Atoris - cov lus qhia ua qauv rau siv > Kev khomob thiab kev tiv thaiv

zaj duab xis-ntsiav tshuaj ntsiav tshuaj

1 txheej zaj duab xis-ntsiav tshuaj 10 mg / 20 mg muaj:
Lub ntsiab
Yam tshuaj muaj sia:
Atorvastatin calcium 10.36 mg / 20.72 mg (sib npaug ntawm atorvastatin 10.00 mg / 20.00 mg)
Cov muaj tswv yim:
povidone - K25, sodium lauryl sulfate, calcium carbonate, microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate
Zaj duab xis sheath
Opadry II HP 85F28751 Dawb *
* Opadry II HP 85F28751 dawb muaj: cawv polyvinyl, titanium dioxide (E171), macrogol-3000, talc

Kev piav qhia

Hloov, me ntsis biconvex ntsiav tshuaj, zaj duab xis-coated dawb los yog yuav luag dawb.
Kink saib: dawb ntxhib nrog ib txheej zaj duab xis ntawm dawb los yog yuav luag dawb xim.

Cov Tshuaj Hauv Tshuaj

Atorvastatin yog tus neeg saib xyuas hypolipidemic los ntawm pab pawg ntawm statins. Lub tshuab tseem ceeb ntawm kev ua ntawm atorvastatin yog qhov inhibition ntawm kev ua ntawm 3-hydroxy-3-methylglutaryl-coenzyme A - (HMG-CoA) reductase, ib qho enzyme uas catalyzes hloov dua siab tshiab ntawm HMG-CoA rau mevalonic acid. Qhov kev hloov pauv no yog ib qho ntawm thawj kauj ruam ntawm kev sib tshooj hauv cov roj (cholesterol) coj los ua ke hauv lub cev.

Atorvastatin kev tawm tsam ntawm cov roj (synthesis) ua rau cov tshuaj tiv thaiv kab mob lipoprotein tsawg (LDL) ua rau lub siab ua rau lub siab, ntxiv rau cov ntaub so ntswg. Cov txais no khi cov ntshav LDL thiab tshem tawm ntawm cov ntshav ntshav, uas ua rau kom cov kua roj LDL (Ch-LDL) tsawg nyob hauv cov ntshav. Cov nyhuv antisclerotic ntawm atorvastatin yog qhov muaj txiaj ntsig ntawm nws cov nyhuv ntawm phab ntsa ntawm cov hlab ntsha thiab cov ntshav ua haujlwm. Atorvastatin inhibits kev sib txuas ntawm isoprenoids, uas yog kev loj hlob ntawm cov hlwb ntawm cov roj ntsha sab hauv. Nyob rau hauv kev cuam tshuam ntawm atorvastatin, endothelium-ywj pheej nthuav dav ntawm cov hlab ntshav txhim kho, qhov kev sib txuam ntawm LDL-C, LDL, apolipoprotein B, triglycerides (TG) poob qis, thiab cov concentration ntawm high-density lipoprotein (HDL-C) thiab apolipoprotein A nce ntxiv.

Atorvastatin txo qis viscosity ntawm ntshav ntshav thiab cov kev ua ntawm qee yam coagulation yam thiab platelet aggregation. Vim qhov no, nws txhim kho hemodynamics thiab normalizes qhov mob ntawm coagulation system. HMG-CoA reductase inhibitors tseem cuam tshuam cov metabolism hauv macrophages, thaiv lawv cov kev ua kom zoo thiab tiv thaiv kev tawg ntawm atherosclerotic plaques.

Raws li txoj cai, txoj kev kho mob ntawm atorvastatin kev txhim kho tom qab ob lub lim tiam ntawm kev siv atorvastatin, thiab cov txiaj ntsig siab tshaj plaws tau tiav tom qab plaub lub lis piam.

Atorvastatin nyob rau hauv ib koob ntawm 80 mg txo qhov kev pheej hmoo ntawm kev tsim ischemic muaj teeb meem (suav nrog kev tuag los ntawm myocardial infarction) los ntawm 16%, kev pheej hmoo rov qab pw hauv tsev kho mob rau angina pectoris, nrog cov cim ntawm myocardial ischemia - los ntawm 26%.

Cov Tshuaj Pharmacokinetics

Atorvastatin nqus tau ntau, kwv yees 80% yog nqus los ntawm txoj hnyuv plab. Kev ntsuas nqus thiab kev nqus ntawm cov ntshav ntshav nce ntxiv hauv kev faib ua feem. Lub sijhawm kom ncav cuag qhov siab tshaj plaws (TCmax) yog, nyob rau nruab nrab, 1-2 teev. Rau cov poj niam, TCmax tau siab dua 20%, thiab thaj chaw hauv qab cov phiaj xwm concentration-sijhawm (AUC) yog 10% qis dua. Qhov sib txawv ntawm cov khw muag tshuaj hauv cov neeg mob los ntawm lub hnub nyoog thiab poj niam txiv neej yog qhov tsis txaus ntseeg thiab tsis tas yuav hloov kho koob tshuaj.

Hauv cov neeg mob uas muaj cawv ua mob rau lub siab, TCmax yog 16 npaug ntau dua li ib txwm. Noj ib nyuag txo qhov nrawm thiab ncua sijhawm ntawm kev nqus ntawm cov tshuaj (los ntawm 25% thiab 9%, feem), tab sis qhov txo qis hauv kev ua siab ntawm LDL-C yog zoo li ntawd nrog atorvastatin tsis muaj zaub mov.

Atorvastatin bioavailability muaj tsawg (12%), cov kab ke ua haujlwm ntawm bioavailability ntawm kev tiv thaiv kev ua si tiv thaiv HMG-CoA reductase yog 30%. Kev siv lub cev tsis tshua muaj txiaj ntsig zoo yog vim lub cev ua haujlwm (presystemic metabolism) nyob rau hauv cov qog ua pa ntawm txoj hnyuv thiab "txoj kev pib" los ntawm daim siab.

Qhov nruab nrab ntim ntawm kev faib tawm atorvastatin yog 381 litres. Ntau tshaj li 98% ntawm atorvastatin khi rau cov ntshav protein.

Atorvastatin tsis hla cov ntshav-hlwb teeb meem.

Nws yog metabolized feem ntau hauv daim siab nyob rau hauv kev txiav txim ntawm ZA4 isoenzyme ntawm cytochrome P450 nrog kev tsim cov pharmacologically nquag metabolites (ortho- thiab parahydroxylated metabolites, beta-oxidation khoom lag luam), uas suav txog kwv yees li 70% ntawm cov kev tiv thaiv tiv thaiv HMG-CoA reductase nyob rau lub sijhawm 20-30 teev.

Ib nrab-lub neej (T1 / 2) ntawm atorvastatin yog 14 teev. Nws yog feem ntau raug mob nrog cov kua tsib (tsis tau hais tawm ntawm enterohepatic recirculation, tsis yog tawm thaum lub sijhawm hemodialysis). Kwv yees li 46% ntawm atorvastatin raug tawm hauv txoj hnyuv thiab tsawg dua 2% los ntawm lub raum.

Kev ntsuas rau siv

Kev qhia rau kev siv tshuaj Atoris 20 mg yog:

Thawj hypercholesterolemia (heterozygous tsev neeg thiab tsis-tsev neeg hypercholesterolemia (hom II raws li Fredrickson),
Sib xyaw (sib xyaw) hyperlipidemia (IIa thiab IIb yam raws li Fredrickson),
Dysbetalipoproteinemia (hom III raws li Fredrickson) (raws li kev pabcuam rau kev noj haus),
Familial endogenous hypertriglyceridemia (hom IV los ntawm Fredrickson), tiv taus kev noj haus,
Homozygous tsev neeg hypercholesterolemia nrog tsis muaj txiaj ntsig ntawm kev noj zaub mov noj thiab lwm txoj kev siv tshuaj tsis yog ntawm kev kho mob,

Kev tiv thaiv cov kab mob plawv:

Kev tiv thaiv kab mob plawv hauv cov neeg mob tsis muaj kev soj ntsuam kab mob ntsig txog lub plawv, tab sis nrog ntau yam kev pheej hmoo rau nws txoj kev loj hlob: hnub nyoog laus dua 55 xyoos, kev muaj nicotine, kev mob ntshav siab, ntshav qab zib mellitus, qis HDL-C hauv ntshav ntshav, kev mob caj ces, nrog rau tawm tsam keeb kwm ntawm dyslipidemia,
Kev tiv thaiv kab mob thib ob hauv kev mob plawv hauv cov neeg mob uas muaj mob plawv (CHD) 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 ntshav.

Cov Yuav Tsum Tau Ua

Contraindications rau kev siv Atoris ntsiav tshuaj:

ua kom lub cev tsis haum rau ib qho twg ntawm cov tshuaj,
mob siab tus kab mob nyob hauv theem nquag (nrog rau kev muaj mob rau daim siab ntev, mob siab cawv ntev),
cirrhosis ntawm lub siab ntawm ib qho kev etiology,
nce kev ua haujlwm ntawm "mob siab" kev hloov pauv ntawm cov tsis paub lub hauv paus los ntawm ntau dua 3 zaug piv nrog kev txwv qis ntawm qhov tsis suav,
mob pob txha leeg mob
cev xeeb tub thiab lactation,
hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv tsis tau tsim),
lactase deficiency, lactose intolerance, qabzib-galactose malabsorption syndrome.

Siv thaum cev xeeb tub thiab pub niam mis

Atoris yog contraindicated rau hauv kev xeeb tub thiab lub sijhawm pub mis. Kev tshawb fawb tsiaj qhia tias kev pheej hmoo rau tus me nyuam hauv plab yuav dhau qhov txiaj ntsig tau rau leej niam.

Hauv cov poj niam ntawm kev ua me nyuam hnub nyoog uas tsis siv txoj hauv kev tiv thaiv kom muaj txiaj ntsig, kev siv Atoris tsis pom zoo. Thaum npaj kev cev xeeb tub, koj yuav tsum tsum tsis siv Atoris tsawg kawg 1 hlis ua ntej koj npaj cev xeeb tub.

Tsis muaj pov thawj ntawm kev faib cov atorvastatin nrog rau niam mis. Txawm li cas los xij, hauv qee hom tsiaj, qhov kev nkag siab ntawm atorvastatin hauv cov ntshav cov ntshav thiab hauv cov mis ntawm lactating tsiaj yog qhov zoo sib xws. Yog tias yuav tsum tau siv cov tshuaj Atoris thaum lactation, txhawm rau kom tsis txhob muaj kev pheej hmoo ntawm kev tshwm sim tsis zoo hauv cov menyuam mos, kev pub mis niam yuav tsum tau tsum.

Tsuas tshuaj thiab tswj hwm

Ua ntej pib siv cov Atoris, tus neeg mob yuav tsum pauv mus rau kev noj haus. muab kev txo qis hauv kev saib xyuas ntawm lipids hauv cov ntshav, uas yuav tsum tau pom thaum lub sijhawm kho tag nrho nrog rau cov tshuaj. Ua ntej pib txoj kev kho mob, koj yuav tsum tau sim ua kom tiav kev tswj hwm ntawm hypercholesterolemia los ntawm kev tawm dag zog thiab kev poob phaus hauv cov neeg mob rog, nrog rau kev kho mob rau lwm tus kab mob.

Cov tshuaj tau noj ntawm qhov ncauj, tsis hais noj mov. Cov koob tshuaj ntawm cov tshuaj txawv ntawm 10 mg rau 80 mg ib hnub ib zaug thiab raug xaiv los saib xyuas qhov pib kev xav ntawm LDL-C, lub hom phiaj ntawm txoj kev kho thiab cov tib neeg siv tshuaj kho kom zoo.

Atoris tuaj yeem noj ib zaug ntawm txhua lub sijhawm ntawm hnub, tab sis tib lub sijhawm txhua hnub.

Kev kho mob zoo yog pom tom qab ob lub lim tiam ntawm kev kho mob, thiab cov txiaj ntsig siab tshaj plaws yuav tshwm sim tom qab plaub lub lis piam. Yog li, cov koob tshuaj yuav tsum tsis txhob hloov ua ntej plaub lub lis piam tom qab pib siv tshuaj nyob hauv koob tshuaj dhau los.

Thaum pib kho thiab / lossis thaum qhov nce ntxiv, nws yog qhov yuav tsum tau saib xyuas qhov kev nkag siab ntawm lipids hauv cov ntshav ntshav txhua 2-4 lub lis piam thiab kho qhov tshuaj raws li.

Homozygous muaj keeb tiv thaiv hypercholesterolemia

Cov koob tshuaj ntau yog tib yam li nrog lwm hom hyperlipidemia.

Thawj koob tshuaj tau xaiv ib tus zuj zus nyob ntawm qhov mob hnyav ntawm tus kab mob. Hauv feem ntau cov neeg mob homozygous kab mob hypercholesterolemia, cov txiaj ntsig zoo tshaj plaws yog pom nrog kev siv tshuaj hauv ib hnub ntawm 80 mg (ib zaug). Atoris® yog siv los ua kev kho rau lwm txoj hau kev kho mob (plasmapheresis) los yog kev kho mob tseem ceeb yog tias kev kho nrog lwm txoj kev tsis tuaj yeem ua.

Siv rau cov laus

Hauv cov neeg laus laus thiab cov neeg mob raum, cov tshuaj Atoris yuav tsum tsis txhob hloov pauv. Lub raum ua haujlwm tsis zoo cuam tshuam rau qhov kev txiav txim ntawm atorvastatin nyob rau hauv cov ntshav ntshav lossis qhov qis ntawm qhov txo qis hauv cov concentration ntawm LDL-C nrog kev siv atorvastatin, yog li ntawd, hloov cov koob tshuaj tsis tas yuav tsum.

Lub siab ua haujlwm tsis zoo

Hauv cov neeg mob uas muaj lub siab ua haujlwm tsis zoo, kev ceev faj yog qhov tsim nyog (vim kev ua haujlwm qeeb hauv kev tshem tawm cov tshuaj tawm hauv lub cev). Thaum muaj qhov xwm txheej zoo li no, cov chaw kuaj mob thiab kuaj ntsuas yuav tsum tau ua tib zoo saib xyuas (kev saib xyuas tsis tu ncua ntawm kev ua ntawm aspartate aminotransferase (ACT) thiab alanine aminotransferase (ALT)). Nrog txoj kev nce siab ntxiv hauv cov haujlwm ntawm hepatic transaminases, koob tshuaj Atoris yuav tsum tau txo lossis txoj kev kho yuav tsum tau txiav tawm.

Sab sij huam

Thaum lub sijhawm siv Atoris 20 mg ntsiav tshuaj, kev phiv tuaj yeem tshwm sim:

Los ntawm cov leeg hlwb: feem ntau: mob taub hau, pw tsaug zog, kiv taub hau, dhuav, txha caj qaum, asthenic syndrome, tsis xws luag: peripheral neuropathy. amnesia, hypesthesia,
Los ntawm cov kab mob hauv lub siab: ua haujlwm: pheej: tinnitus, tsis tshua muaj: nasopharyngitis, ntswg,
Los ntawm cov ntshav hemopoietic plab hnyuv siab raum: tshwm sim: tus mob thrombocytopenia,
Los ntawm cov kab mob ua pa: feem ntau: mob hauv siab,
Los ntawm lub plab zom mov: feem ntau: cem quav, dyspepsia, xeev siab, raws plab. flatulence (tsam plab), mob plab, tso zis: tsis nco qab, tsis hnov qab, ntuav, txhaws qa, tsis tshua muaj: kab mob siab, cholestatic daj ntseg,
Los ntawm cov leeg musculoskeletal: feem ntau: myalgia, mob caj dab, mob rov qab. sib koom tes o, los ntshav: myopathy, mob leeg, tsis tshua: myositis, rhabdomyolysis, tendopathy (qee qhov mob ntawm caj dab txhaws),
Los ntawm cov kaw lus genitourinary: ua haujlwm: poob qis potency, lub raum tsis ua haujlwm,
Ntawm daim tawv nqaij: feem ntau: tawv nqaij ua pob khaus, khaus khaus, tsis xws luag: urticaria, tsis tshua muaj tshwm sim: angioedema, alopecia, tawv nqaij vog, erythema multiforme, Stevens-Johnson syndrome, mob lom ua paug epidermal necrolysis,
Kev ua xua rau: feem ntau: kev ua xua tshua, tsis tshua muaj: anaphylaxis,
Kuaj qhov ntsuas: tsis xws luag: nce kev ua si ntawm aminotransferases (ACT, ALT), nce kev ua si ntawm cov ntshav creatine phosphokinase (CPK), tsis tshua muaj: hyperglycemia, hypoglycemia,
Lwm yam: feem ntau: peripheral edema, ua tsis xws luag: malaise, qaug zog, kub taub hau, hnyav tuaj.
Kev sib raug zoo ntawm qee qhov teebmeem tsis txaus siab nrog kev siv tshuaj Atoris, uas tau hais ua "tsis tshua muaj neeg", tsis tau tsim. Yog tias pom qhov tshwm sim tsis zoo, yuav tsum tsum siv cov tshuaj Atoris.

Noj ntau dhau

Cov teeb meem ntawm kev haus dej ntau dhau tsis piav qhia.

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 ua haujlwm (ib qho mob tsis tshua tab sis muaj kev cuam tshuam loj heev), cov tshuaj yuav tsum tau muab tso tseg sai sai thiab txoj kev lis ntshav ntawm diuretic thiab sodium bicarbonate pib. Yog tias tsim nyog, yuav tsum ua cov kab mob hemodialysis. Rhabdomyolysis tuaj yeem ua rau hyperkalemia, uas yuav tsum tau tswj hwm cov tshuaj calcium calcium los yog cov tshuaj calcium gluconate, txoj kev daws teeb meem ntawm 5% daws teeb meem ntawm dextrose (qabzib) nrog insulin, kev siv ntawm cov potassium-pauv cov resins, lossis, nyob rau hauv loj heev, hemodialysis. Hemodialysis tsis muaj txiaj ntsig.

Tsis muaj ib qho tshuaj tua kab mob tshwj xeeb.

Yeeb tshuaj sib cuam tshuam

Kev siv ib txhij atorvastatin nrog cyclosporine, tshuaj tua kab mob (erythromycin, clarithromycin, quinupristine / dalphopristine), HIV tiv thaiv kab mob tiv thaiv kab mob ntshav (indinavir, ritonavir), tshuaj tua kab mob ua ke (fluconazole, itraconazole, ketoconazole) lossis nrog nefazatone tsub kom nce ntxiv ntshav. kev pheej hmoo ntawm kev tsim myopathy nrog rhabdomyolysis thiab lub raum tsis ua haujlwm. Yog li, nrog tib lub sijhawm siv ntawm erythromycin TCmax atorvastatin nce 40%. Tag nrho cov tshuaj no inhibit cytochrome CYP4503A4 isoenzyme, uas koom nrog cov metabolism hauv atorvastatin hauv lub siab.

Kev sib cuam tshuam zoo sib xws yog ua tau nrog kev siv tib lub sij hawm ntawm atorvastatin nrog fibrates thiab nicotinic acid hauv lipid txo cov koob tshuaj (ntau dua 1 g nyob rau ib hnub). Kev siv tib lub sij hawm ntawm atorvastatin ntawm ib koob ntawm 40 mg nrog diltiazem ntawm ib koob ntawm 240 mg ua rau kev nce siab ntawm cov tshuaj atorvastatin hauv cov ntshav ntshav. Kev siv tib lub sij hawm ntawm atorvastatin nrog phenytoin, rifampicin, uas yog inducers ntawm cytochrome CYP4503A4 isoenzyme, tuaj yeem ua rau txo qis kev ua haujlwm ntawm atorvastatin. Txij li thaum atorvastatin metabolized los ntawm isoenzyme ntawm CYP4503A4 cytochrome, kev siv tib lub sijhawm ntawm atorvastatin nrog tshuaj tiv thaiv ntawm cytochrome CYP4503A4 isoenzyme tuaj yeem ua rau muaj kev nce ntshav ntxiv ntawm atorvastatin.

OAT31B1 thauj cov tshuaj tiv thaiv protein (xws li, cyclosporine) yuav nce cov bioavailability ntawm atorvastatin.

Nrog rau kev siv ua ke nrog antacids (raug tshem tawm ntawm magnesium hydroxide thiab aluminium hydroxide), cov tshuaj atorvastatin hauv cov ntshav ntshav poob qis.

Nrog kev siv atorvastatin nrog colestipol, kev siv atorvastatin hauv cov ntshav ntshav yog txo 25%, tab sis cov tshuaj kho ntawm kev sib xyaw yog siab dua cov nyhuv ntawm atorvastatin ib leeg.

Kev siv cov tshuaj atorvastatin nrog rau cov tshuaj uas txo qis ntawm cov tshuaj hormones endogenous steroid (suav nrog cimetidine, ketoconazole, spironolactone) yuav ua rau muaj kev pheej hmoo ntawm txo qis cov tshuaj hormones endogenous steroid (ceev faj yuav tsum tau siv).

Nrog tib lub sijhawm siv atorvastatin nrog tshuaj tiv thaiv qhov ncauj (norethisterone thiab ethinyl estradiol), nws muaj peev xwm nce ntxiv kev nqus ntawm kev tswj kom tsis txhob muaj menyuam yaus thiab nce lawv cov kev xav hauv ntshav ntshav. Kev xaiv ntawm kev tswj kom tsis txhob muaj menyuam yaus nyob rau hauv cov poj niam uas siv atorvastatin yuav tsum tau saib xyuas.

Kev siv tib txhij ntawm atorvastatin nrog warfarin thaum ntxov ntxov tuaj yeem ua rau muaj txiaj ntsig ntawm warfarin ntawm cov ntshav coagulation (txo lub sijhawm prothrombin).Cov nyhuv no ploj mus tom qab 15 hnub ntawm kev siv cov tshuaj no ib txhij.

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.

Thaum siv atorvastatin nrog cov tshuaj tiv thaiv kab mob thiab estrogens ua ib feem ntawm kev hloov kho kho, tsis muaj cov cim ntawm qhov chaw tsis txaus siab hauv kev kho mob.

Kev siv cov txiv kab ntxwv kua txiv thaum lub sijhawm siv Atoris® tuaj yeem ua rau nce ntshav ntau dua ntawm atorvastatin. Hauv qhov no, cov neeg mob noj cov tshuaj Atoris® yuav tsum tsis txhob haus cov kua txiv kab ntxwv qaub ntau dua li ntawm 1.2 litres ib hnub.

Cov lus qhia tshwj xeeb

Thaum noj tshuaj Atoris, txoj kev pheej hmoo ntawm kev tsim myalgia nce. Cov neeg mob yuav tsum tau saib xyuas mob tas mus li. Hauv qhov xwm txheej uas muaj kev tsis txaus siab ntawm qhov tsis muaj zog thiab kev txhim kho ntawm cov leeg mob, siv Atoris nres tam sim ntawd.

Cov tshuaj muaj pes tsawg leeg suav nrog lactose, qhov no yuav tsum tau coj mus rau hauv tus neeg mob uas tsis haum lactose thiab lactase tsis muaj peev xwm.

Cov tshuaj Atoris yuav tsum tau siv nrog kev ceebtoom rau cov neeg mob uas quav dej quav cawv thiab yog tias muaj keeb kwm ntawm lub cev tsis ua haujlwm li qub.

Thaum muaj qhov tshwm sim ntawm myopathy pom, kev siv ntawm Atoris yuav tsum nres.

Atoris tuaj yeem pab txhawb rau kev kiv taub hau, yog li rau lub sijhawm ntawm kev kho mob yuav tsum tsis kam tsav tsheb thiab kev ua si uas yuav tsum muaj kev mloog zoo.

Cov Cai Siv Tshuaj So

Atoris analogues yog cov tshuaj hauv qab no: Liprimar, Atorvastatin-Teva, Torvakard, Liptonorm. Yog tias nws yog qhov yuav tsum tau xaiv qhov hloov, nws pom zoo kom koj sab laj nrog koj tus kws kho mob ua ntej.

Tus nqi Atoris 20 mg ntsiav tshuaj hauv khw muag tshuaj hauv Moscow yog:

20 mg ntsiav tshuaj, 30 pcs. - 500-550 rub.
Ntsiav tshuaj 20 mg, 90 pcs. - 1100-1170 RUB.

Cov chaw muag tshuaj

Cov Tshuaj Hauv Tshuaj
Atorvastatin yog tus neeg saib xyuas hypolipidemic los ntawm pab pawg ntawm statins. Lub tshuab tseem ceeb ntawm kev ua ntawm atorvastatin yog qhov inhibition ntawm kev ua ntawm 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, ib qho enzyme uas catalyzes hloov dua siab tshiab ntawm HMG-CoA rau mevalonic acid. Qhov kev hloov pauv no yog ib qho ntawm thawj kauj ruam ntawm kev sib tshooj hauv cov roj (cholesterol) coj los ua ke hauv lub cev. Kev tsuj ntawm atorvastatin roj synthesis ua rau cov tshuaj tiv thaiv muaj zog ua kom tsawg ntawm cov lipoprotein tsawg (LDL) hauv cov nplooj siab, nrog rau cov nqaij mos. Cov receptors khi rau LDL cov kab mob thiab tshem tawm ntawm ntshav ntshav, uas ua rau txo qis ntshav plasma (Ch) LDL (Ch-LDL) hauv ntshav ntshav.
Cov nyhuv antisclerotic ntawm atorvastatin yog qhov muaj txiaj ntsig ntawm nws cov nyhuv ntawm phab ntsa ntawm cov hlab ntsha thiab cov ntshav ua haujlwm. Atorvastatin inhibits kev sib txuas ntawm isoprepoids, uas yog yam kev loj hlob rau cov qe ntawm cov roj ntsha sab hauv. Raws li kev cuam tshuam ntawm atorvastatin, endothelium-ywj pheej nthuav dav ntawm cov hlab ntshav txhim kho, qhov kev mloog ntawm LDL-C, apolipyrotein B (apo-B) txo qis. triglycerides (TG). muaj qhov nce ntxiv ntawm qhov kev coj ntawm cov roj (cholesterol) ntawm cov lipoproteins uas ntau (HDL-C) thiab apolipoprotein A (apo-A).
Atorvastatin txo qis viscosity ntawm ntshav ntshav thiab cov kev ua ntawm qee yam coagulation yam thiab platelet aggregation. Vim qhov no, nws txhim kho hemodynamics thiab normalizes qhov mob ntawm coagulation system. HMG-CoA reductase inhibitors tseem cuam tshuam cov metabolism hauv macrophages, thaiv lawv cov kev ua kom zoo thiab tiv thaiv kev tawg ntawm atherosclerotic plaques.
Raws li txoj cai, txoj kev kho mob ntawm atorvastatin raug pom tom qab 2 lub lis piam ntawm kev kho mob, thiab cov txiaj ntsig siab tshaj plaws yuav tshwm sim tom qab 4 lub lis piam.
Atorvastatin ntawm koob tshuaj 80 mg txo qhov kev pheej hmoo ntawm kev tsim ischemic muaj teeb meem (suav nrog kev tuag los ntawm myocardial infarction) los ntawm 16%, kev pheej hmoo rov qab pw tsev kho mob rau angina pectoris nrog cov cim ntawm myocardial ischemia los ntawm 26%.
Cov Tshuaj Pharmacokinetics
Atorvastatin nqus tau ntau, kwv yees 80% yog nqus los ntawm txoj hnyuv plab. Qhov degree ntawm kev nqus thiab kev xav hauv cov ntshav ntshav nce ntxiv hauv kev faib ua feem. Lub sijhawm kom ncav cuag qhov siab tshaj plaws (TCmax), ntawm nruab nrab, 1-2 teev. Hauv cov poj niam, TCmax tau siab dua 20%, thiab thaj chaw hauv qab qhov ntsuas-lub sijhawm nkhaus (AUC) qis dua 10%. Qhov sib txawv ntawm cov khw muag tshuaj hauv cov neeg mob los ntawm lub hnub nyoog thiab poj niam txiv neej yog qhov tsis txaus ntseeg thiab tsis tas yuav tsum kho cov hmab.
Hauv cov neeg mob uas muaj cawv ua mob rau lub siab, TCmax yog 16 npaug ntau dua li ib txwm. Noj ib nyuag txo qhov nrawm thiab ncua sijhawm ntawm kev nqus ntawm cov tshuaj (los ntawm 25% thiab 9%, feem), tab sis qhov txo qis hauv kev ua siab ntawm LDL-C yog zoo li ntawd nrog atorvastatin tsis muaj zaub mov. Atorvastatin bioavailability muaj tsawg (12%), cov kab ke ua haujlwm ntawm bioavailability ntawm kev tiv thaiv kev ua si tiv thaiv HMG-CoA reductase yog 30%. Kev siv lub cev tsis tshua muaj txiaj ntsig zoo yog vim cov kab mob presystemic hauv cov plab zom mov thiab txoj kev nkag mus rau hauv lub siab. Qhov nruab nrab ntim ntawm kev faib tawm atorvastatin yog 381 litres. Ntau tshaj li 98% ntawm atorvastatin khi rau cov ntshav protein. Atorvastatin tsis hla cov ntshav-hlwb teeb meem. Nws yog metabolized feem ntau hauv daim siab nyob rau hauv kev txiav txim ntawm CYP3A4 isoenzyme nrog kev tsim cov pharmacologically nquag metabolites (ortho- thiab parahydroxylated metabolites, beta-oxidation khoom lag luam), uas suav txog kwv yees li 70% ntawm cov kev tiv thaiv tiv thaiv HMG-CoA-reductase rau 20-30 teev.
Ib nrab-lub neej (T1 / 2) ntawm atorvastatin yog 14 teev. Nws yog tawm hauv feem ntau nrog cov kua tsib (nws tsis yauv mus ua ke nkag mus hauv qhov recirculation, nws tsis tas tawm thaum mob hemodialysis). Kwv yees li 46% ntawm atorvastatin raug tawm hauv txoj hnyuv thiab tsawg dua 2% los ntawm lub raum.
Cov pab pawg neeg tshwj xeeb
Cov menyuam
Muaj cov ntaub ntawv txwv ntawm 8-lub limtiam qhib kev kawm ntawm cov tshuaj pharmacoketics hauv cov menyuam yaus (hnub nyoog 6-17 xyoo) nrog heterozygous tsev neeg hypercholesterolemia thiab kev pib ua haujlwm ntawm LDL cov roj cholesterol ≥4 mmol / l, kho nrog atorvastatin hauv daim ntawv ntawm chewable ntsiav tshuaj ntawm 5 mg lossis 10 mg lossis ntsiav tshuaj zaj duab xis-coated ntawm ib koob ntawm 10 mg lossis 20 mg 1 zaug hauv ib hnub, ntsig txog. Qhov tseem ceeb tsuas yog covariate hauv tus qauv pharmacokinetic ntawm cov pej xeem tau txais atorvastatin yog lub cev hnyav. Kev pom tseeb ntawm kev tshem tawm atorvastatin hauv cov menyuam yaus tsis txawv qhov ntawd ntawm cov neeg mob cov neeg laus nrog ntsuas txhua qhov me me los ntawm lub cev nyhav. Hauv qhov ntau ntawm kev ua ntawm atorvastatin thiab o-hydroxyatorvastatin, qhov txo qis hauv LDL-C thiab LDL raug pom.
Cov neeg laus cov neeg mob
Qhov siab tshaj plaws (Cmax) hauv ntshav thiab AUC ntawm cov tshuaj hauv cov neeg mob laus (tshaj 65) yog 40% thiab 30%, feem, siab dua nyob hauv cov neeg mob cov neeg laus uas muaj hnub nyoog yau. Tsis muaj qhov sib txawv hauv kev ua kom muaj txiaj ntsig thiab kev nyab xeeb ntawm cov tshuaj, los yog hauv kev ua tiav cov hom phiaj ntawm kev kho lipid-txo qis hauv cov neeg mob laus piv rau cov pej xeem.
Lub raum khiav tsis zoo
Lub raum ua haujlwm tsis zoo cuam tshuam rau qhov kev txiav txim ntawm atorvastatin hauv ntshav ntshav lossis nws cov nyhuv ntawm lipid metabolism vim li ntawd, kev hloov tshuaj rau cov neeg mob uas lub raum tsis ua haujlwm tsis tas yuav tsum.
Lub siab ua haujlwm tsis zoo
Qhov tshuaj ntawm cov tshuaj tsub kom ntau zuj zus (Cmax - txog 16 npaug, AUC - txog 11 zaug) hauv cov neeg mob haus dej cawv (qib B raws li menyuam-Pugh kev faib tawm).

Siv thaum cev xeeb tub thiab thaum pub niam mis

Cov tshuaj Atoris ® yog sib kis thaum cev xeeb tub thiab thaum pub niam mis.
Kev tshawb fawb tsiaj qhia tias kev pheej hmoo rau tus me nyuam hauv plab yuav dhau qhov txiaj ntsig tau rau leej niam.
Hauv cov poj niam uas muaj hnub nyoog yug me nyuam uas tsis siv txoj hauv kev tiv thaiv kom muaj txiaj ntsig, kev siv Atoris ® tsis pom zoo. Thaum npaj kev cev xeeb tub, koj yuav tsum tsum tsis siv Atoris ®, tsawg kawg, 1 hlis ua ntej npaj cev xeeb tub.
Tsis muaj xov xwm hais txog kev faib cov atorvastatia nrog rau niam mis. Txawm li cas los xij, nyob rau qee hom tsiaj thaum lub sijhawm lactation, qhov concentration ntawm atorvastatia hauv cov ntshav cov ntshav thiab cov mis zoo ib yam. Yog tias koj yuav tsum tau siv cov tshuaj Atoris ® lub sijhawm pub niam mis, txhawm rau kom tsis txhob muaj kev phom sij ntawm cov menyuam mos, kev pub mis niam yuav tsum tau tsum.

Tsuas tshuaj thiab tswj hwm

Ua ntej pib siv cov tshuaj Atoris ®, tus neeg mob yuav tsum pauv mus rau qhov khoom noj uas ua rau kom muaj qhov txo qis ntawm cov lipids hauv cov ntshav ntshav, uas yuav tsum tau pom thaum lub sijhawm kho tag nrho nrog cov tshuaj. Ua ntej pib txoj kev kho mob, koj yuav tsum tau sim ua kom tiav kev tswj hwm ntawm hypercholesterolemia los ntawm kev tawm dag zog thiab kev poob phaus hauv cov neeg mob rog, nrog rau kev kho mob rau lwm tus kab mob.
Cov tshuaj tau noj ntawm qhov ncauj, tsis hais lub sijhawm noj mov. Cov koob tshuaj ntawm cov tshuaj txawv ntawm 10 mg txog 80 mg Kuv ib hnub ib zaug thiab raug xaiv los xav txog thawj zaug kev xav ntawm LDL-C hauv ntshav, lub hom phiaj ntawm txoj kev kho thiab cov tib neeg siv tshuaj kho kom zoo.
Atoris ® tuaj yeem noj ib zaug nyob rau txhua lub sijhawm ntawm hnub, tab sis tib lub sijhawm txhua hnub. Kev kho mob nyhuv yog pom tom qab 2 lub lis piam ntawm kev kho mob, thiab cov txiaj ntsig siab tshaj plaws yuav tshwm sim tom qab 4 lub lis piam.
Thaum pib kho thiab / lossis thaum qhov nce ntxiv, nws yog qhov yuav tsum tau saib xyuas qhov kev nkag siab ntawm lipids hauv cov ntshav ntshav txhua 2-4 lub lis piam thiab kho qhov tshuaj raws li.
Thawj hypercholesterolemia thiab ua ke (qaub) hyperlipidemia
Rau feem ntau cov neeg mob, qhov kev pom zoo ntawm Atoris ® yog 10 mg ib hnub ib zaug, qhov kev kho mob tshwm sim nws tus kheej tsis pub dhau 2 lub lis piam thiab feem ntau nce mus txog qhov siab kawg tom qab 4 tus nqi Nrog kev kho mob ntev, cov nyhuv cuam tshuam.
Homozygous tsev neeg hypercholesterolemia
Feem ntau, tab sis 80 mg yog tau sau tseg ib hnub ib hnub (qhov kev txo qis ntawm cov concentration ntawm LDL-C hauv plasma los ntawm 18-45%).
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 tseeb ntawm qhov koob tshuaj txhua 4 lub lis piam nrog kev nce ntxiv txog 40 mg ib hnub twg. Tom qab ntawd, txawm tias qhov koob tshuaj yuav raug nce ntxiv txog qhov siab tshaj ntawm 80 mg rau ib hnub, lossis nws yog ua tau los sib txuas cov tshuaj tiv thaiv kab mob sib txuas nrog kev siv atorvastatin ntawm ib koob ntawm 40 mg ib hnub twg.
Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob
Hauv kev tshawb nrhiav ntawm kev tiv thaiv kev tiv thaiv thawj zaug, koob tshuaj atorvastatin yog 10 mg rau ib hnub.
Qhov koob tshuaj ntxiv yuav tsim nyog kom ua tiav LDL-C tus nqi raws li cov lus qhia tam sim no.
Siv rau hauv cov menyuam yaus ntawm 10 txog 18 xyoo nrog rau kev tiv thaiv heterozygous tsev neeg hypercholesterolemia
Qhov pom zoo pib tsob txiv hmab 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.
Cov koob tshuaj ntawm cov tshuaj yuav tsum raug xaiv raws li lub hom phiaj ntawm kev kho lipid-txo qis. Kev hloov koob tshuaj yuav tsum tau ua ntawm ncua sijhawm ntawm 1 lub sijhawm hauv 4 lub lis piam lossis ntau dua.
Daim siab ua haujlwm
Yog tias lub siab ua haujlwm tsis txaus, koob tshuaj Atoris ® yuav tsum txo qis, nrog kev soj ntsuam tas li ntawm kev ua haujlwm ntawm "daim siab" hloov pauv: aspartate aminotransferase (ACT) thiab alanine aminotransferase (ALT) hauv ntshav ntshav.
Tsis hlauv
Lub raum ua haujlwm tsis zoo cuam tshuam rau lub zog ntawm atorvastatin lossis qhov neeg kawm poob qis hauv kev ua haujlwm ntawm lub siab ntawm LDL-C hauv ntshav, yog li ntawd, kev hloov tshuaj ntau dua yog tsis xav tau (saib ntu "Pharmacokinetics").
Cov neeg laus cov neeg mob
Tsis muaj qhov sib txawv hauv kev siv tshuaj thiab kev nyab xeeb ntawm atorvastatin hauv cov neeg mob laus piv nrog cov pej xeem sawv daws, kev hloov tshuaj yog tsis xav tau (saib Ntu Pharmacokinetics).
Siv nrog rau lwm cov tshuaj
Yog tias nws yuav tsum tau siv nws ib txhij nrog cyclosporine, telaprevir, lossis kev sib xyaw ntawm tipranavir / ritonavir, koob tshuaj Atoris ® yuav tsum tsis pub tshaj 10 mg / hnub (saib Tshooj "Cov Lus Qhia Tshwj Xeeb").
Kev ceev faj yuav tsum tau siv thiab kev siv tshuaj qis tshaj plaws ntawm atorvastatin yuav tsum tau siv thaum nws siv nrog HIV tiv thaiv kab mob tiv thaiv kab mob, kis kab mob siab C tiv thaiv kab mob siab (boceprevir), clarithromycin thiab itraconazole.
Cov lus pom zoo ntawm Lavxias Cardiological Society, National Society rau Txoj Kev Kawm ntawm Atherosclerosis (NLA) thiab Lavxias Society of Cardiosomatic Rehabilitation thiab Secondary Tiv Thaiv (RosOKR) (V kho dua 2012)
Cov tshuaj zoo siab tshaj plaws ntawm LDL-C thiab tag nrho cov roj (cholesterol) rau cov neeg mob muaj feem ntau yog: ≤2.5 mmol / L (lossis ≤100 mg / dL) thiab ≤4.5 mmol / L (lossis ≤ 175 mg / dL), feem thiab rau cov neeg mob uas muaj qhov pheej hmoo loj: ≤1.8 mmol / l (lossis ≤70 mg / dl) thiab / lossis, yog tias nws tsis tuaj yeem ua tiav, nws raug nquahu kom txo qhov siab ntawm LDL-C los ntawm 50% los ntawm thawj tus nqi thiab ≤4 mmol / l (lossis ≤150 mg / dl), feem.

Sab sij huam

Kev faib tawm ntawm qhov tshwm sim ntawm cov kev mob tshwm sim ntawm Lub Ntiaj Teb Kev Noj Qab Haus Huv (WHO):

heev heev

≥1/10

feem ntau

≥1 / 100 txog 1/1000 rau Kis thiab cov kab mob cab:
feem ntau: nasopharyngitis.
Kev cuam tshuam los ntawm cov ntshav thiab cov lymphatic system:
tsis tshua muaj: thrombocytopenia.
Lub cev tsis muaj zog tiv thaiv kab mob:
feem ntau: ua xua,
tsawg tsawg: anaphylaxis.
Kev ntshaib plab thiab zaub mov tsis haum:
pheej: yuag yuag, tsis nco qab,
Tsis tshua muaj heev: hyperglycemia, ntshav qab zib tsawg.
Mob Hlwb:
feem ntau: pw ntxhov siab, suav nrog insomnia thiab "npau suav phem" npau suav:
zaus tsis paub: kev nyuaj siab.
Ua txhaum ntawm lub paj hlwb:
feem ntau: mob taub hau, kiv taub hau, mob caj dab, mob asthenic,
tsis xws luag: muaj hlwb neuropathy, mob ntshav qab zib, ua rau tsis hnov qab, poob lossis ploj nco.
Kev hnov lus thiab lub labyrinth tsis meej:
ncaw: tinnitus.
Kev ua tsis taus ntawm lub tshuab ua pa, hauv siab thiab mediastinal kabmob:
feem ntau: mob mob caj pas, txhawm ntswg,
zaus tsis paub: raug cov kab mob sib xws hauv lub ntsws (feem ntau yog siv ntev heev).
Digestive ntshawv siab:
feem ntau: cem quav, dyspepsia, xeev siab, raws plab, mob plab (tsam plab), mob plab,
ncus: ntuav, pancreatitis.
Kev ua txhaum ntawm daim siab thiab kab mob:
tsis tshua muaj: kab mob siab, mob siab tawv nqaij daj ntseg.
Kev ua tsis taus los ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous:
feem ntau: tawv nqaij ua pob, khaus,
pheej: urticaria,
muaj tsawg kawg: angioedema, alopecia, ua pob liab vog, mob erythema multiforme, Stevens-Johnson syndrome, cov kab mob ua paug lom hauv lub cev.
Kev ua txhaum ntawm cov leeg nqaij thiab pob qij txha:
feem ntau: myalgia, mob caj dab, mob nraub qaum, o ntawm pob qij txha,
tsis tuaj yeem: mob raum, mob leeg,
tsis tshua muaj: myositis, rhabdomyolysis, genopathy (qee qhov mob txhaws),
zaus tsis paub: mob ntawm kev tiv thaiv-mediated necrotizing myopathy.
Ua txhaum ntawm ob lub raum thiab lub plab:
tsis nkag siab: lub raum tsis ua haujlwm.
Ua txhaum ntawm cov qau thiab qhov chaw mos ntawm lub plab:
yooj yim: kev ua niam txiv tsis ua hauj lwm,
tsis tshua muaj: gynecomastia.
Kev cuam tshuam dav dav thiab cuam tshuam ntawm qhov chaw txhaj tshuaj:
feem ntau: peripheral edema,
ncus: mob hauv siab, kub siab, nkees, kub cev.
Kuaj thiab ntsuas cov ntaub ntawv:
tsis nkag siab: nce kev ua haujlwm ntawm aminotransferase (ACT, ALT), kev ua si ntawm cov ntshav creatine phosphokinase (CPK) hauv ntshav ntshav,
Tsis tshua muaj heev: muaj kev xav ntau ntxiv ntawm glycosylated hemoglobin (HbAl).
Kev sib raug zoo ntawm qee qhov teebmeem tsis txaus siab nrog kev siv tshuaj Atoris ®, uas tau hais tias "muaj tsawg kawg", tsis tau tsim. Yog tias muaj qhov tshwm sim tsis pom tshwm sim ntau, yuav tsum siv Atoris ® txuas mus ntxiv.

Daim ntawv tso tawm

Cov ntsiav tshuaj ua yeeb yaj kiab, 10 mg thiab 20 mg.
10 ntsiav tshuaj rau ib lub blister (blister sawb ntim) los ntawm cov khoom sib txuas ua ke polyamide / aluminium ntawv ci / PVC - txhuas ntawv ci (Coldforming OPA / A1 / PVC-AI).
1, 3, 6 lossis 9 hlwv (hlwv) nrog rau cov lus qhia rau kev siv yuav muab tso rau hauv lub thawv ntawv thawv.

Cov tshuaj sib cuam tshuam

Txoj kev pheej hmoo ntawm kev tsim myopathy nce ntxiv thaum kho nrog HMG-CoA reductase inhibitors thiab kev siv cyclosporin, cov leeg fibroic acid, boceprevir, nicotinic acid thiab cytochrome P450 3A4 inhibitors (erythromycin, antifungal agents ntsig txog azoles). Hauv cov neeg mob ib txhij noj atorvastatin thiab boceprevir, nws raug nquahu kom siv Atoris® nyob rau hauv qis dua thawj zaug thiab coj los soj ntsuam. Thaum lub sijhawm siv ua ke nrog boceprevir, koob tshuaj txhua hnub ntawm atorvastatin yuav tsum tsis pub tshaj 20 mg.

Cov ntawv tshaj tawm tsis tshua muaj txhaj tshuaj tiv thaiv kab mob myopathy (OSI) tau qhia tawm thaum lub sijhawm lossis tom qab kho nrog statins, suav nrog atorvastatin. OSI yog qhov kev kuaj mob los ntawm qhov tsis sib thooj ntawm cov leeg tsis muaj zog thiab ua kom cov ntshav muaj zog ntau ntau, uas ua rau muaj kev mob siab txawm tias tsis siv tshuaj kho statin.

P450 3A4 Cov Tshuaj Hluav Taws Xob: atorvastatin yog metabolized los ntawm cytochrome P450 3A4. Kev siv tib lub sijhawm ntawm Atoris thiab cytochrome P450 3A4 inhibitors tuaj yeem ua rau nce qhov kev cia siab ntawm atorvastatin hauv cov ntshav ntshav. Qib kev sib cuam tshuam thiab kev muaj zog ntawm cov nyhuv yog nyob ntawm qhov txawv txav ntawm kev txiav txim ntawm cytochrome P450 3A4.

Ib txhij siv muaj zog inhibitorsP450 3A4(xws li cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posaconazole thiab HIV protease inhibitors)suav nrog ritonavir, lopinavir, atazanavir, indinavir, darunavir, thiab lwm yam..) Yuav tsum zam zam kom deb li deb tau. Hauv qhov xwm txheej uas tsis tuaj yeem siv cov tshuaj no nrog atorvastatin tsis tuaj yeem zam, nws raug nquahu kom txo qis qis qis tshaj plaws ntawm kev siv tshuaj atorvastatin, nrog rau kev soj ntsuam kom zoo ntawm tus neeg mob lub sijhawm.

Muaj pes tsawg inhibitorsP450 3A4 (Xws li. erythromycin, diltiazem, verapamil thiab fluconazole) tej zaum yuav nce plasma ntau ntawm atorvastatin. Thaum siv erythromycin txuam nrog statins, muaj kev pheej hmoo ntawm myopathy. Cov kev tshawb fawb sib cuam tshuam los ntsuas qhov tshwm sim ntawm amiodarone lossis verapamil ntawm atorvastatin tsis tau ua tiav. Ob qho tshuaj amiodarone thiab verapamil inhibit kev ua si ntawm P450 3A4, thiab lawv siv nrog atorvastatin tuaj yeem ua rau muaj kev tiv thaiv ntau dua ntawm atorvastatin. Yog li, nrog rau kev siv tib lub sijhawm nrog P450 3A4 inhibitors, nws raug nquahu kom txhaj tshuaj tsawg dua ntawm atorvastatin thiab nqa tawm kev soj ntsuam uas tsim nyog hauv tus neeg mob. Kev saib xyuas hauv chav kho mob raug pom zoo tom qab pib kho mob lossis tom qab hloov kho koob tshuaj ntawm lub inhibitor.

Cov thauj khoom siv hloov pauv: atorvastatin thiab nws cov metabolites yog cov substrates ntawm OATP1B1 transporter. OATP1B1 inhibitors (piv txwv li, cyclosporine) yuav ua rau kom muaj kev nyab xeeb ntawm atorvastatin. Kev siv tib txhij ntawm 10 mg ntawm atorvastatin thiab cyclosporine (5.2 mg / kg / hnub) ua rau muaj kev nce ntxiv ntawm atorvastatin los ntawm 7,7 lub sijhawm.

Nrog rau kev siv atorvastatin thiab tshuaj tiv thaiv ib txwm ntawm CYP3A4 isoenzyme lossis cov cab kuj muaj cov protein, kev nce siab ntawm atorvastatin hauv cov ntshav ntshav thiab kev pheej hmoo ntawm myopathy yog tau. Txoj kev pheej hmoo kuj tuaj yeem nce nrog kev siv atorvastatin nrog rau lwm cov tshuaj uas tuaj yeem ua rau mob myopathy, xws li derivatives ntawm fibroic acid thiab ezetimibe.

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 3A4, ib qho kev nce siab ntawm atorvastatin hauv cov ntshav ntshav tau pom.

Protease Inhibitionitors: concomitant siv atorvastatin nrog protease inhibitors hu ua cytochrome P450 3A4 inhibitors tau nrog los ntawm kev nce ntshav ntau dua ntawm atorvastatin.

Diltiazem hydrochloride: kev siv tib txhij ntawm atorvastatin (40 mg) thiab diltiazem (240 mg) ua rau muaj kev nce siab ntawm atorvastatin hauv cov ntshav ntshav.

Cimetidine: ib txoj kev tshawb nrhiav tau ua rau kev cuam tshuam ntawm atorvastatin thiab cimetidine, tsis muaj kev cuam tshuam loj hauv kev tshawb pom.

Itraconazole: kev siv tib txhij ntawm atorvastatin (20 mg-40 mg) thiab itraconazole (200 mg) ua rau muaj kev nce ntxiv ntawm AUC ntawm atorvastatin.

Cov kua txiv kab ntxwv qaub: muaj ib lossis ob qho sib xyaw uas tiv thaiv CYP 3A4 thiab tuaj yeem nce qhov tshuaj atorvastatin nyob rau hauv cov ntshav ntshav, tshwj xeeb tshaj yog kev noj cov txiv kab ntxwv qaub ntau dhau (ntau tshaj li 1.2 liv ib hnub).

Cov kws kho mob ntawm cytochrome P450 3A4: tib lub sijhawm siv atorvastatin nrog cytochrome P450 3A4 inducers (efavirenz, rifampin thiab St. John lub wort npaj) tuaj yeem ua rau kom txo qis ntawm cov tshuaj atorvastatin hauv ntshav ntshav. Tau muab ob lub tshuab ua haujlwm ntawm rifampin (induction ntawm cytochrome P450 3A4 thiab inhibition ntawm OATP1B1 hloov enzyme hauv daim siab), nws raug nquahu kom muab Atoris® tib lub sijhawm nrog rifampin, txij li thaum noj Atoris tom qab noj rifampin ua rau txo qis hauv theem ntawm atorvastatin hauv ntshav ntshav.

Tshuaj Antacids: kev noj haus ib txhij ntawm kev ncua kev kawm uas muaj cov khoom siv magnesium thiab aluminium hydroxides txo qhov kev xav ntawm atorvastatin hauv cov ntshav ntshav los ntawm li ntawm 35%, txawm li cas los xij, cov neeg kawm ntawv qib poob ntawm cov ntsiab lus ntawm LDL-C tseem tsis hloov.

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

Gemfibrozil / fibroic acid derivatives: monotherapy nrog fibrates nyob rau qee kis muaj nrog kev xav tsis zoo los ntawm cov leeg, nrog rau rhabdomyolysis. Txoj kev pheej hmoo ntawm cov tshwm sim no tuaj yeem tau nce nrog kev tswj hwm tib lub sij hawm ntawm derivatives ntawm fibroic acid thiab atorvastatin. Yog tias siv kev sib txig tsis tuaj yeem zam, kom ua tiav lub hom phiaj kho, qhov tshuaj tiv thaiv qis ntawm atorvastatin yuav tsum siv thiab cov neeg mob yuav tsum tau saib xyuas kom zoo.

Ezetimibe: Ezetimibe monotherapy yog nrog cov kev mob tshwm sim los ntawm cov leeg, nrog rau rhabdomyolysis. Thiaj li, qhov txaus ntshai ntawm cov tshwm sim tuaj yeem raug nce nrog kev tswj hwm tib lub sijhawm ntawm ezetimibe thiab atorvastatin. Kev tshuaj xyuas kom zoo yog pom zoo hauv cov neeg mob no.

Kauj ruam: nrog rau kev siv tib lub sijhawm ntawm colestipol, qhov kev txiav txim siab ntawm atorvastatin hauv cov ntshav ntshav poob qis li 25%, txawm li cas los xij, lipid-txo cov nyhuv ntawm kev sib xyaw ntawm atorvastatin thiab colestipol ntau tshaj li qhov ntawm txhua cov tshuaj ib leeg zuj zus.

Digoxin: Nrog kev rov ua dua ntawm digoxin thiab atorvastatin ntawm koob tshuaj 10 mg, qhov sib npaug ntawm digoxin hauv cov ntshav plasma 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.

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

Qhov ncauj txwv tsis pub muaj: nrog kev siv atorvastatin thiab kev noj tshuaj ntau qhov ncauj muaj norethindrone thiab ethinyl estradiol, muaj qhov nce ntxiv ntawm AUC ntawm norethindrone thiab ethinyl estradiol txog 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: hauv kev tshawb nrhiav hauv cov neeg mob uas tau txais kev kho mob ntev warfarin, kev siv tshuaj atorvastatin ntawm kev siv tshuaj ntawm 80 mg rau ib hnub nrog warfarin ua rau muaj kev cuam tshuam me ntsis ntawm prothrombin lub sijhawm los ntawm 1.7 vib nas this thaum thawj 4 hnub ntawm kev kho mob, uas rov qab mus rau qhov qub tsis pub dhau 15 hnub tom qab kho atorvastatin. Txawm hais tias tsuas yog qee qhov mob tsawg kawg ntawm kev kho mob tseem ceeb nrog cov tshuaj tiv thaiv anticoagulants tau tshaj tawm, hauv cov neeg mob noj coumarin anticoagulants, lub sijhawm prothrombin yuav tsum txiav txim siab ua ntej pib kho nrog atorvastatin thiab feem ntau txaus nyob rau theem pib ntawm kev kho kom paub tseeb tias tsis muaj kev hloov pauv ntau ntawm prothrombin lub sijhawm. Thaum lub sijhawm ruaj khov prothrombin lub sijhawm tau sau tseg, nws tuaj yeem soj ntsuam thaum lub sijhawm ib txwm muaj kev pom zoo rau cov neeg mob tau txais cov tshuaj coumarin anticoagulants. Cov txheej txheem qub yuav tsum tau rov ua dua thaum hloov cov tshuaj atorvastatin lossis nws tshem tawm txoj haujlwm. Txoj kev kho Atorvastatin tsis yog nrog los ntawm kis los ntshav lossis hloov pauv lub sijhawm prothrombin hauv cov neeg mob

Warfarin: Tsis muaj kev tshawb nrhiav qhov tseem ceeb ntawm cov atorvastatin nrog cov tshuaj warfarin pom.

Amlodipine: nrog kev siv tib txhij ntawm atorvastatin 80 mg thiab amlodipine 10 mg, pharmacokinetics ntawm atorvastatin hauv lub xeev equilibrium tsis hloov.

Colchicine: Txawm hais tias kev tshawb fawb ntawm kev sib cuam tshuam ntawm atorvastatin thiab colchicine tsis tau ua, tus neeg ntawm myopathy tau tshaj tawm nrog kev siv cov atorvastatin thiab colchicine.

Fusidic acid: cov kev tshawb fawb ntawm kev sib cuam tshuam ntawm atorvastatin thiab fusidic acid tsis tau ua, txawm li cas los xij, mob ntawm rhabdomyolysis nrog lawv siv tib txhij tau qhia hauv kev tshawb fawb tom qab kev lag luam. Yog li, cov neeg mob yuav tsum tau saib xyuas thiab, yog tias tsim nyog, Kev kho Atoris tuaj yeem raug ncua ib ntus.

Lwm txoj kev kho kom zoo: hauv kev tshawb fawb soj ntsuam, atorvastatin tau siv ua ke nrog cov tshuaj antihypertensive thiab estrogens, uas tau sau tseg nrog lub hom phiaj hloov chaw, tsis muaj cov tsos mob ntawm qhov chaw tsis txaus ntseeg muaj kev cuam tshuam.

Ua rau daim siab

Tom qab kho nrog atorvastatin, qhov tseem ceeb (ntau dua 3 zaug hauv qhov sib piv nrog qhov tsis pub tsawg tshaj qhov ib txwm) tau nce siab ntxiv cov kev ua ub no ntawm "mob siab" transaminases tau sau tseg.

Ib qho kev nce siab ntxiv hauv kev ua haujlwm ntawm hepatic transaminases feem ntau tsis muaj kab mob daj ntseg lossis lwm yam kev kuaj mob hauv lub cev. Nrog rau qhov txo qis dua ntawm cov tshuaj atorvastatin, ib ntus lossis ua tiav tsis raug tshuaj, cov haujlwm ntawm hepatic transaminases rov qab mus rau nws qhov qub. Feem ntau ntawm cov neeg mob txuas ntxiv noj atorvastatin hauv kev txo qis yam tsis muaj teeb meem.

Nws yog ib qho tsim nyog yuav tau soj ntsuam daim siab kev ua haujlwm hauv lub sijhawm thaum tag nrho kev kho mob, tshwj xeeb tshaj yog thaum pom cov tsos mob ntawm daim siab tshwm sim. Nyob rau hauv cov ntaub ntawv ntawm kev nce hauv cov ntsiab lus ntawm hepatic transaminases, lawv cov kev ua haujlwm yuav tsum tau saib xyuas kom txog thaum cov kev txwv ntawm kev suav tau mus txog. Yog tias nce hauv AST lossis ALT kev ua haujlwm los ntawm ntau dua 3 zaug piv nrog kev ntsuas siab ntawm tus neeg ua haujlwm siab, nws raug nquahu tias cov koob tshuaj yuav raug txo lossis tshem tawm.

Skeletal leeg ua

Thaum sau tshuaj rau atorvastatin hauv hypolipidemic doses nyob rau hauv kev sib xyaw nrog kev sib txuas ntawm cov fibroic acid, erythromycin, immunosuppressants, azole antifungal tshuaj los yog nicotinic acid, tus kws kho mob yuav tsum ua tib zoo ntsuas cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob thiab saib xyuas cov neeg mob kom paub qhov mob lossis tsis muaj zog hauv cov leeg, tshwj xeeb tshaj yog thaum thawj lub hli kev kho mob thiab nyob rau lub sij hawm muab cov tshuaj ntau ntxiv rau. Nyob rau tej qhov xwm txheej zoo li no, kev txiav txim siab ntawm CPK cov haujlwm txhua lub sijhawm tuaj yeem pom zoo, txawm hais tias kev saib xyuas zoo li no tsis tiv thaiv kev txhim kho kev mob myopathy. Atorvastatin tuaj yeem ua rau nce hauv creatine phosphokinase kev ua ub no.

Thaum siv atorvastatin, muaj qee yam mob ntawm rhabdomyolysis nrog mob raum tsis ua haujlwm vim qhov mob myoglobinuria thiab myoglobinemia tau piav qhia. Atorvastatin kev kho mob yuav tsum tau txiav tawm ib ntus los sis txiav tawm tag nrho yog tias muaj cov cim qhia tias muaj myopathy lossis muaj kev pheej hmoo rau kev txhim kho lub raum tsis ua haujlwm vim rhabdomyolysis (piv txwv li, mob hnyav, mob ntshav qis, kev phais mob loj, kev poob plig, metabolic, endocrine thiab electrolyte cuam tshuam thiab kev tswj tsis tau tus mob).

Cov ntaub ntawv rau tus neeg mob: cov neeg mob yuav tsum tau ceeb toom tias lawv yuav tsum tau sab laj nrog kws kho mob tam sim ntawd yog tias qhov mob tsis qhia lossis qhov tsis muaj zog ntawm cov leeg yuav tshwm sim, tshwj xeeb yog tias lawv nrog mob malaise lossis kub taub hau.

Siv nrog ceev faj hauv cov neeg mob uas quav cawv thiab / lossis raug mob los ntawm daim siab mob (keeb kwm).

Kev soj ntsuam ntawm 4731 cov neeg mob uas tsis muaj mob plawv (CHD) uas muaj mob stroke lossis hloov ischemic nres 6 lub hlis dhau los thiab tus uas pib noj atorvastatin 80 mg tau qhia tawm qhov feem pua ntawm hemorrhagic mob stroke ntawm pab pawg 80 mg ntawm atorvastatin piv nrog placebo ( 55 ntawm atorvastatin piv rau 33 ntawm cov tshuaj placebo). Cov neeg mob hemorrhagic mob stroke pom tias muaj kev pheej hmoo ntxiv ntawm cov mob stroke (7 ntawm atorvastatin tiv thaiv 2 ntawm cov placebo). Txawm li cas los xij, cov neeg mob noj atorvastatin 80 mg muaj tsawg dua qhov mob stroke ntawm txhua yam (265 piv rau 311) thiab tsawg dua cov kab mob plawv.

Cov mob ntsws interstitial

Nrog kev siv qee yam statins, tshwj xeeb nrog kev kho mob mus sij hawm ntev, tsis tshua muaj tus neeg uas mob ntsws los ntawm lub ntsws. Qhov pom kev ua ke yuav suav nrog ua rau ua tsis taus pa, tsis hnoos tsis meej, thiab tsis muaj mob (nkees, poob phaus, thiab kub cev). Yog tias muaj kev ua xyem xyav ntawm tus neeg mob txhim kho cov kab mob ntsws interstitial ntsws, kev kho statin yuav tsum tsis ua mus ntxiv.

Qee cov pov thawj qhia tias statins, raws li chav kawm, nce ntshav qabzib ntshav thiab hauv qee cov neeg mob uas muaj kev pheej hmoo loj ntawm kev mob ntshav qab zib yav tom ntej, lawv tuaj yeem ua rau hyperglycemia, nyob rau hauv uas nws raug nquahu kom pib kho mob ntshav qab zib. Txawm li cas los xij, qhov kev pheej hmoo no tau dhau los ntawm cov txiaj ntsig ntawm kev txo qis kev pheej hmoo rau cov hlab ntshav nrog statins, thiab yog li ntawd yuav tsum tsis txhob yog lub laj thawj ntawm kev txiav cov kev kho statin. Cov neeg muaj mob pheej hmoo (yoo qab zib ntawm 5.6–6.9 mmol / l, BMI> 30 kg / m2, nce triglycerides, kub siab)

yuav tsum tau saib xyuas ob qho tib si hauv tsev kho mob thiab cov kab mob tshuaj lom neeg raws li cov lus qhia hauv lub teb chaws.

Cev xeeb tub thiab lactation

Cov poj niam ntawm kev muaj me nyuam hnub nyoog yuav tsum siv txoj kev ua kom muaj txiaj ntsig thaum lub sijhawm kho. Atorvastatin tuaj yeem siv tau rau cov poj niam muaj hnub nyoog yug me nyuam tsuas yog tias qhov tshwm sim ntawm cev xeeb tub muaj tsawg heev, thiab tus neeg mob tau paub txog qhov kev pheej hmoo rau tus me nyuam hauv plab thaum kho.

Cov lus ceeb toom tshwj xeeb txog cov neeg excipients Atoris® muaj cov lactose. Cov neeg mob uas tsis tshua muaj keeb rau galactose tsis txaus, Lapp lactase deficiency lossis glucose-galactose malabsorption tsis tas noj cov tshuaj no. Cov yam ntxwv ntawm cov nyhuv ntawm cov tshuaj ntawm lub peev xwm tsav lub tsheb thiab muaj cov phom sij phom sij

Muab cov kev phiv los ntawm cov tshuaj, ceev faj yuav tsum tau siv thaum tsav tsheb thiab lwm yam uas yuav muaj kev phom sij.

Daim Ntawv Tso Npe Sau Npe

Krka, hnub, Novo mesto, Slovenia

Chaw nyob ntawm lub koom haum uas lees txais kev thov nyiaj los ntawm cov neeg siv khoom ntawm cov khoom lag luam zoo (cov khoom lag luam) hauv thaj chaw ntawm lub koom pheej ntawm Kazakhstan thiab muaj lub luag haujlwm rau kev tso npe tom qab kev soj ntsuam kev nyab xeeb tshuaj nyob hauv thaj chaw ntawm koom pheej ntawm Kazakhstan

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