associated with plasma proteins, the hemorrhage does not expect significantly increasing the clearing of statins.

    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.

    Side Effects

    When using Lovastatin 20 mg, you may experience unwanted effects (ADR).

    Common, ADR> 1/100

  • Digestive system: diarrhea, constipation, flatulence, abdominal pain and nausea, test results increase liver function more than 3 times the upper limit of normal.

    • Nervous system: headache, dizziness, blurred vision, insomnia, weakness.

  • musculoskeletal system: muscle pain, joint pain.

    • Uncommon, 1/1000

  • musculoskeletal system: muscle disease (combining muscle weakness and increasing the content of creatin phosphokinase plasma),

    • DA: Ban Da.

    Respiratory system: rhinitis, sinusitis, sore throat, cough.

    Rare, 1/10000

  • musculoskeletal system: muscle inflammation, muscle pattern, leading to secondary secondary renal failure due to myoglobin urine.
  • Nervous system: Cognitive impairment (such as memory loss, confusion ...).
  • Endocrine system: hyperglycemia, HBA1C.

    • Instructions on how to handle ADR

    When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

    Warnings

    Before using the drug you need to read the instructions carefully and refer to the information below.

    Contraindications:

    Lovastatin 20 mg contraindicated in the following cases:

  • Hypersensitivity to HMG-COA Reductase inhibitors or any ingredients of the preparation.

    • Liver or transaminase disease persists in the persistent without explanation.

  • During pregnancy or lactation.
  • Contraindicated Lovastatin in combination with strong CYP 3A4 inhibitors such as Itraconazol, Ketoconazol, Posaconazol, Erythromycin, Clarithromycin, Telithromycin, Protase inhibitors of HIV HIV, Boceprevir, TelapReviron.

    • Anti -expenses simultaneously use lovastatin with cyclosporin, gemfibrozil.

    Caution when using

    Before starting treatment with statin, it is necessary to eliminate the causes of hypercholesterol (such as under -control diabetes, thyroid disobination, kidney syndrome, blood protein disorders, biliary obstruction, due to some other drugs, alcoholism) and quantitative cholesterol quantitative ldl cholesterol, cholesterol, cholesterol

    Periodic lipid quantification must be conducted at a distance of no less than 4 weeks and adjust the dose according to the response of the patient with the drug. The goal of treatment is to reduce LDL cholesterol, so it is necessary to use LDL cholesterol levels to start treatment and evaluate treatment. Only without testing LDL cholesterol, will it use total cholesterol to monitor treatment.

    In clinical trials, a small number of adult patients drink statin see significantly increasing serum transaminase (> 3 normal limits). When stopping the drug in this patient, the transaminase concentration often lowered the level before treatment. Some of these patients before treatment with statins have abnormal liver function test results and/or drink a lot of alcohol. Recommended the liver enzyme test before starting statin treatment and in case of clinical indications for testing later. Caution should be used in patients who drink a lot of alcohol and/or have a history of liver disease.

    Statin therapy must be suspended or stop in any patient who shows signs of acute and severe muscle disease or has a risk factor prone to acute renal impairment due to muscle pattern, such as severe acute infection, hypotension, surgery and large injury, abnormalities in metabolism, endocrine, electrolytes or uncontrolled convulsions.

    Consider monitoring Creatin Kinase (CK) in the case:

  • Before treatment, CK tests should be conducted in the following cases: impaired renal function, hypothyroidism, self -history or family history of genetic muscle disease, a history of muscle disease due to the use of statin or FLBRAT before, the history of liver disease and/or drinking lots of alcohol, elderly patients (> 70 years old) have special risk factors for medication and drug -related patients. In these cases, the benefits/risks should be considered and monitor patients clinically when treated with statin. If the results of CK test> 5 times the upper limit of normal levels, do not start treatment with statin.
  • During statin treatment, patients need to notify when there are muscle manifestations such as muscle pain, muscle stiffness, muscle weakness ... When there are these manifestations, patients need to test CK to take appropriate interventions.

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

    The ability to drive and operate machines

    drugs do not affect the driver and operate machinery.

    Pregnancy

    Because statins reduce cholesterol synthesis and maybe many other substances with biological activity derived from cholesterol, the drug can be harmful to the fetus if used for pregnant women. So contraindicated use of statin during pregnancy.

    The period of breastfeeding

    Many statins are distributed into milk. Because the potential has a serious unwanted effect for breastfeeding children, contraindicated use of statin in nursing mothers.

    Drug interaction

    Statin may increase the effects of warfarin. Prothrombin must be determined before starting to use statin and regular monitoring in the first stage of treatment to ensure no change in prothrombin time.

    Bile acid -mounted resins can significantly reduce the biological capacity of statin when taken. So the time to use these 2 drugs must be apart.

    Increased risk of muscle lesions when using statin simultaneously with the post -gemfibrozil drugs, other fibrat blood cholesterol medications, high -dose niacin (> 1 g/day), Colchicin.

    *Avoid simultaneous use and limit of Lovastatin dosage when used simultaneously with some drugs or drinks that can increase the risk of muscle damage, the most serious is muscle pattern, kidney damage leads to kidney failure and can be fatal:

  • Contraindicated Lovastatin in combination with strong CYP 3A4 inhibitors such as iTraconazol, Ketoconazole, Posaconazole, Erythromycin, Clarithromycin, Telithromycin, HIV Protease inhibitors of HIV, BoCeprevir, TelapRevir, Nefazodon.

    • Contrain to Lovastatin with cyclosporin, gemfibrozil.

  • Avoid using large amounts of grapefruit juice (grapefruit juice) (> 1 liter/day).
  • Do not use more than 20 mg of lovastatin/day when used simultaneously with Danazol, Diltiazem, Verapamil.

    • Do not use more than 40 mg of lovastatin/day when used with amiodaron.

    Although there is no clinical interactive studies in clinical interactions, there is no clinical interactive manifestation of clinical significance when using statin along with angiotensin transferring enzymes, beta blockers, calcium channel blockers, diuretics and nonsteroidal anti -inflammatory drugs.

    Storage

    Sightseeing, from 5 - 30 ° C, avoid direct light.

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