Simvastatin 20-40 mg/day modestly potentiated the effect of coumarin anticoagulants: the prothrombin time , reported as International Normalized Ratio (INR), increased from a baseline of to and from to in a normal volunteer study and in a hypercholesterolemic patient study, respectively. With other statins, clinically evident bleeding and/or increased prothrombin time has been reported in a few patients taking coumarin anticoagulants concomitantly. In such patients, prothrombin time should be determined before starting VYTORIN and frequently enough during early therapy to ensure that no significant alteration of prothrombin time occurs. Once a stable prothrombin time has been documented, prothrombin times can be monitored at the intervals usually recommended for patients on coumarin anticoagulants. If the dose of VYTORIN is changed or discontinued, the same procedure should be repeated. Simvastatin therapy has not been associated with bleeding or with changes in prothrombin time in patients not taking anticoagulants.
A big thank you for this product. I have two elderly horses with Cushings, and Zero has been their saviour as far as feeding goes…both are very fussy eaters, especially my Shetland mare who lost a lot of weight after her diagnosis, compounded by severe laminitis which I struggled to get under control. I had great difficulty finding something to enhance the palatability of her mainly Micrbeet feeds and which was safe for her to eat, and the Zero has proven to be a winner. Both my Cushings horses now gobble up their feeds, and I can hide their supplements without a problem as they love the taste of the Zero. It’s fantastic for helping to maintain their weight, and they lick their feeders clean every time! I now feed it to all my horses, safe in the knowledge that is it very low NSC and completely safe for my metabolically challenged herd. Thank you Hygain!