Roxeracene, nrhiav, yuav > Tshuaj Kho Mob

Lub npe kev lag luam ntawm cov tshuaj: Roxera

Lub Npe Tsis Muaj Npe International: Rosuvastatin (Rosuvastatinum)

Dosage daim ntawv: zaj duab xis-coated ntsiav tshuaj

Yam tshuaj muaj sia: rosuvastatin

Cov tshuaj pab pawg kho mob: lipid-txo cov tshuaj.

Hypocholesterolemic thiab hypotriglyceridemic tshuaj. HMG CoA reductase inhibitors.

Cov yam ntxwv Pharmacological:

Qhov kev ua ntawm lub roxer npaj yog tsom rau kev txwv kev ua ub no ntawm microsomal enzyme hydroxymethylglutaryl-CoA reductase, uas ua cov haujlwm ua kom muaj kev cuam tshuam txog kev txiav cov roj thaum ntxov.

Kev kho kom zoo ntawm cov lipid profile ntsuas (lipid-txo cov nyhuv) vim qhov txo qis hauv cov ntshav ntawm cov roj (cholesterol) tag nrho, triglycerides, lipoproteins tsawg tsawg, nrog rau kev nce siab hauv lipoprotein ntau. Cov tshuaj yog zwm rau hauv pawg tshuaj pharmacological "Statins".

Kev taw qhia rau kev siv:

Thawj hypercholesterolemia (hom IIa raws li Fredrickson) los yog sib xyaw dyslipidemia (hom IIb raws li Fredrickson) yog ib qho kev ntxiv rau kev noj zaub mov nrog qhov tsis muaj txiaj ntsig ntawm kev noj haus thiab lwm yam kev siv tshuaj tsis zoo ntawm kev kho mob (piv txwv, kev tawm dag zog, poob phaus), tsev neeg homozygous hypercholesterolemia ntxiv rau kev noj haus thiab lwm yam lipid-txo txoj kev kho (piv txwv li, LDL-apheresis) lossis yog tias kev kho mob tsis muaj txiaj ntsig, hypertriglyceridemia (Fredrickson yam IV) ntxiv rau kev noj zaub mov, kom ua rau muaj kev vam meej ntawm atherosclerosis raws li ob qho ntxiv rau kev noj haus hauv cov neeg mob uas tau qhia kev kho mob kom txo cov ntshav plasma concentration ntawm Chs thiab Chs-LDL, kev tiv thaiv thawj ntawm cov kev mob plawv tseem ceeb (mob stroke, myocardial infarction, mob hlab ntsha hauv lub plawv) hauv cov neeg laus tsis muaj kev soj ntsuam kab mob ntawm cov hlab ntshav txhaws, tab sis nrog kev pheej hmoo ntawm nws txoj kev loj hlob (hnub nyoog tshaj 50 xyoo rau cov txiv neej thiab ntau dua 60 rau cov poj niam, nce ntshav plasma concentration ntawm C-reactive protein (g2 g / l) thaum muaj tsawg kawg ib qho ntawm cov kev pheej hmoo ntxiv, xws li ntshav siab Zia, qhov uas tsis muaj ntshav concentration ntawm HDL-Xc, haus luam yeeb, thaum ntxov coronary artery kab mob nyob rau hauv tsev neeg keeb kwm).

Cev xeeb tub thiab lactation - Roxer yog contraindicated hauv kev xeeb tub thiab lactation. Cov poj niam ntawm kev muaj me nyuam hnub nyoog yuav tsum siv txoj kev ua kom muaj txiaj ntsig kom tsim nyog.

Txij li cov roj (cholesterol) thiab cov tshuaj sib tov los ntawm cov roj (cholesterol) yog qhov tseem ceeb rau kev loj hlob ntawm tus me nyuam hauv plab, qhov kev pheej hmoo muaj peev xwm los tiv thaiv HMG-CoA reductase rau cov me nyuam hauv plab ntau dua cov txiaj ntsig ntawm kev siv tshuaj thaum cev xeeb tub.

Yog tias cev xeeb tub thaum kho, kev siv cov tshuaj yuav tsum nres tam sim ntawd.

Tsis muaj cov ntaub ntawv hais txog kev zam ntawm rosuvastatin nrog rau niam cov kua mis (nws paub tias lwm cov tshuaj tiv thaiv HMG-CoA reductase tuaj yeem tawm hauv cov kua mis), yog li kev siv tshuaj yuav tsum tsis ua ntxiv thaum pub niam mis.

Cov Tshuaj Tiv Thaiv:

Nrog rau qhov kev noj tshuaj txhua hnub txog 30 mg

Cov kab mob siab nyob hauv theem nquag (suav nrog kev nce ntxiv hauv kev ua haujlwm ntawm hepatic transaminases thiab kev nce siab hauv kev ua haujlwm ntawm hepatic transaminases hauv cov ntshav cov ntshav ntau dua 3 zaug piv nrog VGN), mob raum tsis ua haujlwm (CC tsawg dua 30 ml / min), myopathy, concomitant siv cyclosporine, cov neeg mob predisposed rau txoj kev loj hlob ntawm myotoxic muaj teeb meem, cev xeeb tub, lub sijhawm pub mis niam, siv rau cov poj niam ntawm lub hnub nyoog yug menyuam uas tsis siv txoj hauv kev tsim kom muaj txiaj ntsig, lactose tsis haum, lactose tsis txaus PS, qabzib-galactose malabsorption syndrome, uas muaj hnub nyoog 18 xyoo, npau taws me ntsis rau rosuvastatin los yog rau tej feem ntawm cov tshuaj.

Nrog rau qhov kev noj tshuaj txhua hnub ntawm 30 mg lossis ntau dua:

mob raum mus rau lub raum tsis ua haujlwm (CC tsawg dua 60 ml / min), hypothyroidism,

cov kab mob mob hauv keeb kwm (suav nrog tsev neeg keeb kwm), myotoxicity nrog lwm HMG-CoA reductase inhibitors lossis cov hlab ntsha hauv keeb kwm, kev haus cawv ntau dhau, cov xwm txheej uas tuaj yeem ua rau nce ntshav plasma concentration ntawm rosuvastatin, tib lub sijhawm siv cov fibrates, cov neeg mob ntawm haiv neeg Mongoloid.

Nrog ceev faj nrog ib koob tshuaj txhua hnub txog li 30 mg:

lub hnub nyoog tshaj 65 xyoo, mob ntshav hauv lub plawv, ntau txoj kev phais mob, txhawm rau mob, hnyav kawg hauv lub cev, mob endocrine lossis electrolyte cuam tshuam lossis tsis nco qab qhov chua leeg, ib txhij siv nrog ezetimibe.

Muab thiab kev coj:

Cov tshuaj tau noj ntawm qhov ncauj. Tsis txhob zom lossis zom cov ntsiav tshuaj, nqos tag nrho, ntxuav nrog dej, tuaj yeem noj tau txhua lub sijhawm ntawm hnub, tsis hais txog ntawm cov khoom noj.

Ua ntej pib txoj kev kho mob nrog cov tshuaj roxer, tus neeg mob yuav tsum pib ua raws cov qauv hypocholesterolemic noj haus thiab txuas ntxiv ua raws nws thaum kho. Qhov ntau thiab tsawg ntawm cov tshuaj yuav tsum tau xaiv ib tus zuj zus nyob ntawm lub hom phiaj ntawm txoj kev kho thiab kho cov lus teb rau kev kho mob, noj rau hauv lub teb chaws cov lus pom zoo ntawm phiaj plasma lipid ntau.

Qhov pom zoo kom pib noj rau cov neeg mob pib noj cov tshuaj, lossis rau cov neeg mob hloov pauv los ntawm noj lwm HMG-CoA reductase inhibitors, yuav tsum yog 5 lossis 10 mg ib hnub ib zaug.

Nrog rau kev siv cov tshuaj ib txhij nrog gemfibrozil, fibrates, nicotinic acid nyob rau hauv ib koob tshuaj ntau dua 1 g ib hnub, cov neeg mob raug pom zoo kom pib cov koob tshuaj 5 mg. Thaum xaiv cov tshuaj xub thawj, ib qho yuav tsum tau ua los ntawm cov tib neeg cov ntshav muaj roj cholesterol siab thiab coj mus rau hauv qhov kev pheej hmoo ntawm kev tsim cov hlab plawv muaj teeb meem, thiab kev pheej hmoo ntawm kev phiv los kuj yuav tsum tau coj mus rau hauv tus lej. Yog tias tsim nyog, cov koob tshuaj yuav tau nce ntxiv tom qab 4 lub lis piam.

Vim tias qhov tshwm sim muaj peev xwm tshwm sim ntawm kev phiv thaum thov kev noj tshuaj 40 mg ib hnub, piv nrog qhov qis dua ntawm cov tshuaj, nce qhov koob tshuaj rau 40 mg ib hnub tom qab ib qho kev noj tshuaj ntxiv yog siab dua qhov kev pom zoo pib siv rau 4 lub lis piam ntawm kev kho mob tsuas yog tuaj yeem ua nyob rau hauv cov neeg mob uas muaj kev mob siab ntau ntawm hypercholesterolemia thiab muaj kev pheej hmoo siab ntawm kev tsim cov hlab plawv mob (tshwj xeeb tshaj yog nyob rau cov neeg mob nrog tsev neeg hypercholesterolemia) uas tsis tiav qhov xav tau tshwm sim ntawm txoj kev kho nrog ib koob tshuaj 20 mg ib hnub, thiab rs uas yuav muaj nyob rau hauv saib xyuas ntawm ib tug kws kho mob. Tshwj xeeb kev saib xyuas tshwj xeeb ntawm cov neeg mob tau txais cov tshuaj ntawm koob tshuaj 40 mg ib hnub twg raug pom zoo.

Kev siv ntawm koob tshuaj 40 mg ib hnub twg hauv cov neeg mob uas tsis tau mus sab laj nrog kws kho mob tsis tau pom zoo. Tom qab 2-4 lub lis piam ntawm kev kho thiab / lossis nrog kev nce ntxiv ntawm cov koob tshuaj roxer, kev saib xyuas cov lipid metabolism yog tsim nyog (koob tshuaj yog tsim nyog yog tias tsim nyog).

Hauv cov neeg mob uas mob mentsis lossis mob raum tsis ua haujlwm, koob tshuaj yuav tsis tas kho. Hauv cov neeg mob uas mob raum tsis zoo (CC tsawg dua 30 ml / min), kev siv cov xoos yog contraindicated. Kev siv cov tshuaj nyob rau hauv ib koob ntawm ntau tshaj 30 mg rau ib hnub yog contraindicated nyob rau hauv cov neeg mob uas muaj mob pes tsawg thiab mob raum tsis txaus (CC tsawg dua 60 ml / min). Rau cov neeg mob uas tsis tshua mob raum, qhov kev xav pom zoo thawj zaug ntawm cov tshuaj yog 5 mg rau ib hnub.

Roxer yog contraindicated nyob rau hauv cov neeg mob uas muaj lub siab ua daim siab mob. Tsis muaj kev paub dhau los ntawm kev siv cov tshuaj hauv cov neeg mob uas lub siab tsis ua haujlwm siab dua 9 tus qhab nia (chav C) ntawm Kev Ntsuas Me-Pugh.

Cov neeg mob uas muaj hnub nyoog tshaj 65 xyoos tau pom zoo kom pib siv cov tshuaj nrog rau koob tshuaj 5 mg ib hnub twg.

Thaum kawm cov tshuaj pharmacokinetic ntawm rosuvastatin hauv cov neeg mob uas yog pawg neeg sib txawv, qhov nce ntawm cov txheej txheem kev cia siab ntawm rosuvastatin ntawm cov neeg Nyij Pooj thiab Suav tau sau tseg. Qhov tseeb no yuav tsum raug coj los txiav txim siab thaum siv cov tshuaj Roxer hauv cov pawg neeg mob no. Thaum siv cov koob tshuaj 10 thiab 20 mg rau ib hnub, qhov kev pom zoo thawj zaug rau cov neeg mob ntawm haiv neeg Mongoloid yog 5 mg rau ib hnub. Cov neeg mob ntawm haiv neeg Mongoloid, kev siv cov tshuaj hauv ib koob 40 mg yog contraindicated.

Kev siv cov tshuaj hauv ib koob ntawm 40 mg yog contraindicated hauv cov neeg mob predisposed rau kev txhim kho ntawm myotoxic cov teeb meem. Yog tias nws yuav tsum tau siv cov koob tshuaj 10 thiab 20 mg rau ib hnub, qhov kev pom zoo thawj zaug rau pawg neeg mob no yog 5 mg.

Thaum siv nrog gemfibrazil, qhov koob tshuaj ntawm lub roxer npaj yuav tsum tsis pub tshaj 10 mg rau ib hnub.

Kev cuam tshuam nrog lwm cov tshuaj:

Cyclosporine - nrog kev siv rosuvastatin thiab cyclosporine tib lub sijhawm, AUC ntawm rosuvastatin yog nruab nrab 7 lub sijhawm siab dua li uas pom hauv cov neeg ua haujlwm noj qab haus huv. Lub plasma concentration ntawm rosuvastatin nce li ntawm 11 zaug.

Kev siv tib lub sijhawm nrog rosuvastatin tsis cuam tshuam rau kev cuam tshuam ntawm cyclosporine hauv ntshav ntshav.

Indirect anticoagulants - ib yam li lwm HMG-CoA reductase inhibitors, pib rosuvastatin txoj kev kho lossis nce nws cov koob tshuaj rau cov neeg mob noj cov tshuaj anticoagulants thaum tib lub sijhawm (piv txwv, warfarin) tuaj yeem ua rau MHO nce ntxiv. Kev tshem tawm cov rosuvastatin lossis txo nws cov koob tshuaj yuav ua rau MHO txo qis. Hauv cov xwm txheej zoo li no, kev pom zoo MHO raug saib xyuas.

Ezetimibe - kev siv rosuvastatin thiab ezetimibe tib lub sij hawm tsis nrog kev hloov pauv hauv AUC lossis Cmax ntawm ob qho tshuaj. Txawm li cas los xij, pharmacodynamic kev sib cuam tshuam ntawm rosuvastatin thiab ezetimibe, uas yog pom los ntawm kev pheej hmoo ntawm kev tsim cov leeg tsis haum, tsis tuaj yeem txiav tawm.

Gemfibrozil thiab lwm yam tshuaj lipid-txo qis - kev siv rosuvastatin thiab gemfibrozil ntau ntxiv ua rau muaj 2 npaug ntawm Cmax thiab AUC ntawm rosuvastatin. Gemfibrozil, fenofibrate, lwm cov fibrates, thiab lipid-txo qis ntawm cov tshuaj nicotinic acid (noj ntau dua lossis sib npaug rau 1 g ib hnub) tau muaj kev pheej hmoo ntawm myopathy thaum siv nrog HMG-CoA reductase inhibitors (tej zaum vim qhov tseeb tias lawv tuaj yeem ua rau myopathy thaum siv hauv tshuaj kho mob hlwb). Kev siv tib lub zuj zus ntawm cov fibrates thiab rosuvastatin hauv ib koob tshuaj txhua hnub ntawm 30 mg yog contraindicated. Hauv cov neeg mob zoo li no, txoj kev kho yuav tsum pib nrog ib koob tshuaj 5 mg ib hnub twg.

Cov kab mob HIV protease inhibitors - kev siv HIV sib txuam tiv thaiv ib puag ncig tuaj yeem txo cov ntshav plasma concentration ntawm rosuvastatin. Kev siv ib txhij 20 mg ntawm rosuvastatin thiab kev sib xyaw ntawm ob tus kabmob HIV tiv thaiv cov tshuaj tiv thaiv (400 mg ntawm lopinavir / 100 mg ntawm ritonavir) nrog cov nce ntxiv rau qhov sib npaug AUC (0-24 h) thiab Cmax ntawm rosuvastatin los ntawm 2 thiab 5 zaug, ntsig txog.

Antacids - kev siv rosuvastatin thiab antacids tib lub sij hawm uas muaj aluminium thiab magnesium hydroxide, ua rau txo qis ntawm lub plasma concentration ntawm rosuvastatin los ntawm kwv yees li 50%. Cov nyhuv no tsis tshua pom zoo yog tias antacids siv 2 teev tom qab noj rosuvastatin.

Erythromycin - kev siv rosuvastatin thiab erythromycin tib lub sijhawm ua rau txo qis AUC (0-t) ntawm rosuvastatin los ntawm 20% thiab nws Cmax los ntawm 30%. Xws li kev sib cuam tshuam tuaj yeem tshwm sim los ntawm kev mob plab hnyuv ntxiv los ntawm kev siv erythromycin.

Hormonal tshuaj tiv thaiv / tshuaj kho hloov kho (HRT) - kev siv rosuvastatin thiab cov tshuaj tiv thaiv hormonal ntxiv ib txhij nce AUC ntawm ethinyl estradiol thiab norgestrel los ntawm 26% thiab 34%, feem. Xws li nce hauv plasma concentration yuav tsum raug coj mus rau hauv qhov kev xaiv thaum xaiv cov koob tshuaj tiv thaiv hormonal txwv. Tsis muaj cov ntaub ntawv pharmacokinetic qhia txog kev siv rosuvastatin thiab kev hloov tshuaj lub cev hloov pauv, yog li ntawd, cov txiaj ntsig zoo li tsis tuaj yeem muab cais tawm thaum siv cov tshuaj sib xyaw no. Txawm li cas los xij, qhov kev sib txuam no tau siv dav dav thaum sim kho mob thiab tau txais txiaj ntsig zoo los ntawm cov neeg mob.

Digoxin - Tsis muaj qhov sib cuam tshuam hauv chaw mob ntawm rosuvastatin nrog digoxin yog qhov xav kom.

Isoenzymes ntawm cytochrome P450 - rosuvastatin kuj tsis yog ib qho kev cuam tshuam lossis qhov tsis zoo ntawm cytochrome P450. Tsis tas li ntawd, rosuvastatin yog cov neeg tsis muaj zog rau cov isoenzyme system. Tsis muaj kev cuam tshuam los ntawm kev kho mob tseem ceeb ntawm rosuvastatin thiab fluconazole (ib qho inhibitor ntawm isoenzymes CYP2C9 thiab CYP3A4) thiab ketoconazole (ib qho inhibitor ntawm isoenzymes CYP2A6 thiab CYP3A4). Siv tib lub sijhawm rosuvastatin thiab itraconazole (kev siv tshuaj tiv thaiv ntawm isoenzyme CYP3A4) nce AUC ntawm rosuvastatin los ntawm 28%, uas yog qhov tsis txaus ntseeg tshuaj. Yog li, kev sib txuam cuam tshuam cuam tshuam nrog cytochrome P450 tsis xav pom.

Noj ntau dhau:

Cov duab hauv tsev kho mob ntawm kev noj ntau dua yog tsis piav qhia.

Nrog rau ib qho koob tshuaj ob peb zaug noj tshuaj txhua hnub, cov tshuaj pharmacokinetic ntawm rosuvastatin tsis hloov pauv.

Kev Kho Mob: Cov tsos mob, kuaj xyuas lub siab ua haujlwm thiab CPK kev ua haujlwm yog qhov tsim nyog, tsis muaj ib qho tshuaj tua kab mob, hemodialysis yog qhov tsis muaj txiaj ntsig.

Sab sij huam:

Kev faib tawm ntawm qhov tshwm sim ntawm cov kev mob tshwm sim: ntau heev (> 1/10), feem ntau (> 1/100, tab sis 1/1000, tab sis 1/10 000, tab sis

Kev ntsuas rau siv

Dab tsi pab Roxer? Qhia cov tshuaj hauv cov kis hauv qab no:

sib xyaw dyslipidemia los yog thawj hypercholesterolemia (raws li ib qho kev sib ntxiv ntawm kev noj zaub mov nrog qhov tsis muaj txiaj ntsig ntawm txoj kev tsis siv tshuaj ntawm kev kho - kev poob phaus, kev siv lub cev, thiab lwm yam),
tsev neeg homozygous hypercholesterolemia (ntxiv rau cov qauv kev kho mob dhau los),
hom IV hypertriglyceridemia (ntxiv rau ntawm kev noj haus),
kev txhim kho ntawm cov atherosclerosis hauv cov neeg mob uas tau muab tshuaj kho rau txo qis ntawm cov tshuaj tua kab mob Xc thiab Xs-LDL hauv cov ntshav,
kev tiv thaiv kab mob plawv thawj zaug (arterial revascularization, myocardial infarction, mob hlab ntsha hlwb) hauv cov neeg mob uas muaj lub siab mob ua rau lub plawv mob txoj hlab ntshav, nrog rau cov neeg laus,

Cov lus qhia siv Roxer, noj ntau npaum

Cov koob tshuaj yog siv rau tus kheej, nyob rau hauv kev tswj hwm ntawm cov roj cholesterol hauv ntshav ntshav. Lawv haus cov tshuaj tsis hais noj zaub mov, ntxuav nrog dej. Raws li cov lus qhia, thawj koob tshuaj tsis dhau 1 ntsiav tshuaj ntawm Roxer 5 mg / 10 mg ib hnub ib zaug.

Qhov siab muab ntau tshaj plaws yog 40 mg ib hnub twg.

Tshaj tawm qhov ntau tshaj plaws ntawm 40 mg ib hnub twg yog ua tau tsuas yog rau cov neeg mob uas muaj mob hypercholesterolemia thiab muaj kev pheej hmoo siab ntawm cov teeb meem cuam tshuam los ntawm cov hlab plawv (tshwj xeeb tshaj yog cov mob ntawm tsev neeg hypercholesterolemia), uas qhov xav tau tsis tiav nrog 20 mg rau ib hnub. Ua txoj kev kho yuav tsum tau ua nyob rau hauv kev saib xyuas kev kho mob nkaus xwb.

Tsis txhob noj cov tshuaj no ntawm 40 mg ib hnub twg hauv cov neeg mob uas tsis tau mus cuag kws kho mob yav dhau los tsis pom zoo siv. Tom qab 2-4 lub limtiam ntawm kev siv lossis ntawm txhua qhov nce ntawm cov tshuaj, nws yog ib qho tsim nyog los soj ntsuam cov ntsuas ntawm lipid metabolism (yog tias tsim nyog, yuav tau hloov kho koob tshuaj).

Qhov hno ntawm 20 mg / hnub yog qhov ntau tshaj plaws rau kev thauj khoom ntawm genotypes c.521CC lossis s.421AA. Qhov siab tshaj koob (40 mg) tuaj yeem kho tsuas yog rau cov neeg mob uas muaj kev mob siab ntxiv ntawm cov roj (cholesterol) thiab muaj kev pheej hmoo siab los ntawm lub plawv.

Noj cov tshuaj anticoagulants (warfarin, thiab lwm yam) tib lub sijhawm uas statin tuaj yeem ua rau ntshav los ntshav, thiab mob plawv glycosides (piv txwv li, digoxin) - nce qhov siab ntawm qhov kawg.

Kev kho mob zoo ntawm kev noj tshwm sim nyob rau hauv 5-8 hnub, thiab cov txiaj ntsig siab tshaj plaws - los ntawm 3-4 lub lim tiam ntawm kev kho mob.

Sab sij huam

Raws li cov lus qhia rau kev siv, kev teem caij Roxer tuaj yeem txuas nrog cov kev mob tshwm sim hauv qab no:

Ntawm ib feem ntawm cov kabmob tiv thaiv kabmob: mob hlwb thiab lwm yam kev cuam tshuam cuam tshuam nrog kev tiv thaiv tsis tau.
Los ntawm cov kab mob hauv lub cev: kiv taub hau, mob taub hau, nco ploj, polyneuropathy.
Los ntawm kev mob plab hnyuv: mob hauv plab, xeev siab, cem quav, kab mob pancreatitis, kab mob siab, mob daj ntseg, raws plab, ua kom muaj kev cuam tshuam ntau ntawm cov kab mob siab.
Los ntawm daim tawv nqaij: khaus, tawm pob, mob Stevens-Jones mob.
Los ntawm cov pob txha pob txha thiab mob leeg: myalgia, myopathy, rhabdomyolysis.
Los ntawm cov kab mob urinary: proteinuria, hematuria.
General: asthenia.

Cov Yuav Tsum Muaj

Nws yog contraindicated rau tshuaj Roxer nyob rau hauv rooj plaub no:

cov tshuaj tiv thaiv tsis haum rau rosuvastatin lossis ib yam ntawm cov tshuaj,
kab mob siab hauv lub siab ua haujlwm (suav nrog kev nce ntxiv hauv kev ua haujlwm ntawm hepatic transaminases thiab kev nce siab hauv kev ua haujlwm ntawm hepatic transaminases hauv cov ntshav cov ntshav tau ntau dua 3 zaug piv nrog VGN),
mob raum mus rau lub raum tsis ua haujlwm (creatinine Cl tsawg dua 60 ml / min),
mob hlwb
siv cov cyclosporine txuas mus,
cov neeg mob predisposed rau kev txhim kho ntawm myotoxic muaj teeb meem,
muaj menyuam hauv plab, pub niam mis,
siv nyob rau hauv cov poj niam ntawm lub hnub nyoog yug menyuam uas tsis siv txoj hauv kev tsim nyog ntawm kev tswj kom tsis txhob muaj menyuam,
hypothyroidism
keeb kwm mob leeg (nrog rau tsev neeg muaj keeb kwm),
myotoxicity thaum siv lwm keeb kwm ntawm HMG-CoA reductase inhibitors lossis fibrates,
haus cawv ntau dhau
cov xwm txheej uas tuaj yeem ua rau nce qhov nce ntawm rosuvastatin hauv cov ntshav ntshav,
tib lub sij hawm siv cov fibrates,
lactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome,
Cov neeg mob Mongoloid
hnub nyoog txog 18 xyoo.

Noj ntau dhau

Tsis muaj cov xov xwm hais txog kev soj ntsuam daim duab ntawm kev saib xyuas overdose. Ib qho kev hloov pauv ntawm qhov chaw muag tshuaj ntawm cov tshuaj nquag thaum noj tshuaj ntau tsis pom.

Rosuvastatin tsis muaj ib qho tshuaj tiv thaiv tshwj xeeb; hemodialysis yog qhov tsis muaj txiaj ntsig. Thaum noj ntau dhau, kev kho mob raws kev tswj hwm yog nqa los ntawm kev ua haujlwm ntawm daim siab ua haujlwm thiab creatine phosphokinase kev ua si.

Roxer cov lus qhia sib piv, tus nqi hauv cov chaw muag tshuaj

Yog tias tsim nyog, koj tuaj yeem hloov Roxer nrog ib qho tshuaj rau cov cuab yeej nquag - cov no yog cov tshuaj:

Rosulip,
Neeg Coob
Rosart,
Kev Tshaj Tawm,
Lipoprime,
Rosuvastatin,
Suvardio
Rosistark,
Rosufast,
Rosucard.

Thaum xaiv cov tshuaj analogues, nws yog ib qho tseem ceeb kom nkag siab tias cov lus qhia rau kev siv Roxer, tus nqi thiab tshuaj xyuas cov tshuaj muaj cov teebmeem zoo sib xws tsis siv. Nws yog ib qho tseem ceeb kom kws kho mob sab laj thiab tsis txhob hloov pauv cov tshuaj ywj siab.

Tus nqi hauv khw muag tshuaj Lavxias: Roxer ntsiav tshuaj 5 mg 30 pcs. - los ntawm 384 txog 479 rubles, 10 mg 30 pcs. - los ntawm 489 txog 503 rubles, 15 mg 30pcs. - los ntawm 560 rubles.

Khaws ntawm qhov kub thiab txias mus txog 25 ° C. Khaws tsis ncav cuag ntawm cov menyuam yaus. Txee lub neej yog 3 xyoos. Hauv tsev muag tshuaj, kws kho mob tawm mus yuav tshuaj.

Raws li cov kws kho mob, Roxer ua tau zoo txo qis cov cholesterol. Nws tau sau tseg tias cov tshuaj pib muaj cov tshuaj ua kom sai dua li lwm cov tshuaj nrog cov nyhuv zoo sib xws. Nrog kev sib zam zoo, kev kho mob ntev yog ua tau. Ntawm qhov kev ua tsis tiav tau qhia tias yog tus nqi theej siab thiab kev txhim kho ntawm kev phiv.

3 kev xyuas rau “Roxer”

Nrog rau cov tshuaj no, nws txo qis cov roj hauv ob lub hlis txij li 9 txog 5.8, tuaj yeem tiv taus yooj yim (sib nrug ntawm kev tsis tshua muaj mob taub hau thaum yav tsaus ntuj), nws ua haujlwm me me, tsis muaj kev tsis haum tshuaj. Tus kws kho mob sau tseg kom noj tas li, tus nqi tshuaj yog qhov ntxhov siab, nws kim me ntsis rau kuv.

sai li cov qaug dab peg pib, tsum tsis noj tshuaj, nws pab tau rau qee tus neeg, tab sis tsis yog txhua yam.

Kuv sim nws. Qhov kev txhim kho tau los xaus rau thawj lub asthiv, tab sis hauv parallel kuv tau noj zaub mov noj. Nws tau haus cov tshuaj no ntev, ntev li 1.5 xyoo nrog so ntawm 2 lub hlis. Cov roj (cholesterol) poob qis.

Daim ntawv tso tawm

Roxer muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj coated nrog dawb zaj duab xis membrane, uas txawv nyob rau hauv tsos nyob ntawm seb cov concentration ntawm cov khoom nquag hauv lawv:

Ntsiav tshuaj nrog cov ntsiab lus rosuvastatin ntawm qhov koob tshuaj 5, 10 lossis 15 mg, muaj puag ncig cov duab, biconvex, nrog nrog bevel. Ntawm ib sab cov ntawv sau tau ua raws li cov koob tshuaj: "5", "10" thiab "15", feem.
Ntsiav tshuaj nrog cov ntsiab lus rosuvastatin ntawm ib koob ntawm 20 mg, puag ncig, biconvex, nrog ib tug bevel.
Ntsiav tshuaj nrog cov ntsiab lus rosuvastatin ntawm koob tshuaj 30 mg, biconvex, muaj cov tshuaj ntsiav tshuaj thiab qhov txaus ntshai ntawm ob sab.
Ntsiav tshuaj nrog cov ntsiab lus rosuvastatin ntawm koob tshuaj 40 mg, biconvex, muaj cov duab hauv plhaw.

Ntawm daim ntawv ntawm cov ntsiav tshuaj, ob txheej txheej kom pom meej meej, lub puab yog dawb.

Pharmacological kev txiav txim

Cov nyhuv pharmacological ntawm cov tshuaj Roxer yog tsom rau:

Kev txwv tsis pub ntawm qhov kev ua ub no microsomal enzyme hydroxymethylglutaryl-CoA reductaseuas ua raws li catalyst rau kev txwv txog qib pib ntawm synthesis roj.
Feem ntau ntawm lipid profile (lipid-tej nyhuv) vim muaj kev txo qis ntshav kev suav ntawm tag nrho roj, triglycerides, lipoproteins tsawg ntom ntom ntxiv rau kom muaj kev kub siab ntxiv lipoproteins high ntom.

Cov tshuaj rau cov pab pawg neeg pharmacologicalStatins”.

Pharmacodynamics thiab pharmacokinetics

Ib zaug hauv lub cev rosuvastatin provokes cov teebmeem nram qab no:

Pab txo qis kom ntau ntau cov roj lipoprotein tsawg kawg,
Pab txo qis kom ntau ntau roj,
Pab txo qis kom ntau triglyceride ntau,
Txhawb txhawb kom muaj ntau ntxiv cov roj lipoprotein ntau heev rau cov txiv neej,
Pab txo qis kev saib xyuas tsis tshua muaj ntom lipoprotein apolipoprotein (apoliprotein B),
Pab txo qis kev saib xyuas cov roj lipoprotein tsawg kawg,
Pab txo qis kev saib xyuas cov lipoprotein ntau heev tsawg,
Pab txo qis kev saib xyuas tsawg kawg ntom lipoprotein triglycerides,
Txhawb nqa kev nce siab ntshav ntshav apoliprotein A1,
Lowers roj piv tsis tshua muaj ntom lipoproteinsrau cov roj lipoprotein ntau heev rau cov txiv neej,
Txo kev sib piv tag nrho roj rau cov roj lipoprotein ntau heev rau cov txiv neej,
Txo kev sib piv cov roj lipoprotein tsawg kawg rau cov roj lipoprotein ntau heev
Txo kev sib piv tsis tshua muaj ntom lipoprotein apolipoprotein (apoliprotein B) rau apolipoprotein A1.

Cov lus tshaj tawm hauv kev kho mob ntawm kev siv Roxers txhim kho ib lub lis piam tom qab pib lub sijhawm ntawm kev kho mob nrog tshuaj. Kwv yees li 90% ntawm cov txiaj ntsig siab tshaj plaws ntawm kev kho mob yog sau tseg tom qab ob lub lim tiam.

Nws feem ntau yuav siv plaub lub lis piam kom ua tiav cov txiaj ntsig siab tshaj plaws, tom qab ntawd nws raug tswj xyuas thoob plaws hauv tag nrho kev kho mob tom qab.

Tshaj ntshav siab tshaj plaws rosuvastatin nws yog sau tseg tsib teev tom qab noj cov ntsiav tshuaj, qhov qhia tseeb txog bioavailability yog 20%.

Rosuvastatin feem ntau biotransformed rau hauv mob siabua lub chaw thawj synthesizing roj thiab metabolizing cov roj lipoprotein tsawg kawg.

Kev faib cov khoom tawm yog kwv yees li 134 litres. Kwv yees li 90% rosuvastatin khi rau ntshav protein (feem ntau yog albumin).

Rosuvastatin metabolized kom tsawg kawg (kwv yees li 10%). Hauv vitro siv tib neeg hepatocytes kev tshawb nrhiav metabolism hauv tshuaj qhia pom tias nws raug rau yam tsawg kawg nkaus metabolism hauv raws li cytochrome P450 enzyme systemCov. Thiab no ib metabolism hauv tsis tuaj yeem suav hais tias yog qhov tseem ceeb hauv tsev kho mob.

Lub ntsiab isoenzymekev koom tes hauv rosuvastatin metabolism hauvyog CYP 2C9. Rau qee qhov qis dua me me, lawv koom nrog cov txheej txheem no. isoenzymes 2C19, 3A4 thiab 2D6.

Hauv cov txheej txheem ntawm kev siv tshuaj lom neeg, ob lub ntsiab metabolite:

N-desmethyl tus yam ntxwv li ib nrab ntawm cov haujlwm tsawg dua piv rau rosuvastatinCov. Raws li hais txog lactone, tom qab ntawv nws yog suav tias yog daim ntawv hauv chaw kuaj mob.

Rosuvastatin muaj ntau dua 90% inhibitory kev ua ub no tiv thaiv hydroxymethylglutaryl-CoA reductase (HMG-CoA reductase), uas khiav hauv tib neeg lub cev hauv cov hlab ntsha.

Feem ntau noj rosuvastatin (kwv yees 90%) yog tso tawm tsis hloov nrog cov ntsiab lus txoj hnyuvCov. Hauv qhov no, ob qho tib si nqus thiab unabsorbed cov khoom ua kom muaj zog yog tawm.

Cov seemrosuvastatin tawm los ntawm ob lub raum nrog zis (kwv yees 5% - hloov pauv tsis tau).

Ib nrab-lub neej ntawm cov yeeb tshuaj yog li 20 teev thiab tsis nyob ntawm qhov nce hauv qhov ntau ntxiv ntawm cov tshuaj. Nruab nrab kom meej meej los ntawm ntshav ntshav yog li ntawm 50 litres ib teev twg. Kev ntsuas hloov pauv piv rau qhov nruab nrab tus nqi (coefficient of variation) yog 21.7%.

Raws li yog qhov teeb meem nrog rau lwm cov tshuaj uas txwv kev ua si hydroxymethylglutaryl-CoA reductasetxhom los ntawm daim siabrosuvastatin txhawb txoj kev koom tes ntawm daim nyias nyias transporter OATP-S, uas ua lub luag haujlwm tseem ceeb hauv cov txheej txheem ntawm kev tshem cov tshuaj los ntawm mob siab.

Rosuvastatin tsiag ntawv los ntawm qhov tshuaj txhaj tiv thaiv kab mob uas muaj qhov sib luag, uas nce ntxiv hauv qhov sib npaug rau qhov nce hauv koob tshuaj.

Rov qab siv txhua hnub ntawm cov tshuaj tsis cuam tshuam rau txhua qhov kev hloov pauv ntawm cov yam ntxwv pharmacokinetic ntawm nws cov tshuaj nquag.

Tus neeg mob lub hnub nyoog thiab poj niam txiv neej tsis cuam tshuam rau pharmacokinetics ntawm cov tshuaj. Nyob rau tib lub sijhawm, kev tshawb fawb pom tias hauv cov neeg mob ntawm haiv neeg Mongoloid, AUC thiab ntshav siab tshaj plaws rosuvastatin kwv yees li ob zaug ntau dua li nyob hauv cov neeg mob uas yog haiv neeg Caucasian.

Cov neeg Khab muaj cov cim zoo sib xws uas siab dua rau Cov Neeg Coob Teb Chaws Asmeskas los ntawm li ntawm 1,3 npaug. Tsis muaj qhov sib txawv hauv qhov chaw kho mob hauv qhov ntsuas rau cov neeg sawv cev ntawm Negroid haiv neeg thiab Caucasians.

Hauv cov neeg mob nrog lub raum tsis ua hauj lwm nyob rau hauv daim ntawv me me los sis mob hnyav, ntsuas ntawm ntau dua ntawm rosuvastatin thiab N-desmethyl hauv plasma tsis tshua pauv.

Hauv cov ntawv hnyavlub raum tsis ua hauj lwm qhov taw qhia ntawm ntshav siab dua cov ntshav siab rosuvastatin nce ntxiv peb npaug, thiab qhov ntsuas ntawm ntshav ntshav siab dua N-desmethyl- kwv yees li cuaj zaug hauv kev sib piv nrog cov ntsuas pom hauv cov neeg ua haujlwm noj qab haus huv.

Ntshav siab rosuvastatin hauv cov neeg mob uas tau nyob hauv hemodialysiskwv yees li ob zaug tshaj cov nyob hauv cov neeg ua hauj lwm pub dawb.

Ntawm daim siab ua hauj lwmvim tias tus kab mob cawv lom lub siab ntev, ntshav ntau rosuvastatin txhawb kev nqeg.

Hauv cov neeg mob uas muaj tus kab mob mus rau hoob A tus me nyuam pew nplai, kev ntsuas ntawm qhov siab tshaj rosuvastatin hauv ntshav ntshav thiab AUC tau nce los ntawm 60 thiab 5%, feem, piv nrog cov neeg mob, mob siab uas yog noj qab nyob zoo.

Yog hais tias muaj tus kab mob mob siab Tus neeg ntawm qeb B los ntawm tus me nyuam pew nplai, kev ntsuas ntsuas nce ntawm 100 thiab 21%. Rau cov neeg mob uas lawv mob yog qeb C, cov ntaub ntawv tsis muaj, uas cuam tshuam nrog qhov tsis muaj kev paub dhau los ntawm rosuvastatin rau lawv.

Cov Yuav Tsum Muaj

Cov kev txwv tsis pub mus rau lub sijhawm teem ntawm cov tshuaj Roxer uas muaj cov rosuvastatin hauv kev muab sib npaug yog 5, 10 thiab 15 mg yog:

muaj tshuaj tiv thaiv ib qho los yog ntau qhov ntxiv ntawm cov tshuaj,
nquag ua cov ntaub ntawv daim siab pathologies (suav nrog nrog rau cov kab mob ntawm qhov tsis paub meej ntawm keeb kwm), nrog rau cov xwm txheej muaj tus yam ntxwv tsis tu ncua hepatic transaminases, thiab tej yam mob uas ib yam ntawm hepatic transaminases nce los ntawm tsis muaj tsawg tshaj li peb zaug,
raum pathologyntawm kev tshem tawm neeg tsim tswv tsis tshaj tus nqi ntawm 30 ml / min,
muaj mob loj muaj keeb cov kab mob neuromuscularlub cev ua rau los ntawm cov leeg puas (myopathies),
siv cov tshuaj tiv thaiv mob siab phem Cyclosporin,
kuaj mob nrog kev pheej hmoo siab ntawm txoj kev loj hlob mob myotoxic,
intolerance lactose,
lactase tsis muaj peev xwm,
piam thaj galactose malabsorption,
cev xeeb tub (tseem, cov tshuaj tsis raug txwv rau cov poj niam ntawm lub hnub nyoog yug menyuam yog tias lawv tsis siv tshuaj tiv thaiv),
pub niam mis
hnub nyoog txog 18 xyoo.

Tsuas tshuaj ntsiav tshuaj rosuvastatin 30 thiab 40 mg yog contraindicated:

cov neeg mob siab mob lub cev tsis sib haum rau ib lossis ntau qhov sib txawv ntawm cov tshuaj,
cov neeg mob nrog cov ntawv nquag daim siab pathologies (suav nrog nrog rau cov kab mob ntawm qhov tsis paub meej ntawm keeb kwm), nrog rau cov xwm txheej muaj tus yam ntxwv tsis tu ncua hepatic transaminases, thiab tej yam mob uas ib yam ntawm hepatic transaminases nce los ntawm tsis muaj tsawg tshaj li peb zaug,
raum pathologyntawm kev tshem tawm neeg tsim tswv tsis tshaj tus nqi ntawm 60 ml / min,
muaj mob loj muaj keeb cov kab mob neuromuscularlub cev ua rau los ntawm cov leeg puas (myopathies),
hypothyroidism,
siv cov tshuaj tiv thaiv mob siab phem Cyclosporin,
kuaj mob nrog kev pheej hmoo siab ntawm txoj kev loj hlob mob myotoxic (thaum nyob hauv tus neeg mob lub keeb kwm muaj sau tseg rau cov nqaij mob ua rau muaj mob los ntawm lwm cov tshuaj inhibitor hydroxymethylglutaryl-CoA reductase lossis derivative npaj fibroic acid),
haus dej caw
cov foos hnyav daim siab ua hauj lwm,
Cov haiv neeg Mooboid
tib txhij txais tos fibrate,
intolerance lactose,
lactase tsis muaj peev xwm,
piam thaj galactose malabsorption,
cev xeeb tub (tseem, cov tshuaj tsis raug txwv rau cov poj niam ntawm kev muaj me nyuam hnub nyoog yog tias lawv tsis siv pov thaiv),
pub niam mis
hnub nyoog txog 18 xyoo thiab laus dua 70 xyoo.

Sab sij huam

Cov kev mob tshwm sim hauv qab no tuaj yeem tshwm sim thaum kho nrog Roxeroy:

dysfunctions lub cev tiv thaiv kab mobsuav nrog kev cuam tshuam vim hypersensitivity rau rosuvastatin lossis lwm yam tshuaj ntawm cov tshuaj, suav nrog kev txhim kho angioedema,
dysfunctions lub plab zom mov, qhia nyob rau hauv daim ntawv ntawm feem ntau cem quav, mob nyob rau hauv lub cheeb tsam epigastric, xeev siab, nyob rau hauv tsawg mob yuav tsim pancreatitis,
cov kev tsis sib haum xeeb uas tshwm sim rau ntawm daim tawv nqaij thiab cov nqaij mos thiab nqaij hauv qhov tawv nqaij thiab raug nthuav tawm ua qauv pob ntawm daim tawv nqaij, khaus tawv,urticaria,
pob txha leeg mob, uas tshwm sim myalgia (feem ntau) thiab qee zaum myopathies thiab rhabdomyolysis,
kev cuam tshuam dav dav, feem ntau ntawm cov uas asthenia,
dysfunctions raum thiab mob txeeb zig, uas feem ntau ua ke nrog kev nce ntxiv hauv cov concentration ntawm cov protein hauv cov zis.

Roxer tej zaum yuav cuam tshuam qhov hloov ntawm chav ntsuas. Yog li, tom qab noj cov tshuaj, cov haujlwm yuav tau nce ntxiv creatine kinasekev ntsuas siab piam thaj, bilirubindaim siab ua hauj lwm enzyme gamma glutamyl transpeptidases, alkaline phosphatase, thiab cov ntsuas ntawm cov ntshav plasma concentration ntawm cov tshuaj hormones hloov lub qog ua haujlwm.

Qhov ntau zaus thiab mob ntawm kev phiv yog koob tshuaj.

Roxer ntsiav tshuaj: cov lus qhia rau kev siv, txoj kev tswj hwm thiab kev siv tshuaj ntau npaum li cas

Ua ntej yuav sau cov tshuaj, tus neeg mob raug nquahu kom hloov mus rau qhov kev noj zaub mov kom zoo, lub hom phiaj yog txo qib rojCov. Ua raws li kev noj haus no yog qhov tsim nyog thiab thoob plaws thaum kawg ntawm kev kho mob.

Cov koob tshuaj yog xaiv tau ib tus zuj zus los ntawm tus kws kho mob nyob ntawm lub hom phiaj ntawm txoj kev kho thiab nws txoj kev ua tau zoo. Nws raug tso cai kom coj cov tshuaj thaum lub sijhawm nruab hnub, tsis khi rau thaum lub sijhawm noj mov.

Cov ntsiav tshuaj tau nqos tag nrho, tsis muaj zuaj, tsis ntxo thiab haus dej ntau.

Cov neeg mob nrog hypercholesterolemia koj yuav tsum pib noj cov tshuaj nrog koob tshuaj sib npaug li 5 lossis 10 mg rosuvastatinCov. Cov ntsiav tshuaj noj ntawm qhov ncauj ib hnub ib zaug. Ntxiv mus, tus mob no tseem mob rau cov neeg mob uas tsis tau kho statins, thiab rau cov neeg mob uas twb tau txais kev kho mob nrog rau cov tshuaj uas txwv kev ua haujlwm hydroxymethylglutaryl-CoA reductase.

Thaum txiav txim siab thawj zaug ntawm Roxers, tus kws kho mob them nyiaj rau cov ntsuas qhov ntsuas roj, thiab tseem tshuaj xyuas kev pheej hmoo txaus ntshai txoj kev loj hlob kev mob plawv thiab cov kev mob tshwm sim.

Thaum muaj kev tsim nyog, cov koob tshuaj tuaj yeem hloov kho rau qib tom ntej, txawm li cas los xij, xws li kev kho kom haum tau nqa tawm tsis pub dhau 4 lub lis piam tom qab thawj zaug teem tseg.

Muab hais tias muaj kev phiv tshuaj yog qhov koob tshuaj-nyob ntawm qhov xwm txheej, thiab thaum noj 40 mg ntawm rosuvastatin tshwm sim ntau dua thaum noj nws hauv qhov ntau thiab tsawg, nce qhov koob tshuaj txhua hnub rau 30 lossis 40 mg yuav tsum tau ua nrog kev saib xyuas zoo:

cov neeg mob hnyav hypercholesterolemia,
cov neeg mob uas muaj peev xwm ua kom muaj teeb meem ntau ntxiv los ntawm txoj haujlwm lub siab thiab leeg vauv system (tshwj xeeb, yog hais tias tus neeg mob raug kuaj tsev neeg hypercholesterolemia).

Yog noj tsawg dua rosuvastatin nyob rau hauv cov pawg no ntawm cov neeg mob tsis tau muab qhov kev cia siab tshwm sim, tom qab lub sijhawm Roxers hauv kev noj 30 lossis 40 mg rau ib hnub, cov neeg mob yuav tsum nyob hauv qab kev tswj hwm ntawm lawv tus kws kho mob.

Tsis tas li, kev saib xyuas kev noj qab haus huv tas li yog qhia nyob rau hauv cov xwm txheej uas kev kho mob pib tam sim ntawd nrog 30 lossis 40 mg.

Ua raws li cov lus qhia rau kev siv, Roxer 20 mg yog qhia raws li kev pib txhaj tshuaj rau kev tiv thaiv kab mob lub siab thiab cov hlab rau cov neeg mobuas muaj kev pheej hmoo ntau ntxiv ntawm kev txhim kho cov kev thuam.

Cov neeg uas muaj qhov tsis haum ntawm kev ua haujlwm raum tsis tas yuav txhaj koob tshuaj, txawm li cas los xij, cov tshuaj tau tawm nrog kev ceev faj rau pab pawg ntawm cov neeg mob no.

Thaum tsis ua haujlwm tsis zoo raum pes tsawg thaum clearance neeg tsim tswv yog hauv 60 ml / min, kev kho mob pib nrog koob tshuaj 5 mg. Kev noj tshuaj ntau dua (30 thiab 40 mg) yog contraindicated.

Cov neeg mob mob hnyav rau lub cev tsis ua hauj lwm raumtxwv tsis pub sau tshuaj rau hauv ib qho tshuaj yog txwv tsis pub.

Thaum kws kho mob muab tshuaj rau tus neeg mob nrog daim siab pathologies, ntsuas ntawm uas tus me nyuam pew nplai tsis pub tshaj 7, tsis muaj kev nce toj hauv neeg rosuvastatin.

Yog tias ntsuas ntawm kev ua haujlwm tsis taus mob siabsib npaug zos rau 8 lossis 9 ntsiab lus hauv tus me nyuam pew nplai, kev sib kis system nce ntxiv. Yog li, ua ntej sau cov tshuaj rau cov neeg mob zoo li no, yuav tsum tau kawm ntxiv txog kev ua haujlwm. raum.

Cov kev paub hauv kev kho cov neeg mob uas nws qhov ntsuas tau tshaj 9 tus lej hauv tus me nyuam pew nplaiploj lawm.

Noj ntau dhau

Cov chaw kuaj mob uas tuaj yeem tshwm sim yog tias cov koob tshuaj pom zoo dhau los ntawm cov koob tshuaj tsis tau piav qhia. Tom qab txhaj ib koob tshuaj Roxer nyob rau hauv ib koob tshuaj ob peb zaug ntau dua li cov tau tsim txhua hnub, qhov chaw kho mob tau hloov pauv hauv pharmacokinetics. rosuvastatin tsis sau tseg.

Nyob rau hauv cov ntaub ntawv ntawm overdose thiab tshwm sim cov tsos mob ntawm intoxication lub cev qhia tau hais tias muaj kev kho mob thiab, yog tias tsim nyog, kev teem caij ntawm ib pawg ntawm kev txhawb nqa kev ntsuas.

Kev saib xyuas kev ua si kuj raug pom zoo. creatine kinase thiab ua ib qho kev ntsuas los ntsuas kev ua haujlwm mob siab.

Kev tsim nyog ntawm kev teem caij hemodialysis suav hais tias tsis zoo li.

Kev sib txuam

Hauv kev teem lub sijhawm Roxers nrog rau Cyclosporine nce siab AUC rosuvastatin (kwv yees li xya zaus), thaum uas cov ntshav plasma concentration cyclosporine tseem tsis hloov pauv.

Nrog rau kev tswj fwm ib txhij nrog cov tshuaj tua kab mob Vitamin K los yog siv yeeb siv tshuaj uas muaj kev txwv yam ub yam no hydroxymethylglutaryl-CoA reductase, thaum pib ntawm chav kawm ntawm txoj kev kho mob, nrog rau kev nce ntxiv ntawm cov koob tshuaj txhua hnub los ntawm nws cov titration, qhov nce ntawm INR (qhov txawv txav thoob ntiaj teb) yuav raug sau tseg.

Raws li txoj cai, tawm tsam keeb kwm ntawm kev txo koob tshuaj los ntawm titration lossis ua tiav kev tshem tawm tshuaj, qhov ntsuas no poob qis.

Siv cov tshuaj lipid-txo cov tshuaj tsawg dua Ezetimibe tsis ua rau kev hloov pauv hauv AUC thiab qhov siab tshaj plaws plasma ntau ntawm ob qho tshuaj, txawm li cas los xij, kev muaj peev xwm ntawm kev sib txuam pharmacodynamic tsis tau muab cais tawm.

Tau nrog Gemfibrozil thiab lwm yam tshuaj uas pab txo kom tsawg lipidsprovokes qhov nce ob zaug hauv AUC thiab cov ntshav siab tshaj plaws rosuvastatin.

Cov kev tshawb fawb tshwj xeeb tau pom tias tau teem sijhawm nrog Fenofibrate uas tsis muaj qhov nyob zoo rau kev hloov pauv hauv pharmacokinetic cov tsis muaj, txawm li cas los xij, kev muaj peev xwm ntawm kev sib txuam ntawm kev sib txuam ntawm cov tshuaj tsis raug cais tawm.

Hom tshuaj Hemfibrozil thiab Fenofibratentxiv rau tshuaj nicotinic acid, thaum lawv teem caij nrog inhibitors hydroxymethylglutaryl-CoA reductase nce txoj kev nyiam txoj kev loj hlob myopathies (uas, feem ntau yuav tshwm sim, yog vim lawv lub peev xwm los ua rau muaj kev cuam tshuam zoo sib xws thaum lawv tau sau tseg los ua tus neeg sawv cev tshuaj tua kab mob).

Nrog tib lub sijhawm siv Roxers nrog fibrates, rosuvastatin nyob rau hauv cov koob tshuaj sib npaug nrog 30 thiab 40 mg tsis yog kws kho mob. Thawj hnub txhaj rosuvastatin rau cov neeg mob noj fibratesyog 5 mg.

Cuag siv cov tshuaj nrog cov inhibitors serineprotease provokes kev hloov pauv nyob rau hauv kev tshwm sim rosuvastatinCov. Vim li no, Roxer tsis raug xaj. HIV-yog mob rau cov neeg mob tau kho nrog cov tshuaj inhibitor serine proteases.

Thaum noj nrog tshuaj antacid ntshav concentration npaj rosuvastatintxo los ntawm kwv yees li ib nrab. Txhawm rau kom txo qhov mob hnyav ntawm cov nyhuv notshuaj tiv thaiv kab mob Nws raug nquahu kom noj ob teev tom qab noj cov tshuaj Roxer.

Tawm tsam keeb kwm yav dhau los teem sijhawm sib txig rosuvastatin nrog Erythromycin AUC tus nqi rosuvastatin txo qis li 20%, thiab nws cov ntshav plasma concentration yog li ib feem peb. Qhov no tuaj yeem yog vim muaj ntau yam ntxiv mus. txoj hnyuv ua haujlwmuas txais tos provokes Erythromycin.

Nrog rau kev teem caij ntawm Roxers ua ke nrog cov tshuaj tiv thaiv hormonal rau kev tswj hwm qhov ncauj, AUC qhov ntsuas ethinyl estradiol nce li ntawm 26%, thiab tib lub ntsuas rau norgestrel - los ntawm 34%.

Qhov nce no ntawm AUC qib yuav tsum raug txiav txim siab thaum xaiv cov koob tshuaj zoo tshaj. tshuaj tiv thaivrau cov thawj coj ntawm qhov ncauj.

Tsis muaj cov ntaub ntawv pharmacokinetic hais txog kev siv nrog cov tshuaj kho mob hloov tshuaj hormone, txawm li cas los xij, kev muaj peev xwm cuam tshuam thiab nce AUC tsis cais.

Kev tshawb fawb ntawm kev sib xyaw ntawm rosuvastatin nrog cov kws txawj qoj ib ce Digoxin tsom tsis muaj kev sib tham tseem ceeb clinically.

Rosuvastatin Nws muaj tsis yog tus twg yooj yim los yog stimulating ntxim rau isoenzymes lub system cytochrome P450Cov. Tsis tas li ntawd, metabolization rosuvastatin raws li lawv lub peev txheej muaj tsawg heev thiab tsis yog qhov tseem ceeb hauv tsev kho mob.

Muaj qab hau dab tsi ntawm rosuvastatin thiab antifungal tus neeg sawv cev Fluconazole thiab Ketoconazoleuas inhibit qhov kev ua si ntawm cytochrome isoenzymes tsis tau sau tseg.

Ua ke nrog cov tshuaj antifungal Intraconazole, uas inhibits kev ua si isoenzyme CYP 3A4, ua rau nce siab ntawm AUC ntawm rosuvastatin los ntawm 28%. Txawm li cas los xij, qhov nce no tsis suav tias yog qhov tseem ceeb hauv tsev kho mob.

Cov Tshuaj Pharmacokinetics

Lub sijhawm mus txog qhov ntshav siab tshaj plaws (Cmax) ntawm rosuvastatin hauv cov ntshav tom qab kev tswj hwm ntawm ncauj yog kwv yees li 5 teev. Kev rho tawm bioavailability ntawm yam khoom ntawd

20% Kev mob ntshav siab tshwm sim hauv lub siab. Qhov ntim ntawm kev faib tawm yog kwv yees li 134 litres. Feem ntau ntawm cov tshuaj (txog 90%) khi rau cov ntshav plasma protein, feem ntau nrog albumin.

Rosuvastatin undergoes txwv metabolism hauv (

10%). Cov tshuaj yog zwm rau cov tsis ua haujlwm tshwj xeeb ntawm cytochrome P450. Lub ntsiab isoenzyme koom nrog nws cov metabolism hauv isoenzyme CYP2C9. Kev koom tes hauv cov metabolism hauv isoenzymes CYP2C19, CYP3A4, CYP2D6 tshwm sim rau qee qhov tsawg dua. Cov tshuaj tiv thaiv kab mob tseem ceeb yog N-desmethylrosuvastatin (kev ua yog kwv yees li 2 npaug tsawg dua li ntawm rosuvastatin) thiab cov lactone metabolites (tsis muaj cov haujlwm pharmacological). Cov haujlwm pharmacological rau kev ua kom tsis muaj ntshav HMG-CoA reductase yog muab feem ntau vim yog rosuvastatin (ntau dua 90%).

Kwv yees li ntawm 90% ntawm cov tshuaj tau tawm los ntawm txoj hnyuv tsis hloov pauv (suav nrog kev tsis haum / nqus rosuvastatin), qhov seem - los ntawm lub raum. Ib nrab-lub neej ntawm ib yam khoom los ntawm ntshav ntshav yog kwv yees li 19 teev (nce cov koob tsis cuam tshuam rau qhov ntsuas no). Tus duab ntsuas lub ntsiab ntawm ntshav plasma yog 50 l / h (nrog coefficient ntawm kev sib txawv - 21.7%).

Nrog rau kev nkag mus txhua hnub, cov kev hloov hauv pharmacokinetic tsis tsis pom. Cov neeg raug kab mob hauv lub cev raug nce siab ib qho zuj zus.

Raws li kev tshawb fawb pharmacokinetic, nyob rau hauv cov neeg mob ntawm haiv neeg Mongoloid (Nyiv, Philippines, Suav, Kauslim thiab Nyab Laj), qhov nruab nrab ntawm AUC thiab qhov siab tshaj plaws ntawm rosuvastatin ntau ntxiv los ntawm 2 zaug piv nrog Caucasoid haiv neeg, rau Isdias Asmesliskas cov coefficient nce hauv nruab nrab AUC thiab Cmax yog 1.3.

Hauv cov neeg mob nrog creatinine tshem tawm (CC) tsawg dua 30 ml / min, ntshav plasma concentration ntawm rosuvastatin thiab N-desmethylrosuvastatin hauv cov ntshav nce siab.

Hauv cov kab mob cawv ua rau lub siab, lub plasma qhov siab ntawm rosuvastatin nce nce pes nrab. Thaum muab piv: cov neeg mob lub siab ua haujlwm / cov neeg mob siab tsis ua haujlwm siab (raws li Child-Pugh nplai: 7 lossis qis dua qhov qhab nia / 8–9) AUC thiab Cmax ntawm rosuvastatin nce ntxiv 5 thiab 60% / 21 thiab 100%, feem. Kev paub nrog rosuvastatin hauv cov neeg mob uas lub siab tsis ua haujlwm tshaj 9 cov ntsiab lus tsis tuaj.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Cov tshuaj Roxer muaj nyob rau hauv daim ntawv foos rau kev tswj hwm qhov ncauj (qhov ncauj tswj hwm). Cov ntsiav tshuaj yog coated nrog cov xim zaj duab xis dawb. Hloov, biconvex nrog bevel, ntawm ib sab kos "10", ntaus thwj. Qhov tseem ceeb ua ke ntawm cov tshuaj yog rosuvastatin. Nws cov ntsiab lus hauv ib ntsiav tshuaj yog 10 mg. Tseem suav nrog cov neeg tshaj lij, uas suav nrog:

Macrogol 6000.
Methyl methacrylate copolymer.
Microcrystalline cellulose.
Colloidal silicon dioxide.
Titanium dioxide
Crospovidone.
Lactose Monohydrate.
Magnesium stearate.

Cov tshuaj tua Roxer tau muab ntim rau hauv cov hlwv qhwv ntawm 10 daim. Daim npav pob ntawv muaj 3 lossis 9 lub hlwv thiab lus qhia rau kev siv tshuaj.

Cov chaw muag tshuaj

Lub hauv paus tseem ceeb ntawm Roxer ntsiav tshuaj, rosuvastatin thaiv cov kev ua si ntawm cov enzyme HMG-CoA reductase, uas yog lub luag haujlwm rau cov hluavtaws ua ntej ntawm mevalonate cov roj cholesterol. Nws nquag ua haujlwm hauv lub siab ua haujlwm, uas yog lub luag haujlwm rau cov synthesis ntawm cov roj endogenous (tus kheej), vim nws qib hauv cov ntshav tsawg. Kuj, tiv thaiv keeb kwm yav dhau los ntawm kev siv tshuaj, cov theem ntawm tsawg thiab tsawg kawg ntawm lipoproteins tsawg (ua rau kom qhov kev tso ntshav ntawm cov cholesterol nyob hauv phab ntsa ntawm cov hlab ntsha) thiab qhov siab ntawm lipoproteins ntau dua tuaj (txo qhov sib zog ntawm cov txheej txheem ntawm deposition ntawm cov cholesterol nyob hauv phab ntsa ntawm cov hlab ntsha).

Tom qab noj Roxer cov ntsiav tshuaj sab hauv, cov tshuaj nquag ua kom nrawm txaus, tab sis tsis tag yuav nqus mus rau hauv cov ntshav. Nrog cov ntshav ntws, nws nkag mus rau hauv cov nplooj siab (hepatocytes), qhov uas nws muaj kev kho mob kom zoo. Rosuvastatin tsis muaj qhov tshwj xeeb thiab raug tshem tawm tsis hloov pauv nrog cov quav.

Tsuas tshuaj thiab tswj hwm

Sab hauv, lub ntsiav tshuaj yuav tsum tsis txhob zom lossis zuaj, nqos tag nrho, ntxuav nrog dej, tuaj yeem nqa tau txhua lub sijhawm ntawm hnub, tsis hais lub sijhawm noj mov. Ua ntej pib txoj kev kho nrog Roxer, tus neeg mob yuav tsum pib ua raws cov qauv hypocholesterolemic noj haus thiab txuas ntxiv ua raws nws thaum kho. Qhov ntau thiab tsawg ntawm cov tshuaj yuav tsum tau xaiv ib tus zuj zus nyob ntawm lub hom phiaj ntawm txoj kev kho thiab kho cov lus teb rau kev kho mob, noj rau hauv lub teb chaws cov lus pom zoo ntawm phiaj plasma lipid ntau. Qhov pom zoo pib koob tshuaj rau cov neeg mob pib noj cov tshuaj, lossis rau cov neeg mob hloov mus los ntawm kev noj lwm yam HMG-CoA reductase inhibitors, yuav tsum yog 5 lossis 10 mg ntawm Roxer tshuaj 1 zaug hauv ib hnub.

Nrog rau kev siv cov tshuaj ib txhij nrog gemfibrozil, fibrates, nicotinic acid nyob rau hauv lipid txo cov koob tshuaj (ntau dua 1 g / hnub), cov neeg mob tau pom zoo pib qhov pib ntawm cov tshuaj 5 mg / hnub. Thaum xaiv cov tshuaj xub thawj, ib qho yuav tsum tau ua los ntawm cov tib neeg cov ntshav muaj roj cholesterol siab thiab coj mus rau hauv qhov kev pheej hmoo ntawm kev tsim cov hlab plawv muaj teeb meem, thiab kev pheej hmoo ntawm kev phiv los kuj yuav tsum tau coj mus rau hauv tus lej. Yog tias tsim nyog, cov koob tshuaj yuav tau nce ntxiv tom qab 4 lub lis piam.

Vim tias qhov tshwm sim muaj feem ntawm kev phiv thaum siv koob tshuaj 40 mg / hnub, piv nrog qis dua ntawm cov tshuaj, nce qhov koob tshuaj mus rau qhov siab tshaj ntawm 40 mg / hnub yuav tsum tau txiav txim siab tsuas yog nyob rau hauv cov neeg mob uas muaj mob hypercholesterolemia thiab muaj kev pheej hmoo loj ntawm kev tsim cov hlab plawv ( tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas muaj tsev neeg hypercholesterolemia) uas tsis tau ua tiav qhov txiaj ntsig ntawm kev kho nrog ib koob tshuaj 20 mg / hnub, thiab leej twg yuav nyob hauv kev saib xyuas ntawm kws kho mob. Tshwj xeeb kev saib xyuas tshwj xeeb ntawm cov neeg mob tau txais cov tshuaj ntawm koob tshuaj 40 mg / hnub yog qhov pom zoo.

Kev siv koob tshuaj 40 mg / hnub hauv cov neeg mob uas tsis tau mus sab laj nrog kws kho mob tsis tau pom zoo. Tom qab 2-4 lub lis piam ntawm kev kho thiab / lossis nrog kev nce ntxiv ntawm cov tshuaj Roxer, kev saib xyuas cov lipid metabolism yog qhov tsim nyog (kev hloov tshuaj yog tsim nyog yog tias tsim nyog).

Cov neeg mob raum tsis ua haujlwm

Hauv cov neeg mob uas mob mentsis lossis mob raum tsis ua haujlwm, koob tshuaj yuav tsis tas kho. Hauv cov neeg mob uas mob raum tsis zoo (CC tsawg dua 30 ml / min), kev siv Roxer yog contraindicated. Kev siv Roxer ntawm ib koob ntawm ntau dua 30 mg / hnub yog contraindicated hauv cov neeg mob uas muaj mob me mus rau lub raum tsis txaus (CC tsawg dua 60 ml / min). Rau cov neeg mob uas tsis tshua mob raum, qhov kev xav pom zoo thawj zaug ntawm Roxer yog 5 mg / hnub.

Siv thaum cev xeeb tub thiab pub niam mis

Roxer cov tshuaj yog contraindicated nyob rau hauv 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 kom tsim nyog.

Yog tias cev xeeb tub thaum kho, kev siv cov tshuaj yuav tsum nres tam sim ntawd.

Lub raum khiav tsis zoo

Hauv cov neeg mob uas tau txais ntau dua ntawm rosuvastatin (tshwj xeeb yog 40 mg / hnub), tubular proteinuria tau pom, uas tau kuaj pom siv cov ntawv xeem thiab, feem ntau, yog ntu lossis luv luv. Xws li cov proteinuria tsis qhia txog cov mob raum sai sai. Qhov ntau zaus ntawm mob raum tsis zoo tau sau tseg hauv kev tshawb fawb tom qab muag ntawm rosuvastatin muaj ntau dua nrog ib koob ntawm 40 mg / hnub. Hauv cov neeg mob noj cov tshuaj Roxer ntawm koob tshuaj 30 lossis 40 mg / hnub, nws raug nquahu kom soj ntsuam cov cim ua haujlwm raum thaum kho (tsawg kawg 1 zaug hauv 3 hlis).

Qhov cuam tshuam rau cov leeg musculoskeletal

Thaum siv rosuvastatin nyob rau hauv txhua koob tshuaj, tab sis tshwj xeeb tshaj yog nyob rau hauv cov koob tshuaj ntau tshaj 20 mg / hnub, cov teebmeem hauv qab no ntawm cov leeg mus rau hauv lub cev tau qhia: myalgia, myopathy, hauv qee qhov mob tsawg, rhabdomyolysis. Feem ntau tsis tshua muaj neeg mob rhabdomyolysis tau sau tseg nrog kev siv HMG-CoA reductase thiab ezetimibe inhibitors tib lub sijhawm. Xws li kev sib xyaw ua ke yuav tsum siv nrog ceev faj, vim tias kev sib txuam pharmacodynamic tsis tuaj yeem tawm tsam. Xws li lwm yam HMG-CoA reductase inhibitors, qhov zaus ntawm rhabdomyolysis nyob rau tom qab kev siv cov tshuaj Roxer ntau dua thaum cov tshuaj yog 40 mg / hnub.

Kev txiav txim siab ntawm CPK cov haujlwm

Kev ua haujlwm ntawm CPK tsis tuaj yeem txiav txim siab tom qab kev tawm dag zog lub cev thiab nyob rau lwm qhov laj thawj uas ua rau muaj kev nce siab hauv nws cov haujlwm, qhov no tuaj yeem ua rau kev txhais tsis raug ntawm cov txiaj ntsig. Yog tias qhov pib ua haujlwm ntawm CPK tau pom zoo dhau (5 zaug siab dua li qhov siab ntawm qhov muaj cai sab nrauv), kev tshuaj xyuas ntxiv yuav tsum tau nqa tawm tom qab 5-7 hnub. Koj tsis tuaj yeem pib txoj kev kho mob yog tias qhov tshwm sim ntawm kev rov ua tiav paub tseeb thawj zaug KFK kev ua haujlwm (ntau tshaj 5-ntau dua dhau ntawm qhov txwv tsis pub tshaj ntawm cov cai).

Ua ntej pib txoj kev kho

Ua raws li kev siv tshuaj txhua hnub, Roxer tshuaj yuav tsum tau sau tseg nrog ceev faj rau cov neeg mob uas muaj kev phom sij txog myopathy / rhabdomyolysis, lossis kev siv cov tshuaj yog contraindicated (saib tshooj "Contraindications" thiab "Ceev Faj").

Tej yam no suav nrog:

lub raum tsis ua hauj lwm zoo,
hypothyroidism
keeb kwm mob leeg (nrog rau tsev neeg muaj keeb kwm),
myotoxic teebmeem thaum noj lwm HMG-CoA reductase inhibitors lossis fibrates hauv keeb kwm,
haus ntau dhau
hnub nyoog 65 xyoos
cov mob uas cov concentration ntawm rosuvastatin hauv cov ntshav ntshav tuaj yeem nce ntxiv,
tib lub sij hawm siv cov fibrates.

Hauv cov neeg mob zoo li no, nws yog ib qho tsim nyog los soj ntsuam qhov pheej hmoo thiab cov txiaj ntsig tau los ntawm kev kho. Soj ntsuam mob kuj tseem pom zoo. Yog tias qhov pib ua haujlwm ntawm CPK yog ntau dua 5 npaug ntau dua li qhov kev txwv qis dua ntawm ib txwm, kev kho mob nrog Roxer yuav tsum tsis txhob pib.

Thaum lub sijhawm cov tshuaj kho

Tus neeg mob yuav tsum tau txais kev ceeb toom txog kev xav tau kev kho mob sai sai yog tias muaj mob sai sai ntawm cov leeg mob, mob leeg tsis muaj zog lossis mob plab, tshwj xeeb tshaj yog ua ke nrog malaise thiab kub taub hau. Hauv cov neeg mob no, CPK cov haujlwm yuav tsum raug txiav txim. Kev kho yuav tsum tsis ua ntxiv yog tias qhov kev ua ntawm CPK tau nce siab (ntau dua 5 zaug piv nrog qhov siab dua qhov qub) lossis yog tias cov tsos mob ntawm cov leeg mob tau tshaj tawm thiab ua rau muaj kev tsis zoo nyob rau txhua hnub (txawm hais tias qhov kev ua haujlwm ntawm CPK tsis ntau tshaj 5 zaug ntawm qhov siab tshaj sab sauv. qauv). Yog tias cov tsos mob ploj thiab CPK cov haujlwm rov qab mus rau qhov qub, yuav tsum tau txais kev txiav txim siab kom rov qab siv Roxer lossis lwm qhov HMG-CoA reductase inhibitors hauv kev noj tshuaj qis nrog kev saib xyuas mob zoo. Saib xyuas kev ua haujlwm ntawm CPK thaum tsis muaj cov tsos mob tsis muaj zog. Cov xwm txheej tsis tshua muaj kev tiv thaiv kab mob rau lub cev tsis ua haujlwm nrog cov mob myopathy nrog cov chaw kuaj mob nyob rau hauv daim ntawv ntawm cov leeg lub cev tsis muaj zog thiab cov ntshav ntau ntxiv CPK kev ua haujlwm thaum kho lossis thaum siv ceev xwm txheej ntawm HMG-CoA reductase inhibitors, suav nrog rosuvastatin, tau sau tseg. Cov kev kawm ntxiv ntawm cov leeg thiab cov leeg hlwb, kev tshawb fawb serological, nrog rau kev kho tshuaj tiv thaiv kab mob kuj yuav tsum tau ua.

Tsis muaj cov cim ntawm kev cuam tshuam ntau ntxiv ntawm cov leeg pob txha thaum noj rosuvastatin thiab concomitant txoj kev kho. Txawm li cas los xij, kev nce ntxiv ntawm qhov tshwm sim ntawm myositis thiab myopathy tau tshaj tawm nyob rau hauv cov neeg mob noj lwm qhov HMG-CoA reductase inhibitors hauv kev sib xyaw nrog fibroic acid derivatives (e.g. gemfibrozil), cyclosporine, nicotinic acid hauv lipid txo cov tshuaj (ntau dua 1 g / hnub), antifungal derivatives azole, HIV protease inhibitors thiab tshuaj tua kab mob macrolide.

Thaum siv nrog qee qhov HMG-CoA reductase inhibitors, gemfibrozil nce kev pheej hmoo ntawm myopathy. Yog li, kev siv tshuaj ib txhij Roxer thiab gemfibrozil tsis pom zoo. Qhov zoo ntawm kev hloov ntshav ntxiv ntawm cov ntshav lipids nrog kev siv Roxer nrog cov tshuaj fibrates lossis nicotinic acid hauv kev tso tshuaj lipid yuav tsum ua tib zoo ntsuas kom tsis txhob muaj qhov phom sij txaus. Cov tshuaj Roxer ntawm ib koob ntawm 30 mg / hnub yog contraindicated rau kev sib txuas ua ke nrog kev kho mob nrog fibrates. Vim tias qhov pheej hmoo ntawm rhabdomyolysis, Roxer yuav tsum tsis txhob siv rau hauv cov neeg mob uas mob hnyav tuaj yeem ua rau mob myopathy lossis cov mob cuam tshuam rau kev txhim kho lub raum tsis ua haujlwm (piv txwv, sepsis, mob ntshav qis, kev phais loj heev, kev poob plig, mob plab zom mov, endocrine thiab electrolyte cuam tshuam) lossis raug tswj tsis tau chua leeg).

Ua rau daim siab

Ua raws li kev siv tshuaj txhua hnub, Roxer yuav tsum siv nrog ceev faj hauv cov neeg mob uas haus cawv ntau dhau thiab / lossis keeb kwm muaj kab mob siab lossis nws siv yog contraindicated (saib ntu "Contraindications" thiab "Ceev Faj").

Nws raug nquahu kom txiav txim siab ua haujlwm ntsuam xyuas lub siab ua ntej pib kev kho thiab 3 lub hlis tom qab nws pib. Kev siv cov tshuaj Roxer yuav tsum tsis ua ntxiv lossis cov koob tshuaj yuav tsum raug txo yog tias qhov kev ua haujlwm ntawm "mob siab" hloov mus rau hauv cov ntshav cov ntshav yog 3 zaug ntau dua li cov kev txwv sab sauv.

Hauv cov neeg mob hypercholesterolemia vim yog hypothyroidism lossis nephrotic syndrome, kev kho mob ntawm cov kab mob hauv qab yuav tsum tau nqa tawm ua ntej kev kho mob nrog Roxer.

Dosage daim ntawv

Cov ntsiav tshuaj ua yeeb yaj kiab 5 mg, 10 mg, 20 mg thiab 40 mg

Ib ntsiav tshuaj muaj

cov tshuaj heev - rosuvastatin calcium 5.21 mg, 10.42 mg, 20.83 mg, lossis 41.66 mg (sib npaug li 5os rosuvastatin, 10 mg, 20 mg thiab 40 mg, ntsig txog),

hauvtus zam: microcrystalline cellulose, anhydrous lactose, crospovidone, silicon dioxide, colloidal anhydrous, magnesium stearate,

zaj duab xis sheath: lub tshuab luam ntawv tseem ceeb ntawm cov kua dej methacrylate, macrogol 6000, titanium dioxide E171, lactose monohydrate.

Cov ntsiav tshuaj muaj puag ncig cov duab, nrog me ntsis biconvex nto, txheej nrog cov xim dawb zaj duab xis, cim “5” ntawm ib sab thiab nrog bevel (rau koob tshuaj 5 mg).

Cov ntsiav tshuaj muaj puag ncig zoo, nrog me ntsis biconvex nto, txheej nrog cov xim dawb zaj duab xis, cim “10” ntawm ib sab thiab beveled (rau kev siv tshuaj ntawm 10 mg).

Cov ntsiav tshuaj uas muaj puag ncig, coated nrog dawb zaj duab xis txheej, nrog bevel (rau qhov ntau npaum ntawm 20 mg).

Cov tshuaj ntsiav zoo li lub ntsej muag nrog lub ntsej muag biconvex, txheej nrog lub tsho dawb zaj duab xis (rau qhov ntau npaum li 40 mg).

Tsuas tshuaj thiab tswj hwm

Ua ntej pib siv tshuaj kho mob, tus neeg mob yuav tsum noj cov zaub mov kom tsis txhob rog nrog cov roj cholesterol tsawg thiab txuas ntxiv ua raws li kev noj haus no thaum kho. Cov koob tshuaj ntawm cov tshuaj tau teeb tsa ua ib tus zuj zus, nyob ntawm lub hom phiaj ntawm txoj kev kho, tus neeg mob cov lus teb rau kev kho. Qhov pom zoo kom pib koob tshuaj txhua hnub yog los ntawm 5 mg txog 10 mg thiab noj ib hnub ib zaug. Qhov koob tshuaj no zoo ib yam rau cov neeg mob uas tau noj cov tshuaj statins thawj zaug, lossis hloov los ntawm kev kho nrog lwm tus HMG inhibitor, CoA reductase. Thaum xaiv txoj kev pib noj tshuaj, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv thawj tus neeg theem ntawm cov roj (cholesterol) thiab cov kev pheej hmoo ntawm cov hlab plawv, nrog rau cov kev pheej hmoo ntawm kev tsim cov kev mob tshwm sim.

Yog tias tsim nyog, cov koob tshuaj yuav tau nce ntxiv tom qab 4 lub lis piam. Muab qhov nce zuj zus ntawm cov lus qhia txog qhov tshwm sim tsis zoo thaum noj ntau dua 40 mg piv nrog koob tshuaj qis dua, qhov nce ntxiv txhua hnub rau 30 mg lossis 40 mg yuav tsum tau txiav txim siab tsuas yog rau cov neeg mob hyperlipidemia loj thiab muaj kev pheej hmoo mob plawv (tshwj xeeb, nrog rau tsev neeg hypercholesterolemia) , nyob rau hauv uas nws tsis tuaj yeem ua tiav cov qib lipid thaum noj tsawg dua, thiab uas yuav tau saib xyuas. Tshwj xeeb saib xyuas cov neeg mob yog qhov tsim nyog thaum lawv pib noj cov koob tshuaj 40 mg lossis 30 mg.

Kev nce ntxiv ntawm koob tshuaj rau 40 mg yog ua tau tsuas yog nyob hauv kev saib xyuas ntawm kws kho mob. Kev noj tshuaj ntawm 40 mg tsis pom zoo rau cov neeg mob uas tsis tau noj cov tshuaj no yav dhau los. Tom qab 2 lub lis piam ntawm kev kho thiab / lossis nrog kev nce ntxiv ntawm koob tshuaj Roxer, kev saib xyuas cov lipid metabolism yog qhov tsim nyog (yog tias tsim nyog, kev hloov kho tshuaj).

Roxera® tuaj yeem noj lub sijhawm twg los tau nruab hnub, tsis hais zaub mov dab tsi.

Siv rau cov neeg laus

Cov neeg mob uas laus dua 70 xyoo tau pom zoo kom pib noj cov tshuaj nrog 5 koob tshuaj mg

Muab hauv cov neeg mob lub raum tsis ua haujlwm

Hauv cov neeg mob uas mob raum me me los sis mob raum tsis ua hauj lwm, tsis tas yuav hloov kho koob tshuaj, qhov pom zoo thawj zaug ntawm cov tshuaj yog 5 mg. Hauv cov neeg mob uas muaj qhov tsis zoo lub raum lub raum ua haujlwm (creatinine tshem tawm tsawg dua 60 ml / min) - kev siv cov tshuaj hauv qhov ntau npaum ntawm 40 mg yog contraindicated. Hauv cov neeg mob uas mob raum tsis ua hauj lwm zoo (kev tshem tawm creatinine tsawg dua 30 ml / min), kev siv Roxer ® yog contraindicated.

Tsuas noj nyob rau hauv cov neeg mob mob siab mob siab

Hauv cov neeg mob uas muaj 7 lossis tsawg dua Cov Menyuam yaus-Pugh cov qhab nia, tsis tas yuav hloov kho koob tshuaj. Tsis muaj kev paub dhau los ntawm kev siv cov tshuaj hauv cov neeg mob uas tau tus qhab nia siab dua 9 ntawm Child-Pugh nplai.

Roxer ® yog qhov sib txawv hauv cov neeg mob uas muaj lub siab ua mob rau daim siab.

Ib qho kev nce ntxiv hauv cov kab ke ntawm rosuvastatin ntawm Japanese thiab Suav tau sau tseg. Qhov pom zoo kom pib noj rau cov neeg mob Asian yog 5 mg. Kev siv cov tshuaj hauv ib koob ntawm 30 mg lossis 40 mg yog contraindicated hauv cov neeg mob ntawm cov haiv neeg Asian.

Koob tshuaj nyob rau hauv cov neeg mob nrog ib tug predisposition rau myopathy

Qhov pom zoo kom pib koob tshuaj rau cov neeg mob uas muaj lwm yam kev xav ua rau qhov kev txhim kho ntawm myopathy yog 5 mg. Cov koob tshuaj ntawm 40 mg thiab 30 mg yog contraindicated hauv cov neeg mob ntawd.