Produced by the manufacturer in tablets of 14 or 28 pieces per pack. The color of the tablets depends on the amount of active substance in the composition of the drug.
|Simvastol pink tablets||1 table.|
|Excipients: lactose monohydrate, ascorbic acid, magnesium stearate, citric acid monohydrate, butyl hydroxyanisole, pregelatinized starch, microcrystalline cellulose, dyes.|
|Simvastol yellow pills||1 table.|
|Excipients: lactose monohydrate, ascorbic acid, magnesium stearate, citric acid monohydrate, butyl hydroxyanisole, pregelatinized starch, microcrystalline cellulose, dyes.|
|Simvastol, brown tablets||1 table.|
|Excipients: lactose monohydrate, ascorbic acid, magnesium stearate, citric acid monohydrate, butyl hydroxyanisole, pregelatinized starch, microcrystalline cellulose, dyes.|
Simvastatin is available in tablet form. Tablets can be packed in plastic cans, blisters of 10, 15, 30 pieces.
Simvastol tablets are sold in a film shell biconvex round brown in a blister pack in a cardboard box No. 14 and 28. The active substance is Simvastatin.
Auxiliary components include lactose monohydrate, butyl hydroxyanisole, citric acid monohydrate, ascorbic acid, microcrystalline cellulose, pregelatinized starch, magnesium stearate, titanium dioxide, hypromellose, glycerol triacetate, lactose monohydrate, iron dye.
- Side effects
- Pharmacodynamics and pharmacokinetics
- Indications for use
- Dosing and Administration
- Side effects
- Conditions of leave from pharmacies
- special instructions
- In pregnancy (and lactation)
- The most famous analogues and substitutes for “Simvastatin”
- Composition and dosage form
- Usage Reviews
- Simvastatin price, where to buy
- Pharmacy Dialog
- Eurofarm * 4% discount on medside11 promotional code
The simultaneous use of antimycotic drugs like ketoconazole, itraconazole, the use of erythromycin, cytostatics, large doses of Vitamin PP (nicotinic acid) are a contraindication to the appointment of Simvastatin. All these drugs have a high incidence of myopathies and other muscle complications in side effects. With synchronous administration, their muscle toxicity is added up, thereby almost doubling the frequency of rhabdomyolysis episodes.
With the parallel appointment of Simvastatin with anticoagulant drugs (warfarin, fenprocoumone), it is necessary to regularly monitor the blood coagulogram, since statins increase the effect of anticoagulants. A change in dosage or drug withdrawal is carried out after INR control.
It is strongly not recommended to use grapefruit juice during a course of lipid-lowering treatment with statins. The allowed maximum is up to 250 ml per day. This fresh drink contains a CYP3A4 inhibitor protein, which changes the pharmacodynamics and pharmacokinetics of Simvastatin.
The active substance of the drug Simvastol, instructions for use informs about this, is simvastatin – a compound that is obtained by fermentation of molds Aspergillus terreus.
Simvastatin blocks one of the initial stages of cholesterol synthesis in the human body and inhibits the activity of the enzyme, which acts as a catalyst for the formation of mevalonate.
In addition, this substance lowers the level of low density lipoproteins, triglycerides and cholesterol in blood plasma, increasing the level of high density lipoproteins. According to reviews of Simvastol, the therapeutic effect of the drug begins to appear after 2 weeks of treatment.
Simvastol medicine, instructions and reviews confirm this, can cause negative reactions of the body from:
- musculoskeletal system: weakness, muscle cramps, myopathy, myalgia; rarely – rhabdomyolysis;
- digestive system: nausea, vomiting, possible abdominal pain, diarrhea, constipation, pancreatitis, flatulence, increased activity of hepatic transaminases, creatine phosphokinase (CPK), alkaline phosphatase, hepatitis;
- nervous system: violation of taste sensations, headache, insomnia, asthenic syndrome, dizziness, muscle cramps, peripheral neuropathy, paresthesia, blurred vision;
- dermatological reactions: hyperemia of the skin, photosensitivity; rarely – skin itching, rash, dermatomyositis, alopecia;
- allergic reactions: urticaria, fever, shortness of breath, lupus-like syndrome, angioedema, vasculitis, arthritis, polymyalgia rheumatica;
- against the background of rhabdomyolysis – acute renal failure;
- laboratory parameters: increased ESR (erythrocyte sedimentation rate), thrombocytopenia, eosinophilia; others: anemia, palpitations, hot flashes, decreased potency.
Co-administration of simvastatin with cytostatics, nicotinic acid, antifungal drugs, HIV protease inhibitors, immunosuppressants, clarithromycin, telithromycin, erythromycin, amiodarone, verapamil and diltiazem increase the risk of myopathy.
Simvastatin enhances the effect of anticoagulants, thereby increasing the risk of bleeding. Colestipol and colestyramine reduce the bioavailability of simvastatin. Grapefruit juice consumed in an amount of more than 1 liter per day increases the inhibitory activity of HMG-CoA reductase in the blood.
The active substance of the drug is simvastatin – a compound that is obtained by fermentation of molds Aspergillus terreus. Simvastatin blocks one of the initial stages of cholesterol synthesis in the human body and inhibits the activity of the enzyme, which acts as a catalyst for the formation of mevalonate.
The therapeutic effect begins to appear after 2 weeks of treatment.
Cytostatics, cyclosporine, fibrates, immunosuppressants, verapamil, aviodarone, nefazodone, erythromycin, clarithromycin, azole antifungal agents (including ketoconazole, itraconazole), HIV protease inhibitors, high doses of nicotinic acid, telithromycin, taken Simvastol, increase the risk of developing myopathy.
With complex use with anticoagulants, the risk of bleeding increases.
Simvastatin increases the concentration of digoxin in the blood.
- Simvastol may enhance the effect of certain oral anticoagulants, significantly increase the risk of vascular bleeding. Therefore, it is important to monitor blood coagulation throughout the course of treatment.
- It is not recommended to combine the reception with strong immunosuppressants, drugs, with a high content of nicotinic acid, and hypotonic agents.
- Simvastol increases the concentration of digoxin in blood plasma when used together.
Hypolipidemic drug. The active ingredient is produced synthetically by fermentation of Aspergillus terreus. The active substance is an inactive lactone, which, as a result of hydrolysis in the human body, becomes a hydroxy acid derivative. The main metabolite inhibits a specific enzyme that catalyzes the formation of mevalonate from HMG-CoA.
While taking Simvastatin, the level of triglycerides, total cholesterol, “bad” and “very bad” cholesterol (LDL and VLDL) is reduced. The effect of the medication appears after 15 days of treatment, and becomes noticeable by laboratory parameters after 1-1.5 months. The cholesterol-lowering effect persists throughout the course of treatment. After discontinuation of therapy, the level of cholesterol gradually returns to its original level.
- muscle cramps;
- severe weakness;
- reduced potency;
- acute renal failure with rhabdomyolysis;
With the manifestation of other negative reactions during treatment, the help of a specialist and self-medication withdrawal of Simvastatin is recommended.
The following medications can cause myopathy:
- HIV protease inhibitors;
- large doses of nicotinic acid;
- antimycotic drugs (Itraconazole, Ketoconazole);
High dosages of simvastatin and the combined use of Danazol and Cyclosporine can lead to rhabdomyolysis. The drug is able to potentiate the effect of oral forms of anticoagulants (Warfarin, Fenprokumon), increase the risk of bleeding. The medication increases the concentration of digoxin.
Pharmacodynamics and pharmacokinetics
Simvastatin has a high absorption rate. The maximum concentration is recorded after 1.5-2.5 hours, but after 12 hours it decreases by 90%. In plasma proteins, the active component is able to bind to 95%. For metabolism in the hepatic system, simvastatin is characterized by a peculiar “first pass” effect, when an active derivative, beta-hydroxy acid, is formed as a result of hydrolysis. The main route of excretion is through the intestines. In an inactive form, 10-15% of the active substance is excreted through the renal system.
Indications for use
- Simvastol should be used as directed by your doctor. According to the instructions, tablets are prescribed for such problems:
- Primary hypercholesterolemia, which often develops in patients with an increased risk of coronary atherosclerosis.
- Hypercholesterolemia of a combined type, which is not amenable to correction by diet and exercise.
- Coronary heart disease of unspecified origin, as well as vascular atherosclerosis.
It helps a lot in order to prevent the occurrence of myocardial infarction, stroke, cardiovascular complications, vascular atherosclerosis, and reduce the risk of revascularization procedures.
Simvastol has a number of contraindications. In particular:
- In acute renal impairment, use with caution. Acute liver failure is a complete contraindication for taking the drug.
- The use of pills should be discontinued at the slightest suspicion of myopathy, as well as the development of any acute disease that predisposes the development of renal failure.
- Simvastol compatibility with alcohol is not safe. It can cause serious malfunctions in the body.
- The safety of the use of this drug in children has not been established.
- It is not recommended to consume a large amount of grapefruit juice (more than one liter per day) while taking Simvastol. This can trigger an increase in the level of active reductase in blood plasma.
- With chronic alcoholism, low blood pressure, epilepsy, tablets should be taken with caution.
What are the pills from? A medication is prescribed to lower cholesterol with hypercholesterolemia and coronary heart disease. The main indications for the use of Simvastatin:
- primary hypercholesterolemia (types: IIa and IIb) in the absence of the effect of diet therapy and other non-drug methods (weight loss, adequate physical activity) and people with a high risk of developing coronary atherosclerosis;
- combined form of hypercholesterolemia and hypertriglyceridemia with diet inefficiency and adequate physical exertion;
- prevention of myocardial infarction;
- reduction of cardiovascular risk (stroke, transient ischemic attack);
- risk reduction after revascularization;
- preventing the progression of atherosclerosis of the heart vessels.
- myopathy and other diseases of the skeletal muscles;
- increased ALT, AST;
- individual hypersensitivity;
- pronounced pathology of the hepatic system;
- age limit – up to 18 years.
Relative contraindications in which simvastatin is prescribed with caution:
- immunosuppressive therapy after organ transplantation;
- alcohol abuse;
- water-electrolyte imbalance;
- severe pathology of the endocrine system;
- metabolic changes;
- traumatic and surgical interventions.
It is used in the development of the following pathologies:
- diagnosed coronary heart disease to slow the progression of coronary atherosclerosis and the prevention of acute disorders of the cardiovascular system (myocardial infarction, stroke, transient attacks of cerebral and heart ischemia);
- primary hypercholesterolemia of types IIa and IIb with a risk of developing coronary atherosclerosis in case of inefficiency or insufficient effectiveness of non-drug therapy (diet and increased physical exertion);
- hypertriglyceridemia in combination with hypercholesterolemia with the failure of non-drug treatment;
- in preparation for revascularization to reduce the risk of postoperative complications.
Contraindicated in the following diseases and conditions:
- impaired liver function;
- hypersensitivity to simvastatin;
- pregnancy and lactation;
- age to 18 years.
It is not recommended for women of childbearing age who do not use contraceptives.
The medicine Simvastatin is prescribed for the treatment of the following conditions and diseases:
- Hypercholesterolemia IIA and IIB types according to the classification of Fredrickson. Statins are prescribed if diet, lifestyle and other non-drug measures have not brought the expected therapeutic effect. They help with persistent high cholesterol at a risk of developing coronary heart disease against the background of atherosclerosis of the blood vessels of the heart and the formation of plaques.
- Their use is justified at high values of not only cholesterol fractions, but also triglycerides. Thanks to the mechanism of action of Simvastatin, it is possible to reduce the concentration of TG (triglycerides) in the blood by almost 25%.
- Simvastatin is prescribed in a complex of maintenance therapy for the prevention of vascular and heart complications – strokes, heart attacks, atherosclerosis. Against the background of the use of this medication, cholesterol levels are gradually returning to normal.
All cholesterol preparations have strictly special indications, an extensive list of side effects and contraindications, therefore they can only be prescribed by a doctor as a prescription in Latin.
Like any drug, Simvastatin has a number of strict contraindications, in which it should be abstained. These conditions include:
- The active stage of pathologies of the hepatobiliary system, as well as a prolonged, uncurable increase in hepatic transaminases of unknown origin.
- Myopathic diseases. Due to myotoxicity, simvastatin can aggravate the course of diseases of the muscle system, provoke rhabdomyolysis and renal failure after it.
- Childhood. In pediatric practice, there is no experience with the use of this drug. In science, there is no data on the profile of the efficacy and safety of Simvastatin for patients under 18 years of age.
- Pregnancy and breastfeeding – no statin is used for cholesterol during these periods.
With great caution, Simvastatin is prescribed for people who abuse alcohol – the compatibility with alcohol in statins is low, renal and hepatic insufficiency can develop very quickly.
Simvastol and analogues of Simvastol is not recommended for women of childbearing age who do not use contraceptives. When combined with other medicines, it should be prescribed with caution, since the combination of simvastatin with some of them can lead to increased toxic effects on the body, impaired absorption and metabolism of drugs.
Dosing and Administration
Depending on the diagnosis, simvastatin is prescribed in the dosage prescribed by the doctor. It varies between the minimum therapeutic (10 mg) and maximum daily (80 mg). The drug should be taken before meals, once a day, preferably in the evening, washed down with plain water at room temperature. Selection and dose adjustment is carried out with an interval of not less than one month.
The answer to the question of how long to take Simvastatin to improve well-being can only be given by the attending doctor. The duration of the course depends on the diagnosis, the dynamics of the disease and the lipid profile indicators – LDL, triglycerides, total cholesterol.
Simvastatin has teratogenic and fetotoxic effects. It is able to penetrate the placenta, therefore, when prescribed during pregnancy, it can cause the development of fetal malformations and pathologies. Girls of reproductive age who need to take drugs from the group of statins for health reasons must adhere to adequate methods of contraception throughout the course of therapy.
In pediatric practice, the drug is not used, since there are no clinically based data on the safety and efficacy profile of Simvastatin for pediatric patients.
It is necessary to control liver function without fail both before and during hypolipidemic treatment. Indicators of liver enzymes (serum transaminases) are checked, and a number of functional liver tests are also performed. With persistent changes in the test results, the drug is stopped.
Patients with a diagnosed mild or moderate stage of renal dysfunction are allowed to prescribe the drug, but it is recommended to refrain from the maximum dose. In severe cases of PN (renal failure), creatinine clearance less than 30 ml per minute, or with the background use of drugs such as cyclosporine, fibrates, dinazole, the maximum dose of the drug is 10 mg per day.
Simvastatin is a representative of the first generation of a group of statins. These are drugs that affect cholesterol production inside the body. About 80% of this substance is formed in the liver under the influence of certain enzymes. It is precisely on them that the action of Simvastatin is directed. It blocks the activity of enzymes and inhibits the reaction of cholesterol formation. The remaining 20% of the substance is ingested through the gastrointestinal tract with food.
The action of statins is based on the inhibition of the enzyme responsible for the production of cholesterol by the liver (a source of about 80% of the substance).
Any dietary fat that enters the body cannot be used as an energy source in this form.
This is due to the fact that lipids do not mix with liquids and cannot be fully transported with blood flow to tissues. A series of biochemical reactions take place in the liver to transform lipids into a form acceptable to the body.
Inhibition of this process significantly reduces the rate of fat in plasma. Untreated lipids are instantly excreted through the excretory system, as they remain unclaimed. In combination with a diet, the effect of the drug reaches its maximum.
“Simvastatin” is prescribed for the following pathologies:
- Increased plasma cholesterol.
- Post-infarction period.
- Rehabilitation after surgery on the heart and blood vessels.
- Atherosclerosis of moderate and severe degree.
- Hereditary diseases of lipid metabolism.
The medicine is available in different dosages: 5, 10, 20, 40 and 80 mg each. Treatment begins, as a rule, with the smallest dose, gradually increasing it with insufficient manifestation of the effect of therapy. Tablets are taken 1 time per day in the evening, 1 piece each. For greater effectiveness, it is recommended to use “Simvastatin” 40-60 minutes after dinner, drinking plenty of water. The course of use is from several months to a life-long appointment. It depends on the general condition of the body and on the diagnosis of the patient.
Indications for use are as follows:
- Coronary heart disease: prevention of myocardial infarction, reducing the risk of death, slowing the progression of atherosclerosis of the coronary arteries, reducing the risk of revascularization, reducing the risk of stroke, transient ischemic attacks and other cardiovascular disorders.
- Hypercholesterolemia: primary (types IIa and IIb) in patients with an increased risk of developing coronary atherosclerosis in the absence of the effect of non-drug therapies such as diets low in cholesterol, physical activity and weight loss; in combination with hypertriglyceridemia, not amenable to correction by diet therapy and physical activity.
Symvastol tablets according to the instructions should be taken once a day in the evening. The dosage of the drug is selected in accordance with the indications – the average daily dose is from 5 to 20 mg. Treatment begins with small doses, and in the absence of the desired effect for a month, the daily dose of the drug is increased by 10 mg.
The dosage of tablets can be increased every 4 weeks, without forgetting to monitor laboratory blood counts. As a rule, the maximum daily dose of Simvastol according to the instructions is 40 mg, but in some cases it can be increased to 80 mg.
According to reviews of Simvastol, the effectiveness of the drug increases if you take it against a background of a diet aimed at lowering cholesterol. This diet is recommended to follow throughout the course of treatment with Simvastol.
In patients suffering from severe renal insufficiency or taking gemfibrozil, danazol, cyclosporine and other fibrates, as well as nicotinic acid in dosages above 1 g per day at the same time as simvastol, the daily dose of the latter should not exceed 10 mg. When taken together with verapamil or amiodarone, the daily dose should not be more than 20 mg.
Analogs for replacement are as follows:
- Zokor forte.
- Simvastatin Alkaloid.
Patients undergoing treatment should follow a hypocholesterol diet.
The drug is taken 1 time per day in the evening, regardless of the meal. Tablets are washed down with a sufficient amount of liquid.
The duration of treatment and dosage are selected by the doctor in each case individually.
For the treatment of hypercholesterolemia, the drug is prescribed in a dosage of 10-80 mg once. You should start taking it with a minimum dose of 10 mg. The maximum allowable dosage is 80 mg per day.
Dosage adjustment is carried out with an interval of 1 month. Often, the therapeutic effect is achieved by taking 20 mg per day.
With homozygous hereditary hypercholesterolemia, Simvastol is prescribed in a dosage of 40 mg once a day or 80 mg, divided into three doses: 20 mg in the morning and afternoon and 40 mg in the evening.
In the treatment of coronary heart disease, the drug is prescribed in a dose of 20-40 mg / day. The initial dosage is 20 mg, and the adjustment is carried out with an interval of 4 weeks. When the LDL content is less than 75 mg / dl (1.94 mmol / L) and total cholesterol is less than 140 mg / dl (3.6 mmol / L), the dosage should be reduced.
Overdose data are not available.
Analogs by ATX code: Aterostat, Vasilip, Zokor, Simvastatin, Holvasim.
Do not make the decision to replace the drug yourself, consult your doctor.
The dosage of simvastol is 5–20 mg. If necessary, about the recommendations of the attending physician, the dose can be increased with a duration of treatment of four weeks.
Pills are usually taken once a day, with meals in the evening. The tablets should be swallowed whole without chewing. Drink plenty of water. The highest tolerated dose is 40 mg per day.
For patients who take immunosuppressants, it is recommended to take the drug in an initial dose of 5 mg, with a frequency of administration once a day. To do this, you can divide the tablet with a dosage of 10 mg into two parts. The highest dose for this category of patients is not more than 5 mg per day. In case of acute renal failure, the standard dose is 5-10 mg per day. With the combined use of simvastol with verapamil and amiodarone, the dosage should not exceed 20 mg.
The duration of treatment with the drug is determined by the doctor. On average, the therapeutic course is at least one month, sometimes longer. The tablets must be taken regularly and in the right dosage and regularly.
While taking the drug, monitor the level of cholesterol in the blood serum, as well as periodically take tests for liver tests. When the desired therapeutic effect is achieved, the dosage can be reduced.
If the patient develops an individual intolerance to Simvastol, the doctor can choose similar substitutes on the basis of the main active substance – simvastatin. Among the main analogues can be called preparations Ariescor, Vazilil, Zokor.
It is difficult to determine which drug is better. Their main differences in the trade name and composition of additional ingredients. In addition, some analogues may be cheaper.
Only the attending physician can choose the right medicine that is right for you.
Before prescribing statins, cholesterol levels are reduced with a special hypocholesterol diet. In case of inefficiency, Simvastatin is additionally prescribed. Instructions for use of simvastatin: 1 time per day, 1 tablet at night, washed down with water. Do not associate medication with food intake. The daily dose depends on the level of cholesterol and lipid profile (from 10 to 80 mg).
Patients with a hereditary (homozygous) form of hyperlipidemia are prescribed 40 mg once a day or 1 mg in 80 doses (3 mg in the morning and in the afternoon, 20 mg in the evening). In coronary heart disease, the daily dose varies in the range of 40-20 mg. With simultaneous therapy with fibrates, Gemfibrozil, Danazol, Cyclosporine, Natsin, it is recommended to take no more than 40 mg of Simvastatin daily. When taking Verapamil and Amiodarone daily, take no more than 10 mg of statin.
From the organs of the gastrointestinal tract there can be abdominal pains, functional dyspeptic syndromes, nausea, vomiting, and stool disorders. The use of the drug can actively affect the liver – according to the instructions, a temporary increase in liver enzymes (blood transaminases) is possible.
The central and peripheral nervous system can respond to the use of simvastatin with the development of an astheno-vegetative syndrome with episodes of cephalgia, fatigue, weakness, mood swings, insomnia, and dizziness. More serious side effects of Simvastatin include muscle twitching (fasciculations), impaired peripheral sensitivity, sensory changes.
With a high individual sensitivity to the active or auxiliary substances of this medication, allergic reactions may develop. There are many types of their manifestations, but according to statistics, urticaria, eosinophilia, allergic arthritis, angioedema and polymyalgia of rheumatoid genesis can most often develop.
Skin manifestations of adverse reactions can be in the form of a red small-pointed erythematous rash, itching, and dermatoses. Hypolipidemic agents are toxic to muscle tissue, therefore, with a number of individual characteristics or high dosages, the appearance of myopathies, muscle pains, inflammatory processes in the muscles, their weakness and fatigue. In very rare cases, rhabdomyolysis develops.
The standard side effects of statin class drugs include: headache, dizziness, insomnia, intestinal dysfunction, epigastric pain.
In some cases, exacerbation of pancreatitis, impaired liver function may occur. Sometimes there are allergic reactions to individual components of the drug, accompanied by redness and itching.
Less commonly, simvastol can cause metabolism, changes in taste, dry mouth, myopathy, exacerbation of rheumatoid arthritis, and decreased muscle activity.
Simvastol may cause the following side effects:
- From the nervous system: asthenia, headaches, sleep disturbances, dizziness, paresthesias, taste disturbances, convulsive syndrome, peripheral neuropathy, visual impairment.
- From the digestive system: symptoms of dyspepsia, pancreatitis, hepatitis.
- From the musculoskeletal system: myopathy, pain in muscles and joints, rhabdomyolysis, myasthenia gravis, arthritis.
- From the cardiovascular system: shortness of breath or tachycardia.
- On the part of the immune system: fever, urticaria, vasculitis, photosensitivity, polymyalgia rheumatism, angioedema, lupus-like syndrome.
- On the part of laboratory parameters: thrombocytopenia, increased ESR, eosinophilia, increased activity of creatine phosphate kinase, alkaline phosphatase and hepatic transaminases.
- From the skin: alopecia, itching, dermatomyositis, rash.
- Other effects: anemia, flushing, impaired renal function, decreased potency and libido.
Conditions of leave from pharmacies
You can purchase without a prescription form.
Dry place. The manufacturer recommends observing the temperature range of 15-25 degrees.
Tablets are recommended to be stored in a dry and dark place at an air temperature of no higher than 20 ° C.
Shelf life is 3 years.
The price of Simvastol for 1 package is from 190 rubles.
Simvastol is not prescribed to patients with an increased risk of rhabdomyolysis and renal failure.
Before and during treatment, an assessment of liver function is performed. If there is an increase in the activity of transaminases, it is recommended to stop taking Simvastol.
If you skip taking the drug, the dose should be taken as soon as possible. If the pass is 24 hours – a doubling of the dosage is not carried out.
Simvastol should not be prescribed to patients with an increased risk of rhabdomyolysis and renal failure. The risk factors for these pathologies include an acute form of severe infection, arterial hypotension, planned extensive surgery, trauma, severe metabolic disorders.
The use of the drug is not indicated for type I, IV and V hypertriglyceridemia. Treatment should be accompanied by monitoring of liver function. Studies of the activity of liver enzymes are carried out before starting the use of the drug and regularly during therapy: 2 times every 6 weeks, then every 8 weeks until the end of the first year, then once every six months.
A test to determine liver function should be performed at each dose increase, and with a daily intake of 80 mg every 12 weeks. A transient increase in the level of liver enzymes is possible at the beginning of therapy. With transaminase activity exceeding 3 times the initial level and maintaining a steady increase, tablets should be discontinued.
Patients with hypothyroidism and / or kidney disease (including nephrotic syndrome) with elevated cholesterol are recommended to first treat the underlying disease. In addition to monotherapy, the use of the drug is indicated in combination with sequestrants of bile acids.
It is recommended to avoid the simultaneous use of a large amount (more than 250 ml) of grapefruit juice, since it is possible to increase the severity of side effects of simvastatin. Against the background of the use of Simvastol, the development of myopathy, rhabdomyolysis and renal failure is possible.
Symptoms of these pathologies include the appearance of muscle soreness, unexplained pain, lethargy or muscle weakness, accompanied by general malaise or fever. The risk of developing myopathy increases with the simultaneous use of fibrates (fenofibrate, gemfibrozil), nefazodone, cyclosporine, macrolides (clarithromycin, erythromycin), HIV protease inhibitors (ritonavir), antifungal agents of the azole group (itraconazole, ketoconazole).
In addition, the likelihood of developing myopathy is higher in patients with severe renal failure. When prescribing the drug, the doctor should warn the patient about the possibility of this disease, its symptoms and the need to immediately contact a specialist if they develop.
In patients with suspected or diagnosed myopathy, discontinuation of the drug is required. Patients of childbearing age must use reliable contraceptives during the entire period of taking the drug. If pregnancy has occurred during treatment, the drug is stopped, and the woman should be warned of a possible risk to the fetus.
Cancellation of hypolipidemic drugs during pregnancy does not significantly affect the outcome of prolonged therapy of primary hypercholesterolemia. With the appearance of myalgia, myasthenia gravis and / or a marked increase in CPK activity, the use of Simvastol should be discontinued.
If the next dose is accidentally missed, it should be taken immediately as soon as remembered, provided that this does not mean taking two doses at the same time. In severe renal failure, treatment should be carried out by monitoring renal function.
The patient should follow a hypocholesterol diet before starting therapy and during the entire period of taking the drug. The effect of the drug on the patient’s ability to drive vehicles and mechanisms has not been established.
The first days of therapy may be accompanied by an increase in ALT, AST, bilirubin. Regular ultrasound monitoring is recommended (when taking 80 mg every 3 months). An increase in liver enzymes by 3 times is an indication for stopping treatment. Following a hypocholesterol diet can achieve the best results.
It is recommended to give up grapefruit juice during treatment. The medication is not used for hypertriglyceridemia of types 1,4 and 5. The drug can provoke myopathy, which leads to renal failure and rhabdomyolysis. The medication is effective both in monotherapy and in joint treatment with bile acid sequestrants.
In pregnancy (and lactation)
Simvastatin is contraindicated in gestation, because able to cause various developmental abnormalities in newborns. During treatment, the use of contraception is mandatory. There is no data on the penetration of the active substance into breast milk. However, it is important to remember that there is a high risk of the effects of simvastatin on the health of the child.
Contraindicated during pregnancy and breastfeeding.
The most famous analogues and substitutes for “Simvastatin”
Consider the most effective and often prescribed analogues and substitutes for Simvastatin. They contain the same substance, but differ in other additives: excipients, preservatives, etc.
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The medicine is used for disorders of lipid metabolism, transmitted genetically. These diseases include familial hypercholesterolemia. It is also effective in secondary forms of atherosclerosis. In severe cases, it is prescribed in combination with other cholesterol-lowering drugs. Country of origin – Slovenia. The company is Krka.
Available doses: 5, 10, 20 mg. In one box there can be 14 or 28 tablets. Large packings are not provided. In Russia, a medicine can be purchased at a cost of 120 rubles. This is the cheapest substitute for “Simvastatin” imported with a high quality indicator.
Reception mode: in the dosage specified by the doctor, tablets are taken once a day after six in the evening. It is advisable to take them after the last meal. The dosage is selected by the doctor; you cannot prescribe the drug yourself, since it can cause complications.
This is a replacement for Simvastatin, manufactured in the Czech Republic. Manufacturing company: Ivax Pharmaceutical. The drug itself is a tablet in various dosages: 20 and 40 mg. Packing is 28 and 84 tablets. In Russian pharmacies, the analogue is sold at a price of 209 rubles (for the smallest box of the minimum dose).
To protect the patient from complications, the doctor must prescribe the patient directions for a blood test for biochemistry. It reveals indicators such as AST and ALT. These are hepatic transaminases, if they are abnormal, then the pathological process is present in the body and it is localized in the liver. In this state of health, taking Simgal is prohibited.
At the age of 70 years, the medicine should not be taken at a dose of more than 5 mg per day. Any deviations from this norm should be discussed with the therapist.
The medicine is available in the Netherlands. Manufacturing company: Merck Sharp. Dosage forms of 20 mg are produced. There may be 14 or 28 pieces per pack. You can buy medicine in Russia from 417 rubles. Zokor is more expensive than other analogues from the list.
This is one of the best analogues of Simvastatin, according to patient reviews. Chemical ingredients go through many stages of purification, and when the basis of the medicine is of high quality, side effects are much less common.
Before discharge “Zokora” creatinine clearance indicator is tested. With its value less than 30 ml / min, taking the medicine is strictly prohibited. An absolute contraindication is renal failure, even in a mild form.
Course of use: 1 tablet per day after six in the evening for several months.
Generic manufacturer “Hexal” (Germany). There are many options for dose component: 5, 10 and 20 mg. Packing is always uniform – 30 tablets. The basis of the drug is simvastatin. The approximate price is 161 rubles. The regimen is exactly the same as with other drugs on the list.
The drug is often prescribed for coronary heart disease. Patients with coronary heart disease taking SimvaHexal die from myocardial infarction 10 times less often than people who refused to take the medication.
The cheapest analogue of Simvastatin. Production – Russian company Alkoloid. The cost of the pharmaceutical market is from 90 rubles per package. The drug of choice for familial hypercholesterolemia. An absolute contraindication is pregnancy and breastfeeding. In childhood, it can be prescribed on special conditions on the individual recommendation of a doctor.
Contraindications: diseases of the liver, kidneys, immune system of any form and severity.
Composition and dosage form
Simvastol belongs to the group of lipid-lowering drugs. Its main active ingredient is simvastatin, which belongs to the class of statins. Additional components are: lactose monohydrate, citric acid, ascorbic acid, lactose, glycerol, magnesium stearate.
Once in the blood cells, the active substances in Simvastol gradually reduce the level of “bad” cholesterol, thereby preventing the formation of sterols. In addition, the drug is able to increase the level of “good” cholesterol.
It is produced in the form of yellow tablets. The pills are round in shape, coated with a uniform yellowish shell with smooth edges. In a longitudinal section, two layers are clearly visible: white inside, and yellow at the edges.
The dosage of the active substance simvastine in one tablet is 10, 20 and 40 mg. Country producer Romania and Russia. The trade name according to the radar site is Simvastol. Shelf life is three years, it is indicated on the blister.
Simvastatin (INN by radar – simvastatin) is an active substance that is included in a number of brand name drugs of different manufacturers and brands under different names (Zentiva, Vertex, Northern Star and others, depending on the country). The compound belongs to the third generation of statins and is a proven lipid-lowering agent.
On drugstore shelves you can find a drug with a name that is completely identical to the active substance – Simvastatin. The form of release of the drug is tablet, has biconvex rounded edges, is coated with a transparent or whitish color. Depending on the concentration of the active substance, Simvastatin tablets are available in several versions – 10 and 20 mg each.
Cholesterol in the bloodstream of a person is present only in protein-bound form. Such compounds are called lipoproteins. In the body there are several types of these molecules – high, low and very low density (HDL, LDL and VLDL, respectively). The negative effect of high cholesterol begins to appear when a clear advantage appears in the lipid metabolism towards LDL, the so-called “bad” cholesterol.
The therapeutic effect of simvastatin is achieved primarily by reducing this fraction of lipoproteins (LDL). By inhibiting the enzymatic chain of HMG – Coenzyme A reductase, the studied drug reduces the concentration of fats inside the cells and activates receptors for low and very low density lipoproteins (LDL and VLDL).
Against the background of a decrease in the harmful fraction of fats, the lipid balance is restored and the concentration of the antagonist, high-density cholesterol, is moderately increased. According to various sources, the increase in HDL after the course of therapy will be from 5 to 14%. Simvastatin not only reduces harmful cholesterol, but also has a vasodilating effect. This medicine inhibits the processes of dysfunction of the vascular wall, increases its elasticity and tone due to the antioxidant effect.
One of the theories of the development of atherosclerosis is inflammatory. The focus of inflammation is an essential part of any atherosclerotic focus in the endothelium. Simvastatin has an antiproliferative effect, thereby protecting the endothelium from sclerotherapy, scarring and stenosis. A number of scientific sources suggest that a protective effect on the endothelium is formed a month after the start of the drug.
The purpose of the drug is carried out only according to strict indications, the selection of a dose is individual. The starting dose is usually 10 mg and, according to patients and doctors, is well tolerated. The maximum daily dosage is 80 mg. It is prescribed for severe hyperlipidemic conditions. For patients with mild liver or kidney disease, the maximum dose is less and is 40 mg.
Most doctors note the high effectiveness of Simvastol. The risk of side effects while observing the dosage and recommendations is minimized. Patients who were treated with this drug note its good tolerance, affordable cost, as well as a significant positive effect of its action. The first results of the drug can be evaluated after two to three weeks of administration.
At reputable medical forums and portals, there are practically no reviews about Simvastol. But you can read reviews about the drug Simvastatin, the active components in these funds are the same.
The reviews of doctors and patients taking Simvastatin are neutral. Doctors note the softness of the drug – severe side effects rarely develop from it, it is well compatible with other medication. A great advantage of the drug is the possibility of its appointment with concomitant diseases of the kidneys or liver in their mild or moderate manifestation. However, simvastatin is somewhat inferior in effectiveness to analogues of other generations of statins, therefore it is rarely used for aggressive therapy.
Reviews about Simvastatin on the forums are different. Patients confirm that the medication really lowers cholesterol, but at the same time they describe various negative reactions against the background of the entire course of hypocholesterol therapy. Patients with chronic pancreatitis note an increase in the frequency of exacerbations during treatment. With prolonged therapy, there is a change in the lipid profile for the better.
Doctors reviews are shared. Some believe that the drug belongs to the “old guard” and has outlived itself, given the severity of adverse reactions, and the appearance on the pharmaceutical market of Atorvastatin and Rosuvastatin, which are a new generation of the drug. Others note that the medication successfully lowers cholesterol and serves as an excellent means of preventing atherosclerosis.
About the drug among patients in the vast majority of reviews are favorable. The use of Simvastol can reduce cholesterol in case of hypercholesterolemia and reduce the risk of complications from CVS.
“It removes part of the cholesterol from the body. But do not flatter yourself, because you can reduce only the content of fats harmful to the body by only 20%. The rest will still have to be reduced by diet. ”
“My cholesterol was raised to 6,0-6,5. I took simvastol for 20 mg for a long time. Now I’ve practically eliminated animal fat from the diet, I take 10 mg simvastol (I have a poor inheritance in atherosclerosis) and cholesterol lasts 4,5-5,0. “
“I used 20mg in the evening. When using the drug, I got: blurred vision, decreased potency, shortness of breath. “
“Simvastol was one of the drugs my father drank to lower cholesterol and improve the work of the remedy. As a result, after half a year, the doctors said that you can do without surgery. ”
“It comes in various dosages, in a package of 28 tablets. The most interesting thing is that this drug, like all statins, can dissolve that cholesterol that has already adhered to the walls of blood vessels. Dosage can only be prescribed by a doctor. ”
“The doctor prescribed me simvastol for the prevention of heart disease. Thanks to them (although not immediately), I even began to feel differently, I can call this condition as booming, of course, and I am on a diet, but still the result pleases. ”
Simvastatin price, where to buy
The price of pills for cholesterol depends on the manufacturer, sales region, dosage. The price of Simvastatin 40 mg varies in the range of 200-600 rubles.
- Online Pharmacies in Russia Russia
- Online Pharmacies Ukraine Ukraine
Simvastatin tab. n / a captive. 10mg No. 30 Ozone LLC
Simvastatin tab p / o captive. 20mg No. 30 Verteks AO
Simvastatin tab. p.p.o. 10mg n30 Vertex AO
Simvastatin-ALSI tab. n / a captive. 10mg No. 30 ALSI Pharma ZAO
Simvastatin tab. 20mg n20 Hemofarm
Simvastatin tablets 40mg No. 30
Simvastatin (tab.p / o 20mg No. 30)
Simvastatin tablets p / o 10mg №30
Simvastatin (tab.p / o 10mg No. 30)
Simvastatin tablets 20mg No. 28
Eurofarm * 4% discount on medside11 promotional code
Simvastatin-Vertex 10 mg No. 30 tablets Ozone LLC
Simvastatin 20 mg No. 30 tablets OZON, LLC
Simvastatin-Vertex 20 mg No. 30 tablets Verteks CJSC
Simvastatin zentiva 20 mg No. 28 tablets Zentiva k.s.
Simvastatin 40 mg No. 30 tablet North Star CJSC
Simvastatin 40 Ananta 40mg No. 28 tablets Marxans Pharma Ltd.
Simvastatin Ananta 20 mg N28 tablets Marxans Pharma Ltd.
Detonic – a unique medicine that helps fight hypertension at all stages of its development.
The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.
Detonic not addictive and withdrawal syndrome, since all components of the product are natural.
Detailed information about Detonic is located on the manufacturer’s page.