Atorvastatin (40 mg) Atorvastatin

Atorvastatin 40 mg - ib qho lipid-txo tshuaj los ntawm pab pawg ntawm statins. Cov txheej txheem ntawm kev ua ntawm cov tshuaj yog tswj rau txo cov roj ntshav

Muaj ib txheej ntim yeeb yaj kiab-tso xim:

• cov tshuaj nquag: atorvastatin calcium trihydrate (hauv cov ntsiab lus ntawm atorvastatin) - 40.0 mg,
• kev zam: microcrystalline cellulose - 103.72 mg, lactose monohydrate - 100.00 mg, calcium carbonate - 20.00 mg, crospovidone - 15.00 mg, sodium carboxymethyl hmoov txhuv nplej siab (sodium starch glycolate) - 9.00 mg, hyprolose (hydroxypropyl cellulose) - 6, .00 mg, magnesium stearate - 3.00 mg,
• zaj duab xis txheej: hypromellose - 4,500 mg, talc - 1,764 mg, hyprolysis (hydroxypropyl cellulose) - 1,746 mg, titanium dioxide - 0,990 mg lossis qhuav sib xyaw rau zaj duab xis txheej muaj hypromellose (50.0%), talc (19.6%), hyprolose (hydroxypropyl cellulose) (19.4%), titanium dioxide (11.0%) - 9,000 mg.

Hloov biconvex ntsiav tshuaj, zaj duab xis-coated dawb los yog yuav luag dawb. Pa hla ntu ntawm tus tub ntxhais yog dawb lossis yuav luag dawb.

Cov Tshuaj Hauv Tshuaj

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

Hauv cov neeg mob uas muaj homozygous thiab heterozygous tsev neeg hypercholesterolemia, tsis yog tsev neeg cov ntaub ntawv ntawm hypercholesterolemia thiab sib xyaw dyslipidemia, atorvastatin txo qhov kev nkag siab ntawm tag nrho cov roj (Ch) hauv cov ntshav ntshav. cov roj lipoprotein tsawg kawg (Cs-LDL) thiab apolipoprotein B (apo-B), nrog rau cov lipoproteins uas muaj tsawg kawg nkaus (Cs-VLL) thiab triglycerides (TG), ua rau muaj kev nce siab ntawm cov lipoproteins ntau-tsawg (Cs-HDL).

Atorvastatin txo qis kev ua haujlwm ntawm Chs thiab Chs-LHNP hauv ntshav plasma, tiv thaiv HMG-CoA reductase thiab cov roj (cholesterol) ua ke nyob rau hauv daim siab thiab nce cov "mob siab" LDL receptors rau ntawm lub ntsej muag ntawm tes, uas ua rau muaj kev nce siab thiab catabolism ntawm Chs-LDL.

Atorvastatin txo cov khoom ntawm LDL-C thiab cov lej ntawm LDL ntau, ua rau muaj kev tshaj tawm thiab ua ntu zus rau cov kev ua haujlwm ntawm LDL-receptors hauv kev ua ke nrog cov kev hloov pauv uas muaj txiaj ntsig hauv LDL-particles, thiab tseem yuav txo qhov kev sib xyaw ntawm LDL-C hauv cov neeg mob homozygous kab mob siab rau tsev neeg hypercholesterolemia uas tawm tsam nrog kev kho mob nrog lwm cov kev kho mob gynolipids. txhais tau tias.

Atorvastatin hauv koob tshuaj ntawm 10 txog 80 mg txo qhov kev concentration ntawm Chs los ntawm 30-46%, Chs-LDL - los ntawm 41-61%, apo-B - los ntawm 34-50% thiab TG - los ntawm 14-33%. Cov txiaj ntsig ntawm kev kho yog qhov zoo sib xws hauv cov neeg mob heterozygous tsev neeg hypercholesterolemia, tsis yog tsev neeg cov ntaub ntawv ntawm hypercholesterolemia thiab hyperlipidemia sib xyaw, suav nrog hauv cov neeg mob uas mob ntshav qab zib hom 2.

Hauv cov neeg mob uas muaj cov kabmob hypertriglyceridemia, atorvastatin txo qhov kev xav ntawm tag nrho cov roj cholesterol, Chs-LDL, Chs-VLDL, apo-B thiab TG thiab nce qhov siab ntawm Chs-HDL. Hauv cov neeg mob uas muaj dysbetalipoproteinsemia, atorvastatin txo qis qhov kev cia siab ntawm cov lipoprotein lipoprotein (cholesterol) nrab (Chs-STD).

Hauv cov neeg mob uas muaj hom IIa thiab IIb hyperlipoproteinemia raws li kev faib tawm Fredrickson, tus nqi nruab nrab ntawm kev nce siab ntawm HDL-C thaum kho nrog atorvastatin (10-80 mg) piv nrog thawj zaug tus nqi yog 5.1-8.7% thiab tsis yog koob tshuaj. Muaj qhov tseem ceeb ntawm qhov txo qis hauv qhov piv: tag nrho cov roj cholesterol / Chs-HDL thiab Chs-LDL / Chs-HDL los ntawm 29-44% thiab 37-55%, feem.

Atorvastatin ntawm koob tshuaj 80 mg txo qhov kev pheej hmoo ntawm kev tsim ischemic cov teeb meem thiab kev tuag los ntawm 16% tom qab kawm 16-lub lis piam, thiab kev pheej hmoo rov qab pw tsev kho mob rau angina pectoris nrog cov cim ntawm myocardial ischemia los ntawm 26%. Hauv cov neeg mob uas muaj kev sib txawv thaum pib sib txawv ntawm LDL-C (uas tsis muaj Q yoj thiab myocardial infarction hauv cov txiv neej, poj niam, thiab cov neeg mob hnub nyoog qis dua 65 xyoos), atorvastatin ua rau muaj kev pheej hmoo ntawm ischemic cov teeb meem thiab kev tuag.

Kev txo qis ntshav plasma qhov ntau ntawm LDL-C yog zoo dua nrog cov koob tshuaj atorvastatin dua nrog nws cov ntshav plasma concentration. Cov koob tshuaj yog xaiv noj rau hauv cov txiaj ntsig kho kho (saib ntu "Noj thiab tswj").

Kev ua rau txoj kev kho tau tiav 2 lub lis piam tom qab pib kho, mus txog qhov siab kawg tom qab 4 lub lis piam thiab tawm tsam mus tas lub sijhawm kho.

Xuas

Atorvastatin nrawm nrawm tom qab kev tswj hwm ntawm qhov ncauj: lub sijhawm mus txog nws qhov siab tshaj plaws (TCmax) hauv cov ntshav ntshav yog li 1-2 teev. Hauv cov poj niam, qhov siab tshaj plaws ntawm atorvastatin (Cmax) yog 20% ​​siab dua, thiab thaj chaw hauv qab qhov ntsuas-lub sijhawm nkhaus (AUC) yog 10% qis dua txiv neej. Kev ntsuas nqus thiab kev nqus ntawm cov ntshav ntshav nce ntxiv hauv kev faib ua feem. Qhov tsis txaus ntseeg txog bioavailability yog li 14%, thiab lub kaw lus bioavailability ntawm qhov kev txwv tsis pub tawm tsam HMG-CoA reductase yog li 30%. Kev siv lub cev tsis tshua muaj txiaj ntsig zoo yog vim cov kab mob (presystemic metabolism) nyob rau hauv cov qog ua pa ntawm lub plab thiab / lossis thaum "pib hla" los ntawm lub siab. Noj ib nyuag txo tus nqi thiab qib ntawm kev nqus ntawm atorvastatin (los ntawm 25% thiab 9%, feem, raws li pom los ntawm cov txiaj ntsig ntawm kev txiav txim siab ntawm Cmax thiab AUC), txawm li cas los xij, qhov txo qis hauv LDL-C zoo ib yam li thaum noj atorvastatin ntawm ib plab khoob. Txawm hais tias qhov tseeb hais tias tom qab noj atorvastatin nyob rau yav tsaus ntuj, nws cov ntshav plasma concentration qis dua (Cmax thiab AUC los ntawm 30%) dua li tom qab noj thaum sawv ntxov, qhov kev txo qis ntawm cov concentration ntawm LDL-C tsis yog nyob ntawm lub sijhawm ntawm hnub uas cov tshuaj noj.

Kev zom zaub mov

Atorvastatin ua rau cov khoom tsim ua tiav ortho- thiab para-hydroxylated derivatives thiab ntau yam beta-oxidation khoom. Hauv cov tshuaj vitro, ortho- thiab para-hydroxylated metabolites muaj qhov cuam tshuam rau HMG-CoA reductase, piv nrog ntawm atorvastatin. Cov kev tiv thaiv tsis ua haujlwm tiv thaiv HMG-CoA reductase yog kwv yees li 70% vim qhov kev ua ntawm cov roj ntsha hloov mus ua pa. Kev tshawb fawb hauv vitro qhia tias daim siab isoenzyme CYP3A4 ua lub luag haujlwm tseem ceeb hauv cov metabolism hauv atorvastatin. Qhov no tau lees paub los ntawm kev nce ntxiv ntawm qhov kev nkag siab ntawm atorvastatin nyob rau hauv tib neeg cov ntshav ntshav thaum noj erythromycin, uas yog qhov tshuaj tiv thaiv ntawm isoenzyme no.

Hauv cov kev tshawb fawb hauv vitro kuj tau qhia tias atorvastatin yog qhov ua kom tsis muaj zog ntawm CYP3A4 isoenzyme. Atorvastatin tsis muaj qhov kev cuam tshuam loj hauv kev kho mob ntshav plasma concentration ntawm terfenadine, uas yog metabolized feem ntau los ntawm CYP3A4 isoenzyme, yog li ntawd, nws cov txiaj ntsig tseem ceeb ntawm pharmacokinetics ntawm lwm qhov chaw ntawm CYP3A4 isoenzyme tsis zoo li (saib ntu "Kev cuam tshuam nrog lwm cov tshuaj").

Atorvastatin thiab nws cov metabolites yog cov tawm nrog cov kua tsib tom qab cov kab mob hepatic thiab / lossis cov kab mob hnyav ntxiv (atorvastatin tsis tau nkag mus rau qhov loj dua qhov rov nkag ua ke). Ib nrab-lub neej (T1 / 2) yog kwv yees li 14 teev, thaum lub zog inhibitory ntawm atorvastatin nrog rau kev hwm HMG-CoA reductase yog kwv yees li 70% txiav txim los ntawm kev ua haujlwm ntawm circulating metabolites thiab kav ntev txog 20-30 teev vim lawv muaj. Tom qab noj cov tshuaj nyob rau hauv cov zis, tsawg dua 2% ntawm kev lees txais ntawm cov tshuaj yog pom.

Kev ntsuas rau siv

• raws li kev pabcuam rau kev noj zaub mov kom txo tau cov roj (cholesterol) tag nrho, LDL-C, apo-B, thiab triglycerides rau cov neeg laus, cov hluas, thiab cov menyuam hnub nyoog 10 xyoo lossis laus dua nrog thawj hypercholesterolemia, suav nrog tsev neeg hypercholesterolemia (heterozygous version) lossis kev sib xyaw (sib xyaw) hyperlipidemia ( hom IIa thiab IIb raws li kev faib tawm ntawm Fredrickson), thaum cov lus teb rau kev noj zaub mov noj thiab lwm yam tshuaj uas tsis siv tshuaj tsis txaus,
• kom txo qis tag nrho cov roj (cholesterol), LDL-C hauv cov neeg laus nrog homozygous tsev neeg hypercholesterolemia ua tus txiav rau lwm txoj kev kho lipid-txo qis (piv txwv li LDL-apheresis) lossis, yog tias tsis muaj kev kho zoo li ntawd,

Kev tiv thaiv cov kab mob plawv:

• kev tiv thaiv ntawm cov kev mob plawv hauv cov neeg mob cov neeg laus uas muaj kev pheej hmoo loj los tsim cov txheej txheem plawv plawv, ntxiv rau kev txhim kho ntawm lwm yam kev pheej hmoo,
• kev tiv thaiv kab mob thib ob hauv kev mob plawv hauv cov neeg mob plawv mob plawv txhawm rau txhawm rau txo qis kev phom sij tag nrho, mob ntshav hlab plawv, mob stroke, rov pw hauv tsev kho mob rau angina pectoris thiab qhov xav kom rov qab kho dua.

Cov Yuav Tsum Tau Ua

Cov kev tsis haum rau kev siv atorvastatin yog:

• cov tshuaj tiv thaiv tsis haum rau atorvastatin thiab / lossis ib qho tshuaj tiv thaiv,
• kev mob siab rau lub siab lossis kev ua haujlwm ntau ntawm "daim siab" hloov ntshav hauv ntshav cov ntshav tsis paub ntau dua li peb zaug piv rau kev txwv qis ntawm cov cai,
• cirrhosis ntawm lub siab ntawm ib qho kev etiology,
• siv rau cov poj niam uas muaj hnub nyoog yug me nyuam uas tsis siv txoj hauv kev los tiv thaiv kev xeeb tub,
• siv txuas nrog fusidic acid,
• hnub nyoog txog li 10 xyoo - rau cov neeg mob heterozygous tsev neeg hypercholesterolemia,
• hnub nyoog txog 18 xyoo thaum siv raws li lwm cov cim (qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv tsis tau tsim),
• kev xeeb tub, kev pub niam mis
• lactose intolerance, lactase deficiency, qabzib-galactose malabsorption.

Atorvastatin tuaj yeem siv tshuaj rau tus poj niam ntawm kev muaj me nyuam tsuas yog tias nws paub tseeb tias nws tsis tau xeeb tub thiab paub txog kev pheej hmoo ntawm cov tshuaj rau cov menyuam hauv plab.

Nrog ceev faj: kev quav dej cawv, muaj keeb kwm muaj kab mob siab, nyob rau hauv cov neeg mob uas muaj kev pheej hmoo rau rhabdomyolysis (lub raum tsis ua haujlwm, hypothyroidism, kev mob plab tsis txaus rau cov neeg mob uas muaj keeb kwm lossis tsev neeg keeb kwm, cov tshuaj lom los ntawm HMG reductase inhibitors lossis fibrates ntawm cov leeg tau twb tau cov nqaij mos, lub hnub nyoog dhau 70 xyoo, tib lub sijhawm siv nrog cov tshuaj uas ua rau muaj kev pheej hmoo ntawm myopathy thiab rhabdomyolysis

Tsuas tshuaj thiab tswj hwm

Sab hauv. Siv sijhawm twg los xij ntawm hnub, tsis hais noj zaub mov.

Ua ntej pib txoj kev kho mob nrog Atorvastatin, koj yuav tsum sim ua kom tiav kev tswj hwm ntawm hypercholesterolemia siv kev noj haus, kev tawm dag zog thiab kev poob phaus hauv cov neeg mob rog, nrog rau kev kho mob ntawm lwm tus kab mob.

Thaum sau tshuaj, tus neeg mob yuav tsum pom zoo rau ib qho kev noj haus hypocholesterolemic noj, uas nws yuav tsum ua raws li txhua lub sijhawm ntawm kev kho mob.

Qhov ntau npaum li cas ntawm cov tshuaj nws txawv ntawm 10 mg rau 80 mg ib hnub ib zaug thiab yog titrated noj mus rau hauv tus lej thawj qhov kev xav ntawm LDL-Xc, lub hom phiaj ntawm txoj kev kho thiab cov tib neeg cov txiaj ntsig ntawm txoj kev kho. Qhov siab tshaj plaws niaj hnub noj tshuaj yog 80 mg.

Thaum pib ntawm kev kho mob thiab / lossis thaum lub sijhawm nce ntxiv ntawm Atorvastatin, nws yog ib qho tsim nyog los saib xyuas qhov tsis txaus ntawm cov lipids hauv cov ntshav ntshav txhua 2-4 lub lis piam thiab kho qhov tshuaj raws li.

Heterozygous tsev neeg hypercholesterolemia

Qhov tshuaj thawj zaug yog 10 mg rau ib hnub. Cov koob tshuaj yuav tsum tau xaiv ib tus zuj zus thiab ntsuas qhov cuam tshuam txhua 4 lub lis piam nrog kev nce ntxiv txog 40 mg ib hnub twg. Tom qab ntawd cov koob tshuaj tuaj yeem ua rau nce mus txog qhov siab kawg ntawm 80 mg rau ib hnub, lossis kev sib txuas ntawm cov tshuaj tiv thaiv cov kab mob kua tsib nrog rau kev siv atorvastatin hauv ib koob ntawm 40 mg ib hnub yog ua tau.

Siv rau hauv cov menyuam yaus thiab cov hluas los ntawm 10 txog 18 xyoo nrog heterozygous tsev neeg hypercholesterolemia

Qhov pom zoo kom pib noj yog 10 mg ib hnub ib zaug. Qhov kev txhaj tshuaj yuav raug nce ntxiv mus rau 20 mg ib hnub twg, nyob ntawm qhov siv los soj ntsuam. Kev paub nrog ib koob ntau tshaj 20 mg (sib haum rau ib koob ntawm 0.5 mg / kg) yog txwv. Nws yog ib qho tsim nyog yuav tau them ib feem ntawm cov tshuaj raws li lub hom phiaj kho lipid-txo qis kev kho mob. Kev hloov koob tshuaj yuav tsum tau ua ntawm ncua sijhawm ntawm 1 lub sijhawm hauv 4 lub lis piam lossis ntau dua.

Siv nrog rau lwm cov tshuaj

Yog tias tsim nyog, ib txhij siv nrog cyclosporine, telaprevir lossis kev sib xyaw ntawm tipranavir / ritonavir, cov koob tshuaj Atorvastatin yuav tsum tsis pub tshaj 10 mg rau ib hnub.

Kev ceev faj yuav tsum tau siv thiab kev siv tshuaj qis kawg ntawm atorvastatin yuav tsum tau siv thaum nws siv nrog HIV tiv thaiv kab mob tiv thaiv kab mob, kab mob siab C virus protease inhibitors (boceprevir), clarithromycin thiab itraconazole.

Sab sij huam

Thaum noj tshuaj Atorvastatin, cov kev mob tshwm sim hauv qab no yuav tshwm sim:

• Los ntawm cov leeg hlwb: insomnia, mob taub hau, asthenic syndrome, malaise, kiv taub hau, peripheral neuropathy, amnesia, paresthesia, hypesthesia, kev nyuaj siab.
• Los ntawm cov txheej txheem plab zom mov: xeev siab, raws plab, mob plab, dyspepsia, flatulence, cem quav, ntuav, tsis nco qab, kab mob siab, kab mob ntsws, mob daj ntseg.
• Los ntawm cov leeg ua haujlwm: myalgia, rov qab mob, mob caj dab, mob leeg, mob leeg mob, mob myopathy, rhabdomyolysis.
• Kev tsis haum tshuaj: urticaria, pruritus, tawv nqaij ua pob, ua xua pob liab vog, anaphylaxis, polymorphic exudative erythema (suav nrog Stevens-Johnson syndrome), Laille syndrome.
• Los ntawm cov kabmob hemopoietic: thrombocytopenia.
• Los ntawm ib sab ntawm cov metabolism: hypo- lossis hyperglycemia, nce kev ua si ntawm ntshiab CPK.
• Los ntawm cov txheej txheem endocrine: mob ntshav qab zib mellitus - qhov ntau dhau ntawm txoj kev loj hlob yuav yog nyob ntawm qhov muaj lossis tsis muaj kev pheej hmoo ntawm qhov phom sij (yoo cov kua nplaum ≥ 5.6, lub cev loj hauv qhov ntsuas> 30 kg / m2, nce ntawm triglycerides, keeb kwm ntawm kev kub siab).
• Lwm yam: tinnitus, qaug zog, kev sib daj sib deev, peripheral edema, qhov hnyav, mob lub hauv siab, alopecia, cov xwm txheej ntawm kev txhim kho ntawm cov kabmob sib kis, tshwj xeeb tshaj yog siv sijhawm ntev, hemorrhagic mob stroke (thaum noj ntau dua thiab nrog CYP3A4 inhibitors), mob raum lwm yam. tsis ua hauj lwm.

Tshaj tsos mob

Cov cim tshwj xeeb ntawm kev siv ntau dhau tsis tau tsim. Cov tsos mob yuav suav nrog mob mob rau daim siab, mob raum tsis ua haujlwm ntev, siv sijhawm ntev ntawm myopathy thiab rhabdomyolysis.

Thaum muaj kev noj ntau dhau, qhov kev ntsuas dav dav hauv qab no yog qhov tsim nyog: kev saib xyuas thiab tswj hwm lub luag haujlwm tseem ceeb ntawm lub cev, nrog rau kev tiv thaiv ntxiv kom nqus cov tshuaj (pais plab lav, noj hluav ncaig lossis laxatives).

Nrog rau kev txhim kho ntawm myopathy, tom qab los ntawm rhabdomyolysis thiab mob raum tsis zoo, cov tshuaj yuav tsum tau muab tshem tawm sai li sai tau thiab txoj kev lis ntshav ntawm diuretic thiab sodium bicarbonate pib. Rhabdomyolysis tuaj yeem ua rau hyperkalemia, uas yuav tsum muaj kev tswj hwm cov tshuaj calcium calcium los yog cov tshuaj calcium gluconate, kev sib tov ntawm 5% kev daws teeb meem ntawm thunderstorm (qabzib) nrog insulin, thiab siv cov poov tshuaj-pauv pauv cov tshuaj.

Txij li thaum cov tshuaj nquag khi rau plasma protein, hemodialysis siv tsis tau.

Dosage daim ntawv

Coated ntsiav tshuaj 10 mg, 20 mg thiab 40 mg

Muaj ib ntsiav tshuaj:

cov tshuaj nquag - atorvastatin (raws li calcium ntsev ntawm trihydrate) 10 mg, 20 mg thiab 40 mg (10.85 mg, 21.70 mg thiab 43.40 mg),

tus zam: calcium carbonate, crospovidone, sodium lauryl sulfate, silicon dioxide, colloidal anhydrous, talc, microcrystalline cellulose,

plhaub muaj pes tsawg leeg: Opadry II liab (talc, polyethylene glycol, titanium dioxide (E171), cawv polyvinyl, hlau (III) oxide daj (E172), hlau (III) oxide liab (E172), hlau (III) oxide dub (E172).

Cov yeeb yuj pleev xim txau nrog cov biconvex nto

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Atorvastatin nrawm nrawm tom qab lub qhov ncauj tswj hwm, nws cov ntshav plasma nce mus txog qhov siab kawg rau 1 - 2 teev. Qhov txheeb ze bioavailability ntawm atorvastatin yog 95-99%, tsis muaj tseeb - 12-14%, ib puag ncig (muab cov inhibition ntawm HMG-CoA reductase) - txog 30 % Kev siv lub cev tsis tshua muaj kab ntsig ua haujlwm tau piav qhia los ntawm cov kab mob presystemic tshem tawm hauv cov qog ua kua rau txoj hnyuv thiab / lossis kev zom zaub mov thaum pib tso lub siab. Kev nqus thiab ntshav qab zib nce ntxiv hauv qhov sib npaug nrog cov koob tshuaj. Txawm hais tias qhov tseeb tias thaum noj nrog zaub mov, qhov nqus ntawm cov tshuaj tsawg dua (qhov siab tshaj plaws thiab AUC yog kwv yees li 25 thiab 9%, feem), qhov txo qis hauv LDL cov qib roj cholesterol tsis nyob ntawm atorvastatin noj nrog zaub mov lossis tsis. Thaum noj atorvastatin thaum yav tsaus ntuj, nws lub plasma ntshav qis dua (kwv yees 30% rau qhov siab tshaj plaws thiab AUC) dua li thaum noj thaum sawv ntxov. Txawm li cas los xij, qhov txo qis hauv theem ntawm LDL cov roj cholesterol tsis yog nyob ntawm lub sijhawm ntawm kev noj tshuaj.

Ntau tshaj li 98% ntawm cov tshuaj khi rau cov ntshav plasma. Qhov piv ntawm erythrocyte / ntshav ntshav yog kwv yees 0.25, uas qhia pom qhov nkag qis ntawm cov tshuaj mus rau hauv cov ntshav liab.

Atorvastatin metabolized rau ortho- thiab para-hydroxylated derivatives thiab ntau yam beta-oxidized khoom. Cov nyhuv inhibitory ntawm cov tshuaj uas txheeb ze rau HMG-CoA reductase yog kwv yees li 70% pom tau vim muaj cov kev ua hauv lub cev hloov cov rog. Atorvastatin tau pom tias yog qhov ua kom tsis muaj zog ntawm cytochrome P450 ZA4.

Atorvastatin thiab nws cov khoom ua kom lub cev txhaws tas nrog cov kua tsib tom qab mob rau hepatic thiab / lossis metabolism ntxiv. Txawm li cas los xij, cov tshuaj tsis raug rau qhov tseem ceeb ntawm kev nkag mus ua ib qho recirculation. Qhov nruab nrab ib nrab ntawm lub neej ntawm atorvastatin yuav luag 14 teev, tab sis lub sijhawm ntawm kev tiv thaiv qhov kev tiv thaiv tiv thaiv HMG-CoA reductase vim yog nthuav tawm cov roj ntsha nquag mus rau 20-30 teev. Tsawg dua li 2% ntawm qhov ncauj ntawm atorvastatin raug tso tawm hauv cov zis.

Lub plasma concentration ntawm atorvastatin hauv cov neeg laus noj qab haus huv (tshaj 65) yog siab dua (kwv yees li 40% rau qhov kev xav ntau tshaj thiab 30% rau AUC) dua li cov neeg hluas. Tsis muaj qhov sib txawv hauv qhov ua tau zoo ntawm kev kho mob nrog atorvastatin hauv cov neeg laus thiab cov neeg mob ntawm lwm pawg hnub nyoog.

Qhov siab ntawm atorvastatin nyob rau hauv cov ntshav ntshav hauv cov poj niam sib txawv ntawm cov concentration hauv cov ntshav ntshav hauv cov txiv neej (hauv cov poj niam, qhov siab tshaj plaws yog kwv yees li 20% siab dua, thiab AUC - 10% qis dua). Txawm li cas los xij, tsis muaj qhov sib txawv hauv tsev kho mob tau pom nyob rau hauv cov nyhuv ntawm lipid ntau ntau hauv cov txiv neej thiab poj niam.

Kab mob hauv lub raum tsis cuam tshuam rau qhov kev txiav txim siab ntawm cov tshuaj hauv plasma lossis cov nyhuv ntawm atorvastatin ntawm qib lipid, yog li tsis tas yuav tsum tau txhaj koob tshuaj rau hauv cov neeg mob lub raum tsis ua haujlwm. Cov kev tshawb fawb tsis tau them rau cov neeg mob raum tsis ua haujlwm ntawm lub raum; tej zaum, hemodialysis tsis hloov pauv ntawm atorvastatin, vim tias cov tshuaj yuav luag txhua cov ntshav muaj ntshav tsis txaus.

Qhov kev txiav txim siab ntawm atorvastatin nyob rau hauv cov ntshav plasma nce ntau (ntau qhov siab tshaj - kwv yees li 16 zaug, AUC - 11 zaug) hauv cov neeg mob uas ua mob rau daim siab ntawm lub siab ntawm cawv cawv.

Cov Tshuaj Hauv Tshuaj

Atorvastatin yog ib qho kev xaiv sib tw muaj zog ntawm HMG-CoA reductase-enzyme, uas tswj cov kev hloov pauv ntawm HMG-CoA rau mevalonate - ua ntej ntawm sterols (suav nrog cov roj (cov roj (cholesterol))). Hauv cov neeg mob uas muaj homozygous thiab heterozygous tsev neeg hypercholesterolemia, ib daim ntawv muaj keeb ntawm hypercholesterolemia thiab sib xyaw dyslipidemia, atorvastatin txo qis qhov kev xav ntawm tag nrho cov roj, cov tshuaj lipoproteins tsawg (LDL) thiab apolipoprotein B (Apo B). Atorvastatin kuj txo qhov kev kub siab ntawm cov lipoproteins tsawg heev (VLDL) thiab triglycerides (TG), thiab kuj nce me ntsis cov ntsiab lus ntawm cov roj lipoproteins (HDL) ntau.

Atorvastatin txo qib ntawm cov roj (cholesterol) thiab lipoproteins hauv ntshav plasma los ntawm kev tiv thaiv HMG-CoA reductase, ua ke ntawm cov roj cholesterol nyob rau hauv daim siab thiab nce cov LDL receptors nyob rau ntawm hepatocytes, uas nrog los ntawm kev nce siab thiab catabolism ntawm LDL. Atorvastatin txo LDL ntau lawm, ua rau muaj suab nrov thiab ntxiv ntev rau LDL receptor kev ua si. Atorvastatin txo qis qis LDL ntau ntau hauv cov neeg mob homozygous tsev neeg hypercholesterolemia, uas tsis yog qhov zoo rau cov qauv kho nrog lipid-txo tshuaj.

Lub hauv paus loj ntawm kev ua ntawm atorvastatin yog lub siab, uas ua lub luag haujlwm tseem ceeb hauv kev sib txuas ntawm cov roj (cholesterol) thiab kev tshem tawm ntawm LDL. Kev txo qis hauv cov qib ntawm LDL cov roj (cholesterol) txuam nrog rau cov tshuaj ntawm qhov tshuaj thiab qhov tshuaj nyob hauv lub cev.

Atorvastatin ntawm ib koob ntawm 10-80 mg txo qib theem ntawm cov roj (los ntawm 30–46%), LDL cov roj (los ntawm 41–61%), Apo B (los ntawm 34 %50%) thiab TG (los ntawm 14–33%). Cov txiaj ntsig no tau ruaj khov nyob hauv cov neeg mob mob heterozygous tsev neeg hypercholesterolemia, ib daim ntawv kis tau los ntawm hypercholesterolemia thiab ib hom tshuaj hyperlipidemia, suav nrog cov neeg mob uas tsis muaj ntshav qab zib tsis muaj tshuaj tiv thaiv ntshav qab zib mellitus.

Hauv cov neeg mob uas muaj tus kabmob hypertriglyceridemia, atorvastatin txo qib ntawm cov roj (cholesterol) tag nrho, LDL cov roj (cholesterol), VLDL cov cholesterol, Apo B, TG thiab nce me ntsis ntawm qib roj HDL. Hauv cov neeg mob uas muaj dysbetalipoproteinemia, atorvastatin txo qib ntawm cov roj cholesterol ua kom lub siab.

Hauv cov neeg mob uas muaj hom IIa thiab IIb hyperlipoproteinemia (raws li kev sib cais ntawm Fredrickson), qhov nruab nrab ntawm nce ntawm HDL cov roj (cholesterol) thaum siv atorvastatin ntawm ib koob ntawm 10-80 mg yog 5.1-8.7%, tsis hais koob tshuaj. Tsis tas li ntawd, muaj qhov tseem ceeb los ntawm qhov txo qis hauv feem ntau ntawm cov roj cholesterol tag nrho / HDL roj thiab roj HDL. Kev siv atorvastatin txo txoj kev pheej hmoo ntawm ischemia thiab kev tuag nyob rau hauv cov neeg mob nrog myocardial infarction tsis muaj Q yoj thiab tsis khov tsis hnov ​​qhov tsis zoo (tsis hais poj niam txiv neej thiab hnub nyoog) yog ncaj qha sib luag rau theem ntawm LDL cov cholesterol.

Heterozygous ntsig txog hypercholesterolemia hauv kev kho mob pediatrics. Hauv cov tub thiab ntxhais hnub nyoog 10-17 xyoo nrog rau kev ua mob rau heterozygous tsev neeg hypercholesterolemia lossis mob ntshav siab, atorvastatin ntawm ib zaug ntawm 10-20 mg ib hnub ib hnub txo cov theem ntawm cov roj (cholesterol) tag nrho, LDL cov rog, TG thiab Apo B hauv ntshav ntshav. Txawm li cas los xij, tsis muaj kev cuam tshuam loj heev rau kev loj hlob thiab kev nkauj nraug hauv tub lossis los ntawm lub sijhawm rau lub cev ntas rau cov ntxhais. Kev nyab xeeb thiab ua tau ntawm cov koob tshuaj siab tshaj 20 mg rau kev kho mob ntawm cov menyuam yaus tsis tau kawm. Kev cuam tshuam ntawm lub sijhawm ntawm atorvastatin kev kho mob hauv lub hnub menyuam yaus txog kev txo qis ntawm kev mob hlwb thiab kev tuag ntawm cov neeg laus tsis tau tsim.

Tsuas tshuaj thiab tswj hwm

Ua ntej pib Atorvastatin txoj kev kho, nws yog qhov yuav tsum tau txiav txim siab txog qib qib ntawm cov roj cholesterol hauv cov ntshav tiv thaiv keeb kwm ntawm kev noj zaub mov kom tsim nyog, qhia txog kev tawm dag zog lub cev thiab ntsuas kev ntsuas los txo lub cev qhov hnyav hauv cov neeg mob rog, nrog rau kev ua rau kev kho mob hauv qab. Thaum kho nrog atorvastatin, cov neeg mob yuav tsum ua raws li cov qauv hypocholesterolemic noj haus. Cov tshuaj tau sau tseg nyob rau hauv ib koob ntawm 10-80 mg ib hnub ib hnub, ntawm ib qho twg, tab sis tib lub sijhawm ntawm hnub, tsis hais noj zaub mov noj. Cov koob tshuaj thaum xub thawj thiab txij nkawm tuaj yeem tsim kho tus kheej raws qib pib ntawm LDL cov roj (cholesterol), cov hom phiaj thiab kev kho kom zoo. Tom qab 2-4 lub lis piam los ntawm kev pib kho thiab / lossis tshuaj kho nrog Atorvastatin, yuav tsum tau siv cov tshuaj lipid thiab qhov tshuaj txhaj raws.

Thawj hypercholesterolemia thiab sib xyaw (sib xyaw) hyperlipidemia. Feem ntau, nws txaus los sau tshuaj rau hauv ib koob tshuaj 10 mg ib hnub ib hnub. Cov kev kho mob muaj txiaj ntsig tom qab 2 lub lis piam, cov nyhuv siab tshaj plaws - tom qab 4 lub lis piam. Cov kev hloov pauv zoo yog txhawb los ntawm kev siv lub sijhawm ntev ntawm cov tshuaj.

Homozygous tsev neeg hypercholesterolemiaCov. Qhov tshuaj no tau sau tseg hauv 10 rau 80 mg ib hnub ib hnub, txhua lub sijhawm, tsis hais noj zaub mov twg. Cov koob tshuaj thaum pib thiab tswj hwm raug teeb tsa ua ib leeg zuj zus. Feem ntau, hauv cov neeg mob homozygous tsev neeg hypercholesterolemia, qhov tshwm sim tau tiav nrog kev siv Atorvastatin ntawm koob ntawm 80 mg ib hnub ib zaug.

Heterozygous tsev neeg hypercholesterolemia hauv kev kho mob hauv plab (cov neeg mob hnub nyoog 10-17 xyoo). Atorvastatin pom zoo nyob rau hauv thawj zaug.

10 mg 1 zaug nyob rau ib hnub. Qhov koob tshuaj ntau tshaj plaws yog 20 mg ib hnub ib hnub ib zaug (cov koob tshuaj ntau tshaj 20 mg tsis tau kawm hauv cov neeg mob ntawm pab pawg hnub nyoog no). Cov koob tshuaj tau teeb tsa ib leeg zuj zus, suav nrog lub hom phiaj ntawm txoj kev kho, qhov tshuaj tuaj yeem hloov kho nrog ncua nrog 4 lis piam lossis ntau dua.

Siv rau hauv cov neeg mob mob raum thiab lub raum tsis ua haujlwmCov. Kab mob hauv lub raum tsis cuam tshuam rau kev txiav txim ntawm atorvastatin lossis txo qis ntshav ntshav LDL cov roj cholesterol, yog li tsis tas yuav siv tshuaj kho kom haum.

Siv rau cov neeg mob lausCov. Tsis muaj qhov sib txawv hauv kev nyab xeeb thiab muaj txiaj ntsig ntawm cov tshuaj hauv kev kho mob hypercholesterolemia hauv cov neeg laus thiab cov neeg laus tom qab lub hnub nyoog 60 xyoo.

Cov neeg mob uas muaj lub siab ua haujlwm tsis zoo cov tshuaj yog sau ntawv nrog kev ceev faj nyob rau hauv kev sib txuas nrog qeeb qeeb hauv kev tshem tawm cov tshuaj ntawm lub cev. Kev tswj hwm ntawm cov chaw kuaj mob thiab kuaj pom, thiab yog tias pom muaj kev hloov pauv loj, cov koob tshuaj yuav tsum raug txo lossis kev kho yuav tsum nres.

Yog tias kev txiav txim siab tau txiav txim siab ntawm kev sib koom tes ntawm Atorvastatin thiab CYP3A4 inhibitors, ces:

Txhua zaus yuav tsum pib kho nrog qhov tsawg kawg nkaus (10 mg), nco ntsoov saib xyuas cov kua lipids ua ntej titrating koob tshuaj.

Koj tuaj yeem txiav tawm ib ntus tsis noj tshuaj Atorvastatin yog tias CYP3A4 inhibitors tau tawm hauv lub sijhawm luv luv (piv txwv, lub sijhawm luv luv ntawm cov tshuaj tua kab mob xws li clarithromycin).

Cov lus pom zoo txog kev txhaj tshuaj ntau tshaj ntawm Atorvastatin thaum siv:

nrog cyclosporine - qhov koob tshuaj yuav tsum tsis pub tshaj 10 mg,

nrog clarithromycin - cov koob tshuaj yuav tsum tsis pub tshaj 20 mg,

nrog itraconazole - cov koob tshuaj yuav tsum tsis pub tshaj 40 mg.

Cov tshuaj sib cuam tshuam

Txoj kev pheej hmoo ntawm myopathy tau nce ntxiv thaum kho nrog lwm cov tshuaj ntawm cov chav kawm no thaum siv cyclosporine, derivatives ntawm fibric acid, erythromycin, antifungals ntsig txog azoles, thiab nicotinic acid.

Antacids: kev noj haus ib txhij ntawm kev ncua kev kawm uas muaj cov magnesium thiab aluminium hydroxide txo qhov kev nkag siab ntawm atorvastatin hauv cov ntshav ntshav los ntawm li 35%, txawm li cas los xij, cov neeg kawm qib qis hauv LDL cov cholesterol tsis hloov.

Antipyrine: Atorvastatin tsis cuam tshuam rau lub pharmacokinetics ntawm antipyrine, yog li ntawd, kev cuam tshuam nrog lwm cov tshuaj metabolized los ntawm tib lub cytochrome isoenzymes tsis xav.

Amlodipine: nyob rau hauv kev kawm txog kev sib cuam tshuam yeeb tshuaj hauv cov neeg muaj kev noj qab haus huv, kev tswj hwm tib lub sijhawm ntawm atorvastatin ntawm ib koob ntawm 80 mg thiab amlodipine ntawm koob tshuaj 10 mg ua rau muaj kev nce ntxiv hauv cov nyhuv ntawm atorvastatin los ntawm 18%, uas tsis yog qhov tseem ceeb hauv chaw kho mob.

Gemfibrozil: vim muaj kev pheej hmoo ntau ntxiv txhim kho myopathy / rhabdomyolysis nrog tib lub sijhawm siv HMG-CoA reductase inhibitors nrog gemfibrozil, kev tswj hwm ua ke ntawm cov tshuaj no yuav tsum raug zam.

Lwm yam fibrates: vim muaj kev pheej hmoo ntawm myopathy / rhabdomyolysis nrog tib lub sijhawm siv HMG-CoA reductase inhibitors nrog fibrates, atorvastatin yuav tsum tau txiav txim nrog kev ceev faj thaum noj cov tshuaj fibrates.

Nicotinic acid (niacin): qhov kev pheej hmoo ntawm kev tsim myopathy / rhabdomyolysis tuaj yeem nce ntxiv thaum siv atorvastatin nrog cov tshuaj nicotinic acid, yog li ntawd, nyob rau hauv qhov xwm txheej no, kev txiav txim siab yuav tsum tau muab txo kom tsawg dua ntawm atorvastatin.

Colestipol: nrog rau kev siv colestipol tib lub sijhawm, kev ua haujlwm ntawm atorvastatin hauv cov ntshav ntshav poob qis li 25%. Txawm li cas los xij, lipid-txo cov nyhuv ntawm kev sib txuam ntawm atorvastatin thiab colestipol ntau dua qhov ntawm txhua cov tshuaj ib tus zuj zus.

Colchicine: nrog kev siv atorvastatin nrog colchicine tib lub sijhawm, muaj tus mob myopathy tau tshaj tawm, suav nrog rhabdomyolysis, yog li ntawd yuav tsum ceev faj thaum siv tshuaj atorvastatin nrog colchicine.

Digoxin: nrog kev tswj hwm rov qab ntawm digoxin thiab atorvastatin ntawm koob tshuaj 10 mg, qhov sib npaug ntawm digoxin hauv cov ntshav ntshav tsis hloov. Txawm li cas los xij, thaum digoxin tau siv nrog kev sib xyaw nrog atorvastatin ntawm ib koob ntawm 80 mg / hnub, qhov kev txiav txim siab ntawm digoxin nce ntxiv txog 20%. Cov neeg mob uas tau txais digoxin ua ke nrog atorvastatin yuav tsum tau saib xyuas kom tsim nyog.

Erythromycin / clarithromycin: nrog kev siv tib txhij ntawm atorvastatin thiab erythromycin (500 mg plaub zaug hauv ib hnub) lossis clarithromycin (500 mg ob zaug ib hnub), uas inhibit cytochrome P450 ZA4, ib qho kev nce siab ntawm atorvastatin hauv cov ntshav ntshav tau pom.

Azithromycin: nrog kev siv atorvastatin sib xyaw ua ke (10 mg ib hnub ib zaug) thiab azithromycin (500 mg / ib hnub ib zaug), qhov tshuaj ntawm atorvastatin hauv cov ntshav tsis hloov pauv.

Terfenadine: nrog rau kev siv tib txhij ntawm atorvastatin thiab terfenadine, thaj chaw kho mob tseem ceeb hloov pauv hauv pharmacokinetics ntawm terfenadine tsis tau kuaj pom.

Qhov ncauj txwv tsis pub muaj: thaum siv atorvastatin thiab tshuaj tiv thaiv qhov ncauj muaj qhov norethindrone thiab ethinyl estradiol, qhov nce ntxiv ntawm AUC ntawm norethindrone thiab ethinyl estradiol tau pom los ntawm kwv yees li 30% thiab 20%, feem. Cov nyhuv no yuav tsum raug txiav txim siab thaum xaiv qhov ncauj tawm tsam rau tus poj niam noj atorvastatin.

Warfarin: thaum kawm txog kev sib cuam tshuam ntawm atorvastatin nrog warfarin, tsis muaj cov cim ntawm kev cuam tshuam loj hauv qhov chaw kuaj mob tau pom.

Cimetidine: thaum kawm qhov kev sib cuam tshuam ntawm atorvastatin nrog cimetidine, tsis muaj cov cim ntawm qhov sib cuam tshuam hauv chaw kho mob tau pom.

Protease Inhibitionitors: kev siv tib txhij ntawm atorvastatin nrog protease inhibitors hu ua cytochrome P450 ZA4 inhibitors tau nrog los ntawm kev nce ntshav ntau dua ntawm atorvastatin.

Cov lus pom zoo rau kev siv ua ke ntawm atorvastatin thiab HIV protease inhibitors:

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Cov khoom siv tshuaj yog xa hauv daim ntawv hauv cov ntsiav tshuaj hauv chaw muag tshuaj. Cov tshuaj nquag siv ntawm cov tshuaj yog atorvastatin calcium trihydrate (40 mg hauv txhua lub ntsiav tshuaj).

Cov khoom siv ntxiv: microcrystalline cellulose, calcium carbonate, StarKap 1500 complex (pregelatinized hmoov txhuv nplej siab thiab hmoov nplej pob kws), aerosil, magnesium stearate, titanium dioxide, talc, macrogol, xim liab, hlau oxide, xim daj, hlau oxide, cawv polyvinyl).

Cov pob muaj 1.2 lossis 3 hlwv ntawm 10.15 lossis 30 ntsiav tshuaj.

Yeeb tshuaj sib cuam tshuam

Kev siv ib txhij nrog cov tshuaj tua kab mob (erythromycin, clarithromycin), tshuaj tua kab mob (fluconazole, ketoconazole, itraconazole), cyclosporine, fibroic acid derivatives ua rau muaj kev cia siab ntau dua ntawm atorvastitis thiab kev pheej hmoo ntawm kev tsim mob myalgia.

Kev siv ib txhij nrog kev ncua, uas suav nrog cov hlau nplaum thiab txhuas, ua rau muaj kev txo qis hauv cov tshuaj atorvastatin. Qhov no tsis cuam tshuam rau theem ntawm kev txo qis cov roj cholesterol thiab qis lipoproteins.

Cov poj niam uas siv tshuaj tiv thaiv qhov ncauj yuav tsum coj mus rau hauv tus account uas atorvastatin tuaj yeem nce qhov kev xav ntawm ethinyl estradiol thiab norethindrone.

Kev sib txuam uas yuav tsum tau ceev faj: kev sib xyaw ntawm atorvastatin nrog cov tshuaj uas pab txo qis cov tshuaj hormones steroid (spironolactone, ketoconazole).

Tsis pom zoo muaj kev sib cuam tshuam ntawm atorvastatin nrog tshuaj antihypertensive tsis tau pom.

Pharmacological kev txiav txim ntawm atorvastatin 40

Cov tshuaj nquag ntawm cov tshuaj muaj cov lus hais tawm lipid-txo qis kev ua haujlwm thiab belongs rau cov qeb ntawm statins. Cov tshuaj tiv thaiv ua rau HMG-CoA reductase, ib qho enzyme tshwj xeeb uas hloov hom A hydroxymethylglutaryl coenzyme rau mevalonic acid.

Qhov tshuaj noj tshuaj txo qhov tsim ntawm LDL (qis lipoproteins tsawg) thiab nce qib ntawm kev ua haujlwm ntawm LDL receptors. Ib qho ntxiv, hauv cov neeg mob hypercholesterolemia, cov tshuaj txo LDL.

Txuas ntxiv, cov tshuaj txo qis qib ntawm Ho (tag nrho cov roj (cholesterol) thiab nce cov roj (cholesterol) ntawm cov lipoproteins ntau ntom (HDL).

Atorvastatin muaj qhov nqus ntawm qhov siab nqus. Statin nyob rau hauv ntshav ntshav nce nws qhov siab tshaj plaws hauv 60-120 feeb. Noj mov me ntsis txo qhov ncua sijhawm ntawm kev nqus ntawm cov tshuaj.

Cov tshuaj muaj cov nyom ntawm 12%. Cov tshuaj yog metabolized hauv cov nqaij hauv lub siab. Cov tshuaj yog tawm nrog rau cov kua tsib. Ib nrab-lub neej ntawm atorvastatin yog 14 teev. Li 2% ntawm cov tshuaj tau tawm los ntawm lub raum. Hemodialysis tsis cuam tshuam rau qhov profile pharmacokinetic ntawm cov tshuaj.

Cov lus qhia tshwj xeeb

Atorvastatin tuaj yeem ua rau muaj kev nce siab ntau ntxiv ntawm CPK, uas yuav tsum raug coj mus rau hauv qhov kev ntsuas txawv txav ntawm lub hauv siab. Nws yuav tsum tau yug los hauv lub siab tias qhov nce hauv CPK los ntawm 10 lub sij hawm piv nrog cov cai, los ntawm myalgia thiab cov leeg tsis muaj zog yuav cuam tshuam nrog myopathy, kev kho mob yuav tsum tau tsum tsis ua ntxiv.

Nrog rau kev siv tib lub sijhawm ntawm atorvastatin nrog cytochrome CYP3A4 protease inhibitors (cyclosporine, clarithromycin, itraconazole), thawj koob tshuaj yuav tsum tau pib nrog 10 mg, nrog lub sijhawm luv luv ntawm kev siv tshuaj tua kab mob, atorvastatin yuav tsum tau txiav tawm.

Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam qhov ntsuas tsis tu ncua ntawm lub siab ua haujlwm ua ntej kev kho mob, 6 thiab 12 lub lis piam tom qab pib siv tshuaj lossis tom qab nce qhov koob tshuaj, thiab tsis tseg (txhua 6 lub hlis) thaum lub sijhawm tag nrho ntawm kev siv (txog thaum qhov ib txwm ua tiav ntawm cov mob ntawm cov neeg mob uas nws qib transaminase ntau dua li ib txwm ) Kev nce ntawm hepatic transaminases yog pom feem ntau hauv thawj 3 lub hlis ntawm kev tswj hwm tshuaj. Nws raug nquahu kom thim cov tshuaj lossis txo cov koob tshuaj nrog kev nce hauv AST thiab ALT ntau dua 3 zaug. Kev siv cov tshuaj atorvastatin yuav tsum tau txiav tawm ib ntus yog hais tias muaj kev txhim kho cov tsos mob uas tau hais kom pom tias muaj tus mob myopathy zoo, lossis nyob rau ntawm qhov muaj feem cuam tshuam txog kev txhim kho ntawm lub raum tsis ua haujlwm vim rhabdomyolysis (mob hnyav, txo ntshav siab, kev phais mob ntau ntxiv, kev poob plig, metabolic, endocrine lossis mob ntshav qab zib cuam tshuam loj) Cov. Cov neeg mob yuav tsum tau ceeb toom tias lawv yuav tsum tau sab laj nrog kws kho mob sai sai yog tias tsis hnov ​​qhov mob lossis cov leeg tsis muaj zog, tshwj xeeb tshaj yog tias lawv nrog mob tshwm sim lossis kub taub hau.