Симанод Капсулы, 30 шт, 300 мг, для внутреннего применения, противовирусное, цвет желтый

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Селективно ингибирует вирус-специфический процессинг вирусных Gag-Pol протеинов в ВИЧ-инфицированных клетках, предотвращая образование зрелых вирионов и заражение других клеток."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"\nКапсулы Симанод,\nназначаемые совместно с низкими дозами ритонавира, показаны для\nлечения ВИЧ-1-инфицированных взрослых в сочетании с другими\nантиретровирусными лекарственными средствами."}},{"type":"paragraph","data":{"text":"\nВыбор Симанод для\nлечения взрослых пациентов должен основываться на индивидуальном\nтестировании на вирусную резистентность и истории лечения пациента."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"\n-\nгиперчувствительность к атазанавиру или к любому из вспомогательных\nвеществ"}},{"type":"paragraph","data":{"text":"\n- комбинация\nатазанавир/ритонавир у пациентов с печеночной недостаточностью\nсредней и тяжелой степени (класс В и С по классификации Чайлд-Пью)"}},{"type":"paragraph","data":{"text":"\n- совместное\nприменение с симвастатином или ловастатином \n"}},{"type":"paragraph","data":{"text":"\n- комбинация с\nрифампицином \n"}},{"type":"paragraph","data":{"text":"\n- комбинация с\nсилденафилом (при его назначении для лечения легочной артериальной\nгипертензии и эректильной дисфункции)"}},{"type":"paragraph","data":{"text":"\n- совместное\nприменение с лекарственными средствами, которые являются субстратами\nизоформы CYP3A4, цитохрома P450 и имеют узкий терапевтический эффект\n(например, кветиапин, луразидон, альфузозин, астемизол, терфенадин,\nцизаприд, пимозид, хинидин, бепридил, триазолам, мидазолам,\nмидазолам, вводимый перорально, мидазолам), с парентерально вводимом\nмидазоламом и алкалоидах спорыньи (в частности эрготамином,\nдигидроэрготамином, эргоновином, метилэргоновином)"}},{"type":"paragraph","data":{"text":"\n- совместное\nприменение с препаратами, содержащими гразопревир, включая комбинацию\nфиксированной дозы эльбасвира / гразопревира"}},{"type":"paragraph","data":{"text":"\n- совместное\nприменение с комбинацией фиксированной дозы глекапревира/\nпибрентасвира"}},{"type":"paragraph","data":{"text":"\n- совместное\nприменение с продуктами, содержащими зверобой (Hypericum perforatum)"}},{"type":"paragraph","data":{"text":"\n- детям до 18 лет\n(наличие в составе лекарственного препарата красителей солнечный\nзакат желтый (Е110), краситель хинолиновый желтый (Е104)"}},{"type":"paragraph","data":{"text":"\n- противопоказано\nприменение лицам с наследственной непереносимостью галактозы,\nдефицитом фермента Lapp (ЛАПП)-лактазы, мальабсорбцией\nглюкозы-галактозы"}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Адекватных и строго контролируемых исследований атазанавира при беременности не проводилось. Применение возможно в случаях, когда ожидаемая польза терапии для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"При необходимости применения в период лактации грудное вскармливание следует прекратить."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Оптимальный режим дозирования определяет врач. Следует строго соблюдать соответствие используемой лекарственной формы конкретного препарата показаниям к применению и режиму дозирования."}},{"type":"paragraph","data":{"text":"Принимают внутрь."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны ЦНС и периферической нервной системы: часто - головная боль, бессонница, периферические неврологические симптомы; редко - беспокойные сновидения, потеря памяти, спутанность сознания, сонливость, беспокойство, депрессия, нарушения сна."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: очень часто - желтуха; часто - боли в животе, диарея, диспепсия, тошнота, рвота; редко - извращение вкуса, метеоризм, гастрит, панкреатит, афтозный стоматит, сухость во рту, анорексия, повышение аппетита, гепатит; в отдельных случаях - гепатоспленомегалия."}},{"type":"paragraph","data":{"text":"Со стороны костно-мышечной системы: редко - артралгия, мышечная атрофия, миалгия; редко - миопатия."}},{"type":"paragraph","data":{"text":"Со стороны мочевыделительной системы: редко - гематурия, учащенное мочеиспускание, протеинурия; в отдельных случаях - боли в области почек, мочекаменная болезнь."}},{"type":"paragraph","data":{"text":"Аллергические реакции: редко - крапивница."}},{"type":"paragraph","data":{"text":"Дерматологические реакции: часто - сыпь; редко - облысение, зуд; редко - вазодилатация, везикулобуллезная сыпь."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ: часто - липодистрофия; редко - уменьшение массы тела, увеличение массы тела."}},{"type":"paragraph","data":{"text":"Со стороны лабораторных показателей: повышение общего билирубина (с преобладанием повышения непрямого билирубина), повышение уровня амилазы, КФК, АЛТ, АСТ, липазы, нейтропения."}},{"type":"paragraph","data":{"text":"Прочие: часто - общая слабость, иктеричность склер; редко - боли в груди, усталость, лихорадка, общее недомогание, гинекомастия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Поскольку атазанавир метаболизируется в печени при участии изофермента CYP3A4, при одновременном применении с другими препаратами, метаболизирующимися данным изоферментом (в т.ч. блокаторами кальциевых каналов, ингибиторами ГМГ-КоА-редуктазы и ингибиторами ФДЭ 5, включая силденафил, тадалафил, варденафил) возможно повышение концентрации в плазме крови одного из компонентов. Это может привести к усилению и пролонгированию терапевтического и побочного действия ингибитора ФДЭ 5."}},{"type":"paragraph","data":{"text":"При одновременном применении атазанавира с индукторами изофермента CYP3A4 (в т.ч. с рифампином) может привести к уменьшению концентрации атазанавира в плазме крови и уменьшению его эффективности."}},{"type":"paragraph","data":{"text":"Рифампицин снижает активность большинства ингибиторов протеазы примерно на 90%."}},{"type":"paragraph","data":{"text":"При одновременном применении атазанавира с ингибиторами изофермента CYP3A4 возможно повышение концентрации атазанавира в плазме крови."}},{"type":"paragraph","data":{"text":"Эфавиренз уменьшает действие атазанавира при одновременном применении."}},{"type":"paragraph","data":{"text":"Предполагается, что невирапин, как индуктор CYP3A4, способен уменьшать действие атазанавира (одновременное применение не рекомендуется)."}},{"type":"paragraph","data":{"text":"Индинавир способен вызывать гипербилирубинемию, поэтому одновременное применение с атазанавиром не рекомендуется."}},{"type":"paragraph","data":{"text":"При одновременном применении с атазанавиром эффективность саквинавира уменьшается."}},{"type":"paragraph","data":{"text":"При одновременном применении с ритонавиром концентрация атазанавира в плазме крови повышается."}},{"type":"paragraph","data":{"text":"Антациды (и препараты, содержащие антациды) снижают кислотность желудочного сока, поэтому абсорбция атазанавира уменьшается."}},{"type":"paragraph","data":{"text":"При одновременном применении с атазанавиром возможно повышение концентраций в плазме крови лидокаина (для системного применения), амиодарона (требуется особая осторожность и контроль терапевтических концентраций данных препаратов), хинидина (применение комбинации атазанавир+ритонавир с хинидином противопоказано)."}},{"type":"paragraph","data":{"text":"При одновременном применении возможно повышение токсичности иринотекана вследствие замедления его метаболизма."}},{"type":"paragraph","data":{"text":"Не рекомендуется одновременное применение с симвастатином и ловастатином."}},{"type":"paragraph","data":{"text":"Атазанавир может усиливать действие дилтиазема и его метаболита дезацетил дилтиазема (рекомендуется снижение дозы дилтиазема на 50% и контроль ЭКГ)."}},{"type":"paragraph","data":{"text":"При одновременном применении с бепридилом возможно потенцирование развития тяжелых и/или угрожающих жизни реакций (применение комбинации атазанавир+ритонавир с бепридилом противопоказано)."}},{"type":"paragraph","data":{"text":"Под влиянием атазанавира возможно усиление действия аторвастатина, церивастатина и повышение риска развития миопатии, включая рабдомиолиз (требуется особая осторожность при одновременном применении)."}},{"type":"paragraph","data":{"text":"Блокаторы гистаминовых H\u003csub\u003e2\u003c/sub\u003e-рецепторов и ингибиторы протонной помпы уменьшают концентрацию атазанавира в плазме крови, что может привести к снижению его терапевтической эффективности или развитию резистентности."}},{"type":"paragraph","data":{"text":"При одновременном применении с циклоспорином, такролимусом, сиролимусом возможно повышение концентраций иммунодепрессантов в плазме крови (рекомендуется мониторинг их терапевтических концентраций)."}},{"type":"paragraph","data":{"text":"При одновременном применении с кларитромицином наблюдается повышение концентрации последнего в плазме крови, что может вызвать увеличение интервала QT (требуется снижение дозы антибиотика на 50%)."}},{"type":"paragraph","data":{"text":"При одновременном применении с атазанавиром эффективность рифабутина повышается (рекомендуется уменьшение дозы рифабутина до 75%)."}},{"type":"paragraph","data":{"text":"Кетоконазол и итраконазол могут повышать концентрации атазанавира и ритонавира в плазме крови."}},{"type":"paragraph","data":{"text":"При одновременном применении с варфарином имеется риск тяжелого и/или угрожающего жизни кровотечения вследствие усиления активности варфарина (рекомендуется контроль МНО)."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Не рекомендуется применять одновременно с индукторами CYP3A4 (в т.ч. с препаратами зверобоя), с препаратами, являющимися субстратами CYP3A4 с узким терапевтическим диапазоном (в т.ч. с астемизолом, терфенадином, цизапридом, пимозидом, хинидином, бепридилом, эрготамином, дигидроэрготамином, эргоновином, метилэргоновином)."}},{"type":"paragraph","data":{"text":"Не рекомендуется одновременное применение комбинации атазанавир+ритонавир с другими ингибиторами протеазы."}},{"type":"paragraph","data":{"text":"С осторожностью применять у пациентов с легкой и умеренной печеночной недостаточностью, т.к. атазанавир метаболизируется главным образом в печени, и имеется риск повышения его концентрации в плазме крови. У пациентов с вирусным гепатитом В или С, или отмеченным до начала лечения повышением уровня трансаминаз, увеличивается риск дальнейшего повышения трансаминаз."}},{"type":"paragraph","data":{"text":"При появлении тяжелой кожной сыпи применение атазанавира следует прекратить."}},{"type":"paragraph","data":{"text":"У пациентов с гемофилией типа A и B на фоне лечения ингибиторами протеазы описаны кровотечения, в т.ч. спонтанные кожные кровоизлияния и гемартрозы. Некоторым из этих пациентов требовалось введение фактора VIII. Более чем у половины пациентов лечение ингибиторами протеазы было продолжено или возобновлено после перерыва. Причинная связь между терапией ингибиторами протеазы и этими случаями не установлена."}},{"type":"paragraph","data":{"text":"При необходимости одновременного применения с фелодипином, нифедипином, никардипином и верапамилом показано титрование дозы блокаторов кальциевых каналов и контроль ЭКГ."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"\nПо 10 капсул в\nконтурную ячейковую упаковку из пленки поливинилхлоридной и фольги\nалюминиевой печатной лакированной."}},{"type":"paragraph","data":{"text":"\nПо 3 (для дозировки\n300 мг) или 6 (для дозировок 150 мг и 200 мг) контурных ячейковых\nупаковок вместе с инструкцией по медицинскому применению на казахском\nи русском языках помещают в пачку из картона."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года.\u003cbr\u003e"}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту.\u003cbr\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"Противовирусное средство. Является азапептидным ингибитором протеазы ВИЧ. Селективно ингибирует вирус-специфический процессинг вирусных Gag-Pol протеинов в ВИЧ-инфицированных клетках, предотвращая образование зрелых вирионов и заражение других клеток.","substance":[{"id":1192,"title":"Атазанавир","title_latin":null,"slug":"atazanavir_1192"}],"branding":null,"valid_for_quick_buy":false,"is_available_to_delivery":false,"comments":null,"image_alt":"Симанод - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/80226/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/80226/share_default/"}},"diseases":[],"other_packages":[],"other_product_forms":[],"related_products":{"title":"Похожие товары","type":"nondrugs","products":[{"id":110563,"title":"Реаферон-ЕС-Липинт®","subtitle":{"full":"Капсулы, 10 шт, 500 000 МЕ","short":"Капсулы, 10 шт, 500 000 МЕ","package":"10 шт, 500 000 МЕ"},"prescription":true,"catalog_section_id":88,"manufacturer":{"id":3178,"title":"Вектор 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