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OBJECTIVE To analyze retrospectively data on lipid lowering efficacy, tolerability and safety of different doses of simvastatin in patients with primary hyperlipidemia. METHODS Thirty five patients (mean age 54.9-/+8.5 years, 15 men, 20 women) received simvastatin for 3-6 months in doses 10 (n=12), 20 (n=8), 40 (n=10) and 80 (n=5) mg/day. Average lowering of low density lipoprotein cholesterol was 28.9, 37.6, 39.7, and 46.2% on doses 10, 20, 40 and 80 mg/day, respectively. Elevation of activity of transaminases (AST and ALT) above 3 upper limits of normal (ULN) accompanied by right upper quadrant pain occurred in 1 patient and the drug (10 mg/day) was stopped. Symptomless elevation of AST and ALT activities above 2 ULN was registered in 2 other patients receiving 10 and 20 mg/day. The dose of 80 mg/day was well tolerated - none of 5 patients had symptoms of myopathy or elevated creatinekinase activity.
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