Mertenil tablets: instructions for use. Instructions for the use of the drug Mertenil and its prices in pharmacies Reviews of Mertenil

Mertenil 10 is a drug formulated to lower cholesterol. It is used as an addition to the diet in the treatment of hypercholesterolemia and mixed dyslipidemic conditions.

Mertenil 10 is a drug formulated to lower cholesterol.

Release form and composition

The drug is produced in the form of round and biconvex tablets, which are film-coated. In one package, their number is 10 pcs. The active substance is rosuvastatin calcium. Auxiliary components:

• microcrystalline cellulose;
• magnesium stearate and hydroxide;
• crospovidone;
• lactose monohydrate.

pharmachologic effect

The medicine belongs to lipid-lowering drugs. It is indicated for patients with increased blood cholesterol concentration. The active component of the drug prevents the synthesis of mevalonic acid in the liver. This result is achieved due to the inhibition of HMG-CoA reductase.

The drug affects specific liver receptors, which quickly absorb LDL and VLDL, reducing the concentration of the latter in the blood.

After undergoing a course of therapy, the HDL level in the blood rises and its atherogenic index changes.

The first positive effect is achieved after 2 weeks of treatment. The maximum result is achieved after a month of taking the pills.

What is Mertenil 10 used for

The drug has the following indications:

• hypercholesterolemia;
• combined dyslipidemic conditions;
• fredrickson type IV hypertriglyceridemia;
• familial homozygous hypercholesterolemia;
• prevention and therapy of atherosclerosis;
• prevention of cardiovascular complications.

The medication is indicated as an additional tool for people on a diet, when proper nutrition and other methods of lipid-lowering therapy do not work enough.

How to take Mertenil 10

The dosage of the drug is determined on an individual basis. The pills are taken inside. The classic drug rate is 5 mg. When choosing an initial dosage of a medication, the possible risk of developing complications in the functioning of the heart is taken into account. If necessary, after 30 days of the therapeutic course, the doctor can adjust the dose.

Side effects

When using the medication, the following side symptoms may occur:

• proteinuria, hematuria;
• type 2 diabetes mellitus;
• shortness of breath, cough;
• arterial hypertension;
• migraine, dizziness, memory loss;
• angioneurotic edema;
• rash, itching, urticaria;
• liver dysfunctions, increased hepatic transaminases;
• myalgia, myopathy;
• hyperglycemia;
• abdominal pain, nausea, vomiting, constipation, jaundice, diarrhea;
• an increase in the level of biliburin, glucose, a malfunction of the thyroid gland.

Contraindications to the use of Mertenil 10

The use of Mertenil tablets is contraindicated in the following cases:

• pregnancy;
• breastfeeding;
• a history of liver disease;
• combined intake of fibrates with cyclosporine;
• lack of lactase and lactose intolerance;
• impaired renal function;
• predisposition to myotoxic complications;
• myopathy;
• hypersensitivity to the components of the drug;
• glucose-galactase malabsorption.

special instructions

During treatment with Mertenil 10, you must follow a diet and lead a healthy lifestyle. It is required to regularly monitor kidney function with blood and urine tests. If protein is found in the urine, you need to notify the doctor about it. If you don't have enough thyroid hormones, you don't need to take statins right away. It is necessary to treat hypothyroidism in order to normalize blood cholesterol levels.

Application during pregnancy and lactation

It is prohibited to use Mertenil during the period of gestation. Women of childbearing age who use statins should use reliable contraception. In case of an unplanned pregnancy, the pill should be stopped. During hepatitis B treatment, Mertenil treatment is prohibited.

Application in children

The remedy is prescribed to patients over 8 years old, treatment is carried out under the supervision of a physician.

Overdose

With the development of an overdose, symptomatic therapy is performed. The effectiveness of hemodialysis is low. It is important to monitor liver function and the degree of CPK activity.

Drug interactions

Mertenil can be combined with other medicines, but you need to know some features of the combination:

1. Cyclosporin in combination with the drug in question increases the therapeutic effect of the latter by 7 times.
2. Ezetimibe in combination with Mertenil contributes to the development of adverse events.
3. Protease inhibitors can prolong the systemic effect of rosuvastatin calcium.
4. Gemfibrozil and other medicines that reduce the concentration of lipids increase the concentration of Mertenil by 2 times.
5. Antacids containing magnesium hydroxide can lower the blood levels of rosuvastatin calcium by half.

Terms and conditions of storage

The drug should be kept in a dry and dark place out of the reach of children. Temperature conditions should not exceed 30 ° C. The tablets can be taken within 2 years from the date of manufacture.

Terms of dispensing from pharmacies

On prescription.

Price

The average cost of the drug is 604 rubles.

Analogs

Mertenil has the following substitutes:

• Klivas 10, Klivas 20;
• Crestor;
• Rovix;
• Rosart;
• Razvator;
• Rosuvastatin Sandoz;
• Rosucard 10, Rosucard 20, Rosucard 40;
• Rosulip;
• Roxer;
• Romazik;
• Fastrong.

Reviews

Marina, 44 years old, Moscow: “Besides varicose veins, my blood cholesterol level has increased since the age of 20. At first, the doctor prescribed a strict diet, but only special results it did not bring. When I was young, I did not want to take medications all the time, so at the next diagnosis I asked my specialist to prescribe an effective remedy. This medicine turned out to be Mertinil. I have been taking the pills for 2 months. After that, I passed the tests again, the results showed that my cholesterol was normal. Now I always use this drug, but only in combination with a diet. "

Mikhail, 47 years old, Vladivostok: “I am taking the remedy to prevent a heart attack, because the level of cholesterol in the blood is exceeded. Although the drug is effective, I have side effects from it in the form of insomnia, headache and dizziness. The doctor first reduced the dosage, but there was no sense in it. Now I don't know what to do, but I still have to refuse such treatment. "

Svetlana, 56 years old, Sochi: “I have been using this drug for several years. Side effects do not bother me, I regularly take tests and the level of cholesterol in the blood is kept at 4.7-4.9. If you do not take pills, then these values \u200b\u200bincrease to 8. Even a long diet does not save me. I did not check my liver condition after treatment with Mertinil, but every six months I take Essentiale. "

Anatoly, 49 years old, Yekaterinburg: “The drug is effective because normalized cholesterol levels in 1.5 years. But this result can be achieved only if the pills are taken regularly. But in this case, I begin to develop side effects. The medicine strongly plants the liver, pain in the head and knees occurs, and the urinary system is also affected. All this develops after a month of treatment at a dosage of 10 mg. Now, with a doctor, we are selecting effective analogs that would be able to have a powerful effect, while not negatively affecting the entire body. "

Anna, 39 years old, Kemerovo: “After 2 months of taking the pills, I have not noticed any results. The tool reduces only cholesterol, or rather LDL, triglycerides have not decreased. And she was taking the medicine in a high dosage. In addition, after 2 weeks of admission, side symptoms arose. I decided to switch to a more expensive analogue, after which my condition completely changed. The fact is that Mertenil is produced in Russia, but it is stored incorrectly, as a result of which the effect of the drug is reduced by 20-30%, so I do not recommend the drug. "

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Instructions for use:

Mertenil is a synthetic medication used as an adjunct to diet therapy to lower cholesterol in the treatment of hypercholesterolemia and combined dyslipidemic conditions.

Pharmacological action of Mertenil

The active component of Mertenil (rosuvastatin calcium) leads to a decrease in the level of both total cholesterol and low density lipoprotein cholesterol. Being a selective and competitive inhibitor of HMG-CoA reductase (an enzyme that is a precursor of cholesterol), rosuvastatin acts on the liver, where cholesterol synthesis and low density lipoprotein catabolism take place.

The effect of the use of Mertenil is observed a week after the start of taking the medication, and the therapy reaches its maximum after a month of use.

Release form Mertenil

Mertenil is produced in the form of biconvex round tablets with the inscription "C33" containing 5 mg, 10 mg, 20 mg and 40 mg of the active ingredient (rosuvastatin calcium).

10 tablets in blister contour packs.

Mertenil's analogs

The analogues of Mertenil include medications: Acorta, Crestor, Rosulip, Tevastor, Rosuvastatin, Roxera and Rosucard. The analogs of Mertenil in terms of the mechanism of action are the tablets Avestatin, Lipona, Zorstat, Tulip, Liprimar, Anvistat, Simlo, Lovastatin, Simvastol, Lescol, Simplakor, Atomax, Zokor, Torvakard, Zovatin, Aktalipid, Cardiostatin, Vastataz Lipo Simford, Simvastatin ...

Indications for use of Mertenil

According to the instructions, Mertenil is prescribed as an addition to diet therapy in the treatment of:

• Hypercholesterolemia and combined dyslipidemic conditions in cases where non-drug methods are not effective enough (for example, weight loss, exercise);
• Hypertriglyceridemia of the fourth type according to Fredrickson;
• Familial homozygous hypercholesterolemia.

In addition, Mertenil is taken to slow the progression of atherosclerosis and as the primary prevention of cardiovascular complications such as stroke, heart attack and arterial revascularization in the absence of clinical signs of coronary heart disease in elderly people (men over 50 and women over 60).

Contraindications

Mertenil is contraindicated to use:

• Pregnant and lactating women, as well as women of childbearing age who do not use reliable contraception;
• Against the background of a predisposition to the development of myotoxic complications;
• With myopathy;
• Simultaneously with cyclosporine and fibrates;
• Against the background of liver failure;
• Against the background of hypersensitivity to the components (active or auxiliary) of the drug, as well as with lactose intolerance and lactase deficiency, or glucose-galactose malabsorption;
• With severe renal dysfunction;
• In pediatrics up to 18 years old.

Also, according to the instructions, Mertenil 40 mg tablets are contraindicated to take against the background:

• Hypothyroidism;
• Liver diseases occurring in the active phase;
• Excessive alcohol consumption;
• Personal or family history of muscle disease.

People of Asian race should also not take tablets of this dosage.

With care according to the instructions, Mertenil is prescribed:

• Against the background of severe metabolic, endocrine or electrolyte disorders;
• Against the background of the risk of developing myopathy;
• With uncontrolled epilepsy;
• With a history of liver disease;
• With injuries;
• People over 65;
• Against the background of arterial hypotension;
• Against the background of sepsis;
• With any major surgical interventions.

Method of using Mertenil

Mertenil, according to the instructions, can be taken at any time of the day, however, during the treatment period, you should follow the diet prescribed by your doctor, including foods with a low cholesterol content.

Doses of Mertenil are selected individually, depending on the purpose of the therapy. The starting dosage usually does not exceed 5-10 mg once a day. It is recommended to correct it not earlier than one month after the start of treatment.

The use of Mertenil at a dosage of 40 mg is possible only under the close supervision of a physician, since taking the medicine against the background of concomitant kidney diseases can provoke the development of proteinuria (mainly of tubular origin).

Elderly people usually do not need a daily dose adjustment. For people of Asian origin, as well as against the background of a predisposition to myopathy, the initial dose of Mertenil should not be more than 5 mg, and the use of the drug at a dose of 40 mg is contraindicated.

Drug interactions

Joint reception of Mertenil with lipid lowering agents (for example, with gemfibrozil) leads to an increase in the concentration of rosuvastatin in the blood.

Fenofibrate, gemfibrozil and nicotinic acid, when used simultaneously with Mertenil, increase the risk of myopathy, therefore, such combinations of medicines are not recommended. Also, you should not concurrently prescribe Mertenil with protease inhibitors in the presence of HIV.

Antacids in suspension (containing magnesium hydroxide and aluminum) and erythromycin, help to reduce the concentration of the active component of Mertenil in the blood plasma, therefore, the interval between taking these medications should be observed at least two hours.

Side effects of Mertenil

As a rule, while taking Mertenil, according to reviews, short-term and moderate side effects may occur. When using Mertenil in tablets of 5-20 mg, the development of type 2 diabetes mellitus, nausea, asthenic syndrome, dizziness, abdominal pain, headache, constipation and myalgia is most often observed. Somewhat less often during the therapy with Mertenil, according to reviews, rash, hypersensitivity reactions, pruritus, pancreatitis, myopathy, urticaria and rhabdomyolysis are observed.

The frequency and severity of liver and kidney disorders is dose-dependent. According to reviews, Mertenil, when taken daily at a dose of 40 mg, can lead to the development of:

• Myalgia;
• Proteinuria (most often of tubular origin);
• An increase in the concentration of glucose and bilirubin;
• Myopathies;
• Violations of indicators of thyroid function.

It is extremely rare against the background of the use of Mertenil according to the instructions:

• Arthralgia;
• Peripheral edema;
• Jaundice;
• Diarrhea;
• Hepatitis;
• Hematuria;
• Memory loss;
• Polyneuropathy;
• Dyspnea;
• Cough.

In case of muscle weakness or unexpected sharp pains in the muscles that accompany malaise and fever, you should immediately consult a doctor and stop using Mertenil or revise the dose of medication taken.

Storage conditions

Mertenil belongs to the number of prescription lipid-lowering medicines with a shelf life of up to 24 months, subject to standard storage conditions (at temperatures up to 30 degrees Celsius).

The drug "Mertenil" is an example of a quality generic drug "Crestor" containing rosuvastatin as an active ingredient. It belongs to the class of IV generation statins and was introduced into clinical practice in 2003. Its use is reasonable in cases of hypercholesterolemia and as an additional means of preventing acute vascular thrombosis. In this role, the drug "Mertenil", the analogues of which are few in number, but well known, fully justifies its purpose.

Release form

The tablet dosage form of the drug "Mertenil", which has no analogues among the registered trade names, is film-coated. Inside it contains rosuvastatin calcium with excipients: lactose monohydrate, magnesium hydroxide and stearate, crospovidone type "A". The film itself is composed of macrogol 3350, talc and titanium dioxide. It is simpler than that of Crestor, although it provides a gradual release of rosuvastatin.

There are 4 dosages of the drug: tablets of 5, 10, 20 and 40 mg. It is produced in tablets, packed in blisters, folded in cardboard boxes. One blister contains 30 tablets, which is enough for a month's treatment. In a certain clinical situation, it is reasonable to use one of the indicated dosages, which can later be changed. The medicine is a prescription and must be stored in a warm, dry, dark place out of the reach of children.

Directions for use instructions

The instruction attached to the drug "Mertenil 10 mg" contains information on clinical indications, contraindications, dosage regimens and side effects. It describes as fully as possible possible drug drug interactions, important clinical recommendations. and it is not available to the patient without a doctor's prescription. Therefore, starting to take "Mertenil", analogues or generics of "Crestor", as well as any statins, you should determine the lipid fractions of the blood and consult a physician or cardiologist.

Indications for use

Before using the drug, it is important to determine the indications and find out the specific type of hypercholesterolemia. A blood lipidogram provides comprehensive information about the violation of fat metabolism and its degree. The target indications for use are as follows:

• familial heterozygous (hereditary) hypercholesterolemia;
• primary (hereditary) polygenic hypercholesterolemia type IIa, classified according to Fredrickson;
• combined dyslipidemia IIb in the Fredrickson classification;
• familial homozygous (hereditary) hypercholesterolemia;
• atherosclerosis and conditions that aggravate cardiovascular risks (an increase in the concentration of total cholesterol and (or) its low-density fraction);
• obliterating atherosclerosis, cerebrovascular and cardiovascular diseases as part of a balanced combination treatment (see explanations);
• treatment of hypertriglyceridemia (type IV dyslipidemia according to Fredrickson) in combination with diet and dosed physical activity.

Explanation of indications

The evidence base that the increase in low-density fractions (LDL) of lipoproteins containing a lot of cholesterol is quite large. It is known that the severity and rate of development of cardiovascular and cerebrovascular diseases depends on the initial plasma concentration of cholesterol and LDL. This creates the prerequisites for the development of atherosclerosis with the formation of plaque inside the elastic-type arteries. The gradual growth of plaques narrows their lumen, reduces the capacity of blood vessels, and causes chronic ischemia of the organ being fed.

According to this mechanism, the development of cerebrovascular diseases, chronic limb ischemia and cardiac ischemic disease occurs. Elastic arteries are present in other areas of the body, which creates the prerequisites for the development of obliterating atherosclerosis of the extremities. Myocardial and brain infarction develops due to tearing of the arterial endothelium over the vessel plaque and the subsequent formation of a thrombus. The latter further narrows the lumen of the arteries feeding the organ, due to which a part of the brain or myocardium dies.

The effectiveness of prophylactic administration of statins of the first three generations, as well as the more advanced drug "Mertenil" instructions for use, reviews, as well as the recommendations of clinicians fully justify. An adult without the existing signs of coronary artery disease, but with the risks of its development, is already recommended to use "Mertenil". This is rational at the age of 50 years for men and 60 years for women.

Contraindications

The instruction attached to the drug "Mertenil", doctors' reviews, as well as the results of many clinical studies confirm the existence of important absolute and temporary relative contraindications. In the case of absolute medicine, it cannot be used, whereas temporary contraindications permit its use. Absolute contraindications are:

• active phase of hepatic disease, cytolysis syndrome or more than threefold increase in transaminases;
• chronic liver failure with 9 points on the Child-Pugh scale;
• chronic renal failure with an indicator of less than 30 ml / min;
• clinically proven myopathy (muscle pain or rhabdomyolysis syndrome, the patient's tendency to any myotoxic complications);
• the need to use the drug "Cyclosporin" for the treatment of specialized diseases;
• the inability to use contraceptives, pregnancy, lactation, children and adolescence (up to 18 years);
• increased individual sensitivity to the components and (or) an allergic reaction to rosuvastatin or substances in the dosage form.

In addition to these, there are some special contraindications exclusively for the dosage of 40 mg of the drug "Mertenil". Instructions for use and analogues of international clinical guidelines explain the following absolute contraindications:

• all of the previously mentioned contraindications, with the exception of chronic renal failure (40 mg / day can be prescribed only with creatinine clearance above 60 ml / min);
• hypothyroidism;
• hereditary muscle tissue disorders;
• combined use with fibrates;
• mongoloid race (it is forbidden to prescribe above 20 mg per day);
• alcohol dependence syndrome;
• initial reception of rosuvastatin.

The original drug Krestor, as well as any rosuvastatin (in this case, Mertenil), analogs (synonyms) and its generics cannot be prescribed at a dose of 40 mg until lipid-lowering therapy has been performed at a lower dose. Only when the daily dose of 20 mg was insufficient to normalize the lipid profile, which was confirmed by conducting a lipidogram 4 weeks after the moment of therapy, 40 mg per day was required. Moreover, this is permissible in the absence of special contraindications for 40 mg.

Dosing of the drug

When choosing a dosage regimen, the instructions for use attached to the drug "Mertenil" are taken into account, analogues of international algorithms developed on the basis of clinical recommendations AHA and ESC, and individual characteristics of the patient. 5 mg of the drug is prescribed for the treatment of IIa and IIb hypercholesterolemia, type IV dyslipidemia according to Fredrickson. In the prevention of ischemic diseases associated with the development of atherosclerosis, the recommended dose is also 5 mg.

A daily dose of 10 mg "Mertenil" is required in the treatment of ischemic diseases to stabilize the endothelium over the atherosclerotic plaque and to suppress its expansion. The same indication is also relevant for a dosage of 20 mg, although it is rational to use this amount of the drug at high values \u200b\u200bof the low-density fraction of drugs and cholesterol, as well as at low concentrations of high-density fractions of drugs. A dosage of 40 mg may be prescribed with a low potency of 20 mg after lipid profile assessment. According to the current AHA and ESC recommendations, the daily dose of Mertenil can be increased to 80 mg.

Features of reception

The main thing about taking the drug "Mertenil" is instructions for use. Analogs and generics of "Crestor" are also used according to these recommendations. According to the peculiarities of pharmacokinetics, tablets of rosuvastatin (in this case, "Mertenil") are taken at any time of the day. They should be swallowed whole and washed down with a sufficient amount of water 50-150 mg. But, according to the ESC and ANA recommendations from 2014, any statins should be taken before bedtime, ignoring the attached instructions for use.

Side effects

Frequent side effects of "Mertenil", the frequency of which is 1-10%, are: dizziness, myalgia, nausea, constipation, diffuse abdominal pain, asthenia, headaches. Uncommon side effects with a frequency of 0.01-1%: insomnia, urticaria, pruritus, mood changes towards depression. Rare effects (0.0001-0.01%): myositis, myopathy, rhabdomyolysis, increased organ-specific hepatic transaminases, panreatitis, Quincke's edema.

Exceptionally rare effects: jaundice due to toxic hepatitis, joint pain, hematuria, memory loss, malignant exudative erythema. They are observed less often than 1 case per 10,000 patients. A frequent effect is also possible - an increase in glycemia and the development of a second type of diabetes mellitus. Side effects are dose-dependent, and their frequency increases with increasing dosage. With an increase in the daily dose, the effectiveness will increase by only 6-10%.

Features of the complex interaction "Mertenil"

Some drugs are characterized by increased toxicity or decreased effectiveness when used simultaneously with the drug "Mertenil". Analogues, reviews of experts about which confirm this trend, are also characterized by important drug interactions. The combined use of "Mertenil" and "Cyclosporin" is prohibited due to a more than 7-fold increase in the plasma concentration of statin.

All rosuvastatin drugs enhance the effect of any coumarin anticoagulants, which requires INR control and their re-correction. When treating HIV, it is not recommended to simultaneously use "Mertenil" and protease inhibitors ("Lopinavir" and others). If necessary, treatment with nonabsorbable antacids should be taken 2 hours after the statin is used. In case of complex treatment together with drugs affecting the cytochrome system, dose adjustment of "Mertenil" is not required.

Analogues of "Mertenil"

The drug "Mertenil" has few analogues. In total, no more than 10 analogues in composition are presented on the domestic pharmacy market. The first and the highest quality is "Krestor". This is the original rosuvastatin produced by Astrazeneca. There are also a number of other foreign generics of the drug "Crestor". These are "Rosulip", "Roxera", "Tevascor", "Rosart", "Rosucard". Such drugs as "Akorta" and "Rosuvastatin Canon", which are practically identical in composition to the drug "Mertenil" - are Russian analogues. They are produced by domestic pharmaceutical companies.

Review of reviews about the drug "Mertenil"

Patients taking cannot confirm or deny the effectiveness of a particular drug. However, based on the results of the lipid profile, assessed by a specialist, one can judge the quality of the drug. "Mertenil" in 3 months in a therapeutic dose normalizes the lipid profile And the clinical effect can be seen in 4-6 weeks. Moreover, due to the weak cytochrome hepatic metabolism, it has a small number of drug interactions.

Patients about "Mertenil" respond positively due to the low frequency of adverse reactions. The use of a simple tablet coating reduces the risk of local gastrotoxicity. By the way patients respond, nausea and dyspepsia occur much less frequently than in the case of early statins ("Simvastatin" and "Pravastatin"). Moreover, according to the recommendations of cardiologists, in terms of effectiveness, "Mertenil" is slightly inferior to "Krestor". Other analogs have a similar therapeutic value in composition.

Photo of the drug

Latin name: Mertenil

ATX code: C10AA07

Active substance: Rosuvastatin calcium (Rosuvastatin)

Producer: Gedeon Richter (Hungary)

Description up to date on: 19.10.17