HOLETAR. 40 mg. 30 tablets
HOLETAR. 40 mg. 30 tablets
Properties and action
Holetar is a potent inhibitor of the endogenous synthesis of cholesterol. It is highly effective in reducing the concentration of total cholesterol, on LDL and VLDL cholesterol on . Also reduces the concentration of triglycerides in the plasma and increases the concentration of sparingly visokoplatnostnite lipoproteins (HDL). Besides the effect of lipid-lowering lovastatin has an antiatherosclerotic effect , as evidenced by the reduction of damage to the coronary and carotid vessels in humans. Following absorption in the gastrointestinal tract , Holetar as an inactive lactone, is hydrolyzed immediately to the corresponding therapeutically active beta - hydroxy acid . This active form acts as a specific inhibitor of the D -hydroxy- D -methylglutaryl -coenzyme A reductase (HMG-CoA reductase) . This enzyme accelerates conversion of HMG-CoA to mevalonate , which is an initial step in the biosynthesis of cholesterol.
Hyperlipidemia : A drug shown to lower high levels of cholesterol and triglycerides in patients with primary hyperlipidemia (type IIa and IIb), including polygenic and heterozygous familial hypercholesterolemia and mixed hiperlipidemiya.Koronarno heart disease : Lovastatin is indicated to slow the process of atherosclerosis and coronary involved in the therapeutic strategy to reduce the lipids in patients with coronary heart disease.
Treatment with lovastatin should be accompanied by a proper diet . The therapeutic effect was observed after a few weeks of treatment the maximum response is obtained after 4 to 6 weeks .
The drug should not be administered to a hypersensitive to any of its ingredients persons, patients with liver disease in persistently elevated serum transaminases during pregnancy and lactation .
Precautions and warnings
Drug should be used with caution by patients who consume substantial quantities of alcohol and from patients with past liver disease. Treatment with lovastatin can cause an increase in the activity of hepatic enzymes , mainly increase the level of serum transaminases . This increase is usually small and clinically insignificant . However, it is recommended that before the start of treatment to determine the level of liver enzymes in serum and to control it at regular intervals during treatment . If the rise in AST and / or ALT levels is three times greater than the upper limit of normal, therapy with lovastatin should be discontinued .
Holetar therapy can cause myopathy , which can lead to rhabdomyolysis and renal failure. The risk of these complications may be greater if the patient is treated with medicines , or to foods , which inhibit the metabolism of lovastatin.
Increased risk of myopathy exists in patients with severe renal nedostatachnost.Lechenieto with Holetar should be discontinued if creatine phosphokinase activity increased enormously (10 times the upper limit of normal) , if it is found or suspected myopathy , and in patients with severe acute diseases , pointing myopathy, or at risk for developing renal failure after rhabdomyolysis ( severe acute infection , hypotension, major surgery , trauma, severe metabolic , endocrine , or electrolyte disturbance , uncontrolled epilepsy) .
Patients should promptly report to their physician with unexplained muscle pain , muscle weakness, particularly if they are accompanied by malaise or high temperatura.Holetar should be used with great caution in women of childbearing age. Upon confirmation of pregnancy , the drug must be immediately stopped.
Pregnancy and lactation
The drug is contraindicated during pregnancy and lactation . Women of childbearing age are recommended to take lovastatin, if reliably exclude the possibility of pregnancy.
Effects on ability to drive and use machines
Lovastatin is not known to exert any effect on the ability to drive and use machines.
Co-administration of Holetar and niacin , cyclosporin , macrolide antibiotics , antifungal containing miconazole , inhibitors of HIV- protease and nefazodone may lead to increases in serum concentrations of lovastatin, and can therefore occur with myopathy , rhabdomyolysis , and renal failure . These drugs and lovastatin is metabolized in the same way in the liver. The same mechanism of action observed with concomitant administration of grapefruit juice and lovastatin. Coadministration of Holetar and fibric acid derivatives may also cause myopathy, although the mechanism is neizvesten.Ednovremennoto applying Holetar warfarin and may enhance the effect of warfarin on the coagulation parameters , and therefore increase the risk of hemorrhage . If these two drugs are taken together , are often recommended to determine the prothrombin time to stabilize . You should tell your doctor about all the medicines you take.
Dosage and Prescription
Dosage and duration of treatment is determined by the doctor.
The initial dose of 20 mg once daily taken during dinner. If necessary , the dose may be increased to a maximum of 80 rag to be taken once or in divided doses to achieve the desired level of cholesterol. Where necessary, the dosage may be adjusted after 4 sedmitsi.Maksimalnata recommended dose for patients of cyclosporine 20 mg / day. Dose increase of more than 20 mg / day in patients with severe renal insufficiency ( creatinine clearance less than 30 ml / min) should be undertaken with caution .
Accidental administration of an overdose , consult your lekar.Dokladvani Several cases of accidental admission of particularly high doses of lovastatin, but not seen special effects and symptoms of overdose tova.Pri impose some general precautions and monitoring of liver function.
Lovastatin is generally well tolerated by patients. The side effects are usually mild and transient.
The most common side effects include: constipation , diarrhea, flatulence , nausea, abdominal pain, indigestion , headache, dizziness , muscle cramps and aches , skin obriv.Dokladvani Rare cases of disorders of the peripheral nervous system , dermatomyositis, fatigue, abnormal sleep and taste , vision stasis of bile , and hepatitis hypersensitivity syndrome .
Myopathy manifested as muscle pain and cramps, increased activity of creatine phosphokinase are very rare but serious side effects during treatment with lovastatin. They may lead to rhabdomyolysis , which can accelerate the onset of acute renal nedostatachnost.Pri treatment Holetar laboratory findings may include elevated liver enzymes , mainly serum transaminases . Moderate increases in serum creatine phosphokinase activity may also occur . Increased abnormal results from laboratory studies in most cases transient . Rarely observed abnormalities that may require discontinuation of therapy. Patients should inform their physician about any side effects , including those not mentioned in the enclosed patient information .
Storage and shelf life
Drug should not be used after the expiration date stated on the packaging.
Do not store above 25 ° C.
Keep out of reach of children.
Only on prescription
20 and 30 Tablets 40 mg