BNF for Children (BNFC) 2018-2019

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug. Forms available from special-order

manufacturers include: oral suspension

Tablet

▶Rosuvastatin (Non-proprietary)

Rosuvastatin (as Rosuvastatin calcium) 5 mgRosuvastatin 5 mg

tablets| 28 tabletP£ 18. 03 DT = £ 2. 92

Rosuvastatin (as Rosuvastatin calcium) 10 mgRosuvastatin 10 mg

tablets| 28 tabletP£ 18. 03 DT = £ 2. 92

Rosuvastatin (as Rosuvastatin calcium) 20 mgRosuvastatin 20 mg

tablets| 28 tabletP£ 26. 02 DT = £ 4. 48

Rosuvastatin (as Rosuvastatin calcium) 40 mgRosuvastatin 40 mg

tablets| 28 tabletP£ 29. 69 DT = £ 5. 97

▶Crestor(AstraZeneca UK Ltd)

Rosuvastatin (as Rosuvastatin calcium) 5 mgCrestor 5 mg tablets

| 28 tabletP£ 18. 03 DT = £ 2. 92

Rosuvastatin (as Rosuvastatin calcium) 10 mgCrestor 10 mg

tablets| 28 tabletP£ 18. 03 DT = £ 2. 92

Rosuvastatin (as Rosuvastatin calcium) 20 mgCrestor 20 mg

tablets| 28 tabletP£ 26. 02 DT = £ 4. 48

Rosuvastatin (as Rosuvastatin calcium) 40 mgCrestor 40 mg

tablets| 28 tabletP£ 29. 69 DT = £ 5. 97

eiiiiF 131

Simvastatin

lINDICATIONS AND DOSE

Hyperlipidaemia including familial hypercholesterolaemia

▶BY MOUTH

▶Child 5–9 years:Initially 10 mg once daily, then

increased if necessary up to 20 mg once daily, dose to

be taken at night, increased at intervals of at least

4 weeks

▶Child 10–17 years:Initially 10 mg once daily, then

increased if necessary up to 40 mg once daily, dose to

be taken at night, increased at intervals of at least

4 weeks

DOSE ADJUSTMENTS DUE TO INTERACTIONS

▶Manufacturer advises max. dose 10 mg daily with

concurrent use of bezafibrate—no specific

recommendation made for children.

▶Manufacturer advises max. dose 20 mg daily with

concurrent use of amiodarone or amlodipine—no

specific recommendation made for children.

▶Manufacturer advises reduce dose with concurrent use

of some moderate inhibitors of CYP 3 A 4 (max. 20 mg

daily with verapamil and diltiazem)—no specific

recommendation made for children.

lUNLICENSED USENot licensed for use in children under

10 years.

lINTERACTIONS→Appendix 1 : statins

lSIDE-EFFECTS

▶Rare or very rareAcute kidney injury.anaemia.muscle

cramps

▶Frequency not knownCognitive impairment

lBREAST FEEDINGManufacturer advises avoid—no

information available.

lRENAL IMPAIRMENTDoses above 10 mg daily should be

used with caution if estimated glomerularfiltration rate

less than 30 mL/minute/ 1. 73 m^2.

lPATIENT AND CARER ADVICEPatient counselling is advised

for simvastatin tablets/oral suspension (muscle effects).

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug. Forms available from special-order

manufacturers include: oral suspension, oral solution

Oral suspension

EXCIPIENTS:May contain Propylene glycol

▶Simvastatin (Non-proprietary)

Simvastatin 4 mg per 1 mlSimvastatin 20 mg/ 5 ml oral suspension

sugar free sugar-free| 150 mlP£ 126. 87 DT = £ 126. 87

Simvastatin 8 mg per 1 mlSimvastatin 40 mg/ 5 ml oral suspension

sugar free sugar-free| 150 mlP£ 193. 80 DT = £ 193. 80

Tablet

▶Simvastatin (Non-proprietary)

Simvastatin 10 mgSimvastatin 10 mg tablets| 28 tabletP

£ 18. 00 DT = £ 0. 35

Simvastatin 20 mgSimvastatin 20 mg tablets| 28 tabletP

£ 29. 60 DT = £ 0. 45

Simvastatin 40 mgSimvastatin 40 mg tablets| 28 tabletP

£ 29. 60 DT = £ 0. 65

Simvastatin 80 mgSimvastatin 80 mg tablets| 28 tabletP

£ 29. 61 DT = £ 1. 28

▶Simvador(Discovery Pharmaceuticals)

Simvastatin 10 mgSimvador 10 mg tablets| 28 tabletP£ 0. 34

DT = £ 0. 35

Simvastatin 20 mgSimvador 20 mg tablets| 28 tabletP£ 0. 44

DT = £ 0. 45

Simvastatin 40 mgSimvador 40 mg tablets| 28 tabletP£ 0. 64

DT = £ 0. 65

Simvastatin 80 mgSimvador 80 mg tablets| 28 tabletP£ 1. 27

DT = £ 1. 28

▶Zocor(Merck Sharp & Dohme Ltd)

Simvastatin 10 mgZocor 10 mg tablets| 28 tabletP£ 18. 03 DT

=£ 0. 35

Simvastatin 20 mgZocor 20 mg tablets| 28 tabletP£ 29. 69 DT

=£ 0. 45

Simvastatin 40 mgZocor 40 mg tablets| 28 tabletP£ 29. 69 DT

=£ 0. 65

Simvastatin 80 mgZocor 80 mg tablets| 28 tabletP£ 29. 69 DT

=£ 1. 28

Simvastatin with ezetimibe

The properties listed below are those particular to the

combination only. For the properties of the components

please consider, simvastatin above, ezetimibe p. 130.

lINDICATIONS AND DOSE

Homozygous familial hypercholesterolaemia, primary

hypercholesterolaemia, and mixed hyperlipidaemia in

patients over 10 years stabilised on the individual

components in the same proportions, or for patients not

adequately controlled by statin alone

▶BY MOUTH

▶Child (initiated by a specialist):(consult product

literature)

lINTERACTIONS→Appendix 1 : ezetimibe.statins

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Tablet

▶Inegy(Merck Sharp & Dohme Ltd)

Ezetimibe 10 mg, Simvastatin 20 mgInegy 10 mg/ 20 mg tablets|

28 tabletP£ 33. 42 DT = £ 33. 42

Ezetimibe 10 mg, Simvastatin 40 mgInegy 10 mg/ 40 mg tablets|

28 tabletP£ 38. 98 DT = £ 38. 98

Ezetimibe 10 mg, Simvastatin 80 mgInegy 10 mg/ 80 mg tablets|

28 tabletP£ 41. 21 DT = £ 41. 21

LIPID MODIFYING DRUGS›OTHER

Evolocumab 24-Apr-2017

lDRUG ACTIONEvolocumab binds to a pro-protein involved

in the regulation of LDL receptors on liver cells; receptor

numbers are increased, which results in increased uptake

of LDL-cholesterol from the blood.

lINDICATIONS AND DOSE

Homozygous familial hypercholesterolaemia (in

combination with other lipid-lowering therapies)

▶BY SUBCUTANEOUS INJECTION

▶Child 12–17 years:Initially 420 mg every month;

increased if necessary to 420 mg every 2 weeks, if

134 Hyperlipidaemia BNFC 2018 – 2019

Cardiovascular system

2