Pravachol
Pravachol
Pravachol (Pravastatin)Pharma group
Preparation, corrective lipide exchange. An inhibitor of synthesis of cholesterol
Structure
1 tablet contains Pravastatin 20 mg
Pharmacological action
Preparation causes reversible inhibition of activity of a reductase that leads to suppression of synthesis of cholesterol at a stage mevalon acids and to moderate depression of its intracellular pools. As a result the quantity of LPNP-RECEPTORS is enlarged by cell surfaces, level of the catabolism which is carried out through receptors raises, being in a vascular bed is enlarged. Pravachol possesses fabric selectivity: its overwhelming activity is most expressed in those tissues where cholesterol synthesis is carried out with the maximum rate, in particular in a liver, and also in an ileal intestine.
Pharmacokinetics
After Pravachol intake it is quickly absorbed from GASTROINTESTINAL TRACT (on the average 34 % from a dose). The maximum concentration of active substance in a blood plasma is reached through 1-1 h. Bioavailability makes 17 %. Linkage with fibers of plasma - 50 %. Is exposed to effect of "the first passage" through a liver. It is deduced by kidneys (20 %) and through an intestine (70 %). The semideducing period - 1 h.
Indications to application
Preventive maintenance of ischemic illness of heart.
At patients with a hypercholesterinemia, irrespective of presence of clinical signs of an ischemic heart disease, Pravachol is shown for:
Depressions of risk of occurrence of myocardial infarctions;
Depressions of risk of necessity of operations on a myocardium revascularization;
Depressions of risk of a mortality from cardiovascular diseases;
Depressions of risk of the general mortality by depression of a mortality from cardiovascular diseases.
Hypercholesterinemia.
Pravachol is shown for depression of the raised concentration of the general cholesterol and cholesterol-lpnp at patients with a primary hypercholesterinemia.
Dosage regimen
The initial dose of a preparation makes 10-20 mg. At considerably raised concentration of cholesterol in a blood plasma (more than 300 mg/dl) the initial dose can be enlarged to 40 mg. Pravachol accept 1 time/sut before a dream, irrespective of food intake. The maximum therapeutic effect, as a rule, is shown within 4 weeks from the treatment beginning. During this period correction of a dose of a preparation depending on dynamics of concentration of lipids in plasma is possible.
Side effect
Probably: transitional rising of activity of hepatic transaminases (to 3 times in relation to the top border of norm), not demanding cancellation of a preparation at the majority of patients. At 0.5 % of patients the appreciable and stable augmentation of indicators of transaminases of Serum (more, than in 3 times in relation to the top limit of norm) was observed, that has not been bound to symptoms of disease of a liver; dermal rashes, an itch.
Contraindications
Acute diseases or exacerbation of chronic diseases of a liver;
Proof rising of functional assays of a liver of an obscure aetiology;
Pregnancy;
Lactemia (thoracal feeding);
Hypersensibility to a preparation.
Special indicatings
Before the beginning and during treatment patients should keep to a diet promoting dropping of level of cholesterol in plasma. Before Pravachol appointment it is necessary to exclude secondary hypercholesterinemias, in particular at badly compensated diabetes, a hypothyrosis, a nephrotic syndrome, a disproteinemia. In treatment it is necessary to supervise periodically level of transaminases of Serum for revealing of the fact of rising of their concentration then to pass to more frequent control.
Pravachol prescribe with care at indicatings in the anamnesis to diseases of a liver and abusing alcohol.
Safety of Pravachol application at patients is elderly till 18 years is not established.
Medicinal interaction
It is not taped clinically significant interactions at Pravachol application simultaneously with diuretics, antihypertensive agents, Digitalis preparations, blockers of calcium channels, beta adrenoblockers and Nitroglycerinums.
At simultaneous Pravachol appointment with Acidum acetylsalicylicum, antacids (accepted for 1 h to Pravachol), Cimetidinum, nicotinic acid it was not observed statistically authentic changes of bioavailability of these preparations.
At simultaneous application with cyclosporine, erythromycin or Niacinum enlarge risk of development of a myopathy.
Pravachol is necessary to prescribe for 1 h to or, at least, through 4 h after reception of the specified preparations.
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