About FAERS: The FDA Adverse Event Reporting System FAERS is used by FDA for activities such as looking for new safety concerns that might be related to a marketed product, evaluating a manufacturer's compliance to reporting regulations and responding to outside requests for information. Reporting of adverse events is a voluntary process, and not every report is sent to FDA and entered into FAERS. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. propranolol
No evidence of mutagenicity was observed in a microbial mutagenicity Ames test with or without rat or mouse liver metabolic activation. In addition, no evidence of damage to genetic material was noted in an in vitro alkaline elution assay using rat hepatocytes, a V-79 mammalian cell forward mutation study, an in vitro chromosome aberration study in CHO cells, or an in vivo chromosomal aberration assay in mouse bone marrow. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.
Pharmacokinetic studies with another statin having a similar principal route of elimination to that of simvastatin have suggested that for a given dose level higher systemic exposure may be achieved in patients with severe renal impairment as measured by creatinine clearance. The following adverse reactions have been identified during post-approval use of Activase. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These reactions are frequent sequelae of the underlying disease, and the effect of Activase on the incidence of these events is unknown.
Acute pulmonary emboli obstructing blood flow to a lobe or multiple lung segments. Check with your doctor or pharmacist if you are not sure. All patients starting therapy with Vytorin or whose dose of Vytorin is being increased should be advised of the risk of myopathy, including rhabdomyolysis, and told to report promptly any unexplained muscle pain, tenderness or weakness particularly if accompanied by malaise or fever or if muscle signs and symptoms persist after discontinuing Vytorin. Vytorin therapy should be discontinued immediately if myopathy is diagnosed or suspected. In most cases, muscle symptoms and CK increases resolved when simvastatin treatment was promptly discontinued. Periodic CK determinations may be considered in patients starting therapy with Vytorin or whose dose is being increased, but there is no assurance that such monitoring will prevent myopathy.
At first, one tablet with ezetimibe 10 milligrams mg plus simvastatin 10 mg or ezetimibe 10 mg plus simvastatin 20 mg once a day in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than ezetimibe 10 mg plus simvastatin 40 mg per day. HHT who had a history of minimal epistaxis began to experience profuse epistaxis 8 to 10 weeks after starting ezetimibe-simvastatin, The patient had been treated with simvastatin 20 mg alone for 9 years without any adverse effects. Two months after starting combination therapy with ezetimibe-simvastatin he noticed epistaxis that increased from a few drops every other day to profuse bleeding for 20 to 30 minutes daily. The patient reported initiation of ezetimibe-simvastatin as the only change in his treatment regimen in the past year. When he stopped ezetimibe-simvastatin, his epistaxis decreased. After six weeks without ezetimibe-simvastatin, he had only one moderate nose bleed. Four months later, the patient's hemoglobin was stable. He then started simvastatin 40 mg monotherapy. The profound epistaxis returned and the patient discontinued the medication. It remains unclear whether the patient's accelerated epistaxis was due to the combination therapy or the double dosage of simvastatin. Body as a whole - general disorders: fatigue. Resources for HEALTHCARE PROFESSIONALS ONLY. In patients without recent use of oral anticoagulants or heparin, Activase treatment can be initiated prior to the availability of coagulation study results. Merck says it plans to submit the data to the Food and Drug Administration in mid-2015 to get approval to market the drug for reducing major cardiovascular events. Keep Vytorin and all medicines out of the reach of children. Cyclosporine or Danazol: The risk of myopathy, including rhabdomyolysis is increased by concomitant administration of cyclosporine or danazol. AA is much more complicated. Extreme stress might trigger AA in some people, but recent research shows that genes can also be involved. LDL-C, Apo B, and non-HDL-C compared to atorvastatin doses pooled 10-80. The hypocholesterolemic effect of ezetimibe was evaluated in cholesterol-fed Rhesus monkeys, dogs, rats, and mouse models of human cholesterol metabolism. The initial volume of distribution approximates plasma volume.
There are a range of treatments for AA, but none are effective for everyone and some people with AA don't respond to any treatment. Because some of the available treatments have a high risk of side effects, they are often not used for children. Olivier, J. L. Anaphylactic reaction to inulin: first identification of specific IgEs to an inulin protein compound. Artichoke is LIKELY SAFE when consumed in amounts used in foods. Artichoke is POSSIBLY SAFE when taken by mouth as a medicine. It has been used safely in research for up to 23 months. In some people, artichoke can cause some side effects such as intestinal gas and allergic reactions. People at the greatest risk of allergic reactions are those who are allergic to plants such as marigolds, daisies, and other similar herbs. Katznelson S "Effect of HMG-CoA reductase inhibitors on chronic allograft rejection. In a study of 12 healthy volunteers, simvastatin at the 80-mg dose had no effect on the metabolism of the probe cytochrome P450 isoform 3A4 CYP3A4 substrates midazolam and erythromycin. This indicates that simvastatin is not an inhibitor of CYP3A4 and, therefore, is not expected to affect the plasma levels of other drugs metabolized by CYP3A4. inderal
Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine. Do not add any other medication to infusion solutions containing Activase. Administer Activase as soon as possible but within 3 hours after onset of symptoms. It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding. They seem to attack the hair follicles, mistakenly thinking that somehow they are a threat to the rest of the body. Vytorin is contraindicated in women who are or may become pregnant. Lipid-lowering drugs offer no benefit during pregnancy, because cholesterol and cholesterol derivatives are needed for normal fetal development. Atherosclerosis is a chronic process, and discontinuation of lipid-lowering drugs during pregnancy should have little impact on long-term outcomes of primary hypercholesterolemia therapy. There are no adequate and well-controlled studies of Vytorin use during pregnancy; however, there are rare reports of congenital anomalies in infants exposed to statins in utero. Animal reproduction studies of simvastatin in rats and rabbits showed no evidence of teratogenicity. Serum cholesterol and triglycerides increase during normal pregnancy, and cholesterol or cholesterol derivatives are essential for fetal development. Because statins, such as simvastatin, decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, Vytorin may cause fetal harm when administered to a pregnant woman. If Vytorin is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Traditionally, AA has been regarded as a stress-induced disease. Unfortunately that view persists today, even among some dermatologists, even though very little scientific evidence supports the view. Grapefruit and grapefruit juice may interact with simvastatin and lead to potentially dangerous effects. Do not drink more than 1 quart of grapefruit juice daily. Cases of myopathy, including rhabdomyolysis, have been reported with simvastatin coadministered with colchicine, and caution should be exercised when prescribing Vytorin with colchicine. Does Vytorin 10-20 oral have side effects? Asian, because a different dose may be applicable to you. Summaries for patients. Muscle abnormalities in four patients taking statins to treat unfavorable cholesterol levels. elov.info lamotrigine
Vytorin has been among the most controversial drugs in the cardiovascular world. After the drug's developers -- Merck and Schering-Plough -- were accused of suppressing negative data in 2007-2008, prescriptions fell and the companies' stock prices plunged. Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Vytorin. These medications may be counterfeit and potentially unsafe. If you purchase medications online, be sure you are buying from a reputable and valid online pharmacy. Ask your health care provider for advice if you are unsure about the online purchase of any medication. The active substances are ezetimibe and simvastatin. Muscle problems myopathy may occur with Vytorin. The risk of muscle problems may be greater in people who take higher doses of Vytorin, in people older than 64 years old, in females, or in people who have kidney problems or low thyroid function. It may also be greater in those who take it with certain other medicines eg, niacin especially in Chinese patients. Tell your doctor right away if you notice any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever or general body discomfort. Tell your doctor if you have muscle problems that persist even after your doctor has told you to stop taking Vytorin. Hikino, H. Assay method for antihepatotoxic activity using carbon tetrachloride induced cytotoxicity in primary cultured hepatocytes. Weise WJ, Possidente CJ "Fatal rhabdomyolysis associated with simvastatin in a renal transplant patient. The recommended total doses for acute myocardial infarction AMI is based on patient weight, not to exceed 100 mg, regardless of the selected administration regimen accelerated or 3 hour, described below. This medicine has been prescribed for you only. Do not pass it on to others. The results, which have not yet been peer-reviewed, could dramatically alter the landscape for the multi-billion-dollar cholesterol drug industry. The American Heart Association and the American College of Cardiologists currently only recommend statins. When used together with higher doses of simvastatin, these medicines may increase your risk of muscle injury and could result in kidney problems. What should I avoid while taking ezetimibe and simvastatin Vytorin? Stein says. "A study like this shows us the magnitude of how bad things can really get. generic revia online payment
Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. When such reactions occur, they usually respond to conventional therapy. The combination of ezetimibe and simvastatin is used to treat high cholesterol in adults and children who are at least 10 years old. Camarasa J, Laguna JC, and Gaspar A. Biochemical and histological pattern of cyanarin and caffeic acid treatment in CCl4-induced hepatoxicity. Koldziej, B. Protective properties of artichoke Cynara scolymus against oxidative stress induced in cultured endothelial cells and monocytes. Life Sci. digoxin
Concomitant cholestyramine administration decreased the mean AUC of total ezetimibe approximately 55%. The incremental LDL-C reduction due to adding Vytorin to cholestyramine may be reduced by this interaction. Simvastatin has been associated with rare cases of severe myopathy and rhabdomyolysis. This is accompanied by elevations in creatine kinase, myoglobinuria, and proteinuria, as well as renal failure. Experience with HMG-CoA reductase inhibitors indicates that concomitant use with gemfibrozil, niacin, cyclosporine, or erythromycin may increase the incidence and the severity of musculoskeletal side effects. LDL apheresis or if such treatments are unavailable. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, alcohol use. Simvastatin occasionally causes myopathy manifested as muscle pain, tenderness or weakness with creatine kinase above ten times the upper limit of normal ULN. Myopathy sometimes takes the form of rhabdomyolysis with or without acute renal failure secondary to myoglobinuria, and rare fatalities have occurred. The risk of myopathy is increased by high levels of statin activity in plasma. Vytorin, promptly interrupt therapy. If an alternate etiology is not found do not restart Vytorin. What is ezetimibe and simvastatin Vytorin? These elevations in transaminases were generally asymptomatic, not associated with cholestasis, and returned to baseline after discontinuation of therapy or with continued treatment. What should I tell my doctor before and while taking Vytorin? General Information about the safe and effective use of Vytorin. The Study of Heart and Renal Protection SHARP was a multinational, randomized, placebo-controlled, double-blind trial that investigated the effect of Vytorin on the time to a first major vascular event MVE among 9438 patients with moderate to severe chronic kidney disease approximately one-third on dialysis at baseline who did not have a history of myocardial infarction or coronary revascularization. An MVE was defined as nonfatal MI, cardiac death, stroke, or any revascularization procedure. Patients were allocated to treatment using a method that took into account the distribution of 8 important baseline characteristics of patients already enrolled and minimized the imbalance of those characteristics across the groups.
Should not be used in patients with these conditions. Compare Zetia Prices - GoodRx", "side_effects_page": "Zetia Side Effects, Information and Pricing - GoodRx", "medicare_seo_page": "Zetia Medicare Coverage and Co-Pay Details - GoodRx", "price_page": "Zetia Prices and Zetia Coupons - GoodRx", "info_page": "What is Zetia? Compare prices and print coupons for Zetia Ezetimibe and other High Cholesterol drugs at CVS, Walgreens, and other pharmacies. FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not take ezetimibe and simvastatin if you are pregnant. Stop taking this medication and tell your doctor right away if you become pregnant. Use effective birth control to avoid pregnancy while you are taking ezetimibe and simvastatin. Chan MH, Mak TW, Chiu RW, Chow CC, Chan IH, Lam CW "Simvastatin increases serum osteocalcin concentration in patients treated for hypercholesterolaemia. Talk to your doctor before you start taking any new medicines. There are no adequate and well-controlled studies in pregnant women. Store in the original package in order to protect from moisture and light. The risk of myopathy, including rhabdomyolysis, occurring with use of Vytorin is increased when taking certain types of medication or consuming grapefruit juice. Patients should discuss all medication, both prescription and over the counter, with their healthcare professional. Some researchers who were not involved in the study said back then that they wondered whether Vytorin and Zetia lowered cholesterol but did not reduce heart attacks or strokes. The results released Monday appeared to indicate that bringing a patient's cholesterol lower does appear to reduce heart incidents. IV infusion for at least 48 hours; subsequent heparin therapy was at the physician's discretion. HeFH were randomized to receive either ezetimibe coadministered with simvastatin or simvastatin monotherapy. Do not take fusidic acid while using this medicine. Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit. Abernethy DR, Greenblatt DJ, Morse DS, Shader RI "Interaction of propoxyphene with diazepam, alprazolam and lorazepam. Holtmann G, Adam B, Haag S, et al. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. buy synthroid cheap online
Vytorin when taking lomitapide. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Our Vytorin Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. Simvastatin acid is a substrate of the transport protein OATP1B1. Concomitant administration of medicinal products that are inhibitors of the transport protein OATP1B1 may lead to increased plasma concentrations of simvastatin acid and an increased risk of myopathy. ChoquetKastylevsky G, Kanitakis J, Dumas V, Descotes J, Faure M, Claudy A "Eosinophilic fasciitis and simvastatin. No specific diagnostic signs were observed in rodents. At these doses the only signs seen in dogs were emesis and mucoid stools. In postmarketing experience with ezetimibe, cases of myopathy and rhabdomyolysis have been reported. Most patients who developed rhabdomyolysis were taking a statin prior to initiating ezetimibe. However, rhabdomyolysis has been reported with ezetimibe monotherapy and with the addition of ezetimibe to agents known to be associated with increased risk of rhabdomyolysis, such as fibric acid derivatives. Vytorin and a fenofibrate, if taking concomitantly, should both be immediately discontinued if myopathy is diagnosed or suspected. Store at room temperature between 68-77 degrees F 20-25 degrees C away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Initiate treatment as soon as possible but within 3 hours after symptom onset. is there a generic equivalent for actonel
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Vytorin. See the end of this leaflet for a complete list of ingredients in Vytorin. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. However, in studies with another structurally-related statin, skeletal malformations were observed in rats and mice. Fintelmann V. Therapeutic profile and mechanism of action of artichoke leaf extract: hypolipemic, antioxidant, hepatoprotective and choleretic properties. In 4- to 12-week toxicity studies in mice, ezetimibe did not induce cytochrome P450 drug-metabolizing enzymes. In toxicity studies, a pharmacokinetic interaction of ezetimibe with statins parents or their active hydroxy acid metabolites was seen in rats, dogs, and rabbits. This drug may infrequently cause muscle problems which can rarely lead to a very serious condition called rhabdomyolysis. ULN occurred in two 2% individuals in the ezetimibe coadministered with simvastatin group and in zero individuals in the simvastatin monotherapy group. Violon, C. Belgian Chinese herb nephropathy: why? Use Vytorin as directed by your doctor. Check the label on the medicine for exact dosing instructions. Ezetimibe and simvastatin is usually taken once daily in the evening, with or without food. Your doctor may occasionally change your dose to make sure you get the best results. price of generic podophyllotoxin in canada
Galli, C. Local food and cardioprotection: the role of phytochemicals. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. It is not known if Vytorin is safe and effective in children under 10 years of age or in girls who have not started their period menses. Meier CR, Schlienger RG, Kraenzlin ME, Schlegel B, Jick H "HMG-CoA reductase inhibitors and the risk of fractures. Fintelmann V. Antidyspeptic and lipid-lowering effects of artichoke leaf extract - results of clinical studies into the efficacy and tolerance of Hepar-SL forte involving 553 patients. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. For triglycerides, median % change from baseline. Hold the vial of Activase upside down, position it so that the center of the stopper is directly over the exposed piercing pin of the transfer device, and push the vial of Activase down so that the piercing pin is inserted through the center of the Activase vial stopper. The cause of the increased risk of myopathy is not known. It is also unknown if the risk for myopathy with coadministration of simvastatin with lipid-modifying doses of niacin-containing products observed in Chinese patients applies to other Asian patients. This list is not complete and there are many other drugs that can cause serious or life threatening medical problems if you take them together with ezetimibe and simvastatin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you. Ask your doctor or pharmacist for advice before taking any medicine. Many of the patients who have developed rhabdomyolysis on therapy with simvastatin have had complicated medical histories, including renal insufficiency usually as a consequence of long-standing diabetes mellitus. Such patients taking Vytorin merit closer monitoring. Vytorin who need to be initiated on an interacting drug that is contraindicated or is associated with a dose cap for simvastatin should be switched to an alternative statin or statin-based regimen with less potential for the drug-drug interaction. theophylline
Vytorin is effective in men and women with hyperlipidemia. Experience in non-Caucasians is limited and does not permit a precise estimate of the magnitude of the effects of Vytorin. Statins, which lower the amount of LDL or bad cholesterol in the blood, are considered a kind of miracle drug in modern medicine. Among the most widely prescribed in the world, they are often able to lower a person's cholesterol to very low levels with few noticeable side effects. But they don't work for everyone and some can't tolerate a full dose -- they can cause muscle pain, digestive issues and liver damage -- and until now there haven't been any good alternatives. Krasovec M, Elsner P, Burg G "Generalized eczematous skin rash possibly due to HMG-CoA reductase inhibitors. Take Vytorin by mouth with or without food, preferably in the evening, unless directed otherwise by your doctor. For acute massive pulmonary embolism, bleeding events were consistent with the general safety profile observed with Activase treatment of AMI patients receiving the 3-hour infusion regimen.
If your symptoms do not improve or if they become worse, check with your doctor. In the post-marketing setting, there have been reports of orolingual angioedema in patients primarily patients with AIS receiving concomitant angiotensin-converting enzyme inhibitors. Do not share this medication with others. Ask your health care provider any questions you may have about how to use Vytorin. This drug is more popular than comparable drugs. It is available in generic and brand versions. Food and Drug Administration. Havranek JM, Wolfsen AR, Warnke GA, Phillips PS "Monotherapy with ezetimibe causing myopathy. generic serophene reviews
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Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Kupke D, Sanden HV, Trinczek-Gartner H, and et al. Prüfung der choleretischen Aktivitat eines pflanzlichen Cholagogums. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Nursing mothers. It is not known whether simvastatin is excreted into human milk; however, a small amount of another drug in this class does pass into breast milk. Eligibility did not depend on lipid levels. Some medical conditions may interact with Vytorin.
What are the ingredients in Vytorin? Controlled application of cynarin in the treatment of hyperlipemic syndrome. These data provide support for the acute increase in cardiovascular risk associated with statin discontinuation, they write. Gebhardt R. Hepatoprotection with artichoke extract.
Possibility of causal treatment of bile duct diseases with an artichoke preparation. Simvastatin was proven to reduce: the risk of total mortality by reducing CHD deaths; the risk of non-fatal myocardial infarction and stroke; and the need for coronary and non-coronary revascularization procedures. Vytorin is a combination of 2 medicines. Ezetimibe is an antihyperlipidemic agent. It works by reducing the amount of cholesterol that your body absorbs from your diet. Simvastatin is an HMG-CoA reductase inhibitor or "statin. Remove the appropriate volume from a port second injection site on the infusion line after the infusion set is primed.