Suvardio - Instructions For Use, Price, Reviews, Analogs, Tablets 10 Mg

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Suvardio

Suvardio: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Suvardio

ATX code: C10AA07

Active ingredient: rosuvastatin (Rosuvastatin)

Manufacturer: LEK d.d. (LEK dd) (Slovenia)

Description and photo update: 28.11.2018

Prices in pharmacies: from 298 rubles.

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Suvardio is a hypolipidemic agent.

Release form and composition

The drug is produced in the form of film-coated tablets: biconvex, round, brown or light brown (for a dosage of 5 mg) in color, on one side engraved with RSV 5, RSV 10, RSV 20, RSV 40 for dosages 5, 10, 20 and 40 mg, respectively [7 pcs. in a blister, in a cardboard box 1, 2 or 4 blisters; additionally for dosages of 5 and 20 mg: 10 pcs. in a blister, in a cardboard box 3 blisters of 5 mg; 10 pcs. in a blister, in a cardboard box 3 or 9 blisters of 20 mg; each pack also contains instructions for the use of Suvardio].

1 tablet contains:

• active substance: rosuvastatin calcium (in terms of rosuvastatin) - 5, 10, 20 or 40 mg;
• additional components: silicified microcrystalline cellulose (MCC), anhydrous colloidal silicon dioxide, anhydrous lactose, sodium stearyl fumarate, talc, dry corn starch;
• film shell: mannitol, hypromellose-2910, titanium dioxide, macrogol 6000, talc, iron (III) oxide yellow and red.

Pharmacological properties

Pharmacodynamics

Rosuvastatin, the active component of Suvardio, belongs to the group of competitive inhibitors of hydroxymethylglutaryl coenzyme A reductase (HMG-CoA reductase), an enzyme that converts 3-hydroxy-3-methylglutaryl coenzyme A into mevalonate, which is a precursor of cholesterol (Xc). The active substance has an effect on the liver, in which the synthesis of Xc and the catabolism of low density lipoproteins (LDL) occurs. Rosuvastatin promotes an increase in the number of LDL receptors on the surface of hepatocytes, which enhance the uptake and catabolic process of LDL, and suppress the production of very low density lipoproteins (VLDL) by the liver, thereby reducing the total amount of LDL and VLDL.

The active ingredient provides a decrease in the concentration of total Xc, Xc-LDL, triglycerides (TG), as well as an increase in the concentration of Xc-high density lipoproteins (Xc-HDL) and a decrease in the concentration of apolipoprotein B (ApoV), Xc-non-HDL, Xc-VLDL, TG- VLDL, increases the level of apolipoprotein A-1 (ApoA-1). Rosuvastatin also helps to reduce the ratio of total Xc-HDL-cholesterol, LDL-cholesterol-HDL-cholesterol-HDL-cholesterol and non-HDL cholesterol-HDL cholesterol, as well as ApoV-ApoA-1.

After the start of Suvardio's treatment, the therapeutic effect is noted already during the first week, and after 2 weeks of the course it reaches 90% of the maximum possible. As a rule, the maximum therapeutic effect can be achieved by 4 weeks of treatment and then maintained with regular use of the drug.

The clinical efficacy of rosuvastatin has been established in adult patients with hypercholesterolemia, with or without hypertriglyceridemia, regardless of their age, gender or race, including in the presence of familial hypercholesterolemia and diabetes mellitus. According to the available data, in 80% of patients with type IIa and IIb hypercholesterolemia according to the Fredrickson classification (with an average initial concentration of LDL-C of about 4.8 mmol / L) after using a dose of Suvardio 10 mg, the level of LDL-C decreased to values below 3 mmol / L …

In patients with heterozygous familial hypercholesterolemia, who received Suvardio in doses from 20 to 80 mg (according to the forced dose titration scheme), an improvement in lipid profile parameters was recorded. After titration to a dose of 40 mg per day (12 weeks of treatment), the level of LDL-C decreased by 53%. In 33% of them, LDL-C levels of less than 3 mmol / L were achieved. Against the background of taking rosuvastatin at doses of 20 and 40 mg with homozygous familial hypercholesterolemia, the concentration of LDL-C decreased by 22% on average.

An additive effect was noted when using rosuvastatin in combination with fenofibrate in relation to the level of triglycerides, and with nicotinic acid (in a daily dose of more than 1 g) in relation to the level of HDL-C-C.

In patients with a low risk of developing coronary heart disease (CHD) (according to the Framingham scale less than 10% for more than 10 years), the average LDL-C concentration is 4.0 mmol / l (154.5 mg / dl) and subclinical atherosclerosis, assessed by the thickness of the intima-media complex of the carotid arteries (TCIM), taking rosuvastatin in a daily dose of 40 mg, contributed to a significant slowdown, when compared with placebo, the rate of progression of the maximum TCIM for 12 segments of the carotid artery - 0.0145 mm / year [at p <0.0001 confidence interval (CI) was 95%: from - 0.0196 to - 0.0093].

Suvardio 40 mg should be prescribed only in the presence of severe hypercholesterolemia and a high risk of cardiovascular lesions.

Pharmacokinetics

In blood plasma, the maximum concentration (C _max) of rosuvastatin is observed approximately 5 hours after oral administration. The absolute bioavailability is approximately 20%. The active substance is biotransformed mainly in the liver, which is the main site for the production of Xc and the metabolism of Xc-LDL. The volume of distribution (V _d) of rosuvastatin is approximately 134 liters. On average, 90% of the substance binds to blood plasma proteins, mainly albumin.

Less than 10% of the accepted dose of rosuvastatin undergoes metabolic transformation. To a small extent, the metabolism of a substance depends on isozymes of the cytochrome P450 system. The CYP2C9 isoenzyme takes the greatest part in the process, the isoenzymes CYP3A4, CYP2C19 and CYP2D6 are involved in the course of biotransformation to a lesser extent.

The main metabolites of rosuvastatin that have been identified are lactone metabolites and N-dysmethylrosuvastatin, the latter showing an activity about 50% lower than rosuvastatin. Lactone metabolites are considered pharmacologically inactive. More than 90% of the pharmacological activity aimed at inhibiting the circulating HMG-CoA reductase is accounted for by rosuvastatin, the rest by its metabolites.

Approximately 90% of the administered dose of the drug is excreted through the intestines unchanged (including absorbed and unabsorbed substances), the remaining 10% are excreted by the kidneys, including in unchanged form - about 5% of the dose taken. The half-life (T _1/2) from plasma is 19 hours and does not change with increasing dose. The geometric mean plasma clearance is approximately 50 l / h (coefficient of variation - 21.7%). Also, as in the case of the use of other inhibitors of HMG-CoA reductase, in the process of hepatic uptake of rosuvastatin, a membrane transporter of Xc through membranes is involved, which is of great importance for hepatic excretion of the drug.

The systemic exposure of rosuvastatin increases in proportion to the dose. With repeated daily intake of the drug, its pharmacokinetic characteristics do not change.

Age and gender of patients do not have a clinically significant effect on the main parameters of the pharmacokinetics of rosuvastatin.

Representatives of the Mongoloid race (Chinese, Japanese, Vietnamese, Filipinos and Koreans) showed an approximately two-fold increase in the median exposure (AUC) and C _{max of} rosuvastatin compared with those in patients of the Caucasian race. These indicators in Indian patients were increased by an average of 1.3 times. There were no significant differences in the pharmacokinetics of rosuvastatin among representatives of the Caucasian and Negroid races.

Indications for use

• a homozygous form of familial hypercholesterolemia - as an adjunct to diet and other lipid-lowering therapy (for example, LDL apheresis) or when such treatment is not effective enough;
• primary hypercholesterolemia according to the Fredrickson classification (type IIa, including the heterozygous form of familial hypercholesterolemia) or mixed hypercholesterolemia (type IIb) - as an addition to the diet, in the case when its compliance and other non-drug treatment methods are insufficient;
• hypertriglyceridemia (type IV according to Fredrickson's classification) - as an addition to the diet;
• atherosclerosis - in order to slow down the progression, as an addition to the diet in patients who are indicated for treatment to reduce the level of total cholesterol and LDL cholesterol;
• primary prevention of severe cardiovascular complications such as stroke, heart attack, unstable angina pectoris, arterial revascularization in adults without clinical signs of coronary artery disease, but with an increased risk of its occurrence (in men - age over 50 years, in women - over 60 years old; level C - reactive protein exceeding 2 mg / l, in the presence of at least one additional risk factor - low concentration of HDL-C, arterial hypertension, smoking, family history of early onset of coronary artery disease).

Contraindications

Absolute contraindications:

• severe renal impairment, with creatinine clearance (CC) less than 30 ml / min;
• liver disease in the active phase, including a persistent increase in the activity of hepatic transaminases, as well as any increase in the activity of liver enzymes in the blood serum, exceeding the upper limit of normal (UHN) by more than 3 times;
• myopathy, predisposition to the development of myotoxic complications;
• syndrome of glucose-galactose malabsorption, lactose intolerance, lactase deficiency (since the product includes lactose);
• pregnancy and the period of breastfeeding;
• combined use with cyclosporine;
• age up to 18 years;
• hypersensitivity to any of the constituents of Suvardio.

An additional absolute contraindication for a daily dose of 40 mg is the presence of risk factors for the development of myopathy / rhabdomyolysis, such as:

• renal failure of moderate severity (CC below 60 ml / min);
• myotoxicity observed with the use of other inhibitors of HMG-CoA reductase or fibrates in the anamnesis;
• a history of myopathies, including hereditary;
• hypothyroidism;
• alcohol abuse;
• combined reception with fibrates;
• belonging to the Mongoloid race;
• conditions that can cause an increase in the concentration of rosuvastatin in blood plasma.

Suvardio tablets should be taken with caution in the following conditions / diseases due to the threat of myopathy / rhabdomyolysis (taking should be started only after a careful assessment of the risk and expected benefit of therapy; such patients need to be monitored throughout the course of treatment):

• age over 65;
• renal failure of moderate severity (for a daily dose of 40 mg - mild, with QC above 60 ml / min);
• a history of liver disease;
• high risk of developing diabetes mellitus;
• sepsis;
• arterial hypotension;
• uncontrolled epilepsy;
• severe endocrine, metabolic or water-electrolyte disturbances;
• extensive surgical interventions; trauma.

In addition, for a daily dose of Suvardio 10 mg, 5 mg and 20 mg, the drug should be taken with caution in the following conditions / diseases:

• a personal / family history of hereditary muscle diseases and a previous history of myotoxicity with the use of other HMG-CoA reductase inhibitors (statins) or fibrates;
• hypothyroidism;
• conditions that can lead to an increase in the plasma concentration of rosuvastatin;
• excessive alcohol consumption;
• combined intake of fibrates;
• belonging to the Mongoloid race.

Suvardio, instructions for use: method and dosage

Suvardio is taken orally. The tablet should be swallowed whole without chewing or crushing, and washed down with a small amount of water, at any time of the day, regardless of food intake.

Before treatment, the patient is required to switch to a standard cholesterol-lowering diet, which he must follow throughout the entire period of therapy. The dose of the drug is set individually, taking into account the target indicators of the concentration of Xc and the individual therapeutic response to the treatment.

For patients who have not previously received statins, and transferred to Suvardio after treatment with other HMG-CoA reductase inhibitors, the recommended starting dose is 5 or 10 mg 1 time per day. When determining it in each patient, it is required to take into account the Xc level and the potential risk of cardiovascular complications, as well as the likelihood of side effects. If necessary, dose adjustments can be made 4 weeks after the start of the course.

Since the risk of side effects is aggravated against the background of Suvardio therapy at a dose of 40 mg, compared with lower doses, the risk of side effects is aggravated, the final titration to this maximum dose is advisable only in patients with a high risk of developing cardiovascular complications and severe hypercholesterolemia (mainly in patients with hereditary hypercholesterolemia). Suvardio at a dosage of 40 mg is prescribed only if, when using a dose of 20 mg, patients failed to reach the target concentration of Xc, provided that they will be under regular observation throughout the course.

At the beginning of taking Suvardio at a dosage of 40 mg, careful monitoring of the condition is recommended. It is not recommended to prescribe the drug in a daily dose of 40 mg to patients who have not previously consulted a doctor.

The initial dose of Suvardio in patients of the Mongoloid race, as well as in the streets prone to the onset of myopathy, should not exceed 5 mg.

In carriers of the ABCG2 (BCRP) C.421AA and SLCO1B1 (OATP1B1) C.521CC genotypes, an increase in the AUC of rosuvastatin was found 2.4 and 1.6 times, respectively, when compared with carriers of the ABCG2c.421AA and SLCO1B1c.521TT genotypes. The maximum daily dose of Suvardio for carriers of the c.421AA and c.521CC genotypes should not exceed 20 mg taken once a day.

Side effects

• blood and lymphatic system: with an unknown frequency - thrombocytopenia;
• immune system: rarely - hypersensitivity reactions, including angioedema;
• endocrine system: often - type 2 diabetes mellitus;
• nervous system: often - headache, dizziness; extremely rare - memory loss, polyneuropathy;
• respiratory system: with an unknown frequency - shortness of breath, cough;
• digestive system: often - nausea, constipation, pain in the abdomen; rarely - pancreatitis; with an unknown frequency - diarrhea;
• skin: infrequently - rash, skin itching, urticaria; with an unknown frequency - Stevens-Johnson syndrome;
• liver and biliary tract: rarely - an increase in the activity of hepatic transaminases (it is recommended to determine the indicators of liver function before the course and 3 months after the start of admission); extremely rare - jaundice, hepatitis;
• urinary system: extremely rare - hematuria; the appearance of proteinuria (detected as a result of the use of test strips) was recorded, mainly of tubular origin; changes in the level of protein in urine (from zero or from the presence of trace amounts to ++ and above) were observed in less than 1% of patients who received the drug at a dose of 10 and 20 mg, and on average, 3% received 40 mg per day; when taking doses of 20 mg, there was a slight change in the amount of protein in the urine - from zero to +; as a rule, in the course of treatment, proteinuria decreased and passed on its own; no causal relationship between the development of proteinuria and acute / progressive kidney damage has been identified;
• musculoskeletal system and connective tissue: often - myalgia; rarely - rhabdomyolysis (the frequency of development increases with a dose of 40 mg), myopathy (including myositis); extremely rare - arthralgia; with an unknown frequency - immune-mediated necrotizing myopathy;
• others: often - peripheral edema, asthenic syndrome, gynecomastia;
• laboratory parameters: increased activity of creatine phosphokinase (CPK), increased concentration of glucose, bilirubin in blood plasma, glycosylated hemoglobin; increased activity of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGTP); dysfunction of the thyroid gland.

With the use of some statins, side effects such as sleep disturbances (including insomnia and nightmares), sexual dysfunction, and depression were recorded.

Overdose

In case of an overdose of Suvardio, there is no specific treatment. If there is a suspicion of this condition, symptomatic therapy is prescribed and measures are taken to restore and maintain vital body functions. Monitoring of indicators of liver condition and CPK activity is recommended. Hemodialysis is presumably ineffective.

special instructions

It is not necessary to determine the activity of CPK after significant physical exertion or if there are other possible reasons for an increase in the activity of this enzyme, since this may cause an incorrect interpretation of the test results. When, before the start of the course, the level of CPK activity was significantly increased (exceeded VGN by more than 5 times), after 5-7 days, it is necessary to carry out a control measurement. If the results of the repeated test confirm the initial CPK activity, which is 5 times higher than the ULN, the drug should not be started.

Due to the risk of myopathy / rhabdomyolysis, it is imperative for patients to immediately inform their doctor about any unexpected occurrence of muscle weakness, spasms, muscle pain, especially when malaise or fever occurs at the same time.

During therapy with Suvardio in persons with risk factors for myopathy / rhabdomyolysis (see "Contraindications"), regular monitoring of CPK activity is required. If in such patients the CPK activity exceeds the VGN by more than 5 times or muscle symptoms are significantly expressed (even if the CPK activity is 5 times lower than the VGN), the drug should be discontinued. In case of withdrawal of symptoms and return of CPK activity to normal values, treatment with a drug or an alternative inhibitor of HMG-CoA reductase at lower doses and with careful observation can be resumed. Regular monitoring of the CPK level in the absence of rhabdomyolysis symptoms in patients is inappropriate.

After 2–4 weeks after starting therapy and / or increasing the dose, it is recommended to determine the parameters of lipid metabolism, and, if necessary, adjust the dose.

Severe violations of the liver, associated mainly with an increase in the activity of hepatic transaminases, most often occur during treatment with Suvardio at a dose of 40 mg.

In the presence of secondary hypercholesterolemia due to nephrotic syndrome or hypothyroidism, therapy of the underlying disease should be carried out before starting rosuvastatin.

During treatment with some statins, especially over a long period, isolated cases of interstitial lung disease have been reported. This complication can present with shortness of breath, unproductive coughing, and poor overall well-being (including weight loss, weakness, and fever). Statin use should be discontinued if interstitial lung disease is suspected.

In patients with glucose levels between 5.6 and 6.9 mmol / L, Suvardio treatment was associated with an increased risk of type 2 diabetes.

Influence on the ability to drive vehicles and complex mechanisms

Patients driving motor vehicles or any other complex and potentially dangerous equipment should be careful because of the risk of dizziness during treatment.

Application during pregnancy and lactation

It is contraindicated to use Suvardio tablets during pregnancy and lactation. Women of reproductive age should use reliable contraception during the course of treatment.

Due to the fact that Xc and Xc biosynthesis products play an important role in fetal development, the possible risk of inhibition of HMG-CoA reductase exceeds the expected benefit from using a lipid-lowering agent in pregnant women. When pregnancy occurs, Suvardio must be stopped immediately.

There is no data on the penetration of rosuvastatin into breast milk. If the appointment of the drug is necessary during lactation, it is necessary to resolve the issue of stopping breastfeeding.

Pediatric use

Suvardio is contraindicated in children and adolescents under 18 years of age, since the safety profile of rosuvastatin in patients of this age group has not been studied.

With impaired renal function

Patients with severe renal failure (CC below 30 ml / min) are contraindicated to take any doses of Suvardio. With renal failure of moderate severity (CC below 60 ml / min), the use of the drug at a dose of 40 mg is also contraindicated.

Renal failure mild (CC above 60 ml / min) or moderate dose adjustment does not require. Such patients should begin therapy with Suvardio at a dose of 5 mg.

In the case of taking rosuvastatin at a dose of 40 mg, an increase in the frequency of severe renal dysfunction was noted, and therefore it is recommended to monitor the indicators of their function during treatment.

For violations of liver function

Hepatic failure with a child-Pugh score of 7 or less did not show an increase in the systemic concentration of rosuvastatin. However, such an increase was found in patients with liver failure of 8 and 9 points on the Child-Pugh scale. Against the background of rosuvastatin therapy, patients from this group require monitoring of liver activity. There is no experience of using Suvardio with liver failure of 9 points or more on the Child-Pugh scale.

If patients have liver disease in the active phase, including a persistent increase in the activity of hepatic transaminases, as well as any increase in the activity of hepatic enzymes in the blood serum, exceeding the ULN by more than 3 times, Suvardio is contraindicated.

Use in the elderly

Elderly patients should use Suvardio with caution.

Persons over the age of 65 are advised to start treatment with a dose of 5 mg.

Drug interactions

• cyclosporine: there is an 11-fold increase in the plasma concentration of rosuvastatin, while the concentration of cyclosporin remains unchanged; recorded in combination with cyclosporine AUC of rosuvastatin, used in a daily dose of 10 mg, was approximately 7 times higher than the value observed in healthy volunteers; this combination is contraindicated;
• fusidic acid: there are reports of cases of development against the background of this combination of rhabdomyolysis; it is required to monitor the condition of patients, since it may be necessary to temporarily discontinue therapy with rosuvastatin;
• vitamin K antagonists (including warfarin or other coumarin anticoagulants): an increase in the international normalized ratio (MHO) is possible at the beginning of concomitant therapy with rosuvastatin or with an increase in its dose; with a decrease in the dose of rosuvastatin or its cancellation, a decrease in INR may be observed, and therefore it is recommended to monitor the latter;
• gemfibrozil and other drugs that reduce the concentration of lipids: the AUC and C _{max of} rosuvastatin increases by approximately 2 times when it is taken once at a dose of 80 mg;
• fibrates (including fenofibrate and gemfibrozil), nicotinic acid in a daily dose of 1 g or more (in lipid-lowering doses): the risk of myopathy is aggravated, probably due to the ability of these substances to cause myopathy when used as monotherapy drugs; the combination of rosuvastatin at a dose of 40 mg and fibrates is contraindicated; the initial dose of rosuvastatin in combination with lipid-lowering agents should be 5 mg;
• fenofibrate: no pharmacokinetically significant interaction with this substance is expected;
• ezetimibe: there is no change in AUC or C _{max of} both substances, however, it is impossible to completely exclude the pharmacodynamic interaction of rosuvastatin and ezetimibe, which can lead to undesirable reactions;
• protease inhibitors (including ritonavir in combination with atazanavir, lopinavir or tipranavir): the plasma concentration of rosuvastatin increases due to interaction with transporter proteins and the risk of myopathy is aggravated; lengthening of T _{1/2 of} rosuvastatin may be observed, while the exact mechanism of this interaction is unknown; according to the results of a pharmacokinetic study with the combined use of rosuvastatin at a dose of 20 mg and a drug containing two protease inhibitors (lopinavir 400 mg / ritonavir 100 mg), healthy volunteers showed a 5-fold increase in C _max and 2-fold in AUC _(0-24) rosuvastatin; when treating patients with human immunodeficiency virus (HIV), this combination is not recommended;
• erythromycin: there is a 20% and 30% decrease in AUC _{(0- t)} and C _{max of} rosuvastatin, respectively; this phenomenon may be associated with increased intestinal motility caused by the action of erythromycin;
• antacids in suspensions containing aluminum / magnesium hydroxide: there is a decrease in the concentration of rosuvastatin in plasma by about 50%; when taking antacids 2 hours after rosuvastatin, this effect is weaker; the clinical significance of this interaction has not been determined;
• oral contraceptives: an increase in the AUC of norgestrel and ethinyl estradiol by 34 and 26%, respectively; it is required to take this fact into account when selecting doses of oral contraceptives; there are no pharmacokinetic data on the combined use of rosuvastatin and hormone replacement therapy, therefore, a similar effect cannot be excluded with such a combination; however, this combination was widely used in clinical trials and was well tolerated;
• dronedarone: there is an increase in the AUC of rosuvastatin by 1.4 times;
• digoxin: no clinically significant interaction expected;
• fluconazole (inhibitor of CYP3A4 and CYP2C9 isoenzymes), ketoconazole (inhibitor of CYP3A4 and CYP2A6 isoenzymes): no clinically significant interactions have been observed;
• itraconazole (an inhibitor of the isoenzyme CYP3A4): there is an increase of 28% in the AUC of rosuvastatin (has no clinical significance); no interactions associated with cytochrome P450 metabolism are expected.

Analogs

The analogues of Suvardio are Rosuvastatin, Lipoprime, Akorta, Mertenil, Krestor, Rosart, Reddistatin, Rustor, Rosucard, Rosufast, etc.

Terms and conditions of storage

Store the drug in its original packaging, in a place protected from moisture penetration, at a temperature not exceeding 25 ° C.

Keep out of the reach of children.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Suvardio

In the predominantly positive reviews of Suvardio, patients characterize it as an effective tool for the therapy and prevention of atherosclerosis. The drug prevents the formation of cholesterol plaques, reduces the level of Xc in the blood, prevents the development of cardiovascular complications. Some patients note that after three months of treatment they managed to achieve the target values for the level of total cholesterol. The advantages also include a convenient dosing regimen. Everyone recommends starting therapy with the minimum doses used according to an individual scheme prescribed by a specialist.

Patients consider the development of such undesirable reactions as constipation, nausea, headache, weakness in some cases as a disadvantage of the drug.

Price for Suvardio in pharmacies

The price for Suvardio (film-coated tablets) for a pack containing 28 pcs. May be:

• dosage of 10 mg - 320-480 rubles,
• dosage 20 mg - 400-560 rubles.

Suvardio: prices in online pharmacies

Drug name Price Pharmacy

Suvardio 10 mg film-coated tablets 28 pcs. RUB 298 Buy

Suvardio 20 mg film-coated tablets 28 pcs. 431 r Buy

Suvardio tablets p.p. 10mg 28 pcs. 459 r Buy

Suvardio tablets p.p. 20mg 28 pcs. 532 RUB Buy

Suvardio 10 mg film-coated tablets 90 pcs. 650 RUB Buy

Suvardio tablets p.p. 10mg 90 pcs. 874 RUB Buy

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!