what is tamoxifen

In the case of co-administration of these two drugs is recommended to carry out an appropriate frequency determination of prothrombin time until reaching the stable figures of this indicator. Cholestyramine and colestipol reduce bioavailability (lovastatin may use 2-4 hr. After  what is tamoxifenadministration of these drugs, while noting additive effect).

Specific guidance
Treatment must be accompanied by an appropriate diet .
Therapy  drug can cause increased activity of “liver” enzymes. This increase is usually small and clinically insignificant. However, it is recommended to monitor the levels of the enzymes before treatment and during treatment at regular intervals (for one year, then at least one fold at 6 months).
With increasing  to three times the upper limit  rate of drug treatment should be discontinued.
treatment of drug should be discontinued in the event of a persistent increase of the activity of creatine phosphokinase what is tamoxifen.

This should be considered in the differential diagnosis of chest pain.
Therapy  can lead to myopathy, and as a consequence, to rhabdomyolysis and renal failure. The risk of this disease increases in patients receiving both, one or more of the what is tamoxifen following drugs: fibrates (gemfibrozil, fenofibrate), cyclosporine, nefazodone, macrolides (erythromycin, clarithromycin), antifungal agents of “azole” group (ketoconazole, itraconazole) and inhibitors  proteases (ritonavir).The risk of myopathy is also increased in patients with severe renal insufficiency. Patients should promptly inform your doctor in case of unexplained pain in the muscles, especially if accompanied by malaise or fever.
Caution should be exercised when using  in patients who consume excessive amounts of alcohol, and in patients with liver disease in history.
In the period  treatment, women of childbearing age should use reliable contraception.
Less effective in patients with rare homozygous familial hypercholesterolemia , possibly because these patients are no functioning  receptors. Apparently, in these patients can increase faster Activity “liver” transaminases.
Lovastatin has only a modest effect in reducing triglycerides and not shown in the cases where the primary pathology is hypertriglyceridemia what is tamoxifen

.Effects on ability to drive and other complex mechanisms: There was no any effect on the ability to drive a car or work with technical devices.

 

tamoxifen citrate

Preparation  usually well tolerated by patients. For part of the digestive system: often – heartburn, nausea, abdominal pain, constipation or diarrhea, flatulence, dyspepsia; very rarely – dry mouth, taste perversion, biliary cholestasis, hepatitis, gastralgia, cholestatic jaundice, hepatic dysfunction, hepatitis, acute pancreatitis. On the part of the central tamoxifen citrate and peripheral nervous system: often – headache, dizziness; very rarely – peripheral neuropathy, sleep disorders, fatigue, insomnia, paresthesia, mental disorders (including anxiety). From the side of the musculoskeletal system: often – myalgia, muscle cramps; rare – myopathy, myositis, dermatomyositis; very rarely – in patients taking cyclosporine, gemfibrozil or nicotinic acid increased risk of rhabdomyolysis.

From the side of hematopoiesis: rarely – as a manifestation of a hypersensitivity syndrome (hemolytic anemia, leukopenia, thrombocytopenia). From a sight organ: very rarely – “fog” before your eyes, cataract, cataracts, optic atrophy. Laboratory tests: a moderate increase in activity of “liver” transaminases: alanine aminotransferase and asparaginaminotransferazy  (including a three-fold increase in relation to the upper limit of normal – 1.5% cases); rarely – increasing the activity of creatine phosphokinase ; very rare – increase in alkaline phosphatase and bilirubin. Allergic tamoxifen citrate reactions: very rarely – hypersensitivity syndrome (anaphylaxis, lupus-like syndrome, arthralgia, angioedema, urticaria, erythema multiforme, including Stevens – Johnson), toxic epidermal necrolysis (Lyell’s syndrome), skin rash , itchy skin. Other: very rarely – reduced potency, acute renal failure (due to rhabdomyolysis), chest pain, palpitations, alopecia.

Overdose
described several cases of accidental admission of unnecessarily large doses of the drug, but the specific symptoms in patients with no observed. Treatment: removal of preparation, general activities: monitoring and maintenance of vital functions, preventing further absorption of the drug (gastric lavage, administration of activated charcoal or laxatives) , monitor liver function. With the development of myopathy and rhabdomyolysis with acute renal failure must be intravenous sodium bicarbonate solution and a diuretic, with hyperkalemia – intravenous calcium chloride or calcium gluconate solution, glucose infusion with insulin; in severe cases – hemodialysis.

The interaction with other drugs
simultaneously tamoxifen citrate the drug and nicotinic acid (more than 1 g / day), cyclosporine, macrolide antibiotics (erythromycin, clarithromycin) “azole” antifungal drugs (ketoconazole, itraconazole),  protease inhibitors (ritonavir), nefazodone may increase the lovastatin concentration in the blood plasma, which can occur due to rhabdomyolysis and myopathy, renal insufficiency. Grapefruit juice in large amounts (above 1 l / d) increases the maximum plasma concentration of lovastatin, and the risk of myopathy. Simultaneous administration of the drug  with fibric acid derivatives . Can also lead to the development of myopathy, although the mechanism in this case is unclear.
Co-administration of warfarin and tamoxifen citrate drug can increase the influence of the latter on the parameters of coagulation and therefore , may increase the risk of bleeding.

nolvadex

In the gastrointestinal tract lovastatin absorbed slowly and incompletely – about 30% of the dose. Lovastatin should be taken in conjunction with the food, because the drug when receiving a third lower fasting its concentration in plasma than when taken with food. The maximum therapeutic concentration is reached after 4.2 hours, and then the concentration in the blood plasma decreases rapidly, amounting to 10 hours at 24% of maximum. Contact with blood plasma proteins – 96% -98.5%. The equilibrium concentration of lovastatin and its active metabolite by a single appointment for the night is achieved at 2-3 days of therapy and 1.5 times higher than after a single dose. Lovastatin penetrates the blood-brain and placental barriers. Subjected to intensive metabolism at the “first pass” through the liver. The major metabolites formed by oxidation of the lactone with the participation of cytochrome nolvadex.

Indications

 

  • For lowering elevated serum total cholesterol, cholesterol and triglycerides in the blood serum of patients with primary hypercholesterolemia (Types 2a and 2b according to Fredrickson) including heterozygous familial hypercholesterolemia, polygenic hypercholesterolemia, and mixed hyperlipidemia. The drug is indicated for the lack of effectiveness of diet therapy and other non-drug measures.
  • Treatment of coronary atherosclerosis in patients with coronary heart disease nolvadex in order to slow its progression.Contraindications
  • Increased individual sensitivity to lovastatinu or other ingredients;
  • liver disease in the active phase or a persistent increase in activity of “liver” transaminases of unknown etiology;
  • pregnancy and lactation;
  • age of 18 years (effectiveness and safety have not been established). Precautions: liver disease (history), chronic alcoholism, organ transplantation, concomitant immunosuppressive therapy, chronic renal failure : urgent (emergency) surgical procedures (including dental ), while taking gemfibrozil, fenofibrate, and others. fibrates, nicotinic acid (more than 1 g / d) (due to the risk of myopathy), cyclosporine, nefazodone, macrolides (erythromycin, clarithromycin), antifungal agents from the group of “azole” (ketoconazole, itraconazole) and  protease inhibitors (ritonavir). pregnancy and lactation The drug is contraindicated during pregnancy and lactation. During drug treatment , women of childbearing age should use reliable contraception. It is not known whether lovastatin is excreted in breast milk.Therefore, if the drug during this period is required, breast-feeding should be abolished.Dosing and Administration
    Inside, during a meal. Prior to the appointment of the drug, as well as at the time of its application, the patient must assign a standard hypocholesterolemic diet.
  • Hyperlipidemia
    recommended dose of lovastatin nolvadex 10 to 80 mg once a day. Typically, the initial dose in patients with moderate hypercholesterolemia is 20 mg once a day during the evening meal; in patients with severe giierholesterinemiey. If necessary to reach target cholesterol values in serum  dose may be increased to a maximum daily dose of 80 mg per day in single or divided doses (at breakfast and dinner). Changes (selection) the dose should be performed at intervals of not less than 4 weeks.
  • Coronary atherosclerosis
    Daily doses ranging from 20 to 80 mg once nolvadex or divided into 2 doses.The dosage and duration of admission determined by the attending physician.

tamoxifen side effect

Individual hypersensitivity to the components of the drug, acute hepatitis, cirrhosis of the liver.
Age up to 18 years in the absence of specifically-designed tamoxifen side effect clinical trials.

Dosing and Administration
Inside. At 10 drops of the drug to dissolve in 1/4 cup of water and take small portions, no longer swallowing and no drinking. 3 times a day (5 days to accept, 2 days break) for 30 minutes before or 30 minutes – 1 hour after meal. The course of treatment for 2 months. Possible repeated courses.

Side effects
are possible allergic reactions.

Overdose.
Overdose cases to date tamoxifen side effect have not been registered.

The interaction with other drugs
may use homeopathic preparations in combination with other drugs.

Cautions
When receiving homeopathic medicines may be a temporary worsening of symptoms. When the manifestation of the worsening should consult a doctor and take a break from taking the drug for 7-10 days.
The maximum daily dose contains about 0, 24g of absolute alcohol.

Application of pregnancy and lactation
is not recommended due to the presence of ethyl (ethanol) alcohol.

Effects on ability to drive and use machines
is not affected.

Form release
Drops for oral homeopathic. 25 ml in a bottle-dropper dark glass, with stoppers (dropper or deaf) and the screw cap made of polyethylene. On tamoxifen side effect the outside of the dropper bottle has embossed trademark of the manufacturer. In addition, the lid is put on the bottle-dropper color shrink cap. Each vial-dropper along with instructions for use are placed in a pile of cardboard.