Tulip: cov lus qhia rau kev siv, analogues thiab tshuaj xyuas, cov nqi hauv cov khw muag tshuaj ntawm Russia
Atorvastatin - xaiv cov tshuaj tiv thaiv HMG-CoA reductasekev koom tes hauv hluavtaws roj hauv lub siab. Tsis tas li ntawd, cov tshuaj pab ua kom ntau ntawm cov receptors - LDL rau ntawm lub hlwb, uas ua rau kom nce siab thiab metabolism hauv ntawm LDL. Pab rau qib qis dua roj, lipoproteins, LDL cov roj cholesterol, apolipoprotein-B.
Hauv cov neeg mob nrog hypercholesterolemia (tsev neeg, thawj) thiab xyaw hyperlipidemia txo qib VLDL roj (cholesterol) thiab TG.
Thaum ib koob tshuaj 40 mg, cov tshuaj txo LDL los ntawm 50%, roj cholesterol ntawm 37%, triglycerides los ntawm 29%, thiab apo-B los ntawm 42%. Ua raws li cov koob tshuaj, nws txo qib ntawm LDL hauv tsev neeg hypercholesterolemia, uas tiv thaiv kev kho mob nrog lwm cov lipid-txo cov tshuaj. Cov nyhuv tshwm nyob rau hauv lub lim tiam thib peb los ntawm kev pib kho mob, thiab cov txiaj ntsig siab tshaj plaws tau ua tiav hauv ib hlis.
Cov Tshuaj Pharmacokinetics
Theem nqus tau yog qhov siab. Cmax hauv cov ntshav tau txiav txim siab tom qab 2 teev. Qhov kev txo qis ntawm LDL cov cholesterol yuav tsis yog nyob ntawm lub sijhawm noj tshuaj (sawv ntxov lossis yav tsaus ntuj). Muaj kev sib txheeb ntawm koob tshuaj thiab qib nqus.
Bioavailability yog tsawg -12%, uas cuam tshuam nrog cov kabmob presystemic hauv kev zom zaub mov. Kev sib txuas lus nrog cov ntshav protein 98%. Nws yog metabolized hauv daim siab ua haujlwm nyob rau hauv isoenzymes nrog kev tsim ntawm active metabolites. Cov kev ua ntawm metabolites kav 20-30 teev. Nws tawm dhau los ntawm txoj hnyuv. T1 / 2 - 14 teev. Hauv cov zis, 2% ntawm cov koob tshuaj tiv thaiv yog txiav txim siab.
Cov Yuav Tsum Tau Ua
- daim siab mob
- kev tiv thaiv tsis haum
- mob hlwb,
- cev xeeb tub thiab lactation,
- hnub nyoog txog 18 xyoo
- intolerance lactose.
Nrog ceev faj yog kws kho thaum hyperthyroidism, arterial hypotension, sepsiselectrolyte tsis txaus.
Sab sij huam
Tej yam tshwm sim tsis zoo:
- mob taub hau astheniatsis muaj zog insomnia, paresthesia,
- myalgiatxha thiab mob nraub qaum,
- daim tawv nqaij ua pob, khaus, urticaria,
- peripheral edema.
Tsis tshua pom qhov kev phiv tshuaj:
- amnesia, peripheral neuropathy,
- kab mob siab, dajntoo, kev tsis nco qab, pancreatitis,
- cramps mob mob vwm, rhabdomyolysis,
- tinnitus
- angioedema, polymorphic erythema,
- hyper- lossis hypoglycemia, ntau ntau ntawm CPK hauv cov ntshav,
- thrombocytopenia,
- alopecia,
- qhov hnyav nce, hloov hauv potency.
Tulip, cov lus qhia rau kev siv (Txoj kev thiab ntau npaum li cas)
Cov tshuaj yog muab ntawm qhov ncauj txhua lub sijhawm ntawm ib hnub.
Cov koob tshuaj ntawm cov tshuaj yog nyob ntawm tus neeg mob cov roj (cholesterol) nyob rau hauv thiab ntau npaum li 10 mg txog 80 mg rau ib hnub. Feem ntau, 10 mg lossis 20 mg yog tshuaj. Qhov siab tshaj plaws ntshav qab zib yog 80 mg.
Txhua txhua 3-4 lub lis piam, qib ntawm lipids yog tswj thiab qhov koob tshuaj ntawm yuav raug kho. Hauv cov neeg mob uas lub raum tsis ua hauj lwm, qhov koob tshuaj tsis tau hloov kho. Yog tias lub siab ua haujlwm tsis txaus, lub koob tshuaj poob qis nrog kev soj ntsuam ib txwm muaj qhov hloov pauv (ACT thiab ALT).
Kev sib txuam
Thaum ua ntawv thov nrog fibrates, erythromycin, cyclosporine, clarithromycin, antifungal thiab tshuaj tiv thaiv kab mob, nicotinic acid kev pheej hmoo ntawm myopathy nce.
CYP3A4 Isoenzyme Tus Neeg Txom Nyem ua rau muaj kev nce ntxiv ntawm atorvastatin concentration.
Cyclosporin nce lub bioavailability thiab kev xav ntawm atorvastatin. Erythromycin, diltiazem thiab clarithromycin kuj nce lub siab ntawm cov tshuaj. Itraconazole ua rau muaj kev nce ntxiv hauv AUC ntawm atorvastatin los ntawm 3 zaug.
Kev noj cov txiv kab ntxwv qaub ntau dhau ua rau muaj qhov nce ntawm atorvastatin.
Sib koom siv nrog efavirenz lossis rabampicin entails ib tug txo nyob rau hauv lub concentration ntawm cov tshuaj.
Tshuaj Antacids txo qhov siab ntawm cov tshuaj no los ntawm 35%.
Hypolipidemic nyhuv thaum noj nrog colestipol muaj ntau dua li ib qho tshuaj ib qho zuj zus.
Thaum ua ntawv thov digoxin thiab atorvastatin hauv kev txhaj tshuaj ntau, cov concentration ntawm digoxin nce ntxiv. Atorvastatin ua kom luv luv prothrombin lub sijhawm thaum siv ua ke nrog warfarin. Amlodipine tsis cuam tshuam rau lub pharmacokinetics ntawm cov tshuaj no.
Analogs ntawm Tulip
Cov Ator, Atoris, Atorvastatin, Atorvastatin-Teva, Thorvacard, Liptonorm, Novostat, Torvazin, Torvalip, Keebkwm.
Tulip tshuaj xyuas
Cov tshuaj siv ntau tshaj plaws los kho hyperlipidemia yog statins, qhov kev ua tau zoo uas tau muab pov thawj hauv kev tshawb fawb. Hauv kev xyaum, cov tshuaj qub thiab lawv cov generics yog siv dav: atorvastatin (Tulip) simvastatin (Vasilip, Atherostat, Simlo), lovastatin (Holartar) Atorvastatin (Tulip) yog cov tshuaj siv hluavtaws uas muaj lub sijhawm ua haujlwm ntev tshaj li lwm lub statins. Nws muaj peev xwm ua kom qis triglycerides. Raws li kev siv cov tshuaj ntawm no, txo qis hauv lub zaus ntawm kev tuag sai li sai tau, myocardial infarction, qhov kev xav tau rau kev cuam tshuam tsis zoo ntawm cov nkoj. Nws ua rau qhov qeeb zuj zus. atherosclerosisCov. Txoj kev kho mob pib nrog ib qho tshuaj me me, maj mam nce nws kom ua tiav qib theem ntawm lipoproteins.
Ib qho ntawm cov teeb meem ntawm kev kho statin yog lawv tus nqi siab, thiab cov neeg mob qhia nws. Cov teeb meem no daws tau los ntawm generics, uas suav nrog Tulip. Cov tshuaj muaj peev xwm tiv thaiv tau zoo, tab sis nws yog qhov tshwm sim los ntawm cov kev mob tshwm sim ntawm statins: kev nce qib ntawm daim siab thiab cov leeg ntshav (CPK). Hauv lawv txoj kev ntsuam xyuas, cov neeg mob them sai sai rau qhov no. Yog hais tias theem ntawm daim siab ua haujlwm siab tshaj li 3 zaug, thiab CPK yog 5 zaug siab dua li lub chav ntsuas cov neeg mob, cov tshuaj tau muab tso tseg. Thaum cov enzymes rov qab mus rau qhov tseem ceeb, kev kho mob tau rov ua dua, tab sis cov tshuaj nyob rau hauv qis dua. Ntau tus neeg mob kuj tseem hnov mob plab, pom pob, mob plab zawv lossis cem quav, thiab insomnia. Myopathy yog qhov tsawg thiab ua rau pom los ntawm qhov mob thiab tsis muaj zog hauv cov leeg. Tag nrho cov tshwm sim no tsuas yog ib ntus thiab ploj tom qab kev txo koob tshuaj.
Kev ntsuas rau siv
Dab tsi pab kom Tulip? Qhia cov tshuaj hauv cov kis hauv qab no:
- qhov kev txo qis hauv cov theem ntawm cov roj (cholesterol) thiab cov roj (cholesterol) thiab cov roj (LDL) (cov roj lipoprotein tsawg) nyob hauv cov neeg mob homozygous tsev neeg hypercholesterolemia (nrog kev noj haus tsis zoo lossis tsis txaus noj tshuaj thiab lwm yam tshuaj tsis zoo),
- qhov kev txo qis hauv qhov ntau ntawm apo-B (apolipoprotein B), TG (thyroglobulin), Chs thiab Chs-LDL thiab kev nce siab ntawm Chs-HDL (ntshav siab lipoprotein roj) nyob rau hauv cov neeg mob nrog hyperlipidemia thiab heterozygous tsis-tsev neeg thiab mob ntshav qab zib. thiab cov kev kho mob tsis-pharmacological ntawm lawv qhov kev ua haujlwm tsis txaus),,
- kev tiv thaiv kab mob plawv hauv cov neeg mob uas tsis muaj kev soj ntsuam cov kab mob hauv lub plawv (mob plawv), tab sis nrog ntau yam kev pheej hmoo rau nws txoj kev loj hlob (mob ntshav siab, retinopathy, ntshav qab zib mellitus, kev siv tshuaj tsis muaj nicotine, albuminuria, kev mob caj ces, tsis tshua muaj HDL-C hauv ntshav), hnub nyoog tshaj 55)
- kev tiv thaiv kab mob thib ob ntawm cov kev mob plawv hauv cov neeg mob uas muaj mob rau cov hlab ntshav ntawm lub cev.
Cov lus qhia rau kev siv Tulip, ntau npaum li cas
Ua ntej pib txoj kev kho (raws li thaum nws), ib qho kev cai hypocholesterolemic noj yuav tsum tau ua raws.
Cov ntsiav tshuaj tau noj ntawm qhov ncauj, tsis hais txog ntawm cov khoom noj. Cov koob tshuaj yog los ntawm 10 mg txog 80 mg rau ib hnub thiab nyob ntawm qhov mob hnyav ntawm cov kabmob thiab cov yam ntxwv ntawm lub cev.
Qhov siab tshuaj ntau tshaj plaws niaj hnub yog 80 mg rau ib hnub.
Cov qauv tshuaj raws li cov lus qhia rau kev siv:
- Lub Koom Haum Me Nyuam Hwj (hom mob heterozygous hereditary thiab polygenic) hypercholesterolemia (hom IIa) thiab sib xyaw hyperlipidemia (hom IIb): Tulip 10 mg ib hnub ib zaug. Yog tias tsim nyog, maj mam nce ntxiv ntawm koob tshuaj rau 80 mg yog ua tau (2 ntsiav tshuaj ntawm 40 mg).
- Homozygous kab mob hypercholesterolemia: 80 mg (2 tab. Tulip 40 mg) 1 zaug nyob rau ib hnub.
- Kev tiv thaiv ntawm kev loj hlob ntawm cov kab mob plawv: Tulip 10 mg 1 zaug nyob rau ib hnub.
- Yog tias qhov ua kom zoo ntshav LDL cov ntsiab lus tsis tau ncav cuag, nws tuaj yeem nce qhov ntau ntxiv rau 80 mg rau ib hnub, nyob ntawm tus neeg mob cov tshuaj tiv thaiv nrog ntu li 2 mus rau 4 lub lis piam.
Thaum pib ntawm txoj kev kho, tom qab 2-4 lub lim tiam ntawm kev kho mob, thiab tseem tom qab txhua koob nce, nws yog qhov yuav tsum tau txiav txim siab txog qib theem ntawm cov lipids hauv cov ntshav txhawm rau txhawm rau kho lub sijhawm.
Dosage hloov kho rau cov mob puas lub raum thiab hauv lub hnub nyoog laus tsis tas yuav.
Yog tias lub raum tsis ua haujlwm thiab hauv cov neeg laus, yuav tsum tsis txhob kho ntau dua. Thaum lub cev ua haujlwm tsis zoo, siv nrog ceev faj, ua tib zoo saib xyuas cov haujlwm ntawm daim siab ua haujlwm ntawm lub siab.
Yog tias qhov kev pom tau nce siab hauv kev ua haujlwm ntawm ACT lossis ALT los ntawm ntau dua 3 zaug piv nrog VGN mob siab, nws raug nquahu kom txo qis lossis tsis haus cov tshuaj.
Cov neeg mob yuav tsum raug qhia paub txog qhov xav tau tam sim ntawd sab laj nrog kws kho mob yog tias qhov mob tsis pom thiab / lossis cov leeg tsis muaj zog tshwm tuaj, tshwj xeeb yog muaj kev cuam tshuam nrog dav dav thiab kub cev.
Qhia txog ntawm cov tshuaj
Tulip - Tus neeg sawv cev Hololipidemic.
Atorvastatin yog xaiv cov kev sib tw tshwj xeeb ntawm HMG-CoA reductase, ib qho enzyme uas hloov 3-hydroxy-3-methylglutaryl coenzyme A rau mevalonic acid, ua ntej ntawm sterols, suav nrog cov roj (cholesterol).
Triglycerides (TG) thiab cov roj (Xc) yog suav nrog kev sib xyaw ntawm cov lipoproteins tsawg heev (VLDL) thaum lub zog ua ke hauv lub siab, nkag rau cov ntshav ntshav thiab thauj mus rau cov ntaub so ntswg. Tsawg lipoproteins tsawg (LDL) yog tsim los ntawm VLDL thaum muaj kev sib cuam tshuam nrog LDL receptors.
Cov kev tshawb fawb pom tias nce ntau ntawm tag nrho cov roj (cholesterol), LDL thiab apolipoprotein B (apo-B) hauv cov ntshav ntshav pab txhawb kev txhim kho atherosclerosis thiab yog cov muaj kev pheej hmoo rau cov kab mob plawv, thaum nce siab ntawm lipoproteins ntau ntom (HDL) txo txoj kev pheej hmoo kev txhim kho cov kab mob plawv.
Atorvastatin txo cov tshuaj cholesterol thiab lipoproteins ntau nyob rau hauv cov ntshav plasma vim tias tsis muaj HMG-CoA reductase, cov roj (cholesterol) hauv lub siab ua haujlwm thiab nce ntau ntawm cov "siab" LDL receptors rau ntawm lub ntsej muag ntawm tes, uas ua rau muaj kev nce siab ntau dua thiab catabolism ntawm LDL (raws li kev tshawb nrhiav preclinical).
Atorvastatin txo qis kev coj ua ke thiab cov ntsiab lus ntawm LDL-C, tag nrho Ch, apo-B nyob rau hauv cov neeg mob homozygous thiab heterozygous tsev neeg hypercholesterolemia, thawj hypercholesterolemia thiab sib xyaw hyperlipidemia.
Nws kuj ua rau muaj kev txo qis hauv cov kev sib txuam ntawm cov roj cholesterol-VLDL thiab TG thiab kev nce siab ntawm cov roj-HDL thiab apolipoprotein A-1 (apo-A).
Hauv cov neeg mob uas mob dysbetalipoproteinemia, qhov kev cia siab ntawm cov tshuaj lipoproteins Xc-LAPP tsawg dua.
Atorvastatin hauv koob tshuaj 10 mg thiab 20 mg txo qhov concentration ntawm cov roj (cholesterol) tag nrho los ntawm 29% thiab 33%, LDL - los ntawm 39% thiab 43%, apo-B - los ntawm 32% thiab 35% thiab TG - los ntawm 14% thiab 26%, feem, ua rau kom muaj zog ntawm cov roj (HDL) cov roj cholesterol thiab apo-A.
Atorvastatin nyob rau hauv koob tshuaj 40 mg txo qhov kev xav ntawm tag nrho cov roj (cholesterol) los ntawm 37%, LDL - los ntawm 50%, apo-B - los ntawm 42% thiab TG - los ntawm 29%, ua rau muaj kev nce siab ntawm cov roj cholesterol thiab HDL thiab apo-A.
Koob-dependently txo qhov concentration ntawm LDL hauv cov neeg mob nrog homozygous tsev neeg hypercholesterolemia, tiv taus kev kho mob nrog lwm cov lipid-txo tshuaj.
Nws tsis muaj carcinogenic thiab mutagenic teebmeem.
Kev kho mob nyhuv ntev li 2 lub lis piam tom qab pib kho, mus txog qhov siab kawg tom qab 4 lub lis piam thiab kav ntev hauv lub sijhawm kho.
Txaj Muag Rau Suav Taub Hau Kev Sib Tw
Cov analogue yog pheej yig dua los ntawm 104 rubles.
Atorvastatin yog ib qho piv txwv ntawm cov neeg hauv tebchaws Lavxias, yog li nws raug nqi tsawg dua li cov tshuaj txawv teb chaws, txawm hais tias nws tsis txawv ntau ntawm kev sau. Contraindicated nyob rau hauv cov ntaub ntawv ntawm hypersensitivity, thaum cev xeeb tub thiab lactation.
Atorvastatin-Teva (ntsiav tshuaj) Ntsuas: 11 Sab saum toj
Cov analogue yog pheej yig dua los ntawm 97 rubles.
Atorvastatin-Teva yog Israeli tshuaj uas xyaum tsis txawv hauv tshuaj muaj pes tsawg leeg, yog li cov npe ntawm qhov ntsuas, contraindications thiab phiv yog zoo heev. Cov khoom xyaw nquag: atorvastatin calcium hauv ntau cov tshuaj noj (nyob ntawm daim ntawv tso tawm.)
Cov kab mob analogue yog pheej yig dua los ntawm 65 rubles.
Cov tsim tawm: Oxford (Is Nrias teb)
Cov Ntawv Tso Tawm:
- 20 mg ntsiav tshuaj, 30 pcs.
Lipoford muaj daim ntawv tso tawm zoo tib yam li cov tshuaj qub. Nquag tivthaiv ntawm atorvastatin calcium trihydrate (uas sib haum rau atorvastatin 10 mg). Hloov chaw no muaj cov npe ntau dua, yog li, ua ntej pib kev kho mob, koj yuav tsum sab laj nrog kws kho mob.
Analogs hauv kev muaj pes tsawg leeg thiab qhia txog kev siv
| Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
|---|---|---|
| Amvastan | -- | 56 UAH |
| Cov Atorvacor | -- | 31 UAH |
| Atoris | 34 RUB | 7 UAH |
| Vasocline | -- | 57 UAH |
| Livostor atorvastatin | -- | 26 UAH |
| Liprimar atorvastatin | 54 rub | 57 UAH |
| Thorvacard | 26 RUB | 45 UAH |
| Atorvastatin | 12 RUB | 21 UAH |
| Limistin Atorvastatin | -- | 82 UAH |
| Lipodemin Atorvastatin | -- | 76 UAH |
| Litorva atorvastatin | -- | -- |
| Pleostin atorvastatin | -- | -- |
| Cov ntaub so qhov ncauj atorvastatin | -- | 106 UAH |
| Torvazin Atorvastatin | -- | -- |
| Torzax atorvastatin | -- | 60 UAH |
| Etset atorvastatin | -- | 61 UAH |
| Aztor | -- | -- |
| Astin Atorvastatin | 89 rub | 89 UAH |
| Atocor | -- | 43 UAH |
| Atorvasterol | -- | 55 UAH |
| Atotex | -- | 128 UAH |
| Novostat | 222 RUB | -- |
| Atorvastatin-Teva Atorvastatin | 15 RUB | 24 UAH |
| Atorvastatin Alsi Atorvastatin | -- | -- |
| Lipromak-LF atorvastatin | -- | -- |
| Vazator atorvastatin | 23 RUB | -- |
| Atorem atorvastatin | -- | 61 UAH |
| Vasoclin-Darnitsa atorvastatin | -- | 56 UAH |
Cov npe saum toj no ntawm cov yeeb tshuaj analogues, uas qhia Tulip hloov chaw, yog qhov tsim nyog tshaj plaws vim tias lawv muaj tib cov tshuaj sib luag thiab sib luag ua ke raws li kev taw qhia rau kev siv
Analogs los ntawm qhov taw qhia thiab cov qauv ntawm kev siv
| Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
|---|---|---|
| Vabadin 10 mg simvastatin | -- | -- |
| Vabadin 20 mg simvastatin | -- | -- |
| Vabadin 40 mg simvastatin | -- | -- |
| Vasilip simvastatin | 31 RUB | 32 UAH |
| Zokor simvastatin | 106 rub | 4 UAH |
| Zokor Forte simvastatin | 206 rub | 15 UAH |
| Simvatin simvastatin | -- | 73 UAH |
| Vabadin | -- | 30 UAH |
| Simvastatin | 7 RUB | 35 UAH |
| Vasostat-Health simvastatin | -- | 17 UAH |
| Vasta simvastatin | -- | -- |
| Kardak simvastatin | -- | 77 UAH |
| Simvakor-Darnitsa simvastatin | -- | -- |
| Simvastatin-zentiva simvastatin | 229 RUB | 84 UAH |
| Kev Simstat simvastatin | -- | -- |
| Alleste | -- | 38 UAH |
| Zosta | -- | -- |
| Lovastatin lovastatin | 52 rub | 33 UAH |
| Tib neeg txoj cai pravastatin | -- | -- |
| Leskol | 2586 rub | 400 UAH |
| Leskol Forte | 2673 rub | 2144 UAH |
| Leskol XL fluvastatin | -- | 400 UAH |
| Crestor rosuvastatin | 29 RUB | 60 UAH |
| Mertenil rosuvastatin | 179 RUB | 77 UAH |
| Klivas rosuvastatin | -- | 2 UAH |
| Rovix rosuvastatin | -- | 143 UAH |
| Rosart Rosuvastatin | 47 rub | 29 UAH |
| Rosuvastatin Rosator | -- | 79 UAH |
| Rosuvastatin Krka rosuvastatin | -- | -- |
| Rosuvastatin Sandoz Rosuvastatin | -- | 76 UAH |
| Rosuvastatin-Teva Rosuvastatin | -- | 30 UAH |
| Rosucard Rosuvastatin | 20 RUB | 54 UAH |
| Rosulip Rosuvastatin | 13 RUB | 42 UAH |
| Rosusta Rosuvastatin | -- | 137 UAH |
| Roxera rosuvastatin | 5 txhuam | 25 UAH |
| Romazik rosuvastatin | -- | 93 UAH |
| Romestine rosuvastatin | -- | 89 UAH |
| Rosucor rosuvastatin | -- | -- |
| Fastrong rosuvastatin | -- | -- |
| Acorta Rosuvastatin calcium | 249 txhuaj | 480 UAH |
| Tevastor-Teva | 383 tshiav | -- |
| Rosistark rosuvastatin | 13 RUB | -- |
| Suvardio rosuvastatin | 19 RUB | -- |
| Redistatin Rosuvastatin | -- | 88 UAH |
| Rustor rosuvastatin | -- | -- |
| Livazo pitavastatin | 173 RUB | 34 UAH |
Sib txawv muaj pes tsawg leeg, tuaj yeem ua ke nyob rau hauv kev taw qhia thiab cov qauv ntawm daim ntawv thov
| Npe | Nqe hauv Lavxias | Nqe hauv Ukraine |
|---|---|---|
| Lopid Gemfibrozil | -- | 780 UAH |
| Lipofen cf fenofibrate | -- | 129 UAH |
| Tricor 145 mg fenofibrate | 942 rub | -- |
| Trilipix Fenofibrate | -- | -- |
| Pms-cholestyramine txiv kab ntxwv tsw flavored colestyramine | -- | 674 UAH |
| Ua noob qes taub dag tau taub dag | 109 rub | 14 UAH |
| Ravisol Periwinkle me me, Hawthorn, Tiaj nyom clover, Nees txiv ntseej, Dawb mistletoe, Japanese Sofora, Horsetail | -- | 29 UAH |
| Sicode ntses roj | -- | -- |
| Vitrum cardio ua ke ntawm ntau cov tshuaj nquag | 1137 rub | 74 UAH |
| Omacor ua ke ntawm ntau cov tshuaj nquag | 1320 RUB | 528 UAH |
| Cov roj ntses roj ntses | 25 RUB | 4 UAH |
| Epadol-Neo kev sib xyaw ntawm ntau cov tshuaj nquag | -- | 125 UAH |
| Ezetrol ezetimibe | 1208 rub | 1250 UAH |
| Repata Evolokumab | 14 500 rub | UAH 26381 |
| Praluent alirocoumab | -- | 28415 UAH |
Yuav ua li cas thiaj nrhiav tau qhov pheej yig tshuaj ntawm cov tshuaj kim?
Txhawm rau kom pom qhov pheej yig cov khoom sib piv rau cov tshuaj, cov dav dav lossis cov lus sau, ua ntej txhua yam peb pom zoo kom them sai sai rau qhov muaj pes tsawg leeg, uas yog rau tib cov tshuaj nquag thiab qhia tau rau kev siv. Cov tshuaj sib xyaw zoo ib yam ntawm cov tshuaj yuav qhia tau tias cov tshuaj cuam tshuam nrog cov tshuaj, kws tshuaj sib npaug lossis chaw muag tshuaj. Txawm li cas los xij, tsis txhob hnov qab txog qhov ua tsis muaj zog ntawm cov tshuaj uas zoo sib xws, uas tuaj yeem cuam tshuam kev nyab xeeb thiab ua haujlwm. Tsis txhob hnov qab txog cov lus qhia ntawm cov kws kho mob, kev noj tshuaj rau nws tus kheej tuaj yeem tsim kev puas tsuaj rau koj kev noj qab haus huv, yog li nco ntsoov sab laj nrog koj tus kws kho mob ua ntej siv cov tshuaj.
Dosage Cov Ntawv
| TULIP ® | reg. Tsis yog: P N015755 / 01 ntawm 02/02/09 - tsis paub kawgRov teev npe dua tshiab: 01/11/13
| reg. Tsis yog: P N015755 / 01 ntawm 02/02/09 - tsis paub kawgRov teev npe dua tshiab: 01/11/13 |
| reg. Tsis muaj .: LP-000126 txij 01/11/11 - tsis paub kawgRov teev npe dua tshiab: 01/12/16 |
Tso tawm daim ntawv, muaj pes tsawg leeg thiab ntim khoom
Zaj duab xis-coated ntsiav tshuaj dawb lossis yuav luag dawb, puag ncig, biconvex, sau nrog "HLA 10" ntawm ib sab, saib puas pob: daim ntawv dawb.
| 1 tab | |
| atorvastatin (nyob rau hauv daim ntawv ntawm atorvastatin calcium) | 10 mg |
Tshwjxeeb: lactose monohydrate - 34.8 mg, croscarmellose sodium - 19.2 mg, hyprolose - 2 mg, polysorbate 80 - 2.6 mg, hnyav magnesium oxide - 26 mg, colloidal silicon dioxide - 1.2 mg, magnesium stearate - 1 mg, microcrystalline cellulose - txog 250 mg Cov.
Muaj pes tsawg leeg plhaub: hypromellose - 2.976 mg, hyprolose - 0.744 mg, titanium dioxide (E171) - 1.38 mg, macrogol 6000 - 0.6 mg, talc - 0.3 mg.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (9) - pob khoom los ntawm cardboard.
Zaj duab xis-coated ntsiav tshuaj lub teeb daj, puag ncig, biconvex, nrog sau nrog "HLA 20" ntawm ib sab, saib ntawm qhov tawg: cov ntsiav tshuaj dawb.
| 1 tab | |
| atorvastatin (nyob rau hauv daim ntawv ntawm atorvastatin calcium) | 20 mg |
Tshwjxeeb: lactose monohydrate - 34.8 mg, croscarmellose sodium - 19.2 mg, hyprolose - 2 mg, polysorbate 80 - 2.6 mg, hnyav magnesium oxide - 26 mg, colloidal silicon dioxide - 1.2 mg, magnesium stearate - 1 mg, microcrystalline cellulose - txog 250 mg Cov.
Muaj pes tsawg leeg plhaub: hypromellose - 2.976 mg, hyprolose - 0.744 mg, titanium dioxide (E171) - 1.368 mg, macrogol 6000 - 0.6 mg, talc - 0.3 mg, daj hlau oxide (E172) - 0.012 mg.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
10 Pcs - hlwv (9) - pob khoom los ntawm cardboard.
Zaj duab xis-coated ntsiav tshuaj dawb nrog lub daj-daj-xim av zas, puag ncig, biconvex, sau nrog "HLA 40" - ntawm ib sab, txhawm rau pom: cov ntsiav tshuaj dawb.
| 1 tab | |
| atorvastatin calcium | 41.43 mg |
| uas sib haum rau cov ntsiab lus ntawm atorvastatin | 40 mg |
Tshwjxeeb: microcrystalline cellulose - 284.97 mg, lactose monohydrate - 69.6 mg, croscarmellose sodium - 38.4 mg, hyprolose - 4 mg, polysorbate 80 - 5.2 mg, hnyav magnesium oxide - 52 mg, colloidal silicon dioxide - 2.4 mg, magnesium stearate - 2 mg.
Muaj pes tsawg leeg plhaub: hypromellose - 5,952 mg, hyprolose - 1.488 mg, titanium dioxide - 2.736 mg, macrogol 6000 - 1.2 mg, talc - 0.6 mg, daj hlau oxide (E172) - 0.024 mg.
10 Pcs - hlwv (3) - pob khoom los ntawm cardboard.
Pharmacological kev txiav txim
Atorvastatin yog xaiv cov kev sib tw tshwj xeeb ntawm HMG-CoA reductase, ib qho enzyme uas hloov 3-hydroxy-3-methylglutaryl coenzyme A rau mevalonic acid, ua ntej ntawm sterols, suav nrog cov roj (cholesterol).
Triglycerides (TG) thiab cov roj (Xc) yog suav nrog kev sib xyaw ntawm cov lipoproteins tsawg heev (VLDL) thaum lub zog ua ke hauv lub siab, nkag rau cov ntshav ntshav thiab thauj mus rau cov ntaub so ntswg. Tsawg lipoproteins tsawg (LDL) yog tsim los ntawm VLDL thaum muaj kev sib cuam tshuam nrog LDL receptors.
Cov kev tshawb fawb pom tias nce ntau ntawm tag nrho cov roj (cholesterol), LDL thiab apolipoprotein B (apo-B) hauv cov ntshav ntshav pab txhawb kev txhim kho atherosclerosis thiab yog cov muaj kev pheej hmoo rau cov kab mob plawv, thaum nce siab ntawm lipoproteins ntau ntom (HDL) txo txoj kev pheej hmoo kev txhim kho cov kab mob plawv.
Atorvastatin txo cov tshuaj cholesterol thiab lipoproteins ntau nyob rau hauv cov ntshav plasma vim tias tsis muaj HMG-CoA reductase, cov roj (cholesterol) hauv lub siab ua haujlwm thiab nce ntau ntawm cov "siab" LDL receptors rau ntawm lub ntsej muag ntawm tes, uas ua rau muaj kev nce siab ntau dua thiab catabolism ntawm LDL (raws li kev tshawb nrhiav preclinical).
Atorvastatin txo qis kev coj ua ke thiab cov ntsiab lus ntawm LDL-C, tag nrho Ch, apo-B nyob rau hauv cov neeg mob homozygous thiab heterozygous tsev neeg hypercholesterolemia, thawj hypercholesterolemia thiab sib xyaw hyperlipidemia.
Nws kuj ua rau muaj kev txo qis hauv cov kev sib txuam ntawm cov roj cholesterol-VLDL thiab TG thiab kev nce siab ntawm cov roj-HDL thiab apolipoprotein A-1 (apo-A).
Hauv cov neeg mob uas mob dysbetalipoproteinemia, qhov kev cia siab ntawm cov tshuaj lipoproteins Xc-LAPP tsawg dua.
Atorvastatin hauv koob tshuaj 10 mg thiab 20 mg txo qhov concentration ntawm cov roj (cholesterol) tag nrho los ntawm 29% thiab 33%, LDL - los ntawm 39% thiab 43%, apo-B - los ntawm 32% thiab 35% thiab TG - los ntawm 14% thiab 26%, feem, ua rau kom muaj zog ntawm cov roj (HDL) cov roj cholesterol thiab apo-A.
Atorvastatin nyob rau hauv koob tshuaj 40 mg txo qhov kev xav ntawm tag nrho cov roj (cholesterol) los ntawm 37%, LDL - los ntawm 50%, apo-B - los ntawm 42% thiab TG - los ntawm 29%, ua rau muaj kev nce siab ntawm cov roj cholesterol thiab HDL thiab apo-A.
Koob-dependently txo qhov concentration ntawm LDL hauv cov neeg mob nrog homozygous tsev neeg hypercholesterolemia, tiv taus kev kho mob nrog lwm cov lipid-txo tshuaj.
Nws tsis muaj carcinogenic thiab mutagenic teebmeem.
Kev kho mob nyhuv ntev li 2 lub lis piam tom qab pib kho, mus txog qhov siab kawg tom qab 4 lub lis piam thiab kav ntev hauv lub sijhawm kho.
Kev noj tshuaj ntxiv
Ua ntej pib siv cov tshuaj Tulip ®, tus neeg mob yuav tsum pom zoo rau tus qauv hypocholesterolemic noj cov zaub mov, uas nws yuav tsum tau txuas ntxiv mus kom txog rau tag nrho lub sijhawm kho nrog cov tshuaj.
Cov tshuaj tau noj ntawm qhov ncauj, tsis hais lub sijhawm noj mov. Qhov koob tshuaj Tulip ® sib txawv ntawm 10 mg txog 80 mg rau ib hnub, thiab raug xaiv los xav txog qhov pib ntau ntawm LDL-C, lub hom phiaj ntawm txoj kev kho thiab cov tib neeg siv tshuaj rau txoj kev kho.
Rau feem ntau cov neeg mob, qhov kev muab tshuaj thawj zaug yog 10 mg 1 zaug / hnub.
Thaum pib kho, tom qab 2-4 lub lis piam ntawm kev kho mob thiab / lossis tom qab nce koob tshuaj Tulip ®, nws yog qhov tsim nyog los tswj kev ua haujlwm ntawm cov lipids hauv cov ntshav plasma thiab, yog tias tsim nyog, kho qhov koob tshuaj ntawm cov tshuaj.
Qhov siab tshaj plaws niaj hnub noj yog 80 mg / hnub.
Thawj (kab mob heterozygous muaj keeb thiab polygenic) hypercholesterolemia (hom IIa) thiab sib xyaw hyperlipidemia (hom IIb)
Feem ntau, nws txaus siv cov tshuaj Tulip ® ntawm ib koob ntawm 10 mg 1 zaug / hnub (nws yog siv tau atorvastatin hauv ntsiav tshuaj ntawm 10 thiab 20 mg). Yog tias tsim nyog, maj mam nce ntxiv ntawm lub koob tshuaj ntxiv rau 80 mg (2 ntsiav tshuaj ntawm 40 mg) yog ua tau, nyob ntawm tus neeg mob cov tshuaj tiv thaiv nrog ntu ncua ntev li 2-4 lub lis piam, txij li kev kho mob tau pom tom qab 2 lub lis piam, thiab cov txiaj ntsig kho tau ntau tshaj plaws tom qab 4 lub lis piam. Nrog kev kho mob ntev, cov nyhuv no mob tsawv.
Homozygous muaj keeb tiv thaiv hypercholesterolemia
Cov tshuaj Tulip ® feem ntau siv rau hauv koob tshuaj 80 mg (2 ntsiav tshuaj ntawm 40 mg) 1 zaug / hnub.
Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob
Tulip ® yog siv rau hauv ib koob tshuaj 10 mg 1 zaug / hnub. Yog tias qhov ua tau zoo ntawm LDL nyob rau hauv cov ntshav tsis tiav, nws yog qhov ua tau kom nce qhov ntau ntxiv rau 80 mg / hnub, nyob ntawm tus neeg mob cov lus teb nrog lub sijhawm 2-4 lub lis piam.
Koob tshuaj kho Tulip ® cov neeg mob uas lub raum tsis ua haujlwm thiab hauv cov neeg laus laus tsis tas yuav.
Ntawm cov neeg mob lub siab ua tsis tau haujlwm Kev tshem tawm ntawm atorvastatin los ntawm lub cev qeeb qeeb, yog li ntawd nws raug nquahu kom siv nws nrog kev ceev faj nrog kev soj ntsuam tas li ntawm kev ua haujlwm ntawm hepatic transaminases: ACT thiab ALT. Yog tias qhov pom tau nce siab ntxiv hauv kev ua haujlwm ntawm ACT lossis ALT los ntawm ntau dua 3 zaug piv nrog VGN mob siab, nws raug nquahu kom txo qhov tshuaj lossis tsis txuas lub tshuaj Tulip ®.
Sab sij huam
Raws li cov lus qhia rau kev siv, kev teem caij Tulip tuaj yeem txuas nrog cov kev mob tshwm sim hauv qab no:
- cov leeg ua haujlwm: rhabdomyolysis, mob myalgia, neuropathy, myositis, bursitis, mob caj dab,
- Genitourinary: uterine lossis lub paum los ntshav, qhov sib xws, ua kom lub cev tsis muaj zog, lub cev tsis zoo, lub cev tsis muaj zog, tshuaj muaj zog ntawm cov zis, urolithiasis, mob urogenital,
- cov kab mob ua pa: mob ntsws asthma, nquag los ntswg, mob ntsws, ua tsis taus pa, mob ntsws, mob ntsws, mob ntsws,
- lub plab zom mov: mob ua kab mob rau hauv lub raum, mob plab, mob plab, mob plab, mob plab, mob plab, lub qhov ncauj qhuav, xeev siab, kub siab, poob qis lossis nce siab, rov qab, ntuav, cem quav lossis raws plab, xeev siab.
- kiv taub hau, kev nyuaj siab, mob taub hau, tsaug zog, ua xua, tinnitus, malaise, mob hauv siab, mob siab intraocular, arrhythmia yog tau.
Ua ntej pib kho nrog tshuaj, 1.5 lub hlis thiab 3 lub hlis tom qab pib kho, nrog rau txhua qhov nce ntawm koob tshuaj atorvastatin, daim siab ua haujlwm yuav tsum tau txiav txim siab. Cov kev ua ntawm lub siab enzymes yuav tsum tau saib xyuas thaum muaj cov tsos mob ntawm daim siab puas tshwm sim.
Cov Yuav Tsum Tau Ua
Nws yog contraindicated rau tshuaj Tulip nyob rau hauv rooj plaub no:
- hypersensitivity rau atorvastatin thiab lwm yam ntu ntawm cov tshuaj,
- lub siab ua mob rau lub siab lossis nce siab ntxiv ntawm kev ua haujlwm ntawm "nplooj siab" hloov ntshav hauv ntshav ntawm cov tsis paub keeb kwm (ntau dua 3 zaug piv nrog kev txwv siab tshaj ntawm ib txwm),
- mob hlwb
- cev xeeb tub thiab lactation,
- hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis tau tsim tsa),
- lactase tsis muaj peev xwm
- lactose intolerance,
- piam thaj-galactose malabsorption syndrome.
Nrog kev ceev faj: kev haus dej cawv, ib qho keeb kwm muaj kab mob siab, kab mob ntawm cov leeg ua haujlwm (keeb kwm ntawm kev siv lwm tus neeg sawv cev ntawm HMG-CoA reductase inhibitor pawg), muaj mob electrolyte tsis txaus, mob endocrine (hyperthyroidism) thiab cov teeb meem ntawm lub cev hauv lub cev, mob ntshav khov, mob hnyav ( sepsis), tswj tsis tau tus mob epilepsy, kev phais loj heev, kev poob plig.
Noj ntau dhau
Thaum noj ntau dhau, tsis muaj kev kho kom meej meej. Nws yog ib qho tsim nyog yuav tsum tau ua los ntsuas kev txiav kom tsis txhob nqus ntawm cov tshuaj (pais plab lav, kev tso tawm ntawm adsorbents), ua cov tsos mob kho kom zoo rau lub cev tseem ceeb.
Cov qauv ntawm Tulip, tus nqi hauv cov khw muag tshuaj
Yog tias tsim nyog, koj tuaj yeem hloov Tulip nrog ib qho tshuaj tiv thaiv ntawm cov tshuaj nquag - cov no yog cov tshuaj:
Thaum xaiv cov tshuaj analogues, nws yog ib qho tseem ceeb kom nkag siab tias cov lus qhia rau kev siv Tulip, tus nqi thiab tshuaj xyuas cov tshuaj uas muaj cov txiaj ntsig 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.
Nqe nyob rau hauv cov chaw muag tshuaj Lavxias: Tulip ntsiav tshuaj 10 mg 30 pcs. - txij li 240 txog 270 rubles, 20 mg 30 ntsiav tshuaj. - los ntawm 363 txog 370 rubles.
Khaws ntawm qhov kub thiab txias tsis tshaj 25 ° C. Khaws tsis ncav cuag ntawm cov menyuam yaus. Txee lub neej yog 3 xyoos. Hauv cov khw muag tshuaj, nws raug muag los ntawm cov tshuaj noj.
2 kev txheeb xyuas rau “Tulip”
Tulip pib haus tom qab kev kuaj ntshav uas pom tias muaj cov cholesterol ntau dua. Cov tshuaj no yog tsim los tiv thaiv cov ntshav txhaws los ntawm kev cov ntshav hauv cov ntshav. Kuv haus cov tshuaj noj tau 2 lub hlis, tab sis tom qab ntawd kuv xav phem thiab tsis noj. Nws tau yooj yim rau lawv haus, vim nws yuav tsum tau noj 1 lub tshuaj ib hnub. Thaum xub thawj txhua yam zoo. Tom qab ntawd lub plab pib raug mob, kiv taub hau heev, dias me ntsis ntawm caj npab thiab txhais ceg tau tshwm sim. Tsis kam noj cov tshuaj no, tom qab ib pliag kuv xis nyob dua. Txawm hais tias nws yuav tsum raug sau tseg qhov tseeb tias theem ntawm cov cholesterol hauv cov ntshav qis.
Tsis yog qhov nrov tshaj plaws ntawm Atorvastatin, raws li rau kuv nws yog qhov zoo dua los xaiv atoris.
Sab sij huam
Raws li WHO, cov teebmeem tsis xav tau raug cais raws li lawv qhov kev loj hlob raws li hauv qab no: feem ntau (> 1/100, 1/1000, 1/10 000, ® yog sib kis thaum cev xeeb tub. Vim tias cov roj (cholesterol) thiab cov tshuaj tiv thaiv los ntawm cov roj cholesterol tseem ceeb rau txoj kev loj hlob ntawm tus me nyuam hauv plab, kev pheej hmoo txaus ntshai ntawm kev txwv tsis pub HMG-CoA reductase ntau dua cov txiaj ntsig ntawm kev siv tshuaj thaum cev xeeb tub.
Yog tias kuaj pom tias cev xeeb tub thaum kho nrog Tulip ®, nws txoj kev tswj hwm yuav tsum nres sai li sai tau, thiab tus neeg mob yuav tsum ceeb toom rau qhov kev pheej hmoo rau tus menyuam hauv plab.
Cov tshuaj Tulip ® tuaj yeem siv rau cov poj niam muaj hnub nyoog yug me nyuam tsuas yog tias muaj feem ntau 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 poj niam ntawm kev muaj me nyuam hnub nyoog thaum kho nrog Tulip ®, txhim khu kev qha kev tiv thaiv kom zoo yuav tsum siv.
Atorvastatin tawm hauv cov kua mis, yog li nws tau contraindicated rau siv thaum pub niam mis. Yog tias nws yog qhov yuav tsum tau siv lub tshuaj Tulip ® thaum lactation, yuav tsum tsis txhob pub niam mis.
Cov lus qhia tshwj xeeb
Ua rau daim siab
Ib yam li lwm yam HMG-Co-reductase inhibitors (statins), nrog Tulip ® kev kho, muaj mob pesnrab (ntau dua 3 zaug piv nrog VGN) nce hauv cov dej num ntawm kev kho mob hepatic transaminases: ACT thiab ALT yog ua tau.
Ua ntej pib kev kho mob, 6 lub lis piam thiab 12 lub lis piam tom qab pib noj cov tshuaj Tulip ® lossis tom qab nce nws cov tshuaj, nws yog ib qho tsim nyog yuav tau soj ntsuam daim siab kev ua haujlwm (ACT, ALT). Lub siab ua haujlwm yuav tsum tau saib xyuas thaum soj ntsuam cov tsos mob ntawm daim siab tshwm sim. Nyob rau hauv cov ntaub ntawv ntawm nce kev ua ntawm ACT thiab ALT, lawv cov kev ua yuav tsum tau saib xyuas kom txog thaum nws normalizes. Tulip ® yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas quav cawv thiab / lossis muaj keeb kwm muaj kab mob siab.
Cov kab mob ntawm daim siab hauv cov theem nquag lossis nce ntxiv hauv kev ua haujlwm ntawm hepatic transaminases ntawm cov ntshav plasma ntawm cov keeb kwm tsis paub zoo yog qhov ua tsis ncaj rau kev siv tshuaj Tulip ®.
Kev tiv thaiv mob txhaws mob txhaws nrog kev kho tus mob lipid-txo qis kho (SPARCL)
Kev rov qab soj ntsuam ntawm ntau yam kev hloov pauv ntawm cov hlab ntsha hauv cov neeg mob tsis yog-IHD uas nyuam qhuav raug mob stroke lossis hloov ischemic nres (TIA) tau qhia txog kev pheej hmoo mob ntshav siab ntau hauv cov neeg mob noj atorvastatin ntawm koob ntawm 80 mg piv nrog placebo. Ib qho kev pheej hmoo siab tshwj xeeb tshaj yog tau pom hauv cov neeg mob uas muaj hemorrhagic stroke lossis lacunar infarction thaum lub sijhawm pib kawm. Rau cov neeg mob uas tau mob hemorrhagic mob stroke lossis lacunar infarction thiab tab tom noj atorvastatin ntawm koob tshuaj 80 mg, qhov txaus ntshai / cov txiaj ntsig tsis txaus ntseeg yog qhov tsis meej, thiab cov kev pheej hmoo ntawm kev tsim mob hemorrhagic mob stroke yuav tsum ua tib zoo ntsuas ua ntej pib kev kho mob.
Skeletal leeg ua
Thaum siv cov tshuaj Tulip ® tuaj yeem txhim kho myalgia. Kev kuaj mob ntawm myopathy (mob leeg thiab tsis muaj zog ua ke nrog kev nce hauv CPK kev ua si los ntawm ntau dua 10 zaug piv nrog VGN) tuaj yeem xav tias cov neeg mob uas mob myalgia, mob nqaij lossis tsis muaj zog thiab / lossis cim tau nce hauv CPK cov haujlwm. Tulip ® kev kho yuav tsum tau tsum tsis ua haujlwm yog tias muaj qhov tshwm sim hauv KFK kev ua haujlwm lossis qhov pom tseeb tias yog tus mob myopathy.
Thaum siv lwm cov HMG-Co-reductase inhibitors (statins), kev pheej hmoo ntawm myopathy yuav nce ntxiv thaum siv cyclosporine, fibrates, erythromycin, nicotinic acid hauv lipid txo cov tshuaj (ntau dua 1 g / hnub) lossis tshuaj tua kab mob ntawm cov azole pawg.Siv Tulip ® sib xyaw nrog fibrates, erythromycin, immunosuppressants, antifungal tshuaj ntawm azole pawg los yog nicotinic acid hauv lipid txo cov tshuaj (ntau dua 1 g / hnub), nws yog qhov tsim nyog los ntsuas qhov txiaj ntsig cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob nrog Tulip ®.
Tsis tshua muaj neeg qhia txog kev tiv thaiv kab mob hauv lub cev ua kom tsis txhob myopathy lub sijhawm lossis tom qab kho nrog statins, suav nrog atorvastatin. Immuno-mediated necrotizing myopathy raug kuaj pom los ntawm cov leeg tsis muaj zog nyob rau sab sauv thiab qhov nce ntshav ntshav CPK concentration, uas mob siab txawm hais tias tsis muaj kev kho mob rau statin.
Yog tias tsim nyog, kev sib txuas ua ke yuav tsum xav txog qhov siv tau cov tshuaj no hauv kev txo qis thiab saib xyuas cov koob tshuaj. Peb nquahu kom muaj kev saib xyuas txhua lub sijhawm ntawm CPK cov haujlwm.
Kev siv ua ke ntawm atorvastatin thiab fusidic acid tsis pom zoo, yog li ntawd, kev txiav tsis siv ib ntus ntawm kev kho atorvastatin thaum siv fusidic acid yuav tsum raug txiav txim siab.
Cov neeg mob yuav tsum tau ceeb toom tias lawv yuav tsum tau sab laj nrog kws kho mob sai sai yog tias tsis hnov qhov mob lossis cov leeg tsis muaj zog, tshwj xeeb tshaj yog tias lawv nrog mob tshwm sim lossis kub taub hau.
Thaum siv cov tshuaj Tulip ®, zoo li lwm cov tshuaj tiv thaiv kab mob HMG-Co-reductase (statins), tsis tshua muaj mob ntawm rhabdomyolysis nrog mob raum tsis ua haujlwm vim qhov mob myoglobinuria tau piav qhia.
Yog tias muaj cov tsos mob ntawm tus mob myopathy lossis muaj kev pheej hmoo rau kev tsim kho lub raum tsis ua haujlwm vim mob rhabdomyolysis (piv txwv li, mob hnyav, mob ntshav khov, kev phais mob ntau ntxiv, kev raug mob, kev mob loj ntawm metabolic, electrolyte thiab endocrine cuam tshuam thiab kev tswj tsis tau tus mob), Tulip ® kev kho yuav tsum nres lossis tag nrho rho teb.
Cov mob ntsws interstitial
Cov neeg uas tsis tshua muaj neeg coob txog kev txhim kho cov kab mob ntsws interstitial ntsws tau qhia nrog kev siv qee yam statins, tshwj xeeb nrog kev kho mob ntev. Cov chaw kuaj mob muaj xws li ua tsis taus pa, hnoos tsis txaus, thiab kev noj qab haus huv tsis zoo (nce rog, rog, thiab ua npaws). Yog tias lub sijhawm ua xyem xyav ntawm kev tsim cov kab mob ntsws interstitial, kev kho mob nrog statins yuav tsum tsis ua mus ntxiv
Qee qhov kev tshawb fawb qhia tias kev siv cov statins, raws li chav kawm, tuaj yeem ua rau muaj ntshav qabzib ntau ntxiv, thiab hauv qee cov neeg mob uas muaj kev pheej hmoo ntawm kev muaj ntshav qab zib ntau lawm yav tom ntej, lawv tuaj yeem ua rau hyperglycemia, uas yuav tsum tau muaj cov tshuaj tiv thaiv kab mob ntshav siab. Txawm li cas los xij, qhov kev pheej hmoo no tsis txaus ntseeg piv nrog txo qis ntawm kev pheej hmoo vascular thaum noj cov statins, thiab, yog li ntawd, yuav tsum tsis muaj laj thawj rau kev thim kev kho mob nrog statins. Cov neeg mob uas muaj kev pheej hmoo (nrog lub plab tsis muaj kua nplaum siab ntawm 5.6-6.9 mmol / L, BMI> 30 kg / m 2, txhawb triglycerides, ua kom ntshav nce siab) yuav tsum tau tswj, ob qho tib si kuaj mob thiab biochemical, raws li lub teb chaws tus qauv rau kev muab tshuaj pab.
Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab
Thaum kho Tulip ®, yuav tsum ceev faj thaum tsav tsheb thiab koom nrog lwm qhov kev phom sij uas yuav tsum muaj kev mloog zoo thiab ceev ntawm cov kev tiv thaiv psychomotor.
Yeeb tshuaj sib cuam tshuam
Txoj kev pheej hmoo ntawm myopathy thaum kho nrog HMG-CoA reductase inhibitors nce ntxiv nrog kev siv ua ke cyclosporine, erythromycin, clarithromycin, immunosuppressive, antifungal tshuaj (azole derivatives)vim tias muaj peev xwm nce ntxiv nyob rau hauv cov concentration ntawm atorvastatin hauv cov ntshav cov ntshav.
Nrog tib lub sijhawm siv nrog HIV tiv thaiv cov leeg tiv thaiv - indinavir, ritonavir - kev pheej hmoo ntawm kev tsim myopathy nce.
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 tej tshuaj (ntau dua 1 g / hnub).
CYP3A4 Isoenzyme Tus Neeg Txom Nyem
Txij li thaum atorvastatin metabolized siv isoenzyme CYP3A4, kev sib xyaw ua ke ntawm kev siv tshuaj Tulip ® nrog cov tshuaj tiv thaiv ntawm no isoenzyme tuaj yeem ua rau muaj kev nce ntxiv hauv cov concentration ntawm atorvastatin hauv cov ntshav ntshav. Qib kev sib cuam tshuam thiab cuam tshuam ntawm kev nce siab ntawm atorvastatin yog txiav txim siab los ntawm qhov txawv txav ntawm cov nyhuv rau CYP3A4 isoenzyme.
OATP1B1 thauj cov tshuaj tiv thaiv protein
Atorvastatin thiab nws cov metabolites yog cov me me ntawm OATP1B1 thauj protein. OATP1B1 inhibitors (piv txwv li, cyclosporine) yuav ua rau kom muaj kev nyab xeeb ntawm atorvastatin. Yog li, kev siv atorvastatin ntawm koob tshuaj 10 mg thiab cyclosporine ntawm koob tshuaj 5.2 mg / kg / hnub ua rau kev nce siab ntawm atorvastatin hauv cov ntshav ntshav los ntawm 7,7 lub sijhawm.
Nrog rau kev siv tib txhij ntawm atorvastatin 10 mg thiab erythromycin (500 mg 4 zaug / hnub) lossis clarithromycin (500 mg 2 zaug / hnub), uas inhibit isoenzyme ntawm cytochrome CYP3A4, muaj kev nce siab ntawm atorvastatin hauv ntshav ntshav (los ntawm 40% thaum siv nrog erythromycin thiab 56% - thaum siv nrog clarithromycin).
Kev siv tib txhij ntawm atorvastatin nrog protease inhibitors, paub tias yog inhibitors ntawm cytochrome CYP3A4 isoenzyme, yog nrog los ntawm kev nce ntxiv hauv cov concentration ntawm atorvastatin hauv ntshav ntshav (nrog rau siv ib txhij nrog erythromycin - Cmax atorvastatin nce ntxiv 40%).
Kev siv ua ke ntawm atorvastatin ntawm kev noj tshuaj ntawm 40 mg nrog diltiazem ntawm koob tshuaj ntawm 240 mg ua rau kev nce siab ntawm atorvastatin hauv cov ntshav ntshav.
Tsis muaj qhov sib cuam tshuam loj ntawm kev sib cuam tshuam ntawm atorvastatin nrog cimetidine raug kuaj pom.
Siv tib txhij ntawm atorvastatin hauv koob tshuaj ntawm 20 mg txog 40 mg thiab itraconazole ntawm koob tshuaj 200 mg ua rau muaj 3 zaug nce ntxiv hauv AUC ntawm atorvastatin.
Txij li cov txiv kab ntxwv kua txiv muaj ib lossis ntau qhov cuam tshuam uas tiv thaiv CYP3A4 isoenzyme, nws cov kev noj ntau dhau (ntau tshaj li 1.2 L ib hnub rau 5 hnub) tuaj yeem ua rau muaj ntshav nce ntxiv ntawm atorvastatin.
CYP3A4 Isoenzyme Inductors
Kev siv ua ke ntawm atorvastatin nrog inducers ntawm SURZA4 isoenzyme (piv txwv li, efavirenz lossis rifampicin) tuaj yeem ua rau txo qis ntawm cov tshuaj atorvastatin hauv ntshav ntshav. Vim yog lub tshuab ob ntawm kev sib cuam tshuam nrog rifampicin (ib qho inducer ntawm CYP3A4 isoenzyme thiab ib qho OATP1B1 hepatocyte thauj protein inhibitor), tib lub sijhawm ntawm atorvastatin thiab rifampicin tsis pom zoo, txij li kev ncua sijhawm ntawm atorvastatin tom qab rifampicin ua rau muaj kev txo qis hauv cov ntshav ntawm atorvastatin.
Nrog rau kev siv atorvastatin thiab kev ncua kev kawm uas muaj cov khoom siv magnesium thiab aluminium hydroxides sab hauv, cov tshuaj atorvastatin hauv cov ntshav txo qis li ntawm 35%, txawm li cas los xij, qhov kev kawm txo qis hauv kev suav ntawm LDL-C tseem tsis hloov.
Atorvastatin tsis cuam tshuam rau lub pharmacokinetics ntawm phenazone, yog li ntawd, kev cuam tshuam nrog lwm cov tshuaj metabolized los ntawm tib lub isoenzymes tsis xav.
Cov lipid-txo cov nyhuv ntawm kev sib xyaw nrog colestipol yog qhov zoo dua rau qhov tshuaj rau txhua qhov sib cais, txawm hais tias 25% txo qis ntawm cov tshuaj atorvastatin thaum siv concomitantly nrog colestipol.
Cov kev tshawb fawb txog kev cuam tshuam ntawm atorvastatin thiab fusidic acid tsis tau ua. Ib yam li lwm yam statins, kev tshawb fawb tom qab muag ntawm kev siv cov tshuaj sib txuas ntawm atorvastatin thiab fusidic acid qhia cov kev mob tshwm sim rau cov leeg, nrog rau rhabdomyolysis. Tus txheej txheem ntawm kev sib cuam tshuam tsis paub txog. Cov neeg mob zoo li no yuav tsum tau saib xyuas kom zoo thiab, tej zaum, kev txiav tsis siv tshuaj ib ntus ntawm atorvastatin.
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 sib koom tes nrog colchicine, thiab ceev faj yuav tsum siv thaum lub sijhawm kho atorvastatin thiab colchicine.
Nrog kev siv rov qab ntawm digoxin thiab atorvastatin ntawm ib koob ntawm 10 mg Css ntshav digoxin tsis hloov. Txawm li cas los xij, thaum digoxin siv nrog kev sib xyaw nrog atorvastatin ntawm ib koob ntawm 80 mg / hnub, qhov kev txiav txim siab ntawm digoxin hauv cov ntshav ntshav nce ntxiv li 20%. Cov neeg mob noj digoxin txuam nrog atorvastatin xav tau kev saib xyuas ntawm cov concentration ntawm digoxin hauv cov ntshav ntshav.
Nrog rau kev siv atorvastatin tib lub sijhawm ntawm 10 mg 1 zaug / hnub thiab azithromycin ntawm koob tshuaj 500 mg 1 zaug / hnub, kev siv tshuaj atorvastatin hauv cov ntshav ntshav tsis hloov.
Nrog rau kev siv atorvastatin thiab kev noj tshuaj ntau qhov ncauj muaj norethisterone thiab ethinyl estradiol, muaj qhov nce ntxiv ntawm AUC ntawm norethisterone thiab ethinyl estradiol los ntawm 30% thiab 20%, feem, uas yuav tsum tau txiav txim siab thaum xaiv qhov ncauj tiv thaiv.
Atorvastatin nrog kev siv cov tshuaj concomitant nrog terfenadine tsis muaj kev cuam tshuam loj hauv kev kho mob ntawm pharmacokinetics ntawm terfenadine.
Hauv cov neeg mob uas siv tshuaj warfarin ntev, atorvastatin ntawm 80 mg / hnub qee qhov luv luv sijhawm prothrombin hauv thawj hnub ntawm kev sib koom siv. Cov nyhuv no ploj mus tom qab 15 hnub ntawm kev siv cov tshuaj no ib txhij. Txawm hais tias cov xwm txheej ntawm cov neeg mob hloov pauv ntawm cov nyhuv anticoagulant tau tshaj tawm tsawg, lub sijhawm prothrombin yuav tsum tau txiav txim siab hauv cov neeg mob noj coumarin anticoagulants ua ntej thiab feem ntau txaus thaum pib kho nrog atorvastatin kom ntseeg tau 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 kuaj xyuas ntawm cov sijhawm sib xws rau cov neeg mob noj coumarin anticoagulants. Yog tias koj hloov qhov koob tshuaj lossis tso tseg kev kho mob, cov kev ntsuas no yuav tsum tau ua dua. Tsis muaj kev cuam tshuam los ntawm kev siv cov tshuaj atorvastatin thiab los ntshav lossis hloov pauv lub sijhawm prothrombin hauv cov neeg mob tsis noj tshuaj anticoagulants.
Nrog rau kev siv atorvastatin tib lub sij hawm ntawm 80 mg thiab amlodipine ntawm koob tshuaj 10 mg, pharmacokinetics ntawm atorvastatin hauv kev sib npaug tsis hloov.
Lwm yam tshuaj lipid-txo qis
Nrog rau kev siv atorvastatin nrog lwm cov tshuaj tiv thaiv hypolipidemic (piv txwv li ezetimibe, gemfibrozil, ib qho kev sib txuas ntawm cov fibroic acid) hauv kev txo qis dua cov tshuaj, qhov kev pheej hmoo ntawm kev txhim kho rhabdomyolysis nce.
Lwm txoj kev kho kom zoo
Nrog rau kev siv ua ke ntawm atorvastatin nrog cov tshuaj tiv thaiv kabmob thiab estrogens (raws li kev hloov kho), tsis muaj kev cuam tshuam loj hauv qhov chaw kuaj mob tau pom.
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