Yuav siv cov tshuaj Liprimar li cas? > Kev khomob thiab kev tiv thaiv

Liprimar yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj coated nrog zaj duab xis txheej: dawb, elliptical, ntawm qhov tawg - dawb tub ntxhais, kos rau ob sab nyob ntawm seb ntau npaum - "10" thiab "PD 155" / "20" thiab "PD 156" / " 40 "thiab" PD 157 "/" 80 "thiab" PD 158 "(10 thiab 20 mg txhua - 10 pcs. Hauv cov hlwv, 3 thiab 10 hlwv hauv ib daim ntawv thawv, 7 pcs. Hauv cov hlwv, 2 lub hlwv hauv thawv ntawv ntim, 40 thiab 80 mg ib qho - 10 pcs. hauv cov hlwv, 10 lub hlwv hauv ib pob ntawv cardboard, 7 pcs. hauv blisters, 2 lossis 4 blisters hauv cardboard bundle).

Cov muaj pes tsawg leeg ntawm 1 ntsiav tshuaj suav nrog:

Cov khoom xyaw nquag: atorvastatin - 10, 20, 40 lossis 80 mg (hauv daim ntawv ntawm calcium ntsev),
Lub Cheebtsam pab: calcium carbonate - 33/66/132/264 mg, microcrystalline cellulose - 60/120/240/480 mg, lactose monohydrate - 32.8 / 65.61 / 131.22 / 262.44 mg, croscarmellose sodium - 9/18/36/72 mg, polysorbate 80 - 0.6 / 1.2 / 2.4 / 4.8 mg, hyprolose - 3/6/12/24 mg, magnesium stearate - 0.75 / 1.5 / 3/6 mg,
Cov tsho tiv no zaj duab xis: Opadry dawb YS-1-7040 (hypromellose - 66.12%, polyethylene glycol - 18.9%, titanium dioxide - 13.08%, talc - 1.9%) - 4.47 / 8.94 / 17 , 88 / 35.76 mg, emulsion ntawm simethicone (simethicone - 30%, stearic emulsifier - 0.075%, sorbic acid, dej) - 0.03 / 0.06 / 0.12 / 0.24 mg, tswm ciab candelilla - 0, 08 / 0.16 / 0.32 / 0 mg.

Cov Tshuaj Hauv Tshuaj

Atorvastatin yog ib qho kev xaiv sib tw muaj zog ntawm HMG-CoA reductase, uas yog cov enzyme tseem ceeb uas hloov 3-hydroxy-3-methylglutaryl-CoA rau mevalonate, ua ntej rau steroids, suav nrog cov roj (cholesterol). Liprimar hais txog lipid-txo cov neeg sawv cev ntawm hluavtaws keeb kwm.

Kev siv cov tshuaj atorvastatin hauv cov neeg mob nrog ntshav sib xyaw ua ke, tsis muaj kev sib koom ua ke ntawm hypercholesterolemia, zoo li cov kab mob heterozygous thiab homozygous tsev neeg hypercholesterolemia ua rau txo qis ntshav ntshav ntau ntawm triglycerides (TG), ntshav qis lipoprotein ntau heev (ChL-VLDL-Ap, Apol) cov roj lipoprotein tsawg kawg (cov roj cholesterol-LDL) thiab cov roj (cholesterol) tag nrho. Tsis tas li, thaum noj Liprimar, qhov concentration ntawm high density lipoprotein roj (HDL-C) nce.

Atorvastatin inhibits kev tsim cov roj cholesterol hauv lub siab, tiv thaiv HMG-CoA reductase, thiab nce tus naj npawb ntawm hepatic LDL receptors nyob rau sab nraud cov cell, uas ua rau kom muaj kev nce siab thiab catabolism ntawm LDL-C thiab tseem ua rau txo qis hauv qib roj thiab LDL-C hauv ntshav.

Liprimar txo cov LDL ntau ntau thiab inhibits qhov tsim ntawm LDL-C, ua rau kom muaj suab nrov thiab tsis tu ncua ntxiv hauv cov kev ua haujlwm ntawm LDL receptors, ua ke nrog cov kev hloov pauv uas muaj txiaj ntsig zoo ntawm LDL cov kab mob, thiab tseem yuav txo cov qib ntawm LDL cov roj ntsha hauv cov neeg mob homozygous tsev neeg hypercholesterolemia ntawm cov kab mob sib deev tiv thaiv kab mob. kho nrog rau lwm cov lipid-txo cov tshuaj.

Thaum noj nyob rau hauv ntau npaum li cas ntawm 10-80 mg, atorvastatin txo qhov kev xav ntawm TG los ntawm 14–33%, apo-B los ntawm 34–50%, roj-LDL los ntawm 41–61% thiab cov roj cholesterol los ntawm 30–46%. Cov kev kho mob yuav luag zoo ib yam rau cov neeg mob uas tsis yog tsev neeg hom hypercholesterolemia, heterozygous tsev neeg hypercholesterolemia thiab sib xyaw hyperlipidemia, suav nrog cov neeg mob ntshav qab zib hom 2.

Hauv cov neeg mob uas muaj hypertriglyceridemia cais, cov tshuaj ua kom zoo Liprimara txo qis qib ntawm TG, apo-B, roj-VLDL, roj-LDL thiab tag nrho cov roj cholesterol thiab nce cov qib roj cholesterol-HDL. Hauv cov neeg mob dysbetalipoproteinemia, thaum noj Liprimar, qhov tshuaj ntawm lipoprotein (cov roj cholesterol ua haujlwm qis) tsawg dua.

Hauv cov neeg mob uas muaj hom IIa thiab IIb hyperlipoproteinemia, raws li Fredrickson kev faib tawm rau kev kho mob atorvastatin (koob ntau txog 10-80 mg), qhov siab ntawm HDL-C nce rau qhov nruab nrab los ntawm 5.1-8.7% piv rau cov nqi thaum pib, thiab cov nyhuv no tsis yog koob tshuaj vam khom. Qhov feem ntawm cov cholesterol-LDL / cov cholesterol-HDL thiab tag nrho cov roj-cholesterol-HDL raug txo qis (qhov txo yog txiav txim los ntawm koob tshuaj Liprimar noj) yog 37–55% thiab 29–44%, ua ntu zus. Atorvastatin nyob rau hauv ib koob tshuaj 80 mg txo qhov kev pheej hmoo ntawm kev tsim ischemic teeb meem thiab txo kev tuag los ntawm 16% tom qab ua tiav kev kho mob ntawm 16 lub lis piam, thiab kev pheej hmoo rov qab pw hauv tsev kho mob cuam tshuam nrog angina pectoris, uas nrog cov cim ntawm myocardial ischemia, raug txo qis li 26% raws li kev tshawb fawb , muaj qhov txo qis ntawm qhov tshwm sim ntawm tus mob myocardial ischemia thaum sib zog kho lipid-txo qis txoj kev kho (MIRACL). Hauv cov neeg mob uas muaj qib pib sib txawv ntawm LDL-C, cov neeg mob uas tsis khov kho lub plawv tsis txaus thiab myocardial infarction tsis muaj Q yoj, tsis hais tus poj niam (txiv neej thiab poj niam) thiab hnub nyoog (hluas dua thiab laus dua 65 xyoo), noj atorvastatin txo txoj kev pheej hmoo ntawm ischemic tsis yooj yim thiab kev tuag. Kev poob qis hauv kev mloog zoo ntawm LDL-C hauv ntshav qhia tau hais tias muaj qhov sib txuam zoo dua nrog cov koob tshuaj Liprimar dua li nrog qhov kev nthuav dav ntawm nws cov nquag muaj feem hauv cov ntshav ntshav. Cov koob tshuaj yuav tsum tau xaiv coj mus rau hauv tus lej saib xyuas cov nyhuv.

Kev kho mob ntawm Liprimar raug kaw tseg 2 lub lis piam tom qab pib kev kho mob, nce mus txog qhov siab kawg tom qab 4 lub lis piam thiab tawm tsam thoob plaws hauv kev kho mob.

Hauv cov neeg mob uas mob ntshav lub plawv, thiab peb lossis ntau dua cov kev pheej hmoo, noj atorvastatin ntawm koob tshuaj 10 mg txo qhov kev pheej hmoo ntawm kev tsim mob tsis txaus ntshai tuag (tuag taus) lub plawv sib piv nrog cov placebo. Cov txiaj ntsig ntawm Anglo-Scandinavian txoj kev tshawb fawb txog kev ntsuas ntawm qhov tshwm sim ntawm kab mob plawv (ASCOT-LLA) tau paub, raws li kev tswj hwm ntawm Liprimar ntawm ib koob ntawm 10 mg txo cov kev pheej hmoo ntawm qee qhov teeb meem raws li nram no:

mob stroke (tsis-ua rau neeg tuag / ua rau neeg tuag taus) - los ntawm 26%,
mob hlab ntsha hlwb (tsis mob ntshav siab myocardial infarction thiab mob plawv, nrog rau kev tuag) - los ntawm 36%,
cov kab mob plawv dav dav - los ntawm 29%,
cov kev cuam tshuam txog cov hlab plawv cov hlab plawv thiab cov kev ua kom rov zoo tuaj - los ntawm 20%.

Raws li cov txiaj ntsig ntawm kev kawm txog kev tswj hwm ntawm atorvastatin rau hom 2 mob ntshav qab zib mellitus (CARDS), kev siv Liprimar hauv cov neeg mob uas muaj tus kab mob no txo cov kev pheej hmoo ntawm cov hlab plawv tsis hais txog lub hnub nyoog thiab tub los ntxhais lossis kev pib ntawm LDL-C raws li hauv qab no:

mob stroke (tsis-ua rau neeg tuag taus / tuag taus) - los ntawm 48%,
qhov mob tsis muaj myocardial ischemia, tsis mob heev (tuag taus) myocardial infarction - los ntawm 42%,
lub ntsiab ntawm cov hlab plawv (mob stroke, cov txheej txheem hauv lub plawv, tsis muaj mob myocardial ischemia, nonfatal thiab tuag myocardial infarction, percutaneous transluminal coronary coronary angioplasty, tuag vim exacerbation ntawm kab mob plawv, mob ntshav tawm ntawm txoj hlab ntshav tsis txaus, tsis txaus ntseeg angina pectoris) - los ntawm 37%.

Kev tshawb nrhiav txog qhov tshwm sim ntawm kev siv tshuaj kho mob siab ntxiv rau kev thim rov qab ntawm kev mob ntshav siab (atherosclerosis) (REVERSAL) tau qhia tias cov neeg mob plawv mob rau lub plawv mob noj atorvastatin hauv ib hnub 80 mg ua rau txo qis tag nrho cov nyiaj ntawm atheroma los ntawm 0.4% tom qab 1.8 lub hlis ntawm kev kho mob.

Kev tswj hwm ntawm atorvastatin nyob rau hauv kev noj tshuaj txhua hnub ntawm 80 mg tuaj yeem txo qhov kev pheej hmoo tsis mob ntshav siab (tuag taus) hauv cov neeg mob uas tau hla mus rau ischemic nres lossis mob stroke tsis muaj keeb kwm mob plawv mob piv rau cov placebo raws li cov txiaj ntsig ntawm txoj kev tshawb fawb tiv thaiv mob stroke nrog kev txo qis hauv cov roj (cholesterol) (SPARCL). Qhov no pab tau txo txoj kev pheej hmoo ntawm cov mob plawv thiab cov kev xav ua kom rov ua haujlwm. Kev txo qis hauv kev pheej hmoo ntawm kev tsis txaus siab ntawm cov hlab plawv cov ntshav thaum kho nrog atorvastatin raug pom nyob hauv txhua pawg ntawm cov neeg mob, tsuas yog qhov uas suav nrog cov neeg mob thawj lossis rov ua mob hemorrhagic mob stroke.

Hauv cov neeg mob uas muaj mob plawv, noj Liprimar ib koob ntawm 80 mg piv nrog koob tshuaj 10 mg txo qhov kev pheej hmoo ntawm cov mob hnyav raws li hauv qab no (raws li kev soj ntsuam ntawm TNT kho kom ua tiav cov hom phiaj lipid ntau):

sau cia angina pectoris - los ntawm 10.9%,
kev mob plawv rau lub plawv (tsis mob ntshav siab myocardial infarction thiab mob plawv, nrog rau kev tuag) - los ntawm 8.7%,
kev mob rau txoj hlab ntshav hla kev phais mob los yog lwm cov txheej txheem kho plawv - los ntawm 13.4%,
non-fat myocardial infarction, tsis yog los ntawm cov txheej txheem - los ntawm 4.9%,
muab tso rau hauv tsev kho mob cuam tshuam nrog lub plawv tsis ua haujlwm hnyav - los ntawm 2.4%,
mob stroke tsis-tuag-rog (tuag taus) - los ntawm 2.3%.

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov tshuaj muaj nyob hauv cov ntsiav tshuaj enteric-coated. Chav tsev tshuaj muaj 10 mg ntawm atorvastatin calcium uas yog cov khoom ua haujlwm nquag. Rau qhov ceev ntawm kev nqus thiab nce bioavailability, lub ntsiav tshuaj muaj cov tshuaj ntxiv:

microcrystalline cellulose,
magnesium stearate,
mis nyuj qab zib
Kev Hyprolose
croscarmellose sodium,
calcium carbonate.

Cov tshuaj muaj pes tsawg leeg ntawm cov ntsiav tshuaj suav nrog microcrystalline cellulose, magnesium stearate, mis qab zib, hyprolose, croscarmellose sodium, calcium carbonate.

Cov qog ua cov zaj duab xis muaj cov ciab tswm ciab, hypromellose, polyethylene glycol, talc, emulsion simethicone, titanium dioxide. Ntawm cov ntsiav tshuaj dawb ntawm cov duab elliptical, cov duab kos "PD 155" thiab cov koob tshuaj ntawm cov tshuaj nquag tau siv.

Pharmacological kev txiav txim

Liprimar belongs rau chav kawm ntawm lipid-txo cov tshuaj. Cov tshuaj nquag ntawm atorvastatin yog cov kev xaiv cov khoom thaiv ntawm HMG-CoA reductase, qhov tseem ceeb enzyme tsim nyog rau kev hloov pauv ntawm 3-hydroxy-3-methylglutaryl coenzyme rau hauv mevalonate.

Thaum muaj ib hom mob tshwm sim rau hypercholesterolemia (cov roj (cholesterol) ntau ntxiv, cov roj ntshav sib xyaw ua ke), cov khoom ua si Liprimara yuav pab txo cov ntshav plasma tag nrho cov roj (Ch), apolipoprotein B, VLDL thiab LDL (lipoproteins tsawg ceev) thiab triglycerides. Atorvastatin ua rau muaj qhov siab ntxiv ntawm lipoprotein (HDL).

Lub tshuab ua haujlwm ntawm kev txiav txim siab vim yog kev tsuj ntawm kev ua haujlwm ntawm HMG-CoA reductase thiab kev txwv tsis pub cov roj cholesterol tsim cov kab mob hauv hepatocytes.

Atorvastatin muaj peev xwm nce tus naj npawb ntawm cov qis lipoprotein receptors nyob rau sab nraud ntawm daim siab ua mob rau daim siab, uas ua rau kom nce siab thiab rhuav cov LDL.

Cov tshuaj muaj peev xwm nce tus naj npawb ntawm cov qis kom tsis haum lipoprotein receptors nyob rau sab nraud ntawm daim siab ua kua hlwb.

Lub chaw nquag nquag txo qhov kev sib txuas ntawm LDL cov roj (cholesterol) thiab cov lipoproteins uas tsis zoo, vim qhov ntawd muaj ntau ntxiv rau qhov kev ua ntawm LDL receptors. Hauv cov neeg mob nrog homozygous cov kab mob siab hypercholesterolemia tiv taus qhov kev txiav txim ntawm lipid-txo cov tshuaj, LDL units yog txo. Kev kho mob nyhuv yog pom nyob rau hauv 2 lub lis piam tom qab pib kev kho mob. Qhov siab tshaj plaws tau sau tseg tom qab ib hlis ntawm kev kho mob nrog Liprimar.

Cov Tshuaj Pharmacokinetics

Tom qab kev tswj hwm ntawm qhov ncauj, cov ntsiav tshuaj tsis yaj nyob rau hauv kev ua ntawm hydrochloric acid hauv plab, ntog mus rau qhov ze ntawm jejunum. Hauv seem no ntawm txoj hnyuv zom zaub mov, cov xev zaj duab xis yauv ua kua dej.

Cov ntsiav tshuaj tawg tawm, cov as-ham thiab tshuaj pib kom nqus los ntawm microvilli tshwj xeeb.

Atorvastatin nkag mus rau hauv cov hlab ntshav los ntawm cov hnyuv phab ntsa, qhov twg nws nce mus txog qhov ntshav siab tshaj plaws nyob rau hauv 1-2 teev. Rau cov poj niam, qhov concentration ntawm cov tshuaj nquag yog 20% siab dua txiv neej.

Tom qab kev tswj hwm ntawm qhov ncauj, cov ntsiav tshuaj tsis yaj nyob hauv qab qhov kev ua ntawm hydrochloric acid hauv plab.Liprimar 10 nkag mus rau hauv cov hlab ntshav los ntawm phab ntsa hnyuv.
Cov tshuaj yeeb dej caw ua kom sib xyaw mus rau albumin los ntawm 98%, uas yog vim li cas hemodialysis tsis muaj txiaj ntsig.

Bioavailability ncav cuag 14-30%. Qhov ntsuas qis yog vim yog parietal metabolism ntawm atorvastatin hauv cov roj ntsha ntawm txoj hnyuv thiab kev hloov pauv hauv cov qog hlwb los ntawm isoenzyme ntawm cytochrome CYP3A4. Cov tshuaj yeeb dej caw khi rau albumin los ntawm 98%, uas yog vim li cas hemodialysis ua tsis tau zoo. Qhov kev tshem tawm ib nrab-lub neej ncav 14 teev. Kev kho mob nyhuv ntev txog 20-30 teev. Los ntawm cov kab mob tso zis, atorvastatin tawm hauv lub cev maj mam - hauv cov zis, tom qab txhaj ib zaug, tsuas pom 2% ntawm qhov koob tshuaj.

Kev ntsuas rau siv

Cov tshuaj yog siv hauv kev kho mob los kho:

thawj hypercholesterolemia ntawm ib keeb kwm thiab tsis muaj keeb kwm xwm txheej,
nce endogenous theem ntawm triglycerides tiv taus kev kho kev noj haus,
hereditary homozygous hypercholesterolemia muaj txiaj ntsig ntawm kev noj zaub mov kom tsawg thiab lwm txoj kev siv tshuaj tsis yog ntawm kev kho,
ua ke hom hyperlipidemia.

Cov tshuaj no tau sau tseg ua kev tiv thaiv kev mob plawv hauv cov neeg mob uas tsis muaj cov cim kev mob plawv, tab sis nrog cov kev pheej hmoo: tus laus, tus cwj pwm tsis zoo, ntshav siab, ntshav qab zib mellitus. Cov pab pawg muaj kev phom sij suav nrog cov neeg uas muaj qhov tsis txaus siab rau hypercholesterolemia thiab nrog rau theem qis ntawm HDL.

Cov tshuaj yog tshuaj raws li kev tiv thaiv tus kab mob plawv.

Cov tshuaj yog siv los ntxiv rau kev noj zaub mov noj rau kev txhim kho ntawm dysbetalipoproteinemia. Liprimar yog siv ua txoj hauv kev los tiv thaiv kev txhim kho ntawm cov kev mob tshwm sim hauv cov neeg mob myocardial ischemia kom txo qis kev pheej hmoo ntawm kev tuag, mob plawv, mob hlab ntsha tawg thiab mus pw hauv tsev kho mob rau angina pectoris.

Cov Yuav Tsum Tau Ua

Lub siab ua mob siab lossis ua kom muaj qhov dej num ntau ntxiv ntawm transaminases (ntau dua 3 zaug hauv qhov sib piv nrog kev txwv sab sauv ntawm qhov tsis paub) ntawm kev tsis paub txog tus mob etiology,
Lub hnub nyoog txog 18 xyoo (vim tsis txaus cov ntaub ntawv hais txog kev nyab xeeb thiab kev ua haujlwm ntawm Liprimar rau cov pab pawg hnub nyoog ntawm cov neeg mob),
Cev xeeb tub thiab lactation
Hypersensitivity rau cov tshuaj.

Tus txheeb ze (Liprimar yuav tsum tau txiav txim siab nrog ceev faj):

Cawv kev quav cawv
Kev taw qhia txog keeb kwm kab mob siab.

Thaum lub sij hawm kho, cov poj niam uas muaj hnub nyoog yug me nyuam yuav tsum siv cov kev tswj kom muaj txiaj ntsig kom tsim nyog.

Cov lus qhia rau kev siv Liprimar: txoj kev thiab ntau npaum li cas

Ua ntej siv Liprimar, nws yog qhov yuav tsum tau sim ua kom tau tswj hwm hypercholesterolemia nrog kev pab ntawm kev noj zaub mov noj zaub mov, ua si lub cev thiab poob phaus hauv cov neeg mob rog, nrog rau kev kho mob rau lwm tus kab mob.

Thaum muab tshuaj rau, cov neeg mob yuav tsum raug qhia kom ua raws cov qauv hypocholesterolemic noj thaum lub sijhawm tag nrho chav kawm.

Liprimar noj ntawm qhov ncauj, 1 ib hnub rau ib hnub, tsis hais txog kev noj zaub mov thiab lub sijhawm nruab hnub.

Ua raws li cov ntsiab lus pib ntawm LDL-C, lub hom phiaj ntawm kev kho mob thiab cov lus teb rau ib tus neeg, qhov koob tshuaj yuav txawv ntawm 10 mg txog 80 mg (siab tshaj plaws).

Thaum pib ntawm txoj kev kho thiab / lossis thaum lub sijhawm nce ntxiv nyob rau hauv koob tshuaj txhua 2-4 lub lis piam, nws yog ib qho tsim nyog los tswj cov ntsiab lus lipid hauv cov ntshav thiab, raws li qhov no, nqa tawm kev kho kom haum.

Rau feem ntau cov neeg mob, koob tshuaj txhua hnub ntawm Liprimar nrog cov tshuaj sib xyaw (sib xyaw) hyperlipidemia thiab thawj hypercholesterolemia yog 10 mg. Raws li txoj cai, txoj kev kho kom ua kom zoo yog pom tseeb rau 14 hnub, nce mus txog qhov siab kawg nkaus hauv ib hlis. Nrog kev kho ntev, cov nyhuv tseem mob.

Nrog homozygous tsev neeg hypercholesterolemia, Liprimar yog tshuaj rau hauv lub koob tshuaj txhua hnub 80 mg.

Hauv cov neeg mob uas muaj daim siab tsis txaus, qhov tshuaj ntawm lub cev raug txo qis hauv kev tshuaj xyuas tas li ntawm kev ua haujlwm ntawm aspartate aminotransferase thiab alanine aminotransferase.

Kev ua haujlwm hauv lub raum tsis cuam tshuam rau kev txiav txim siab ntawm atorvastatin hauv cov ntshav ntshav lossis qhov qis ntawm cov ntsiab lus ntawm LDL-C, yog li ntawd, cov neeg mob no tsis tas yuav tsum hloov kho koob.

Nrog rau kev tswj hwm tib lub sijhawm nrog cyclosporine, qhov siab tshaj plaws ntawm Liprimar yog 10 mg.

Sab sij huam

Raws li txoj cai, Liprimar tau pom zoo zoo, cov kev tawm tshiab zoo dua yog hloov thiab mob me.

Thaum kho, cov kev mob tshwm sim tom qab no tuaj yeem loj hlob (≥1% - feem ntau, ≤1% - ua haujlwm yam tsis xws luag):

Lub hauv nruab nrab hauv lub paj hlwb: feem ntau - mob taub hau, pw tsaug zog, asthenic syndrome, ua tsis xws luag - mob hlab ntsha hlwb, kiv taub hau, mob siab, mob caj dab, mob ib ce, tsis nco qab,
Cov kab mob plab zom mov: feem ntau - cem quav, dyspepsia, xeev siab, mob plab, raws plab, pom tsis txaus, ua tsis xws luag - tsis nco qab ntuav, ntuav, pancreatitis, mob siab, mob cholestatic daj ntseg,
Musculoskeletal system: feem ntau - myalgia, ua tsis xws luag - mob myopathy, mob nraub qaum, mob leeg, arthralgia, myositis, rhabdomyolysis,
Hematopoietic system: ua tsis tau - thrombocytopenia,
Kev tiv thaiv kab mob: ua haujlwm dhau los - hyperglycemia, hypoglycemia, nce ntawm cov ntshav creatine phosphokinase,
Kev tsis haum tshuaj: ua tsis xws luag - lom neeg mob ua paug (Lyell's syndrome), tawv nqaij ua pob, urticaria, mob pruritus, ua pob khaus, anaphylactic tshua, erythema multiforme exudative (suav nrog Stevens-Johnson syndrome),
Lwm yam: ua haujlwm dhau los - ua rau lub zog ua kom tsis muaj zog, peripheral edema, impotence, hnyav nce, tinnitus, mob hauv siab, mob raum tsis ua haujlwm, alopecia.

Noj ntau dhau

Cov tsos mob ntawm kev noj tshuaj ntau dua ntawm atorvastatin yog cov kev mob tshwm sim ntau ntxiv.

Yog tias tsim nyog, muaj kev kho mob, kev saib xyuas kev ua si ntawm creatine phosphokinase thiab kev kuaj mob lub siab ua haujlwm tau pom zoo. Txij li cov tshuaj yeeb tshuaj yog nquag koom rau hauv cov txheej txheem khi rau cov ntshav plasma, kev siv hemodialysis rau nws cov kev tshem tawm yog suav tias tsis muaj txiaj ntsig.

Qhov tshwj xeeb ntawm cov tshuaj atorvastatin tsis paub meej.

Cov lus qhia tshwj xeeb

Tom qab thov Liprimar, qhov nruab nrab nce ntxiv ntawm cov ntshav dej ntawm alanine aminotransferase thiab aspartate aminotransferase, qhov pheej nce siab ntxiv hauv cov ntshav ntau ntawm kev kho mob hepatic (tsis muaj kev txhim kho jaundice lossis lwm yam kev ua haujlwm hauv chaw kho mob). Nrog rau qhov txo qis hauv koob, kev tshem tawm yeeb tshuaj (ib ntus lossis ua tiav), cov haujlwm ntawm hepatic transaminases feem ntau rov qab mus rau theem pib. Feem ntau, cov neeg mob tuaj yeem txuas ntxiv cov kev kho mob hauv qhov kev txo qis yam tsis muaj kev mob tshwm sim.

Cov cim qhia ntawm lub siab ua haujlwm yuav tsum raug saib xyuas ua ntej kev kho mob, 6 thiab 12 lub lis piam tom qab pib Liprimar lossis tom qab qhov nce ntxiv rau hauv koob tshuaj, ntxiv rau thoob plaws hauv kev kho mob.

Cov tshuaj raug muab tso tseg nrog qhov cim nce ntxiv hauv kev ua si ntawm creatine phosphokinase, nyob rau hauv qhov muaj kev txhawj xeeb lossis paub tseeb tias mob myopathy. Thaum sau tshuaj Liprimar ib txhij nrog cov tshuaj tiv thaiv kab mob, fibrates, erythromycin, tshuaj tua kab mob (azole derivatives) lossis nicotinic acid hauv hypolipidemic koob, nws yuav tsum tau yug los hauv lub siab tias qhov no yuav muaj kev txhim kho myopathy. Kev soj ntsuam tsis tu ncua ntawm tus neeg mob tus mob yog ib qho tsim nyog yuav tau soj ntsuam cov leeg tsis muaj zog lossis mob, tshwj xeeb tshaj yog thaum thawj lub hlis ntawm kev kho thiab thaum lub sijhawm nce ntxiv cov tshuaj ntawm cov yeeb tshuaj. Yog tias nws yuav tsum tau ua txoj kev kho ua ke, nws yog ib qho tsim nyog yuav tau xav txog qhov ua tau los siv cov tshuaj no hauv qis qis thaum pib kho thiab txij nkawm.

Thaum ua ntawv thov Liprimar, cov mob uas tsis tshua muaj mob rhabdomyolysis nrog mob raum tsis ua haujlwm vim yog cov ntshav myoglobinuria tau piav qhia. Yog tias muaj cov cim ntawm qhov ua tau myopathy lossis muaj cov kev pheej hmoo ua rau lub raum tsis ua haujlwm vim rhabdomyolysis (piv txwv li, muaj mob hnyav, mob ntshav qis, kev poob siab, metabolic, endocrine thiab electrolyte kev tsis txaus siab thiab kev tswj tsis taus, kev phais mob ntev) Cov.

Yog tias koj ntsib qhov tsis muaj zog lossis cov leeg mob, tshwj xeeb yog tias lawv nrog kub taub hau lossis mob kub cev, koj yuav tsum sab laj nrog cov kws tshaj lij.

Kev cuam tshuam rau kev muaj peev xwm tsav tsheb thiab cov txheej txheem nyuaj

Tsis muaj xov xwm hais txog cov nyhuv ntawm Liprimar ntawm kev muaj peev xwm ntawm kev tsav tsheb thiab ua muaj peev xwm ua haujlwm txaus ntshai uas xav kom muaj kev xav ntau ntxiv thiab cuam tshuam tam sim psychomotor. Txawm li cas los xij, vim tias tseem muaj kiv taub hau, yuav tsum ceev faj thaum xyaum ua cov haujlwm saum toj no.

Cev xeeb tub thiab lactation

Thaum lub sij hawm kho, cov poj niam uas muaj hnub nyoog yug me nyuam noj Liprimar yuav tsum siv kev tswj kom tsis pub muaj menyuam. Lub hom phiaj ntawm cov tshuaj yog contraindicated hauv cov neeg mob uas tsis muaj kev tiv thaiv los ntawm cev xeeb tub. Muaj cov ntaub ntawv hais txog cov mob uas tsis tshua muaj mob qog ua ntshav tom qab cov leeg mob rau HMG-CoA reductase inhibitors (statins) ntawm tus me nyuam hauv plab. Cov kev tshawb fawb tsiaj tshawb pom tseeb tias ua rau muaj kev phom sij ntawm kev ua tub rog.

Nws tsis tsim nyog sau cia Liprimar rau cov niam tu, vim tias tsis muaj ntaub ntawv txaus ntseeg ntawm kev nkag mus ntawm atorvastatin mus rau niam mis. Yog tias nws yuav tsum tau siv cov tshuaj thaum lactation, pub niam mis yuav tsum tau muab tshem tawm, kom tsis txhob muaj kev pheej hmoo ntawm cov kev tsis txaus ntseeg nyob hauv menyuam mos.

Siv rau thaum yau

Hauv kev xyaum rau menyuam yaus, Liprimar yog contraindicated rau kev kho mob rau cov menyuam yaus thiab cov hluas hnub nyoog qis dua 18 xyoo, vim tsis muaj cov ntaub ntawv tshawb fawb txog kev ua haujlwm thiab kev nyab xeeb ntawm kev kho mob hauv pab pawg hnub nyoog no. Ib qho kev zam yog kev kho tus mob heterozygous tsev neeg hypercholesterolemia, uas qhia txog kev siv atorvastatin hauv menyuam yaus txij li 10 xyoo.

Nrog lub siab ua haujlwm tsis zoo

Nws yog contraindicated yuav siv cov tshuaj rau cov neeg mob uas muaj kab mob siab hauv lub sij hawm nquag, nrog rau kev nce siab hauv kev ua haujlwm ntawm hepatic transaminases ntawm cov keeb kwm tsis paub nyob hauv cov ntshav ntshav los ntawm ntau dua 3 zaug piv nrog kev txwv sab sauv ntawm qhov tsis suav.

Nrog kev ceev faj, Liprimar raug kho rau cov neeg mob uas muaj keeb kwm ua kab mob siab thiab / lossis cov neeg quav cawv.

Siv rau lub sijhawm qub

Thaum siv Liprimar hauv cov neeg mob laus, tsis muaj qhov sib txawv ntawm kev nyab xeeb thiab kev ua tau zoo dua li piv nrog cov pej xeem sawv daws tau txheeb xyuas, yog li ntawd, tsis tas yuav siv tshuaj kho kom haum.

Txij li kev pheej hmoo ntawm rhabdomyolysis tau nce ntxiv thaum muaj hnub nyoog 70 xyoo, Liprimar yuav tsum siv nrog ceev faj.

Yeeb tshuaj sib cuam tshuam

Nrog tib lub sijhawm siv Liprimar nrog qee yam tshuaj, cov teebmeem hauv qab no tuaj yeem tshwm sim:

Cyclosporin, fibrates, erythromycin, clarithromycin, tshuaj tua kabmob (azole derivatives) thiab nicotinic acid hauv hypolipidemic doses: muaj kev pheej hmoo ntawm myopathy,
CYP3A4 isoenzyme inhibitors: nce ntshav ntau ntawm atorvastatin,
OATP1B1 inhibitors (piv txwv li, cyclosporine): nce ntawm bioavailability ntawm atorvastatin,
Erythromycin, clarithromycin, CYP3A4 inhibitors, diltiazem, kua txiv kua txiv: muaj ntshav ntxiv ntawm atorvastatin,
Itraconazole: nce rau hauv AUC (tag nrho cov ntshav ntawm lub zog) ntawm atorvastatin,
Inducers ntawm cytochrome CYP3A4 isoenzyme: qhov txo qis hauv kev ua kom muaj zog ntawm atorvastatin hauv cov ntshav ntshav,
Colestipol: qhov kev txo qis ntawm cov tshuaj atorvastatin hauv ntshav, txawm li cas los xij, lipid-txo cov txiaj ntsig ntawm kev sib txuam ntawm cov tshuaj ntau dua li ntawm lawv ib leeg zuj zus,
Digoxin: qhov kev nce siab hauv nws qhov kev mob siab thaum noj Liprimar hauv kev txhaj tshuaj siab (nws yog ib qho tsim nyog los soj ntsuam cov neeg mob),
Qhov ncauj tiv thaiv uas muaj norethisterone thiab ethinyl estradiol: nce AUC ntawm cov tshuaj no.

Cov tshuaj ntxiv ntawm Liprimar yog: Atorvastatin, Atorvastatin-Teva, Atoris, Liptonorm, Torvakard, Atorvoks, Tribestan, Krestor.

Kev txheeb xyuas ntawm Liprimar

Cov tshuaj no feem ntau tau sau tseg rau cov neeg mob kev txom nyem los ntawm ntau yam kev cuam tshuam hauv kev ua haujlwm ntawm cov hlab plawv. Muaj ntau cov kev tshuaj xyuas txog Liprimar, tshwj xeeb, ntau tus neeg mob qhia txog kev kho mob siab. Txawm li cas los xij, qee tus neeg mob tsis nkag siab meej meej tias yuav siv cov tshuaj li cas vim kev piav qhia tsis txaus ntawm kev kho tus kws kho mob tau. Yog li ntawd, lawv sim ua ywj siab xaiv los yog kho cov tshuaj atorvastatin, uas ua rau cov yam ntxwv tsis muaj kev xav tshwm sim (qhov tshwm sim ntawm bruising thiab doog ntshav, ntshav ntshav, thiab lwm yam).

Cov kws tshaj lij xav txog Liprimar ib qho tshuaj tau zoo tshaj plaws muab tau tias qhov ntau npaum li cas thiab kev kho mob ntev li cas. Lawv kuj tawm tswv yim thaum lub sijhawm kho los ua cov kev tawm dag zog lub cev, ua raws kev noj haus thiab ua kev kuaj ntshav tsis tu ncua.

Yuav ua li cas noj Liprimar 10

Cov ntsiav tshuaj tau sau rau kev tswj hwm qhov ncauj, tsis hais lub sijhawm nruab hnub lossis noj mov. Kev siv tshuaj kho mob yog nqa tawm tsuas yog nrog qhov tsis muaj txiaj ntsig ntawm kev noj zaub mov hypocholesterolemic, kev ntsuas qhov hnyav poob tawm ntawm cov keeb kwm yav dhau los ntawm kev rog rog, kev tawm dag zog. Yog tias qhov nce hauv cov roj (cholesterol) los ntawm qhov pib mob, ua ntej siv Liprimar, koj yuav tsum sim ua kom tshem tawm cov txheej txheem tseem ceeb ntawm cov kab mob. Thaum lub sij hawm kho tag nrho cov tshuaj, koj yuav tsum ua raws li kev noj haus tshwj xeeb.

Kev siv tshuaj kho mob nrog Liprimar 10 yog nqa tawm tsuas yog nrog qhov tsis muaj txiaj ntsig ntawm kev noj ntshav hypocholesterolemic.

Kev siv tshuaj txhua hnub yog 10-80 mg rau kev siv ib zaug thiab raug kho nyob ntawm kev ua haujlwm ntawm LDL-C thiab ntawm kev ua tiav ntawm kev kho kom zoo.

Qhov siab tshaj plaws tau pub rau noj yog 80 mg.

Thaum kho nrog Liprimar, nws yog qhov yuav tsum tau soj ntsuam cov ntshav plasma concentration ntawm lipids txhua 2-4 lub lis piam, tom qab ntawd koj yuav tsum sab laj nrog koj tus kws kho mob txog kev hloov pauv ntawm kev siv tshuaj.

Txhawm rau tshem tawm cov tshuaj sib xyaw ua ke ntawm hyperlipidemia, nws yog ib qho tsim nyog yuav tsum noj 10 mg ib hnub ib zaug, thaum homozygous kab mob hypercholesterolemia yuav tsum muaj kev kho mob siab tshaj plaws ntawm 80 mg. Hauv rooj plaub tom kawg, cov roj (cholesterol) siab tau txo qis txog 20-45%.

Noj cov tshuaj rau ntshav qab zib

Cov neeg mob ntshav qab zib yuav tsum ceev faj thaum muaj hypercholesterolemia tshwm sim. Cov tib neeg zoo li no yog qhov pheej hmoo txhim kho cov kev mob plawv coronary. Liprimar yog siv los ua qhov ntsuas tawm ntawm kev tiv thaiv myocardial infarction. Qhov ntau npaum li cas yog txiav txim los ntawm tus kws kho mob mus kawm nyob ntawm seb muaj qib roj (cholesterol).

Cov neeg mob ntshav qab zib yuav tsum ceev faj thaum muaj hypercholesterolemia tshwm sim.

Nruab nrab hauv lub paj hlwb

Cov kev xav tsis zoo nrog kev puas tsuaj rau cov leeg hlwb uas tau pom tias:

insomnia
dav malaise
asthenic mob ntsws
mob taub hau thiab kiv taub hau,
txo thiab ua tiav poob ntawm rhiab heev,
peripheral lub paj hlwb neuropathy,
amnesia.

Los ntawm lub tshuab ua pa

Dyspnea tuaj yeem tshwm sim.

Nrog tus cwj pwm ua kom pom tus mob tsis haum, tawm pob ntawm daim tawv nqaij, liab, khaus, exudative erythema, necrosis ntawm subcutaneous rog txheej yuav tshwm sim. Hauv cov xwm txheej loj, Quincke's edema thiab anaphylactic shock poob siab.

Prem ntawm cov tshuaj nyob rau hauv nqe lus nug tuaj yeem ua rau pom qhov tsos mob ntawm daim tawv nqaij.

Cawv tau zoo

Cov tshuaj yuav tsum tsis txhob sib xyaw nrog cov dej cawv haus. Ethyl cawv txwv tsis pub lub hauv nruab nrab hauv cov hlab ntsha, hlab ntshav siab thiab mob ntshav, thiab yog li ntawd cov nyhuv hypocholesterolemic ntawm Liprimar txo qis. Qhov tshwm sim ntawm kev tsim cov atherosclerotic plaques ntawm cov phab ntsa ntawm cov hlab ntsha nce ntxiv.

Cov tshuaj yuav tsum tsis txhob sib xyaw nrog cov dej cawv haus.

Kev sib xyaw tsis pom zoo

Vim tias qhov kev pheej hmoo ntawm cov neuromuscular pathologies, cov kab ke khiav ua ke ntawm Liprimar tsis pom zoo nrog:

tshuaj tua kab mob cyclosporin
nicotinic acid derivatives,
Erythromycin
antifungal tshuaj
fibrates.

Tsis pom zoo tswj hwm Liprimar thiab Erythromycin tsis pom zoo.

Cov tshuaj sib xyaw ua ke tuaj yeem ua rau myopathy.

Nrog saib xyuas

Nws raug nquahu kom xyuam xim thaum siv Liprimar nrog lwm cov khw muag tshuaj:

Atorvastatin muaj peev xwm nce AUC ntawm qhov ncauj tiv thaiv kom tsis txhob muaj 20-30%, nyob ntawm seb cov tshuaj hormones muaj nyob hauv qhov kev npaj.
Atorvastatin nrog tshuaj 40 mg sib xyaw nrog 240 mg ntawm Diltiazem ua rau kev nce ntshav ntau ntxiv ntawm atorvastatin hauv cov ntshav. Thaum noj 200 mg ntawm Itraconazole nrog 20-40 mg ntawm Liprimar, ib qho kev nce ntxiv hauv AUC ntawm atorvastatin tau pom.
Rifampicin txo qis ntshav ntshav atorvastatin.
Colestipol ua rau kom txo qis hauv cov ntshav plasma cholesterol-txo tshuaj.
Nrog rau kev kho ua ke nrog digoxin, qhov kev tsuam tsig ntawm tom kawg nce ntxiv 20%.

Cov kua txiv kua txiv tshem tawm kev ua ntawm cytochrome isoenzyme CYP3A4, uas yog vim li cas thaum siv ntau tshaj 1.2 liv ntawm cov kua txiv qaub tauj ib hnub, cov ntshav plasma concentration ntawm atorvastatin ntau ntxiv. Cov txiaj ntsig zoo sib xws yog pom thaum noj CYP3A4 inhibitors (Ritonavir, Ketoconazole).

Liprimar yog txwv tsis pub siv rau 10 tus poj niam cev xeeb tub.

Siv thaum cev xeeb tub thiab lactation

Nws yog txwv tsis pub siv cov tshuaj rau cov poj niam cev xeeb tub, raws li muaj qhov kev pheej hmoo ntawm kev ua txhaum ntawm kev tso cov ntaub so ntswg kom zoo thiab lub plab hnyuv siab raum thaum lub caij embryonic. Tsis muaj ntaub ntawv qhia txog lub peev xwm ntawm Liprimar txeem hematoplacental teeb meem.

Thaum lub sij hawm kho cov tshuaj, kev pub niam mis yuav tsum tau muab tshem tawm.

Hloov chaw ntawm cov tshuaj uas muaj cov nyhuv zoo xws li:

Kev hloov pauv yog nqa tawm tom qab kev sab laj kho mob.

Kev txhawb nqa tus yees duab "Liprimar" Liprimar kev qhiaAtoris qhia

Tsuas tshuaj thiab tswj hwm

Ua ntej sau ntawv tawm Liprimar, nws yog ib qho tsim nyog kom ua tiav kev tswj hwm ntawm hypercholesterolemia nrog kev kho mob ntawm lwm tus neeg, nrog rau lwm txoj hauv kev tsis muaj tshuaj (kev noj haus, kev tawm dag zog thiab kev poob phaus hauv cov neeg mob rog).

Thaum lub sij hawm kho nrog cov tshuaj, tus neeg mob raug nquahu kom ua raws li cov qauv hypocholesterolemic noj tshuaj.

Liprimar yog npaj rau kev tswj hwm qhov ncauj, tsis hais lub sijhawm nruab hnub lossis hnub ua mov noj.

Qhov kev txhaj tshuaj nws txawv ntawm 10 txog 80 mg ib hnub ib zaug. Kev xaiv koob tshuaj yog kwv yees rau hauv qhov pib thaum pib tsawg kawg lipoprotein roj cov ntsiab lus roj (LDL-C), cov tib neeg ua hauj lwm thiab lub hom phiaj kho. Qhov tshuaj ntau ntau txhua hnub yog 80 mg ib zaug.

Thaum pib ntawm txoj kev kho, nrog rau kev nce ntxiv, nws yog ib qho tsim nyog los txiav txim siab qhov concentration ntawm lipids hauv ntshav txhua 2-4 lub lis piam, thiab suav txog cov ntaub ntawv tau txais, kho qhov tshuaj.

Nrog rau kev sib xyaw (sib xyaw) hyperlipidemia thiab thawj hypocholesterolemia, koob tshuaj Liprimar rau feem ntau cov neeg mob yog 10 mg ib hnub ib zaug. Qhov kev kho mob ua kom pom tshwm sim nyob rau thawj ob lub lis piam thiab nce mus txog qhov siab kawg los ntawm 4 lub lim tiam ntawm kev kho mob. Nrog kev kho mob ntev, cov nyhuv tseem mob.

Rau cov neeg mob homozygous tsev neeg hypercholesterolemia, Liprimar yog tshuaj ntawm 80 mg ib hnub ib zaug (qib ntawm LDL-C raug txo los ntawm 18-45%).

Yog tias lub raum lub raum tsis ua haujlwm thiab hauv cov neeg laus, tsis tas yuav hloov kho ntxiv.

Hauv lub siab tsis ua haujlwm, qhov koob tshuaj raug txo qis hauv kev soj ntsuam tas li ntawm kev ua haujlwm ntawm cov enzymes alanine aminotransferase thiab aspartate aminotransferase.

Nrog rau kev siv tib lub sijhawm nrog cyclosporine, lub koob tshuaj Liprimar yuav tsum tsis pub tshaj 10 mg rau ib hnub.