سعر ليبترين 10/20 مجم 2022

Lipitrin 10/20 mg 14 tablets (Chemipharm, Egypt): tablets combining ezetimibe 10 mg and simvastatin 20 mg (strength figures interpreted as ezetimibe/simvastatin).

• Adjunct to diet to reduce elevated LDL-C in adults with primary hyperlipidaemia and in adults and children aged 10 years and older with HeFH; adjunct to other LDL-C-lowering therapies in adults with HoFH.Population: Adults and children aged 10 years and olderDailyMed (U.S. National Library of Medicine)
• Reduce the risk of cardiovascular events in patients with coronary heart disease and a history of acute coronary syndrome; adjunct to diet in primary (heterozygous familial and non-familial) hypercholesterolaemia or mixed hyperlipidaemia not controlled with a statin alone or already treated with a statin and ezetimibe; adjunct in HoFH.Population: Adults (and adolescents 10 years and older per posology)electronic medicines compendium (eMC)

• Common (2% or more and greater than placebo) in clinical trials: headache, increased ALT, myalgia, upper respiratory tract infection, diarrhoea.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Concomitant strong CYP3A4 inhibitors (select azole antifungals, macrolide antibiotics, antivirals, nefazodone); ciclosporin or danazol (the label highlights also list gemfibrozil); acute liver failure or decompensated cirrhosis; hypersensitivity to simvastatin, ezetimibe or any excipient.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Hypersensitivity; pregnancy and lactation; active liver disease or unexplained persistent transaminase elevations; potent CYP3A4 inhibitors (e.g. itraconazole, ketoconazole, posaconazole, voriconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, boceprevir, telaprevir, nefazodone, cobicistat); gemfibrozil, ciclosporin or danazol; lomitapide with doses above 10/40 mg in HoFH.International label, same formulation · electronic medicines compendium (eMC)

• Myopathy and rhabdomyolysis (risk factors: age 65 or older, uncontrolled hypothyroidism, renal impairment, certain concomitant drugs, higher dosage; Chinese patients may be at higher risk); discontinue if markedly elevated CK or myopathy suspected; immune-mediated necrotising myopathy; hepatic dysfunction; increases in HbA1c and fasting glucose.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Myopathy/rhabdomyolysis: risk is dose related for simvastatin (myopathy about 0.03%, 0.08% and 0.61% at 20, 40 and 80 mg/day in trials) and is increased by interacting drugs that raise simvastatin levels; risk is greater with 10/80 mg than with other statin-based therapies of similar efficacy; rhabdomyolysis also reported very rarely with ezetimibe.International label, same formulation · electronic medicines compendium (eMC)

• Strong CYP3A4 inhibitors, ciclosporin, danazolContraindicated (increased simvastatin exposure and myopathy/rhabdomyolysis risk).DailyMed (U.S. National Library of Medicine)
• Amiodarone, amlodipine, verapamil, diltiazem, elbasvir/grazoprevirDose of ezetimibe/simvastatin should not exceed 10/20 mg/day (increased myopathy risk).electronic medicines compendium (eMC)
• Bile acid sequestrantsGive ezetimibe/simvastatin at least 2 hours before or 4 hours after the sequestrant.electronic medicines compendium (eMC)

• Discontinue when pregnancy is recognised, or consider the ongoing therapeutic needs; may cause fetal harm based on mechanism of action; treatment of hyperlipidaemia is not generally necessary during pregnancy.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Contraindicated during pregnancy; no clinical data; animal studies on the combination showed reproductive toxicity; rare reports of congenital anomalies after intrauterine statin exposure.International label, same formulation · electronic medicines compendium (eMC)
• No information on presence of ezetimibe or simvastatin in human milk; other statins pass into milk; breastfeeding is not recommended during treatment.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Ezetimibe: Inhibits intestinal absorption of cholesterol and related phytosterols by binding the sterol transporter NPC1L1 at the small-intestinal brush border.
• Simvastatin: Inactive lactone hydrolysed to the beta-hydroxyacid form, which competitively inhibits HMG-CoA reductase and reduces hepatic cholesterol synthesis.