Zocor

Zokor has a pronounced hypolipidemic effect.

Indications of the zokora

It is used to treat people who are in a group with a high risk of developing coronary artery disease, regardless of the level of lipids inside the blood. This group includes persons with such accompanying violations:

• cerebrovascular diseases, including stroke  (available in history);
• diseases affecting the peripheral circulatory system;
• diabetes mellitus  (the drug prevents the development of complications in the peripheral vascular region and reduces the need for revascularization, as well as for leg amputation).

The medication is also used in the treatment of people diagnosed with ischemic heart disease and patients with hypercholesterolemia. With these disorders, Zocor helps prevent atherosclerotic lesions of the heart vessels, and in addition to the development of other complications.

The administration of the drug is also justified in such disorders:

• people with high rates of apolipoprotein B and total cholesterol, and with it cholesterol, associated with low-density lipoproteins - combined with dietary nutrition;
• hypertriglyceridemia;
• people with low cholesterol and high-density lipoproteins associated with primary-type hypercholesterolemia (during the period of the diet);
• hypercholesterolemia of family homozygous character (in combination with other methods of therapy and diet).

Release form

Release of the medication occurs in tablets, 14 times inside a blister pack. The box contains 1 or 2 such packages.

Pharmacodynamics

Tablets contain the active component of simvastatin, which when hydrolyzed is converted into active compounds. The product of the simvastatin metabolism inhibits the enzyme HMG-CoA reductase, which is a participant in the first stage of cholesterol biosynthesis.

As a result, under the influence of Zokor, there is a pronounced decrease in the volume of total cholesterol, and in addition the values of cholesterol, synthesized with the help of lipoproteins, which have a low and extremely low density. In addition, cholesterol levels also decrease within the triglyceride plasma.

When simvastatin is used, a simultaneous increase in cholesterol (expressed), which is synthesized with the help of high density lipoproteins, is observed.

The drug effectively acts under various forms of hyperlipidemia (familial, heterozygous, and non-family). In addition, it works qualitatively for hyperlipidemia of a mixed nature, in situations when diet is not enough to stabilize plasma lipid indices.

The level of lipids inside the plasma decreases after 2 weeks after the initiation of therapy. Peak indicators are observed during the 4-6th week of the course. Then, during the drug reception this result is saved.

After the end of the course of therapy, the plasma values of total cholesterol gradually return to those initial values that were observed before the drug was started.

Pharmacokinetics

The peak values of the products of the simvastatin metabolism inside the blood are observed after the expiration of 1.3-2.4 hours after taking a single dose of drugs. Absorption of the ingested simvastatin is approximately 85%.

The highest values of the active element, in comparison with other tissues, are observed inside the liver.

At the 1st pass of the medicine through the hepatic blood flow there is a metabolism of simvastatin, after which, together with its metabolic products, it is excreted from the body together with bile.

Taking food immediately after using the medication does not affect its pharmacokinetic properties. With prolonged treatment, there is no cumulation of simvastatin inside the tissues of the body.

Dosing and administration

You need to eat tablets without binding to the time of eating. The daily portion should be taken in the evening, the whole whole - you do not need to separate it into several separate uses.

The average size of a daily portion of drugs is 5-80 mg. Do not take more than 80 mg per day.

The size of the portion is chosen by the treating doctor, who must necessarily take into account plasma lipid indices. Correct the dosage is allowed a maximum of once per 1 month.

In the treatment or for the prevention of coronary heart disease (in combination with diet), 40 mg of the drug per day are prescribed.

If treatment with a diet does not help to eliminate hypercholesterolemia, you should take 20 mg of Zokor per day. If it is necessary to reduce plasma lipid indices by 45% or more, the size of the initial dosage per day can be 40 mg.

With a mild or moderate degree of hypercholesterolemia, the size of the daily dose can be reduced to 10 mg.

The doctor selects the desired portion of the drug, previously determined the lipid index and monitoring the effectiveness of the therapeutic effect after the start of the course. If there is no result after the first month of treatment, it is required to increase the dose of the drug, but to do it gradually - until the necessary effect is achieved.

In the treatment of a family form of hypercholesterolemia, which has a homozygous character (along with diet and other means), the initial daily dose is 40 mg. Another scheme can also be used - with taking 80 mg of medication per day, and 20 mg should be consumed in the afternoon, and 40 mg in the evening.

For adolescents, when eliminating the family form of hypercholesterolemia, a homozygous character is used at 10 mg / day. It is forbidden to appoint adolescents more than 40 mg of the drug per day.

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Use of the zokora during pregnancy

Prescribing Zokor to pregnant or breastfeeding women is contraindicated. During application during pregnancy, there may be disorders in the development of the fetus.

If a lactating woman needs to take a medicine, she should stop breastfeeding for the period of therapy.

Contraindications

Among the unconditional contraindications of the medicine:

• problems with the processes of metabolism and assimilation of lactose;
• hepatic pathology in acute form;
• significant, as well as a steady increase in the number of transaminases, which has an unexplained nature;
• the presence of hypersensitivity to the components of the drug.

Conditional contraindications, in which the medicine is prescribed with caution:

• a decrease in the functional activity of the liver or kidney;
• alcoholism;
• people who suffer from diabetes for a long time.

Side effects of the zokora

Taking medication can cause the development of the following side effects:

• pain or discomfort in the abdomen, problems with the process of defecation and flatulence;
• sensation of general weakness, headaches and anemia;
• convulsions, paresthesia, dizziness, sleep or memory disorders, as well as polyneuropathy;
• alopecia, rashes on the skin surface and itching.

Occasionally, when using simvastatin, rhabdomyolysis or myopathy was noted in patients, and in addition a decrease in hepatic activity. There is also information about the appearance of myalgia. But in general, the medicine is transferred to patients without complications.

Because of the intolerance of the drug, there may be an increase in ESR values, as well as vasculitis, arthritis, dermatomyositis, and in addition arthralgia, thrombocytopenia, angioedema and eosinophilia.

Overdose

When poisoning, standard procedures used to eliminate the effects of drug overdose are used.

Interactions with other drugs

When combined with bile acid sequestrants, a pronounced positive effect of the drug develops.

When used together with cyclosporine, fibrates, and also niacin in lipid-lowering doses, no more than 10 mg of the drug can be used per day.

It is forbidden to take more than 20 mg Zokora per day for simultaneous use with amiodarone or verapamil.

Simvastatin does not affect the activity of CYP3 A4 enzymes.

Combination with drugs that suppress the activity of the element CYP3 A4, leads to an increased risk of rhabdomyolysis or myopathy. It is forbidden to combine the medication with erythromycin, ketoconazole, and also itraconazole, telithromycin and nefazodone.

The risk of rhabdomyolysis or myopathy increases with combined use with diltiazem, cyclosporin, danazol, and in addition to amiodarone, niacin, gemfibrozil, as well as fibrates, fusidic acid and verapamil.

The effect of Zokor (in a dose of 20-40 mg / day) potentiates the properties of anticoagulants of a coumarin type. This increases the likelihood of bleeding in a patient taking these medications simultaneously.

As a result of consuming more than 1 liter of grapefruit juice per day, there is a clinically significant increase in the plasma level of simvastatin, which also increases the risk of rhabdomyolysis.

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Storage conditions

Zokor is required to be kept in a dark place inaccessible to small children. Temperatures are not higher than 25 ° C.

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Shelf life

Zokor is allowed to be used for 2 years from the date of manufacture of the drug.

Application for children

Since sufficient information regarding the use of drugs in children is not available, it is not prescribed to patients under 10 years of age.

Zokor is prescribed for adolescents - for the elimination of familial hypercholesterolemia having a heterozygous type (in combination with diet). Exposure to the drug helps reduce cholesterol, triglycerides, and also apolipoprotein B.

A teenage girl can be prescribed a medication only if her menstruation began at least 1 year ago.

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Analogues

Analogues of the drug are the following drugs: Avestatin, Levomir and Simlo with Simvastatin, and in addition Simvakard, Vabadin, Atherostat, Simvor and Zovatin with Simgal.

Reviews

Zokor receives a lot of positive feedback about its therapeutic effect - it helps to lower cholesterol. But it should be remembered that it must be taken only during the period selected by the treating doctor, strictly following the instructions, and nothing else.

A lot of good reviews were left about the preventive properties of the drug.