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Global Dealer Centre Indicated as an adjunct to diet to reduce total-C, LDL-C, and apo B levels in boys and postmenarchal girls aged 10-17 years with He FH who have an inadequate response to diet alone (ie, LDL-C remains ≥190 mg/d L or LDL-C remains ≥160 mg/d L and there is positive family history or early CV disease or 2 or more other CVD risk factors present) Insomnia (1-5%) Urinary tract infection (4-8%) Nausea (4-7%) Dyspepsia (3-6%) Increased transaminases (2-3%) Muscle spasms (2-5%) Musculoskeletal pain (2-5%) Myalgia (3-8%) Limb pain (3-8%) Pharyngolaryngeal pain (1-4%) Nonserious and reversible cognitive side effects may occur Increased blood sugar and glycosylated hemoglobin (Hb A1c) levels reported with statin intake Use with caution in the elderly; risk of myopathy Heavy alcohol use, renal failure, history of liver disease Fatal and nonfatal hepatic failure reported (rare) Risk of rhabdomyolysis Risk of myopathy: Increased by coadministration with fibrates, niacin, cyclosporine, macrolides, telaprevir, boceprevir, combinations of HIV protease inhibitors (eg, saquinavir plus ritonavir, lopinavir plus ritonavir, tipranavir plus ritonavir, darunavir plus ritonavir, fosamprenavir, and fosamprenavir plus ritonavir), or azole antifungals Withhold or discontinue treatment in any patient developing myopathy, renal failure, or transaminase levels 3x ULN Temporary therapy discontinuation recommended for patients with acute surgical or medical conditions, elective major surgery, or serious condition suggestive of a myopathy or risk factor predisposing to development of renal failure secondary to rhabdomyolysis Rare reports of immune-mediated necrotizing myopathy (IMNM), characterized by increased serum creatine kinase that persists despite discontinuation of statin Use caution in hepatic impairment, recent stroke CYP3A4 substrate; avoid grapefruit products and caution with other CYP3A4 inhibitors Secondary causes of hyperlipidemia should be ruled out before initiating therapy SLCO1B1 (OATP1B1) CC genotype snificantly increases AUCs of parent drug and metabolites compared with the CT or TT genotypes This polymorphism is proposed to reduce transport into the liver, the main site of statin metabolism and elimination SLCO1B1 polymorphism is thought to have a lesser effect on the more hydrophilic statins (eg, rosuvastatin, fluvastatin) compared with those that are more lipophilic (eg, atorvastatin, simvastatin) Other genetic polymorphisms of elimination (eg, CYP450, P-glycoprotein) for each individual drug must also be considered, to explain variability for statin clearance among patients that exhibit SCLO1B1 polymorphism SLCO1B1 CC genotype is most common in Caucasians and Asians (15%) Risk of myopathy is 2.6- to 4.3-fold hher if the C allele is present and 16.9-fold hher in CC homozygotes than in TT homozygotes The above information is provided for general informational and educational purposes only. Global - Public WebSites. live casinos reviews livedealercasino. Global Furniture Global Contract GLOBALcare
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