Clinical and pharmacological group: & nbsp

Bile acid sequestrants

Included in the formulation
АТХ:

C.10.A.X   Other lipid-lowering drugs

Pharmacodynamics:

Binding of bile acids in the small intestine, preventing their reverse absorption. Stimulation of the synthesis of bile acids from cholesterol in the liver, a decrease in the concentration of hepatic cholesterol, an increase in the number of hepatocyte receptors to low density lipoprotein and content reduction low density lipoprotein in blood.

Pharmacokinetics:

It is not absorbed from the digestive tract, it is insoluble in water.

Indications:

Primary hypercholesterolemia (increased content low density lipoprotein), prevention of atherosclerosis and its complications (including coronary heart disease, myocardial infarction), itching with partial obstruction of the biliary tract.

IX.I70-I79.I70.9   Generalized and unspecified atherosclerosis

IX.I70-I79.I70.8   Atherosclerosis of other arteries

IX.I70-I79.I70.2   Atherosclerosis of the arteries of the extremities

IX.I70-I79.I70.1   Atherosclerosis of the renal artery

IX.I70-I79.I70.0   Atherosclerosis of the aorta

IX.I70-I79.I70   Atherosclerosis

IX.I60-I69.I67.20   Cerebral atherosclerosis with hypertension

IX.I60-I69.I67.2   Cerebral atherosclerosis

IX.I20-I25.I25.10   Atherosclerotic heart disease with hypertension

IX.I20-I25.I25.1   Atherosclerotic Heart Disease

IX.I20-I25.I25.00   Atherosclerotic cardiovascular disease, as described with hypertension

IX.I20-I25.I25.0   Atherosclerotic cardiovascular disease, as described

IV.E70-E90.E78.0   Pure hypercholesterolemia

Contraindications:

Hypersensitivity, complete obstruction of the biliary tract, phenylketonuria, pregnancy.

Carefully:

Possible pregnancy.

Pregnancy and lactation:

The category of FDA recommendations is not defined.

If it is necessary to use during pregnancy and during breastfeeding, the estimated benefit of therapy for the mother and the potential risk to the fetus or the baby should be assessed.

Dosing and Administration:

Inside, before meals (the contents of one sachet are poured into a glass, water, cream or juice is added in the amount of 60-80 ml, mixed and drunk after 10 minutes - so that the powder adsorbs a sufficient amount of liquid and the suspension is uniform). Adults - from 1 to 6 bags per day; children are metered individually. The dose for adult patients is 4-24 g per day.

Side effects:

Constipation, pain and discomfort in the abdomen, increased gassing in the intestines, nausea, vomiting, diarrhea, heartburn, anorexia, dyspepsia, pancreatitis, steatorrhea, skin irritation, skin rashes, increased libido.With prolonged treatment - hyperchloremic acidosis, a decrease in blood clotting, hemorrhoidal bleeding, bleeding from a stomach ulcer, duodenal ulcer.

Overdose:The main probable danger is gastrointestinal obstruction.
Interaction:

When used simultaneously with tricyclic antidepressants (including imipramine, amitriptyline, desipramine, nortriptyline), a decrease in their concentration in the blood plasma is possible.

With simultaneous application with acarbose, acarbose effects can be enhanced.

With simultaneous use with amiodarone decreases the concentration of amiodarone in the blood plasma.

With simultaneous use with sodium valproate, a slight decrease in the absorption of sodium valproate is possible.

With simultaneous use with vancomycin decreases the effectiveness of vancomycin.

With simultaneous use with warfarin, fenprokumonom, dicumarol, ethyl biscumacetate, a decrease in the effectiveness of anticoagulants is possible.

With simultaneous application with hydrocortisone, absorption of hydrocortisone from the digestive tract decreases.

When used simultaneously with hydrochlorothiazide, absorption and diuretic absorptioneffect of hydrochlorothiazide.

When used simultaneously with glipizide, a decrease in glipizide absorption is possible.

At reception with an interval of 1,5 hours colestramine has no significant effect on the concentration of digoxin and digitoxin in blood plasma. Reduction in the concentration of digoxin and digitoxin in the blood plasma is possible with long-term combined use with colestyramine.

With simultaneous use with diclofenac, ibuprofen, absorption of diclofenac and ibuprofen from the digestive tract decreases.

When iron sulfate, phenylbutazone is simultaneously used with iron, it is possible to reduce the absorption of iron sulfate and phenylbutazone.

With simultaneous use with levothyroxine, thyroid hormones, absorption of levothyroxine and thyroid hormones from the digestive tract decreases.

With simultaneous application with loperamide, a decrease in the effectiveness of loperamide is possible.

With simultaneous use with methotrexate, a decrease in the concentration of methotrexate in the blood plasma is possible.

With simultaneous use with metronidazole, a slight decrease in the absorption of metronidazole from the gastrointestinal tract is possible.

With simultaneous application with paracetamol, a decrease in paracetamol absorption is possible.

With simultaneous application with colestyramine, it is possible to increase the excretion of piroxicam, meloxicam, tenoxicam from the body and decrease their effectiveness.

With simultaneous use with pravastatin, fluvastatin, the concentration of pravastatin in blood plasma decreases, Cmax and AUC of fluvastatin. In this case, the overall lipid-lowering effect is enhanced.

With simultaneous use with raloxifene, the absorption of raloxifene is reduced.

With simultaneous application with sulindac, the absorption of sulindac is reduced (even in the case of an interval between doses of 3 hours).

With simultaneous use with spironolactone, cases of hypochloremic alkalosis are described.

With simultaneous application with furosemide, absorption and diuretic effect of furosemide decreases.

Special instructions:

During the treatment period it is necessary to control the level of cholesterol and triglycerides.

Use with caution in patients older than 60 years.

When hypoprothrombinemia is recommended, parenteral administration of vitamin K1. With a decrease in the content of folic acid in the plasma - the introduction of folic acid.During the period of treatment, an increased intake of fluids is recommended.

Instructions
Up