Кардиостатин-штада Таблетки, 30 шт, 20 мг, для взрослых

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Максимальная концентрация (7,8 нг/мл для ловастатина и 11,9 нг/мл для бета-гидроксикислоты) в плазме крови отмечается через 2-4 ч, затем уровень в плазме крови быстро снижается, составляя через 24 ч 10% от максимума."}},{"type":"paragraph","data":{"text":"Связь с белками плазмы крови — 95%. Клиренс ловастатина и его активных метаболитов при однократном назначении на ночь достигается на 2-3 сутки терапии и в 1,5 раза выше, чем после однократного приема. Проникает через гематоэнцефалический барьер и плацентарный барьер."}},{"type":"paragraph","data":{"text":"Подвергается интенсивному метаболизму при «первом прохождении» через печень, окисляется до бета-гидроксикислоты, ее 6-оксипроизводного и других метаболитов, часть из которых фармакологически активны (блокируют 3-гидрокси-3-метилглутарил-коэнзим А-редуктазу). В метаболизме препарата участвуют изоферменты CYP3А4, CYP3А5 и CYP3А7."}},{"type":"paragraph","data":{"text":"Период полувыведения — 3 часа. Выводится через кишечник — 83%, почками — 10%."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Первичная гиперхолестеринемия с высокой концентрацией ЛПНП типа IIa и IIb по классификации Фредриксена (не корригируемая специальной диетой и физической нагрузкой), комбинированная гиперхолестеринемия и гипертриглицеридемия."}},{"type":"paragraph","data":{"text":"У пациентов ишемической болезнью сердца с целью замедления прогрессирования коронарного атеросклероза."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к любому из компонентов препарата; заболевания печени в активной фазе; повышение активности «печеночных» трансаминаз (неясной этиологии); общее тяжелое состояние пациента; применение у женщин репродуктивного возраста, не использующих надежные методы контрацепции; беременность или планирование беременности; период грудного вскармливания; возраст до 18 лет (безопасность и эффективность применения не установлены); одновременный прием мощных ингибиторов изофермента CYP3A4 (в т. ч. итраконазол, кетоконазол, позаконазол, ингибиторы ВИЧ-протеазы, боцепревир, телапревир, эритромицин, кларитромицин, телитромицин и нефазодон); одновременный прием гемфиброзила, циклоспорина; непереносимость лактозы, дефицит лактазы, глюкозо-галактозная мальабсорбция; грейпфрутовый сок — более 1 л в сутки."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Заболевания печени (в анамнезе), злоупотребление алкоголем, пациентам после трансплантации органов, которым проводится иммунодепрессивная терапия (повышенный риск развития рабдомиолиза и почечной недостаточности), хроническая почечная недостаточность (клиренс креатинина менее 30 мл/мин), хирургические вмешательства (в том числе стоматологические), при одновременном приеме с другими фибратами, никотиновой кислотой в липидснижающих дозах (более 1 г/сутки) из-за риска развития миопатии."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В связи с тем, что ингибиторы ГМГ-КоА-редуктазы тормозят синтез холестерина, а холестерин и другие продукты его синтеза играют существенную роль в развитии плода, включая синтез стероидов и клеточных мембран, ловастатин может оказывать неблагоприятное воздействие на плод при назначении его беременным (женщины репродуктивного возраста должны тщательно соблюдать меры по контрацепции). Если в процессе лечения возникает беременность, препарат должен быть отменен, а женщина предупреждена о возможной опасности для плода."}},{"type":"paragraph","data":{"text":"Данные в отношении выделения ловастатина с грудным молоком отсутствуют (однако получены экспериментальные данные о проникновении препарата в грудное молоко крыс), поэтому грудное вскармливание во время лечения необходимо прекратить."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, во время приема пищи. Препарат принимают 1 раз в сутки вечером (холестерин синтезируется в основном ночью). Во время лечения препаратом необходимо соблюдать стандартную диету с низким содержанием холестерина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eГиперхолестеринемия\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Начальная доза составляет 10-20 мг/сут. При необходимости дозу увеличивают (1 раз в 4 недели). Максимальная суточная доза — 80 мг за один или два приема (во время завтрака и ужина)."}},{"type":"paragraph","data":{"text":"В случае снижения концентрации в плазме крови общего холестерина до 140 мг/100 мл (3,6 ммоль/л) или липопротеидов низкой плотности до 75 мг/100 мл (1,94 ммоль/л) дозу следует уменьшить."}},{"type":"paragraph","data":{"text":"При одновременном назначении с препаратами, подавляющими иммунитет, фибратами, никотиновой кислотой в липидснижающих дозах (более 1 г/сут), даназолом, дилтиаземом, верапамилом, а также при выраженной хронической почечной недостаточности (клиренс креатинина менее 30 мл/мин) максимальная суточная доза не должна превышать 20 мг. При одновременном назначении с амиодароном максимальная суточная доза не должна превышать 40 мг."}},{"type":"paragraph","data":{"text":"\u003ci\u003eКоронарный атеросклероз\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Начальная доза 20-40 мг/сут. При необходимости дозу увеличивают (1 раз в 4 недели)."}},{"type":"paragraph","data":{"text":"Максимальная суточная доза — 80 мг в один или в два приема (во время завтрака и ужина)."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны пищеварительной системы:\u003c/i\u003e изжога, тошнота, диарея, запор, метеоризм, рвота, боль в животе, сухость во рту, нарушение вкуса, снижение аппетита, анорексия, гастралгия, холестатическая желтуха, нарушение функции печени, гепатит, острый панкреатит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны центральной нервной системы:\u003c/i\u003e головокружение, головная боль, общая слабость, судороги, бессонница, парестезии, периферическая нейропатия, потеря памяти, психические нарушения (включая тревогу)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны опорно-двигательного аппарата:\u003c/i\u003e миалгия, миозит, миопатия, рабдомиолиз (у пациентов, получающих одновременно циклоспорин, гемфиброзил или никотиновую кислоту (более 1 г/сут)), артралгия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органа зрения:\u003c/i\u003e нечеткость зрительного восприятия, помутнение хрусталика, катаракта, атрофия зрительного нерва."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e при приеме статинов описан синдром, который может включать гемолитическую анемию, лейкопению, тромбоцитопению, эозинофилию, повышение скорости оседания эритроцитов (СОЭ), положительные результаты теста на антиядерные антитела, крапивницу, кожную сыпь, ангионевротический отек, токсический эпидермальный некролиз, кожный зуд."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛабораторные показатели:\u003c/i\u003e повышение активности «печеночных» трансаминаз, повышение активности креатинфосфокиназы (КФК), щелочной фосфатазы, билирубина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e снижение потенции, острая почечная недостаточность (обусловленная рабдомиолизом), боль в грудной клетке, ощущение сердцебиения."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Было описано несколько случаев случайного приема излишне больших доз препарата, но специфических симптомов у пациентов при этом не наблюдалось."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение: \u003c/i\u003eсимптоматическое, следует вызвать рвоту, промыть желудок, показано назначение активированного угля, необходим контроль функции печени и активности КФК. Специфического антидота не существует. Гемодиализ неэффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eИммунодепрессанты, мощные ингибиторы изофермента CYP3A4 (в т. ч. итраконазол, кетоконазол, позаконазол, ингибиторы ВИЧ-протеазы, боцепревир, телапревир, эритромицин, кларитромицин, телитромицин и нефазодон), гемфиброзил, циклоспорин, никотиновая кислота в липидснижающих дозах (более 1 г/сут), колхицин, ранолазин и препараты, влияющие на концентрацию эндогенных стероидных гормонов, увеличивают риск развития миопатии с рабдомиолизом и острой почечной недостаточностью.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При одновременном назначении с даназолом, дилтиаземом, верапамилом максимальная суточная доза ловастатина не должна превышать 20 мг, с амиодароном — 40 мг."}},{"type":"paragraph","data":{"text":"Усиливает эффект непрямых антикоагулянтов и риск возникновения кровотечений. Необходим регулярный контроль протромбинового времени."}},{"type":"paragraph","data":{"text":"Колестирамин и колестипол снижают биодоступность (применение ловастатина возможно через 4 часа после приема указанных лекарственных средств)."}},{"type":"paragraph","data":{"text":"Циклоспорин повышает плазменную концентрацию метаболитов ловастатина."}},{"type":"paragraph","data":{"text":"Грейпфрутовый сок в больших количествах (более 1 л/сут) увеличивает максимальную концентрацию (Cmax) и площадь под кривой «концентрация-время» (AUC) ловастатина и риск миопатий (одновременное их применение не рекомендуется)."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения пациенты должны находиться на стандартной диете с низким содержанием холестерина."}},{"type":"paragraph","data":{"text":"Пациенты должны быть предупреждены, что в случае появления необъяснимых болей в мышцах, болезненности и слабости мышц (особенно в сочетании с лихорадкой), им следует обратиться к врачу."}},{"type":"paragraph","data":{"text":"Терапия должна быть прервана на длительное время или прекращена при общем тяжелом состоянии пациента, вследствие какого-либо заболевания."}},{"type":"paragraph","data":{"text":"Лечение препаратом Кардиостатин может вызвать повышение активности «печеночных» трансаминаз и КФК. При длительной терапии показан биохимический контроль функции печени. Активность «печеночных» трансаминаз определяют до начала лечения, каждые 8 недель в течение первого года терапии, далее — не реже 1 раза в полгода. Пациентам, у которых суточная доза препарата составляет 80 мг, следует проводить исследование 1 раз в три месяца. При повышении активности «печеночных» трансаминаз исследование необходимо повторить и в последующем проводить его более часто. При повышении активности «печеночных» трансаминаз и КФК более чем в 3 раза относительно верхней границы нормы, препарат следует отменить."}},{"type":"paragraph","data":{"text":"Применение статинов может приводить к развитию гипергликемии у пациентов сахарным диабетом."}},{"type":"paragraph","data":{"text":"Терапия препаратом может приводить к развитию миопатии с рабдомиолизом и почечной недостаточности. Риск возникновения этой патологии возрастает при одновременном применении с иммунодепрессантами, гемфиброзилом, никотиновой кислотой в липидснижающих дозах (более 1 г/сут), циклоспорином, эритромицином и противогрибковыми препаратами группы азолов (итраконазол и др.)."}},{"type":"paragraph","data":{"text":"В случае пропуска текущей дозы препарат необходимо принять как можно скорее. Если наступило время следующей дозы, дозу не увеличивать."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Следует соблюдать осторожность при управлении транспортными средствами и механизмами ввиду риска развития головокружения."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 20 мг. 10 или 30 таблеток в контурной ячейковой упаковке из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной или в контурной ячейковой упаковке из фольги алюминиевой печатной лакированной и фольги алюминиевой, ламинированной поливинилхлоридной и полиамидной пленкой."}},{"type":"paragraph","data":{"text":"3 контурные ячейковые упаковки по 10 таблеток или 1 контурная ячейковая упаковка по 30 таблеток вместе с инструкцией по медицинскому применению лекарственного препарата в пачке из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом, защищенном от света месте при температуре от 12 ºС до 15 ºС."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не применять позже даты, указанной на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nООО «Хемофарм», Россия"}},{"type":"paragraph","data":{"text":"249032, Калужская обл., г. Обнинск,"}},{"type":"paragraph","data":{"text":"Киевское шоссе, д. 62"}},{"type":"paragraph","data":{"text":"Тел.: (48439) 90-500; факс: (48439) 90-525\n\n"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"\n\nАО «Нижфарм», Россия"}},{"type":"paragraph","data":{"text":"603950, г. Нижний Новгород, ул. Салганская, д. 7"}},{"type":"paragraph","data":{"text":"Тел.: (831) 278-80-88; факс: (831) 430-72-28"}},{"type":"paragraph","data":{"text":"\u003ca href=\"mailto:med@stada.ru\"\u003emed@stada.ru\u003c/a\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"Гиполипидемическое средство, нарушает ранние этапы синтеза холестерина в печени (на стадии левановой кислоты). В организме образует свободную бета-гидроксикислоту, которая конкурентно ингибирует 3-гидрокси-3-метилглутарил-коэнзим А-редуктазу (ГМГ-КоА-редуктаза) и нарушает ее превращение в мевалонат, в результате чего снижается синтез холестерина, усиливается его катаболизм. Снижает содержание в крови липопротеидов очень низкой плотности, липопротеидов низкой плотности (ЛПНП) и триглицеридов, умеренно увеличивает содержание липопротеидов высокой плотности. Значительно уменьшает количество апопротеина В (входящего в состав липопротеидов низкой плотности) и других циркулирующих компонентов липопротеидов низкой плотности. Выраженный терапевтический эффект проявляется в течение 2 недель, а максимальный — через 4-6 недель с момента начала лечения. В желудочно-кишечном тракте всасывается медленно и не полностью — около 30% принятой дозы, прием натощак снижает абсорбцию на 30%. Максимальная концентрация (7,8 нг/мл для ловастатина и 11,9 нг/мл для бета-гидроксикислоты) в плазме крови отмечается через 2-4 ч, затем уровень в плазме крови быстро снижается, составляя через 24 ч 10% от максимума. Связь с белками плазмы крови — 95%. Клиренс ловастатина и его активных метаболитов при однократном назначении на ночь достигается на 2-3 сутки терапии и в 1,5 раза выше, чем после однократного приема. Проникает через гематоэнцефалический барьер и плацентарный барьер. Подвергается интенсивному метаболизму при «первом прохождении» через печень, окисляется до бета-гидроксикислоты, ее 6-оксипроизводного и других метаболитов, часть из которых фармакологически активны (блокируют 3-гидрокси-3-метилглутарил-коэнзим А-редуктазу). В метаболизме препарата участвуют изоферменты CYP3А4, CYP3А5 и CYP3А7. Период полувыведения — 3 часа. 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