سعر التومانيرا 10/40 مجم 21 قرص 2022

Egyptian fixed-dose tablets of ezetimibe 10 mg + simvastatin 40 mg (21 per pack) by Mash Premiere, used to lower LDL cholesterol.

• Adjunct to diet to reduce elevated LDL-C in adults with primary hyperlipidemiaPopulation: AdultsDailyMed (NLM)
• Adjunct to diet to reduce LDL-C in heterozygous familial hypercholesterolemiaPopulation: Adults and children 10 years and olderDailyMed (NLM)
• Reduction of LDL-C in homozygous familial hypercholesterolemia, as adjunct to other LDL-lowering therapiesPopulation: AdultsDailyMed (NLM)

• Most common (incidence at least 2%): headache (5.8%), increased ALT (3.7%), myalgia (3.6%), upper respiratory tract infection (3.6%) and diarrhea (2.8%).International label, same formulation · DailyMed (NLM)

• Concomitant use of strong CYP3A4 inhibitors, cyclosporine, danazol or gemfibrozil.International label, same formulation · DailyMed (NLM)
• Acute liver failure or decompensated cirrhosis.International label, same formulation · DailyMed (NLM)
• Hypersensitivity to ezetimibe, simvastatin or any excipient.International label, same formulation · DailyMed (NLM)

• Myopathy and rhabdomyolysis: risk increases with higher simvastatin doses, age 65 or older, uncontrolled hypothyroidism, renal impairment and certain interacting drugs; stop if CK is markedly elevated or myopathy is suspected.International label, same formulation · DailyMed (NLM)
• Immune-mediated necrotizing myopathy (IMNM) has been reported with statins.International label, same formulation · DailyMed (NLM)
• Hepatic dysfunction: increases in serum transaminases have occurred; check liver enzymes before starting and as clinically indicated.International label, same formulation · DailyMed (NLM)

• Strong CYP3A4 inhibitors (e.g. itraconazole, ketoconazole, clarithromycin, HIV protease inhibitors), cyclosporine, danazol, gemfibrozilMarkedly increased risk of myopathy/rhabdomyolysis; contraindicated.DailyMed (NLM)
• Amiodarone, dronedarone, ranolazine or calcium channel blockersIncreased myopathy/rhabdomyolysis risk: with verapamil, diltiazem or dronedarone do not exceed 10/10 mg daily; with amiodarone, amlodipine or ranolazine do not exceed 10/20 mg daily.DailyMed (NLM)
• Grapefruit juiceIncreases simvastatin exposure; avoid grapefruit juice.DailyMed (NLM)

• Discontinue when pregnancy is recognized (or consider the individual patient's ongoing therapeutic needs); by its mechanism of decreasing cholesterol synthesis it may cause fetal harm, and treatment of hyperlipidemia is not generally necessary during pregnancy.International label, same formulation · DailyMed (NLM)
• Breastfeeding is not recommended during treatment.International label, same formulation · DailyMed (NLM)

• Ezetimibe: Inhibits intestinal absorption of cholesterol and related phytosterols (US Vytorin label).
• Simvastatin: Inhibits HMG-CoA reductase, the rate-limiting enzyme of cholesterol synthesis (US Vytorin label).