Ngati cholesterol yakhala vuto kwa inu, dokotala wanu angakuuzeni za Zetia (ezetimibe) kapena Vytorin (ezetimibe plus simvastatin). Vytorin anakhazikitsidwa monga kuphatikiza kwa Zetia ndi Zocor (simvastatin), yomwe cholinga chake chinali kupititsa patsogolo zofuna za Zocor.
Kusokoneza? Ingokumbukirani kuti Zocor ndi statin yosavuta - mtundu wa mankhwala omwe amagwira pachiwindi kuteteza cholesterol kuti asapangidwe.
Zetia ndi mankhwala atsopano, opangidwa kuti ateteze kuyamwa kwa kolesterolini kuchokera ku chakudya m'matumbo. Vytorin akuphatikiza Zocor ndi Zetia.
Vytorin anadziwitsidwa ndi anthu mu 2004 kudzera mu malonda a TV omwe ankati Vytorin akhoza kulimbana ndi magwero awiri a cholesterol: chakudya ndi majini. Vytorin adagwiritsa ntchito mankhwala ambiri a mafuta a m'thupi omwe anali kale pamsika, koma mtengo wochepa kwambiri. Komabe, kugulitsidwa kwakukulu kwa Zetia, ndiyeno kenako Vytorin, mwamsanga anagwiritsira ntchito mankhwala a cholesterol a US a mankhwalawa.
Mayankho a Zamankhwala Ali ndi Zotsatira Zambiri za Zetia ndi Vytorin
Zetia ndi Vytorin poyamba adavomerezedwa ndi FDA mu 2002 ndi 2004, motero, kuti athetse "cholesterol choipa" ( LDL ). "Cholesterol choipa" amakhulupirira kuti ndi amene amachititsa kuti chikhocho chimangidwe pamakoma ogwiritsira ntchito omwe angabweretse kudwala kapena kupweteka kwa mtima.
Mu January 2008 , Merck / Schering Plow Pharmaceuticals - wopanga Zetia ndi Vytorin - anatulutsa zotsatira za kafukufuku zotsatira za kuphatikizapo ezetimibe ndi mlingo waukulu wa simvastatin motsutsana ndi simvastatin yekha pa njira ya atherosclerotic kwa odwala a heterozygous mtundu wa hypercholesterolemia , wotchedwa KUHANCE kuphunzira.
Kafukufukuyu anayerekezera odwala 720 omwe amatenga Vytorin kapena Zocor okha. Pogwiritsira ntchito ultrasound kuti ayang'ane mitsempha ya mitsempha ya odwalawa kuchokera m'magulu onsewa, ochita kafukufuku ankayembekeza kuti ngati mankhwala osokoneza bongo, Vytorin, adachepetsanso mitsempha ya m'makina awo.
Choyembekeza chinali chakuti omwe amatenga Vytorin adzawonetsedwa kuti ali ndi chipika chochepa pamakoma awo oposa awo omwe adatenga Zocor yekha.
M'malo mwake, ziganiziro za phunzirolo zasonyeza kuti odwala a Vytorin analibe mitsempha yochepa m'mitsempha yawo kusiyana ndi omwe amatenga Zocor okha. Ndipotu, amene amatenga Vytorin kwenikweni anali ndi chipika china.
Uthenga Wabwino mu Phunziro lachiwiri
Phunziro lachiwiri, lomwe limatchedwa Kupititsa patsogolo Kupindula kwa Zotsatira: Vytorin Efficacy International Trial (IMPROVE-IT), zotsatira zayeso mwa odwala oposa 18,000 omwe kale anali ndi matenda a mtima. Zotsatira za phunziroli, zomwe zinachitika mu 2014, zapeza odwala kwambiri pa Vytorin ezetimibe / simvastatin regimen anakwaniritsa zolinga zawo zonse za LDL-C ndi hs-CRP kuposa zomwe zimakhala simvastatin zokha. Iwo anali ndi zotsatira zabwino za thanzi ngati anakwaniritsa zolinga zonse ziwiri, monga kuyerekezedwa ndi imfa ya mtima, chochitika chachikulu chogonjera, kapena kupwetekedwa. Mavuto awo a kupweteka kwa mtima kapena kupwetekedwa mtima kunachepetsedwa ndi 6%. Mankhwalawa pamodzi sanawononge zotsatira zake, makamaka pangozi ya khansa.
Izi zinapitiliza kutsutsana - kodi ndi bwino kutenga mankhwala omwe amachititsa kuti mabala anu aziwoneka bwino, koma ali ndi kusintha kwakukulu kwa zotsatira zaumoyo wanu, ngati zilipo?
Vytorin anali ndi machenjezo ndi zodzitetezera zomwe zinawonjezeredwa mu 2010 ndipo nthawi zonse amachenjeza kuti chenjezo la kuopsa kwa myopathy / rhabdomyolysis. Izi zikuphatikizapo machenjezo a izi poyanjana ndi niacin ndi fibrates.
Kodi Ndiyenera Kusiya Zetia Kapena Vytorin?
Osati mofulumira kwambiri. Pachilombocho, odwala a Vytorin anachita bwino kwambiri, mwachitsanzo, kuchepa kwa "cholesterol choipa," chomwe ndi zotsatira zomwezo zomwe zinagonjetsa FDA kuvomerezedwa poyamba. Poyerekeza ndi odwala a Zocor, odwala a Vytorin adasowa kwambiri mu "ma cholesterol". Chifukwa cha zomwe odwala a Vytorin alili mu phunziroli anali ndi "cholesterol" chochepa chokha popanda kusintha pakamwa kosavuta kumvetsa. The FDA ikupitiriza kufufuza umboni umenewu.
Za Zetia, kafukufuku wakale wasonyeza kuti mankhwalawa amakhudza kwambiri "ma cholesterol" ochepa.
Ngakhale pamene sichiphatikizidwa ndi Zocor, odwala omwe amatenga Zetia ankawoneka kuti ali ndi zotsatira zomwe zinalepheretsa kuyamwa kwa cholesterol ku zakudya zomwe zimadutsa mumatumbo.
Bungwe la American Heart Association lakhala likulimbana ndi nkhaniyi powauza odwala omwe amatenga Vytorin kuti asasiye mankhwala chifukwa cha ngozi ya kuopsa kwa thanzi labwino kuti athetse vuto la kolesterol. Ngakhale kusintha kwa mankhwala ena sikungakhale kofunikira pa zifukwa zingapo:
- Ngakhale ndi zotsatira zokhumudwitsa mu phunziro loyambirira, Vytorin sanawonetseke kuti ndi wotetezeka.
- Zomwe zimapezeka ku Vytorin zimapindula kwambiri polimbana ndi kolesterolini.
- Vytorin kapena Zetia ayenera kuti analamulidwa kwa odwala ena chifukwa Zocor kapena statin ina yokha sankatha kuchepetsa "cholesterol choipa" chawo.
- Mankhwala ena sangakhale oyenera kwa odwala ena, chifukwa cha matenda osagwirizana.
Zoyenera kuchita
Monga nthawi zonse, muyenera kufunsa dokotala wanu. Funsani ngati pali zochitika zomwe zikuyenera kukupatsani mankhwala omwe akuchitika panopo kapena ngati mukufuna kuyamba kufufuza njira zina.
Ngati adokotala akukulangizani kuti mupitirize maphunziro ndi Vytorin kapena Zetia, ndiye kuti muyenera:
- Pitirizani kutsata malingaliro opatsa moyo kusintha kwa zakudya , masewero olimbitsa thupi ndi kusuta fodya kuti musayang'ane cholesterol.
- Sungani malo anu ndipo muzindikire kusintha kulikonse pazithunzi za lipid kuti mudziwe ngati mankhwala anu akugwira ntchito monga momwe mukufunira.
- Onetsetsani zizindikiro zanu za tsiku ndi tsiku ndikufotokozera zotsatira zomwe zingakhalepo ndi dokotala wanu.
Nazi zotsatira zina zomwe zingayambitse kuyang'ana pamene akutenga Vytorin:
- mutu
- kupweteka kwa minofu kapena kuphatikiza
- zowonongeka, kuphatikizapo ziphuphu kapena kutupa
- Zizindikiro za chiwindi kapena ndulu yotupa, kuphatikizapo ululu wamimba kwambiri ndi mkodzo wamitundu yosalekeza ndi zidole
The FDA ikupitiriza kufufuza zotsatira za maphunziro kuti adziwe ngati kanthu kalikonse n'koyenera. Ngati mukukhulupirira kuti mwavutika ndi zotsatirapo, kapena ngati mwakumanapo ndi vuto linalake monga matenda a mtima kapena kupwetekedwa, pamene mutenga Vytorin kapena Zetia, mukufunsidwa kuti muwuze ku madera a FDW a MedWatch Adverse Event Reporting pa intaneti.
Zotsatira:
American Heart Association Association. "Mankhwala Osokoneza Bongo kwa Cholesterol." AmericanHeart.org . 4/21/2014. American Heart Association. February 11, 2016.
American Heart Association Association. "Mawu ochokera ku American Heart Association pa maphunziro a ENHANCE." AmericanHeart.org . 15 Jan. 2008. American Heart Association. 29 Mar. 2008
Jackevicius, Cynthia. "Kugwiritsira ntchito Ezetimibe ku United States ndi Canada." New England Journal of Medicine . 28 Mar. 2008. New England Journal of Medicine. 3 Apr. 2008.
Otsatira a US Food and Drug Administration, "Kulankhulana Kwanthaŵi Yoyamba pa Nkhani Yopitilira Dongosolo la Ezetimibe / Simvastatin (yotengedwa monga Vytorin), Ezetimibe (ogulitsa ngati Zetia), ndi Simvastatin (ogulitsidwa ngati Zocor)." FDA.gov . 25 Jan. 2008. Utsogoleri wa US Food and Drug Administration. 29 Mar. 2008.
Ogwira ntchito ku US Food and Drug Administration, "Inside Clinical Trials: Mankhwala Oyesera Anthu." FDA.gov . 1 Sep. 2003. US Food and Drug Administration. 3 Apr 2008
Antchito a US Food and Drug Administration, "Vytorin (ezetimibe / simvastatin) piritsi." FDA.gov . February 2014. Utsogoleri wa US Food and Drug Administration. February 11, 2016.
Bohula EA, Giugliano RP, Cannon CP, Zhou J, Murphy SA, White JA, Tershakovec AM, Blazing MA, Braunwald E. Kukwaniritsidwa kwa mitundu iwiri yochepa kwambiri ya lipoprotein cholesterol ndi mphamvu yapamwamba kwambiri Puloteni yowonjezera nthawi zambiri ezetimibe ku simvastatin ndikugwirizanitsa ndi zotsatira zabwino mu KUCHITA-IT. Kudutsa. 2015 Sep 29; 132 (13): 1224-33. lembani: 10.1161 / CIRCULATIONAHA.115.018381. Epub 2015 Sep 1.
Lancellotti P, Pierard LA, Scheen AJ. [ACUTE CORONARY SYNDROME NDI LIPID-LOWERING THERAPY. KODI KUPHUNZITSA KWAMBIRI-KUPHUNZITSA KUCHITA ZINTHU ZINTHU ZINACHITIKA?] [Nkhani ya Chifalansa] Rev Med Liege. 2015 Sep; 70 (9): 450-5.