Reduced cholesterol levels in serum using ciprofibrate is the result of reducing the level of atherogenic lipoproteins – very low density lipoproteins (VLDL) and low density lipoprotein (LDL) cholesterol, associated with suppression of the biosynthesis of cholesterol in the liver. In addition, ciprofibrate increases the level of high density lipoprotein (HDL). These two processes lead to the improvement of blood plasma cholesterol distribution, resulting in a significant decline in the ratio (VLDL + LDL) / HDL cholesterol, which is significantly elevated in the atherogenic hyperlipidemia. Tendon and tuberous xanthoma, extravascular low-density cholesterol deposits may be subject to significant regression and even complete disappearance as a result of effective long-term treatment (reduction of cholesterol levels in blood serum). Ciprofibrate has an anadrol reviews inhibitory effect on platelets, and also has a fibrinolytic effect.
Pharmacokinetics Absorption : Ciprofibrate rapidly absorbed from the gastrointestinal tract. Maximum plasma concentration is reached after an average of 2 hours after administration. Distribution : As ciprofibrate significantly bound to plasma proteins, it may displace other agents of the sites they link to. It is therefore recommended to take into account this interaction in determining doses, particularly oral anticoagulants (see. See “Special instructions”) The half-life of plasma : The half-life is about 17 hours, which allows you to assign the preparation of scheme 1 time per day. Metabolism and excretion : Ciprofibrate excreted in the urine as unchanged form and in glucuronyl-conjugated form. Studies indicate no accumulation of matter and show that the concentration of drug in blood plasma are proportional to the injected dose.
Hypercholesterolemia type IIa and endogenous hypertriglyceridemia in adults, as an isolated (type IV), and combined (type IIb and III):
- in case of failure of diet therapy compliance, especially if the blood cholesterol level is high at a diet and / or in the presence of concomitant risk factors.
- Hypersensitivity to the active substance or to any other component of the drug;
- abnormal liver function;
- impairment of renal function;
- concomitant use of other fibrates in combination with inhibitors of HMG-CoA reductase inhibitors (see. “Interaction with other medicinal products”).
- age of 18 years (effectiveness and safety have been established);
- congenital galactosemia;
- malabsorption of glucose and galactose;
- lactase deficiency.
Precautions : hypoalbuminemia, hypothyroidism (see “Special Instructions”.)
Pregnancy and lactation Pregnancy
- The results of tests on animals have not demonstrated a teratogenic effect of the drug.
- In clinical practice to date has not been fixed malformations or fetotoxicity. However, the number of pregnancies occurring while taking ciprofibrate, can not completely eliminate the risk of his appointment.
- Indications for fibrates during pregnancy, with the exception of severe hypertriglyceridemia (> 10 g / L) unresponsive to diet and puts women at risk of acute pancreatitis are not available.
The period of breast-feeding
Information on allocation ciprofibrate in mother’s milk is not available. Consequently, the appointment of the drug during lactation is not recommended.
DOSAGE AND ADMINISTRATION:
In combination with a diet for long-term anadrol reviews symptomatic treatment, the effectiveness of which must be periodically monitored.
Lipanor recommended to take 1 capsule per day. The maximum daily dose is 100 mg (1 capsule).
Side effect On the part of the musculoskeletal system : as for other fibrates described muscular disorders (diffuse myalgias, tenderness, weakness), as well as rare cases of rhabdomyolysis, sometimes severe. Usually, these effects are reversible when the abolition of the treatment (see “Special Instructions”.). On the part of the gastrointestinal tract :. Nausea, vomiting, dyspepsia, diarrhea On the part of the central nervous system : headache, dizziness, and rare cases of drowsiness occur early in treatment, . less frequently -vposledstvii other : skin reactions: itching, hives, rash, photosensitivity reaction, extremely rare (as well as for other fibrates) and alopecia. As with the reception of other fibrates, sometimes there may be an increase in transaminase levels (see “Special instructions. “). Very rare cases of cholestasis or cytolysis have been reported. As in the case of other drugs of this class, described a slight chance of impotence. There have been reports of isolated cases of interstitial pneumonia. Currently, there are no controlled studies that would allow an overall assessment of side effects with prolonged use drug, and in particular – the risk of developing gallstones.
Ciprofibrate not displayed by dialysis. In case of overdose, symptomatic treatment.
INTERACTION WITH OTHER DRUGS Contraindicated combination with other fibrates: enhanced risk of such adverse effects as rhabdomyolysis and pharmacodynamic antagonism between the two substances. We do not recommend the combination with inhibitors of HMG-CoA reductase: increased risk of adverse effects such as rhabdomyolysis. It should also appoint ciprofibrate with inhibitors of monoamine oxidase (MAO). Requires caution when combined with oral Lipanora indirect anticoagulants: anticoagulant effect is enhanced and the risk of bleeding (anticoagulant displacement of binding sites to plasma proteins). It is recommended to monitor the prothrombin levels and adjust the dose of anticoagulants during treatment Lipanorom and after 8 days after its cancellation.
When using fibrates described violations of the musculoskeletal system, including rare cases of rhabdomyolysis.
Such complications are more often may occur in patients with renal insufficiency or gipoalbuminuriey as nephrotic syndrome.
Suspected violations of the musculoskeletal system should occur during the development at patients with diffuse myalgia, muscle tenderness and / or (more than 5 times higher than normal) increase the level of creatine phosphokinase (CPK). In such cases, treatment with the drug should be discontinued.
In addition, the risk of muscle damage may be increased by combination with other fibrates or HMG-CoA reductase inhibitors (see. “Interactions with other medicinal products” section).
Since the degree of muscle damage is dose-dependent, the the maximum daily dose should not exceed 100 mg.
Hypothyroidism, which may be the cause of dyslipidemia should be diagnosed and corrected before initiating therapy. Moreover, hypothyroidism can be a risk factor for myopathy, which in turn may enhance muscle toxicity fibrates.
Due to the presence of lactose in the formulation, it is contraindicated in patients with congenital galactosemia, malabsorption of glucose and galactose and lactase deficiency.
If long (3- . 6 months) treatment of ciprofibrate makes it impossible to satisfactorily control the concentration of lipids in the blood serum, it is necessary to appoint additional or other therapy
some patients had transient increase in the level of activity of “liver” transaminases, which makes it necessary to them:
- systematic identification of every 3 months for 1 year of therapy;
- abolition of the drug with an increase in ACT, ALT more than 3 times the upper limit of normal.
In simultaneous treatment with oral anticoagulants should be monitored prothrombin time expressed in INR (international normalized ratio – MHO).
Currently, there are no long-term data from controlled studies demonstrating the effectiveness of ciprofibrate for primary or secondary prevention of complications of anadrol reviews atherosclerosis.
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