Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Simvastatin increases the effect of warfarin (Coumadin) and the blood
concentration of digoxin (Lanoxin). Patients taking simvastatin and warfarin or
digoxin should be monitored carefully.
Cholestyramine (Questran) decreases the absorption of ezetimibe (Zetia). Administer Vytorin 2
hours before or at least 4 hours after cholestyramine administration.
PREGNANCY: Vytorin should not be taken during
pregnancy because the
developing fetus requires cholesterol for development and Vytorin, due to the
simvastatin component, reduces the production of cholesterol. Vytorin should
only be administered to women of child bearing age if they are not likely to
become pregnant.
NURSING MOTHERS: Because of the risk of adverse effects to the developing
infant, Vytorin should not be administered to
nursing mothers.
SIDE EFFECTS: The most common side effects of Vytorin are headache, nausea,
vomiting, diarrhea, muscle pain, and
abnormal liver tests. Hypersensitivity
reactions have also been reported. The most serious potential side effects are
liver damage and muscle inflammation or breakdown.
The simvastatin component of Vytorin is a statin. Therefore it shares side
effects, such as liver and muscle damage associated with statins. Serious liver
damage caused by statins is rare. More often, statins cause abnormalities of
liver tests, and, therefore, periodic measurement of liver tests in the blood is
recommended for all statins. Abnormal tests usually return to normal even if a
statin is continued, but if the abnormal test value is greater than three times
the upper limit of normal, the statin usually is stopped. Liver tests should be
measured before Vytorin is started and periodically thereafter or if there is a
medical concern about liver damage. Liver tests should be performed before the
10/80 mg dose of Vytorin is initiated, three months after initiation and then
periodically thereafter.
Inflammation of the muscles caused by statins can lead to a serious breakdown
of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of
muscle protein (myoglobin) into the blood. Myoglobin can cause kidney failure
and even death. When used alone, statins cause rhabdomyolysis in less than one
percent of patients. To prevent the development of rhabdomyolysis, patients
taking Vytorin should contact their healthcare provider immediately if they
develop unexplained muscle pain, weakness, or muscle tenderness.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Peripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include: intermittent claudication, rest pain, numbness in the extremities, and more. Treatment for peripheral artery disease include: lifestyle measures, medication, angioplasty, and surgery.
Cholesterol is the most common type of steroid in the body. The treatment of elevated cholesterol involves not only diet but also weight loss, regular exercise, and medications. By understanding your cholesterol profile you can better manage your cholesterol levels.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
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