Юнивит Аква Д3 Капли, 20 мл, 15000 ме / мл

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По сравнению с витамином D2 характеризуется на 25%\nболее высокой активностью."}},{"type":"paragraph","data":{"text":"Витамин D связывается со\nспецифическим рецептором витамина D (VDR), который ре-гулирует экспрессию\nмногих генов, включая гены ионного канала TRPV6 (обеспечивает абсорбцию кальция\nв кишечнике), CALB1 (кальбиндин; обеспечивает транспорт кальция в кровеносное\nрусло), BGLAP (остеокальцин; обеспечивает минерализацию костной ткани и\nгомеостаз кальция), SPP1 (остеопонтин; регулирует миграцию остеокластов), REN (ренин;\nобеспечивает регуляцию артериального давления, являясь ключевым элементом\nренин-ангиотензин-альдостероновой системы регуляции), IGFBP (связывающий белок\nинсулинподобного фактора роста; усиливает действие инсулинподобного фактора\nроста), FGF23 (фактор роста фибробластов 23; регулирует уровни кальция,\nфосфат-аниона, процессы клеточного деления фибробластов), TGFB1\n(трансформирующий фактор роста бета-1; регулирует процессы клеточного деления и\nдифференцировки остеоцитов, хондроцитов, фибробластов и кератиноцитов), LRP2\n(ЛПНП-рецептор-связанный белок 2; является посредником эндоцитоза липопротеинов\nнизкой плотности), INSR (рецептор ин-сулина; обеспечивает эффекты инсулина на\nлюбые типы клеток)."}},{"type":"paragraph","data":{"text":"Витамин D3 является\nактивным антирахитическим фактором. Самой важной функцией витамина D3 является\nрегулирование метаболизма кальция и фосфатов, что способствует правильной\nминерализации и росту скелета. "}},{"type":"paragraph","data":{"text":"Колекальциферол играет\nсущественную роль в абсорбции кальция и фосфатов из кишечника, в транспорте\nминеральных солей и в процессе кальцификации костей, регулирует также выведение\nкальция и фосфатов почками. Концентрация ионов кальция в крови обуславливает\nподдержание тонуса мышц скелетной мускулатуры, функцию миокарда, способствует\nпроведению нервного возбуждения, регулирует процесс свертывания крови."}},{"type":"paragraph","data":{"text":"Недостаток витамина D в\nпище, нарушение его всасывания, дефицит кальция, а также недостаточное\nпребывание на солнце приводит: у детей в период интенсивного роста - к рахиту,\nу взрослых - к остеомаляции, у беременных женщин могут возникнуть симптомы\nтетании, - нарушение процессов обызвествления костей новорожденных. "}},{"type":"paragraph","data":{"text":"Повышенная потребность в\nвитамине D возникает у женщин в период климакса, поскольку у них часто\nразвивается остеопороз в связи с гормональными нарушениями."}},{"type":"paragraph","data":{"text":"Витамин D обладает рядом\nт.н. внескелетных эффектов."}},{"type":"paragraph","data":{"text":"Витамин D участвует в\nфункционировании иммунной системы путем модуляции уровней цитокинов и\nрегулирует деление лимфоцитов Т-хелперов и дифференцировку В-лимфоцитов. В ряде\nисследований отмечено снижение заболеваемости инфекциями дыхательных путей на\nфоне приема витамина D."}},{"type":"paragraph","data":{"text":"Показано, что витамин D\nявляется важным звеном гомеостаза иммунной системы: предотвращает аутоиммунные\nзаболевания (сахарный диабет 1 типа, рассеянный склероз, ревматоидный артрит,\nвоспалительные болезни кишечника и др.)."}},{"type":"paragraph","data":{"text":"Витамин D обладает\nантипролиферативным и продифференцирующим эффектами, которые обуславливают\nонкопротективное действие витамина D. Отмечено, что частота некоторых опухолей\n(рак молочной железы, рак толстого кишечника) повышается на фоне низкого уровня\nвитамина D в крови."}},{"type":"paragraph","data":{"text":"Витамин D участвует в\nрегуляции углеводного и жирового метаболизма путем влияния на синтез IRS1\n(субстрат рецептора инсулина 1; участвует во внутриклеточных путях проведения\nсигнала рецептора инсулина), IGF (инсулиноподобный фактор роста; регулирует\nбаланс жировой и мышечной ткани), PPAR-δ (активированный рецептор пролифераторов\nпероксисом, тип δ; способствует переработке избыточного холестерина)."}},{"type":"paragraph","data":{"text":"По данным\nэпидемиологических исследований, дефицит витамина D ассоциирован с риском метаболических\nнарушений (метаболический синдром и сахарный диабет 2 типа)."}},{"type":"paragraph","data":{"text":"Рецепторы и\nметаболизирующие ферменты витамина D экспрессируются в артериальных сосудах,\nсердце и практически всех клетках и тканях, имеющих отношение к патогенезу\nсердечно-сосудистых заболеваний. На животных моделях показаны антиатеросклеротическое\nдействие, супрессия ренина и предупреждение повреждения миокарда и др. Низкие\nуровни витамина D у человека связаны с неблагоприятными факторами риска сердечно-сосудистой\nпатологии, такими как сахарный диабет, дислипидемия, артериальная гипертензия,\nи ассоциированы с риском сердечно-сосудистых катастроф, в т.ч. инсультов."}},{"type":"paragraph","data":{"text":"В исследованиях на\nэкспериментальных моделях болезни Альцгеймера показано, что витамин D\u003csub\u003e3\u003c/sub\u003e\nснижал накопление амилоида в мозге и улучшал когнитивную функцию. В неитервенционных\nисследованиях у человека показано, что частота развития деменции и болезни\nАльцгеймера увеличивается на фоне низкого уровня витамина D и низкого диетарного\nпотребления витамина D. Отмечалось ухудшение когнитивной функции и\nзаболеваемости болезнью Альцгеймера при низких уровнях витамина D."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФармакокинетика.\n\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Водный раствор витамина D\u003csub\u003e3\u003c/sub\u003e\nвсасывается лучше, чем масляный раствор. У недоношенных детей происходит\nнедостаточное образование и поступление желчи в кишечник, что нарушает\nвсасывание витаминов в виде масляных растворов. После перорального применения\nколекальциферол абсорбируется в тонком кишечнике. Метаболизируется в печени и\nпочках. Период полувыведения колекальциферола из крови составляет несколько\nдней и может продлиться в случае почечной недостаточности. Препарат проникает\nчерез плацентарный барьер и в молоко матери."}},{"type":"paragraph","data":{"text":"Витамин D\u003csub\u003e3\u003c/sub\u003e\nобладает свойством кумуляции. Выводится из организма почками в незначительном\nколичестве, большая часть выводится с желчью."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Профилактика дефицита\nвитамина D и заболеваний, связанных с его недостаточностью (рахита,\nостеомаляции)."}},{"type":"paragraph","data":{"text":"Лечение рахита. "}},{"type":"paragraph","data":{"text":"Комплексная терапия остеопороза\nразличного генеза."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная\nчувствительность к компонентам препарата, особенно к бензиловому спирту."}},{"type":"paragraph","data":{"text":"Дефицит\nсахаразы/изомальтазы, непереносимость фруктозы, глюкозо-галактозная\nмальабсорбция."}},{"type":"paragraph","data":{"text":"Гипервитаминоз витамина D.\n"}},{"type":"paragraph","data":{"text":"Повышенный уровень кальция\nв крови (гиперкальциемия), повышенное выделение кальция с мочой\n(гиперкальциурия), мочекаменная болезнь (образование кальциевых оксалатных\nкамней), в т.ч. в анамнезе, почечная остеодистрофия с гиперфосфатемией, псевдогипопаратиреоз."}},{"type":"paragraph","data":{"text":"Саркоидоз. "}},{"type":"paragraph","data":{"text":"Острые и хронические\nзаболевания печени и почек, почечная недостаточность. "}},{"type":"paragraph","data":{"text":"Активная форма\nтуберкулеза легких."}},{"type":"paragraph","data":{"text":"Детский возраст до 4-х\nнедель жизни. "}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"У пациентов, находящихся\nв состоянии иммобилизации. "}},{"type":"paragraph","data":{"text":"У пациентов, принимающих тиазидные\nдиуретики, а также у пациентов с сердечно-сосудистыми заболеваниями,\nпринимающих сердечные гликозиды (см. раздел «\u003cb\u003eВзаимодействие с другими лекарственными средствами»). \u003c/b\u003e"}},{"type":"paragraph","data":{"text":"В период беременности и\nгрудного вскармливания (см. раздел «\u003cb\u003eПрименение\nпри беременности и в период грудного вскармливания»)\u003c/b\u003e "}},{"type":"paragraph","data":{"text":"У грудных детей при\nпредрасположенности к раннему зарастанию родничков (когда от рождения\nустановлены малые размеры переднего темечка)."}},{"type":"paragraph","data":{"text":"При приеме дополнительных\nколичеств витамина D\nи кальция (например, в составе других препаратов), при нарушении экскреции\nкальция и фосфатов с мочой, при лечении производными бензотиадиазина и у\nиммобилизованных пациентов (риск развития гиперкальциемии и гиперкальциурии)\n(см. раздел \u003cb\u003eОсобые указания\u003c/b\u003e)."}},{"type":"paragraph","data":{"text":"У пациентов со следующими\nсопутствующими заболеваниями: атеросклероз, сердечная недостаточность,\nорганические поражения сердца, гранулематозы, гиперфосфатемия, фосфатный\nнефроуролитиаз, заболевания желудочно-кишечного тракта, язвенная болезнь\nжелудка и двенадцатиперстной кишки, \nгипотиреоз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри\nналичии одного или нескольких из перечисленных заболеваний и состояний перед\nприемом препарата необходимо проконсультироваться с врачом.\u003c/i\u003e"}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В период беременности не\nследует применять препарат в дозах, превышающих рекомендованные для\nпрофилактики дефицита витамина D\n(см.\nраздел «Способ применения и дозы»), из-за возможности проявления тератогенного действия\nв случае передозировки. С осторожностью следует назначать витамин D\u003csub\u003e3\u003c/sub\u003e\nу женщин, кормящих ребенка грудью, т.к. препарат, принимаемый в высоких дозах\nматерью, может вызвать симптомы передозировки у ребенка."}},{"type":"paragraph","data":{"text":"В случае применения\nпрепарата при беременности и в период грудного вскармливания необходимо\nучитывать поступление витамина D из других источников, суточная доза витамина D\nне должна превышать 600 ME."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Перорально. "}},{"type":"paragraph","data":{"text":"Препарат Юнивит Аква Д\u003csub\u003e3\u003c/sub\u003e принимают внутрь в ложечке жидкости. "}},{"type":"paragraph","data":{"text":"1 капля содержит около\n500 ME витамина D\u003csub\u003e3\u003c/sub\u003e. "}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПрофилактика рахита:\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"- доношенные\nноворожденные с 4-х недель жизни - 1 капля (500 ME) в сутки;"}},{"type":"paragraph","data":{"text":"- недоношенные дети с 4-х\nнедель жизни - 2 капли (1000 МЕ) в сутки в течение первого года жизни, затем по\n1 капле (500 МЕ) в сутки. "}},{"type":"paragraph","data":{"text":"Препарат применять в\nтечение первых двух лет жизни ребенка, в периоды пониженной инсоляции (особенно\nв зимний период)."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eЛечение рахита:\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"При отсутствии видимых\nдеформаций костной системы (легкая степень рахита) - по 2-3 капли (1000-1500\nME) в сутки, лечение продолжать в течение 30 дней. "}},{"type":"paragraph","data":{"text":"При наличии деформаций\nкостной системы, характерных для рахита средней и тяжелой степени – по 4-8\nкапель (2000-4000 МЕ) в сутки, лечение продолжать в течение 30-45 дней, доза\nпрепарата и продолжительность терапии зависят от выраженности изменений и\nопределяются врачом (см. \u003ci\u003eОсобые указания\u003c/i\u003e)."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПрофилактика дефицита\nвитамина D и заболеваний, связанных с его недостаточностью (остеомаляции):\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"по 1 капле (500 ME) в\nсутки в течение всего периода, сопровождающегося дефицитом поступления витамина\nD.\nМинимальная продолжительность курса профилактики – 1 месяц."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПри комплексном лечении остеопороза\u003c/i\u003e\u003c/b\u003e\u003ci\u003e:\u003c/i\u003e "}},{"type":"paragraph","data":{"text":"по 1-2 капли (500-1000\nME) в сутки в течение 3 месяцев. Повторное проведение курсов терапии возможно\nпо рекомендации врача, в зависимости от результатов оценки маркеров костного\nобмена и обмена кальция (\u003ci\u003eсм. Особые\nуказания\u003c/i\u003e). "}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота нежелательных\nреакций не определена."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны обмена веществ и питания: \u003c/i\u003eгиперкальциемия и\nгиперкальциурия. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны нервной системы\u003c/i\u003e: головная боль."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны сердечно-сосудистой системы: \u003c/i\u003eповышение артериального\nдавления, аритмии.\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны дыхательной системы, органов грудной клетки и средостения: \u003c/i\u003eобострение\nтуберкулезного процесса в легких.\u003ci\u003e \u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны желудочно-кишечного тракта: \u003c/i\u003eснижение аппетита, запор,\nметеоризм, тошнота, абдоминальная боль или диарея. \u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны кожи и подкожных тканей: \u003c/i\u003eреакции\nгиперчувствительности, такие как зуд, кожная сыпь и крапивница.\u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны скелетно-мышечной и соединительной ткани: \u003c/i\u003eартралгия,\nмиалгия. \u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны почек и мочевыводящих путей: \u003c/i\u003eнарушение функции почек,\nполиурия. \u003ci\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПри возникновении\nпобочных эффектов следует обратиться к врачу.\u003c/i\u003e\u003c/b\u003e"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\nострой передозировки витамина \u003c/i\u003e\u003ci\u003eD\u003c/i\u003e\u003ci\u003e\u003csub\u003e3\u003c/sub\u003e\u003c/i\u003e\u003ci\u003e:\u003c/i\u003e "}},{"type":"paragraph","data":{"text":"\u003ci\u003eранние\nпроявления\u003c/i\u003e (обусловленные гиперкальциемией) – запор или диарея,\nсухость слизистой оболочки полости рта, головная боль, жажда, поллакиурия,\nниктурия, полиурия, анорексия, металлический привкус во рту, тошнота, рвота,\nобщая слабость и усталость, гиперкальциемия, гиперкальциурия, дегидратация;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eпоздние\nпроявления\u003c/i\u003e – боль в костях, помутнение мочи (появление в моче\nгиалиновых цилиндров, протеинурии, лейкоцитурии), повышение артериального\nдавления, кожный зуд, фоточувствительность глаз, гиперемия конъюнктивы,\nаритмия, сонливость, миалгия, тошнота, рвота, панкреатит, гастралгия,\nпохудание, редко – психоз (изменения психики) и изменение настроения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\nхронической передозировки витамина\u003c/i\u003e \u003ci\u003eD\u003c/i\u003e\u003ci\u003e\u003csub\u003e3\u003c/sub\u003e\u003c/i\u003e\n(при приеме в течение нескольких недель или месяцев для взрослых в дозах\n20000-60000 МЕ/сут, детей – 2000-4000 МЕ/сут): кальциноз мягких тканей, почек,\nлегких, кровеносных сосудов, артериальная гипертензия, почечная и хроническая\nсердечная недостаточность (эти эффекты наиболее часто возникают при\nприсоединении к гиперкальциемии гиперфосфатемии), нарушение роста у детей\n(длительный прием в дозе 1800 МЕ/сут)."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eЛечение\u003c/i\u003e\u003c/b\u003e:\nПри появлении вышеописанных симптомов следует прервать применение препарата и\nобратиться к врачу. Показана диета с низким содержанием кальция (в течение\nнескольких недель), потребление больших количеств жидкости,  формированный диурез с применением фуросемида,\nэлектролитов, а также назначение глюкокортикостероидов, кальцитонина. При надлежащем\nфункционировании почек уровень кальция может быть значительно снижен путем\nинфузии изотонического раствора хлорида натрия (3-6 литров в течение 24 ч) с\nдобавлением фуросемида и, в некоторых случаях, также натрия эдетата в дозе 15\nмг/кг/ч, при одновременном постоянном мониторинге уровня кальция и данных электрокардиограммы.\nПри олигоанурии, напротив, необходимо проведение гемодиализа (диализат без\nкальция). Специфический антидот неизвестен."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля\nпредупреждения передозировки в ряде случаев рекомендуется контроль концентрации\nкальция в крови.\u003c/i\u003e"}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Противоэпилептические\nсредства (особенно фенитоин и фенобарбитал, примидон), рифампицин, колестирамин\nснижают реабсорбцию витамина D\u003csub\u003e3\u003c/sub\u003e."}},{"type":"paragraph","data":{"text":"Применение одновременно с\nтиазидными диуретиками повышает риск развития гиперкальциемии. В подобных\nслучаях необходимо проводить постоянный мониторинг концентрации кальция в\nкрови."}},{"type":"paragraph","data":{"text":"При гипервитаминозе D\u003csub\u003e3\u003c/sub\u003e\nвозможно усиление действия сердечных гликозидов и повышение риска возникновения\nаритмии, обусловленные развитием гиперкальциемии (целесообразны контроль\nконцентрации кальция в крови, электрокардиограммы, а также коррекция дозы\nсердечного гликозида)."}},{"type":"paragraph","data":{"text":"Сопутствующая терапия\nглюкокортикостероидами может снижать эффективность витамина D\u003csub\u003e3\u003c/sub\u003e. "}},{"type":"paragraph","data":{"text":"Длительное применение\nантацидных средств, содержащих алюминий и магний, в комбинации с витамином D\u003csub\u003e3\u003c/sub\u003e может\nспособствовать повышению концентрации алюминия и магния в крови и как следствие\n– токсическому влиянию алюминия на костную ткань и гипермагниемии у пациентов с\nпочечной недостаточностью. "}},{"type":"paragraph","data":{"text":"Колестирамин, колестипол\nи минеральные масла снижают абсорбцию в желудочно-кишечном тракте\nжирорастворимых витаминов и требуют повышения их дозы."}},{"type":"paragraph","data":{"text":"Сопутствующее применение\nбензодиазепинов повышает риск развития гиперкальциемии."}},{"type":"paragraph","data":{"text":"Препараты, содержащие высокие\nконцентрации кальция и фосфора, увеличивают риск развития гиперфосфатемии.  "}},{"type":"paragraph","data":{"text":"При одновременном\nприменении с натрия фторидом интервал между приемом должен составлять не менее\n2 ч; с пероральными формами тетрациклинов - не менее 3 ч."}},{"type":"paragraph","data":{"text":"Одновременное применение\nс другими аналогами витамина D\nповышает риск развития гипервитаминоза витамина D."}},{"type":"paragraph","data":{"text":"Кетоконазол может\nугнетать как биосинтез, так и катаболизм 1,25(ОН)2-колекальциферола."}},{"type":"paragraph","data":{"text":"Витамин D является антагонистом препаратов,\nприменяемых при гиперкальциемии: кальцитонин, этидронат, памидронат,\nпликамицин, галлия нитрат."}},{"type":"paragraph","data":{"text":"Изониазид и рифампицин\nспособны снижать эффект препарата из-за увеличения скорости биотрансформации."}},{"type":"paragraph","data":{"text":"Витамин D\u003csub\u003e3\u003c/sub\u003e не\nвзаимодействует с пищей."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Избегать передозировки. "}},{"type":"paragraph","data":{"text":"При приеме препарата\nдолжно учитываться количество витамина D и кальция, поступающих с пищей и в\nсоставе других лекарственных препаратов. "}},{"type":"paragraph","data":{"text":"Слишком высокие дозы\nвитамина D\u003csub\u003e3\u003c/sub\u003e, применяемые продолжительно, или ударные дозы могут быть\nпричиной хронического гипервитаминоза D\u003csub\u003e3\u003c/sub\u003e. "}},{"type":"paragraph","data":{"text":"Не следует применять\nодновременно с витамином D\u003csub\u003e3\u003c/sub\u003e высокие дозы кальция. "}},{"type":"paragraph","data":{"text":"Препарат следует\nприменять с осторожностью у пациентов с нарушенной экскрецией кальция и\nфосфатов с мочой, при лечении производными бензотиадиазина и у иммобилизованных\nпациентов (риск развития гиперкальциемии и гиперкальциурии). У таких пациентов\nследует контролировать уровень кальция в плазме крови и моче."}},{"type":"paragraph","data":{"text":"Не следует принимать\nвитамин D\u003csub\u003e3\u003c/sub\u003e\nпри псевдогипопаратиреозе, так как при этом заболевании потребность в витамине D может быть снижена, что может\nпривести к риску длительной передозировки. "}},{"type":"paragraph","data":{"text":"К основным клиническим\nпроявлениям рахита легкой степени относятся нервная возбудимость, беспокойство,\nвздрагивания при резком звуке, вспышке света, нарушения ритма сна,\nповерхностный «тревожный» сон, потливость, зуд кожи, облысение затылка, податливость\nкраев большого родничка. "}},{"type":"paragraph","data":{"text":"Наличие видимых\nдеформаций костной ткани характерно для средней и тяжелой степени рахита,\nкоторые, как правило, требуют госпитализации и проведения комплексной терапии,\nназначаемой врачом по результатам обследования."}},{"type":"paragraph","data":{"text":"Повторное проведение\nкурсов терапии остеопороза возможно по рекомендации врача, в зависимости от\nрезультатов оценки маркеров костного обмена и обмена кальция. Если врач\nназначил более длительное лечение, чем рекомендовано в инструкции, то следует\nрегулярно (через каждые три месяца терапии) определять уровень кальция в\nсыворотке крови и моче, а также проводить оценку функции почек путем измерения\nуровня креатинина в сыворотке крови. При необходимости доза может быть\nскорректирована врачом в соответствии с уровнем кальция в сыворотке крови. "}},{"type":"paragraph","data":{"text":"В случае гиперкальциемии\nили наличия признаков нарушения функции почек дозу препарата следует снизить\nили приостановить лечение. Если уровень кальция в моче превышает 7,5 ммоль/24 ч\n(300 мг/ 24 ч), рекомендуется снизить дозу препарата или приостановить лечение."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Данные о возможном\nвлиянии препарата на способность управлять транспортными средствами и\nмеханизмами отсутствуют."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Капли для приема внутрь,\n15000 МЕ/мл. "}},{"type":"paragraph","data":{"text":"По 10 мл, 20 мл во\nфлаконы-капельницы из темного (янтарного) стекла, укупоренные полиэтиленовыми\nпробками-капельницами и полиэтиленовыми крышками с контролем первого вскрытия."}},{"type":"paragraph","data":{"text":"Один флакон-капельницу по\n10 мл или 20 мл, или два флакона-капельницы по 20 мл, вместе с инструкцией по\nприменению помещают в пачку из картона.\u003cb\u003e\u003c/b\u003e"}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищённом от света\nместе при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в местах,\nнедоступных для детей."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не применять по истечении срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ОАО \"Фармстандарт-Лексредства\",\nРоссия, Курская обл., г. Курск, ул. 2-я Агрегатная,"}},{"type":"paragraph","data":{"text":"д. 1а/18, тел./факс:\n(4712) 34-03-13"}},{"type":"paragraph","data":{"text":"\u003ca href=\"http://www.pharmstd.ru\"\u003ewww.pharmstd.ru\u003c/a\u003e"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"АО \"Отисифарм\",\nРоссия"}},{"type":"paragraph","data":{"text":"123112, г. Москва, ул.\nТестовская, д. 10 "}},{"type":"paragraph","data":{"text":"эт. 12, пом. II, ком. 29"}},{"type":"paragraph","data":{"text":"Тел.: +7 (800) 775-98-19 "}},{"type":"paragraph","data":{"text":"Факс: +7(495) 221-18-02 "}},{"type":"paragraph","data":{"text":"www.otcpharm.ru"}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаВитамин D3 является естественной формой витамина D, которая образуется у человека в коже под действием солнечных лучей. По сравнению с витамином D2 характеризуется на 25% более высокой активностью. Витамин D связывается со специфическим рецептором витамина D (VDR), который ре-гулирует экспрессию многих генов, включая гены ионного канала TRPV6 (обеспечивает абсорбцию кальция в кишечнике), CALB1 (кальбиндин; обеспечивает транспорт кальция в кровеносное русло), BGLAP (остеокальцин; обеспечивает минерализацию костной ткани и гомеостаз кальция), SPP1 (остеопонтин; регулирует миграцию остеокластов), REN (ренин; обеспечивает регуляцию артериального давления, являясь ключевым элементом ренин-ангиотензин-альдостероновой системы регуляции), IGFBP (связывающий белок инсулинподобного фактора роста; усиливает действие инсулинподобного фактора роста), FGF23 (фактор роста фибробластов 23; регулирует уровни кальция, фосфат-аниона, процессы клеточного деления фибробластов), TGFB1 (трансформирующий фактор роста бета-1; регулирует процессы клеточного деления и дифференцировки остеоцитов, хондроцитов, фибробластов и кератиноцитов), LRP2 (ЛПНП-рецептор-связанный белок 2; является посредником эндоцитоза липопротеинов низкой плотности), INSR (рецептор ин-сулина; обеспечивает эффекты инсулина на любые типы клеток). Витамин D3 является активным антирахитическим фактором. Самой важной функцией витамина D3 является регулирование метаболизма кальция и фосфатов, что способствует правильной минерализации и росту скелета. Колекальциферол играет существенную роль в абсорбции кальция и фосфатов из кишечника, в транспорте минеральных солей и в процессе кальцификации костей, регулирует также выведение кальция и фосфатов почками. Концентрация ионов кальция в крови обуславливает поддержание тонуса мышц скелетной мускулатуры, функцию миокарда, способствует проведению нервного возбуждения, регулирует процесс свертывания крови. Недостаток витамина D в пище, нарушение его всасывания, дефицит кальция, а также недостаточное пребывание на солнце приводит: у детей в период интенсивного роста - к рахиту, у взрослых - к остеомаляции, у беременных женщин могут возникнуть симптомы тетании, - нарушение процессов обызвествления костей новорожденных. Повышенная потребность в витамине D возникает у женщин в период климакса, поскольку у них часто развивается остеопороз в связи с гормональными нарушениями. Витамин D обладает рядом т.н. внескелетных эффектов. Витамин D участвует в функционировании иммунной системы путем модуляции уровней цитокинов и регулирует деление лимфоцитов Т-хелперов и дифференцировку В-лимфоцитов. В ряде исследований отмечено снижение заболеваемости инфекциями дыхательных путей на фоне приема витамина D. Показано, что витамин D является важным звеном гомеостаза иммунной системы: предотвращает аутоиммунные заболевания (сахарный диабет 1 типа, рассеянный склероз, ревматоидный артрит, воспалительные болезни кишечника и др.). Витамин D обладает антипролиферативным и продифференцирующим эффектами, которые обуславливают онкопротективное действие витамина D. Отмечено, что частота некоторых опухолей (рак молочной железы, рак толстого кишечника) повышается на фоне низкого уровня витамина D в крови. Витамин D участвует в регуляции углеводного и жирового метаболизма путем влияния на синтез IRS1 (субстрат рецептора инсулина 1; участвует во внутриклеточных путях проведения сигнала рецептора инсулина), IGF (инсулиноподобный фактор роста; регулирует баланс жировой и мышечной ткани), PPAR-δ (активированный рецептор пролифераторов пероксисом, тип δ; способствует переработке избыточного холестерина). По данным эпидемиологических исследований, дефицит витамина D ассоциирован с риском метаболических нарушений (метаболический синдром и сахарный диабет 2 типа). Рецепторы и метаболизирующие ферменты витамина D экспрессируются в артериальных сосудах, сердце и практически всех клетках и тканях, имеющих отношение к патогенезу сердечно-сосудистых заболеваний. На животных моделях показаны антиатеросклеротическое действие, супрессия ренина и предупреждение повреждения миокарда и др. Низкие уровни витамина D у человека связаны с неблагоприятными факторами риска сердечно-сосудистой патологии, такими как сахарный диабет, дислипидемия, артериальная гипертензия, и ассоциированы с риском сердечно-сосудистых катастроф, в т.ч. инсультов. В исследованиях на экспериментальных моделях болезни Альцгеймера показано, что витамин D3снижал накопление амилоида в мозге и улучшал когнитивную функцию. В неитервенционных исследованиях у человека показано, что частота развития деменции и болезни Альцгеймера увеличивается на фоне низкого уровня витамина D и низкого диетарного потребления витамина D. Отмечалось ухудшение когнитивной функции и заболеваемости болезнью Альцгеймера при низких уровнях витамина D.Фармакокинетика.Водный раствор витамина D3всасывается лучше, чем масляный раствор. У недоношенных детей происходит недостаточное образование и поступление желчи в кишечник, что нарушает всасывание витаминов в виде масляных растворов. После перорального применения колекальциферол абсорбируется в тонком кишечнике. Метаболизируется в печени и почках. Период полувыведения колекальциферола из крови составляет несколько дней и может продлиться в случае почечной недостаточности. Препарат проникает через плацентарный барьер и в молоко матери. Витамин D3обладает свойством кумуляции. Выводится из организма почками в незначительном количестве, большая часть выводится с желчью.","substance":[],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":true,"comments":null,"image_alt":"Юнивит Аква Д3","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/225515/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/225515/share_default/"}},"diseases":[],"other_packages":[{"id":303234,"title":"Юнивит Аква Д3","subtitle":{"full":"Капли, 10 мл, 15000 ме/мл","short":"Капли, 10 мл, 15000 ме/мл","package":"10 мл, 15000 ме/мл"},"prescription":false,"catalog_section_id":100282,"manufacturer":{"id":6025,"title":"Отисифарм","slug":"otisifarm","logo":{"isTouch":{"retina":null,"default":null},"isFromTablet":{"retina":null,"default":null}}},"is_advert":false,"product_form":"Капли","slug":"303234-yunivit_akva_d3","attributes":{"count":"","dose":"15000 ме/мл","volume":"10 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