Ask your healthcare professional how you should dispose of any medicine you do not use. Lavermicocca, P. In vitro and in vivo survival and transit tolerance of potentially probiotic strains carried by artichokes in the gastrointestinal tract. Appl Environ. Inegy throughout the following leaflet. When such reactions occur, they usually respond to conventional therapy.
Combination of these drugs with Vytorin is contraindicated. If short-term treatment with strong CYP3A4 inhibitors is unavoidable, therapy with Vytorin must be suspended during the course of treatment. No specific diagnostic signs were observed in rodents. At these doses the only signs seen in dogs were emesis and mucoid stools. 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.
The risk of myopathy, including rhabdomyolysis, is dose related. The recommended dose is 100 mg administered by IV infusion over 2 hours. Fatal cases of hemorrhage associated with traumatic intubation in patients administered Activase have been reported.
Rudski L, Rabinovitch MA, Danoff D "Systemic immune reactions to HMG-CoA reductase inhibitors - Report of 4 cases and review of the literature. Do not share this medication with others. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Your pharmacist can provide more information about ezetimibe and simvastatin.
Schumacher YO, Zdebik A, Huonker M, Kreisel W "Sildenafil in HIV-related pulmonary hypertension. Initiate treatment as soon as possible but within 3 hours after symptom onset. COOR6; R6, R7 and R8 are H, lower alkyl or aryl-substituted Ic R9 is lower alkyl, aryl or aryl-substituted lower alkyl; are disclosed, as well as a method of lowering serum cholesterol by administering said compounds, alone or in combination with a cholesterol biosynthesis inhibitor, pharmaceutical compositions containing them; and a process for preparing them. What should I discuss with my healthcare provider before taking ezetimibe and simvastatin Vytorin? 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. Ezetimibe localizes at the brush border of the small intestine and inhibits the absorption of cholesterol, leading to a decrease in the delivery of intestinal cholesterol to the liver. Activase is for intravenous administration only. Extravasation of Activase infusion can cause ecchymosis or inflammation. If extravasation occurs, terminate the infusion at that IV site and apply local therapy. The Physician must register to access tools and materials for patient support, product sample requests, up-to-date professional resources, and other Merck professional sites. Bundy R, Walker AF, Middleton RW, et al. Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis.
What is ezetimibe and simvastatin Vytorin? Ezetimibe reduces blood cholesterol by inhibiting the absorption of cholesterol by the small intestine. The molecular target of ezetimibe has been shown to be the sterol transporter, Niemann-Pick C1-Like 1 NPC1L1 which is involved in the intestinal uptake of cholesterol and phytosterols. Vytorin should be used with extreme caution in CHILDREN younger than 10 years old; safety and effectiveness in these children have not been confirmed. The effect of Vytorin on the prothrombin time has not been studied. 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. The interaction of Activase with other cardioactive or cerebroactive drugs has not been studied. Anticoagulants and antiplatelet drugs increase the risk of bleeding if administered prior to, during, or after Activase therapy. Vanpuijenbroek EP, Dubufvereijken PWG, Spooren PFMJ, Vandoormaal JJ "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil.
LDL, promote human atherosclerosis. In addition, decreased levels of HDL-C are associated with the development of atherosclerosis. Epidemiologic studies have established that cardiovascular morbidity and mortality vary directly with the level of total-C and LDL-C and inversely with the level of HDL-C. Like LDL, cholesterol-enriched triglyceride-rich lipoproteins, including VLDL, intermediate-density lipoproteins IDL and remnants, can also promote atherosclerosis. The independent effect of raising HDL-C or lowering TG on the risk of coronary and cardiovascular morbidity and mortality has not been determined. The increased incidence of thyroid neoplasms appears to be consistent with findings from other statins. Liver problems. Your doctor should do blood tests to check your liver before you start taking Vytorin and if you have any symptoms of liver problems while you take Vytorin. Cases of myopathy, including rhabdomyolysis, have been reported with simvastatin coadministered with colchicine, and caution should be exercised when prescribing Vytorin with colchicine. Take this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. ChoquetKastylevsky G, Kanitakis J, Dumas V, Descotes J, Faure M, Claudy A "Eosinophilic fasciitis and simvastatin. Do not change your dose or stop taking Vytorin without talking to your doctor.
These elevations in transaminases were generally asymptomatic, not associated with cholestasis, and returned to baseline after discontinuation of therapy or with continued treatment. Maxa JL, Melton LB, Ogu CC, Sills MN, Limanni A "Rhabdomyolysis after concomitant use of cyclosporine, simvastatin, gemfibrozil, and itraconazole. Because of the higher risk of intracranial hemorrhage in patients treated for acute ischemic stroke, limit treatment to facilities that can provide timely access to appropriate evaluation and management of intracranial hemorrhage. LDL apheresis or if such treatments are unavailable. Do not add any other medication to infusion solutions containing Activase. Simvastatin exposure is approximately doubled with concomitant use of lomitapide; therefore, the dose of Vytorin should be reduced by 50% if initiating lomitapide.
Severe allergic reactions rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness; breathing problems eg, persistent cough, shortness of breath; burning, numbness, or tingling; change in the amount of urine produced; confusion; decreased sexual ability; depression; difficult or painful urination; dizziness; fever, chills, or persistent sore throat; irregular heartbeat; joint pain; memory problems; muscle tenderness, pain, or weakness with or without fever and fatigue; red, swollen, blistered, or peeling skin; severe stomach or back pain with or without nausea or vomiting; swelling of the hands, ankles, or feet; symptoms of liver problems eg, dark urine, loss of appetite, pale stools, severe stomach pain, yellowing of the skin or eyes; trouble sleeping; unusual bruising or bleeding; unusual tiredness or weakness; vomiting. Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Vytorin. Side effects may include - Allergic reaction including swelling of the face, lips, throat, or tongue, difficulty breathing or swallowing, or rash; flu; gallstones; headache; inflammation of the gallbladder; inflammation of the liver; inflammation of the pancreas; muscle pain, tenderness, or weakness; nausea; numbness or pain in the hands or feet; upper respiratory infection. Activase using a syringe and needle. If this method is used with the 50 mg vials, the syringe should not be primed with air and the needle should be inserted into the Activase vial stopper. If the 100 mg vial is used, the needle should be inserted away from the puncture mark made by the transfer device. Chagnon JP, Cerf M "Simvastatin-induced protein-losing enteropathy. Keep container tightly closed. Two placebo-controlled, double-blind trials Studies 1 and 2 were conducted in patients with AIS. Both studies enrolled patients with measurable neurological deficit who could complete screening and begin study treatment within 3 hours from symptom onset. A cranial computerized tomography CT scan was performed prior to treatment to rule out the presence of intracranial hemorrhage. 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. Walshe, J. J. Renal failure associated with alternative medical therapies. Ren Fail. 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. Hg or lower for 24 hours. MVE and MAE in this CKD population. The study design precluded drawing conclusions regarding the independent contribution of either ezetimibe or simvastatin to the observed effect. 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. Check with your doctor or pharmacist if you are not sure. Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage. Each 100 mg Activase vial 58 million IU is packaged with diluent for reconstitution 100 mL Sterile Water for Injection, USP and one transfer device: NDC 50242-085-27.
Take Vytorin 1 time each day in the evening. SWFI will remain in the diluent vial. Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. AB1, AB2, AB3, etc. Statins work by reducing the cholesterol made in the liver while Zetia or ezetimibe work by blocking absorption of the cholesterol. Sinzinger H, Wolfram R, Peskar BA "Muscular side effects of statins. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. FDA product labels and may differ in countries outside the USA. Every effort has been made to ensure that the information provided on this page is accurate, up-to-date and complete, but no guarantee is made to that effect. Drugs. When used together with higher doses of simvastatin, these medicines may increase your risk of muscle injury and could result in kidney problems. No incremental benefit of Vytorin on cardiovascular morbidity and mortality over and above that demonstrated for simvastatin has been established. Eligibility did not depend on lipid levels.
The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. All medicines may cause side effects, but many people have no, or minor, side effects. Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. If repackaged in blisters, then opaque or light-resistant blisters should be used. Body as a whole - general disorders: fatigue. All patients recovered without sequelae. Compare prices and print coupons for Zetia Ezetimibe and other High Cholesterol drugs at CVS, Walgreens, and other pharmacies. Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high cholesterol or triglycerides do not feel sick. Lowering "bad" cholesterol and triglycerides and raising "good" cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks. An extra patient leaflet is available with Vytorin. Talk to your pharmacist if you have questions about this information. Always consult a healthcare professional for medical advice.
IV infusion for at least 48 hours; subsequent heparin therapy was at the physician's discretion. Pittler MH, Thompson CO, Ernst E. Artichoke leaf extract for treating hypercholesterolaemia. Patent and Trademark Office at any time during a drug's development and may include a wide range of claims. Vytorin has not been shown to reduce heart attacks or strokes more than simvastatin alone. Swirl gently to dissolve the Activase powder. DO NOT SHAKE.
There have been rare reports of immune-mediated necrotizing myopathy IMNM an autoimmune myopathy, associated with statin use. IMNM is characterized by: proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment; muscle biopsy showing necrotizing myopathy without significant inflammation; improvement with immunosuppressive agents. Concomitant food administration high-fat or non-fat meals had no effect on the extent of absorption of ezetimibe when administered as 10-mg tablets. The C max value of ezetimibe was increased by 38% with consumption of high-fat meals. Some received IV heparin on arrival to the emergency room prior to enrollment and randomization. Some medical conditions may interact with Vytorin. Activase 100 mg over 2 hours experienced moderate or marked lysis of pulmonary emboli when assessed by pulmonary angiography 2 hours after treatment initiation. 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. No clinically significant pharmacokinetic interaction was seen when ezetimibe was coadministered with simvastatin. No specific pharmacokinetic drug interaction studies with Vytorin have been conducted other than the following study with NIASPAN Niacin extended-release tablets. Yurdakok M, Gurakan B, Ergin H, Kirazli S "Plasma concentrations of granulocyte colony stimulating factor in preterm infants in the first few hours of life. If you have any questions about Vytorin, please talk with your doctor, pharmacist, or other health care provider. The most frequent adverse reaction associated with Activase in all approved indications is bleeding. Abernethy DR, Greenblatt DJ, Morse DS, Shader RI "Interaction of propoxyphene with diazepam, alprazolam and lorazepam. 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? The mechanism of interaction is unknown. There are 1417 other drugs known to interact with amlodipine ingredient of exforge There are 60 other drugs known to interact with ezetimibe ingredient of vytorin. There are 381 other drugs known to interact with simvastatin ingredient of vytorin. There are 751 other drugs known to interact with valsartan ingredient of exforge. Your doctor would normally be conversant with these details. The primary endpoint, the proportion of patients with a 4 point or greater improvement in the National Institutes of Health Stroke Scale NIHSS score or complete recovery NIHSS score of 0 was not significantly different between treatment groups. A prespecified secondary analysis suggested improved 3-month outcome associated with Activase treatment using the following stroke assessment scales: Barthel Index, Modified Rankin Scale, Glasgow Outcome Scale, and the NIHSS. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
See 7. Drug Interactions. F. Protect the lyophilized material during extended storage from excessive exposure to light. These data provide support for the acute increase in cardiovascular risk associated with statin discontinuation, they write. Women of childbearing age should be advised to use an effective method of birth control to prevent pregnancy while using Vytorin. Discuss future pregnancy plans with your patients, and discuss when to stop taking Vytorin if they are trying to conceive. Patients should be advised that if they become pregnant they should stop taking Vytorin and call their healthcare professional. F Activase may be used within 8 hours following reconstitution. Discard any unused solution after administration is complete. Acute pulmonary emboli obstructing blood flow to a lobe or multiple lung segments. What should I avoid while taking ezetimibe and simvastatin Vytorin? Meding, B. Allergic contact dermatitis from artichoke, Cynara scolymus. As your body gets used to the medicine these side effects may disappear. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. In extensive cases, systemic corticosteroids those taken in pill or other form to affect your body are used, though not continuously since they can cause significant side effects like bone thinning. But short-term " therapy" often has good results.
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For patent information: www. You should keep on this cholesterol-lowering diet while taking Inegy. For these reasons, FAERS case reports cannot be used to calculate incidence or estimates of risk for a particular product or compare risks between products. If treatment with itraconazole, ketoconazole, posaconazole, voriconazole, erythromycin, clarithromycin or telithromycin is unavoidable, therapy with Vytorin must be suspended during the course of treatment. Englisch W, Beckers C, Unkauf M, et al. Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia.
Vytorin is a prescription medicine that contains 2 cholesterol lowering medicines, ezetimibe and simvastatin. 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. Using these medicines together with ezetimibe and simvastatin may increase your risk of muscle injury and could result in kidney problems. 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.
Ezetimibe and simvastatin reduces levels of "bad" cholesterol low-density lipoprotein, or LDL and triglycerides in the blood, while increasing levels of "good" cholesterol high-density lipoprotein, or HDL. Kraft K. Artichoke leaf extract- recent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts. Approximately 78% and 11% of the administered radioactivity were recovered in the feces and urine, respectively, over a 10-day collection period. Ezetimibe was the major component in feces and accounted for 69% of the administered dose, while ezetimibe-glucuronide was the major component in urine and accounted for 9% of the administered dose.
Safety and effectiveness of Activase in pediatric patients have not been established. This information should not be used to decide whether or not to take Vytorin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Vytorin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Vytorin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Vytorin.