Momwe mungagwiritsire ntchito mankhwala a Liprimar?

Liprimar amapangidwa mwanjira ya mapiritsi okhala ndi zokutira za filimu: yoyera, yodziwoneka bwino, pakhungu - loyera pakati, lojambula mbali ziwiri kutengera mlingo - "10" ndi "PD 155" / "20" ndi "PD 156" / " 40 "ndi" PD 157 "/" 80 "ndi" PD 158 "(10 ndi 20 mg aliyense - ma PC 10. M'matumba, matuza atatu ndi 10 m'bokosi lamakatoni, ma PC 7. M'matumba, matuza awiri mu katoni katoni, 40 ndi 80 mg aliyense - ma PC 10. mumatumba, matuza 10 mu chikwama cha makatoni, ma PC 7. M'matumba, matuza awiri kapena anayi mu bokosi la makatoni).

Piritsi limodzi lili ndi:

Zogwira pophika: atorvastatin - 10, 20, 40 kapena 80 mg (mwanjira yamchere wamchere),
Zothandiza: calcium carbonate - 33/66/132/264 mg, microcrystalline cellulose - 60/120/240/480 mg, lactose monohydrate - 32.8 / 65.61 / 131.22 / 262.44 mg, croscarmellose sodium - 9/18/36/72 mg, polysorbate 80 - 0.6 / 1.2 / 2.4 / 4.8 mg, hyprolose - 3/6/12/24 mg, magnesium stearate - 0,75 / 1.5 / 3/6 mg,
Chovala chamufilimu: Opadry yoyera YS-1-7040 (hypromellose - 66.12%, polyethylene glycol - 18.9%, titanium dioxide - 13.08%, talc - 1.9%) - 4.47 / 8.94 / 17 , 88 / 35.76 mg, emulsion ya simethicone (simethicone - 30%, stearic emulsifier - 0,075%, sorbic acid, madzi) - 0,03 / 0,06 / 0,12 / 0,24 mg, masamba a candelilla - 0, 08 / 0.16 / 0.32 / 0 mg.

Mankhwala

Atorvastatin ndi mpikisano wosankha wa HMG-CoA reductase, womwe ndi njira yofunika kwambiri yomwe imatembenuza 3-hydroxy-3-methylglutaryl-CoA kukhala mevalonate, wotsogola wama steroid, kuphatikiza cholesterol. Liprimar amatanthauza othandizira okhala ndi lipid.

Kugwiritsidwa ntchito kwa atorvastatin mwa odwala omwe ali ndi dyslipidemia wosakanikirana, mitundu yokhala m'magulu a hypercholesterolemia, komanso heterozygous ndi homozygous Famel hypercholesterolemia kumabweretsa kuchepa kwa magazi a plasma of triglycerides (TG), otsika kwambiri osalimba lipoprotein ApoleLol (ApGL) otsika osalimba lipoprotein cholesterol (cholesterol-LDL) ndi cholesterol yathunthu (cholesterol). Komanso, mukamatenga Liprimar, kuchuluka kwa anthu ochulukitsa lipoprotein cholesterol (HDL-C) kumawonjezeka.

Atorvastatin imalepheretsa kupanga cholesterol m'chiwindi, imalepheretsa kuchepa kwa HMG-CoA, ndikuwonjezera kuchuluka kwa zolandilira za LDL pamagobeloti akunja a maselo, zomwe zimapangitsa kuti pakuwonjezeke kuchuluka ndi choleabolism ya LDL-C komanso kumathandizira kuchepa kwa cholesterol ndi LDL-C mu plasma.

Liprimar imachepetsa kuchuluka kwa tinthu tating'onoting'ono ta LDL ndikulepheretsa mapangidwe a LDL-C, kumabweretsa kuwonjezereka kwa ntchito ya LDL receptors, kuphatikiza kusintha koyenera kwa zinthu za LDL, komanso kumachepetsa mulingo wa cholesterol wa LDL kwa odwala omwe ali ndi homozygous Famer hypercholesterolemia torederal etiological. mankhwala ndi lipid-kuchepetsa mankhwala.

Mukamamwa mlingo wa 10-80 mg, atorvastatin amachepetsa kuchuluka kwa TG ndi 14-3%, pomwe-B wolemba 34-50%, cholesterol-LDL ndi 41-61% ndi cholesterol ndi 30-46%. Zotsatira zamankhwala zimafanana chimodzimodzi ndi odwala omwe siabanja la hypercholesterolemia, heterozygous Famial hypercholesterolemia ndi hyperlipidemia, kuphatikizapo odwala omwe ali ndi matenda a shuga a 2.

Odwala omwe ali ndi okhazikika hypertriglyceridemia, mankhwala okhudzika Liprimara amatsitsa TG, apo-B, cholesterol-VLDL, cholesterol-LDL ndi cholesterol yokwanira ndikuwonjezera kuchuluka kwa cholesterol-HDL. Odwala omwe ali ndi dysbetalipoproteinemia, akamamwa Liprimar, kuchuluka kwa apakati-kachulukidwe lipoprotein cholesterol (cholesterol-lowering steroids) kumachepa.

Odwala omwe ali ndi mtundu wa IIa ndi IIb hyperlipoproteinemia, malinga ndi gulu la Fredrickson la atorvastatin mankhwala (kuchuluka kwa 10-80 mg), kuchuluka kwa HDL-C kumawonjezeka pafupifupi ndi 5.1-8.7% poyerekeza ndi mtengo woyambira, ndipo izi sizitero amadalira mlingo. Kuwerengera kwa cholesterol-LDL / cholesterol-HDL ndi cholesterol-cholesterol-HDL kwathunthu kumachepera (kuchepa kumatsimikiziridwa ndi mlingo wa Liprimar wotengedwa) ndi 37-55% ndi 29-44%, motsatana. Atorvastatin muyezo wa 80 mg kwambiri amachepetsa chiopsezo chokhala ndi zovuta za ischemic ndikuchepetsa kufa ndi 16% atamaliza maphunziro a milungu 16, ndipo chiwopsezo chakugonekanso kuchipatala komwe kumayenderana ndi angina pectoris, komwe kumayendetsedwa ndi zizindikiro za myocardial ischemia, kumachepetsedwa ndi 26% malinga ndi kafukufuku , pakuchepa kwambiri kwa zizindikiro za myocardial ischemia panthawi yolimbitsa lipid-kutsitsa mankhwala (MIRACL). Odwala omwe ali ndi magawo angapo oyambira a LDL-C, odwala omwe ali ndi vuto losakhazikika la angina ndi myocardial infarction opanda Q wave, mosaganizira jenda (wamwamuna ndi wamkazi) komanso msinkhu (wocheperako ndi wamkulu kuposa zaka 65), kutenga atorvastatin kwambiri kumachepetsa chiopsezo cha ischemic zovuta ndi kufa. Kuchepa kwa ndende ya LDL-C mu plasma kumawonetsa kulumikizana kwabwino ndi mlingo wa Liprimar kuposa kuphatikizika kwazomwe zimagwira mu plasma yamagazi. Mlingo uyenera kusankhidwa poganizira matenda.

Zowonjezera zochizira Liprimar zalembedwa masabata awiri pambuyo poyambira chithandizo, zimafika pakatha milungu 4 ndipo zimapitilira pakadali pano zamankhwala.

Odwala omwe ali ndi matenda oopsa, komanso zinthu zitatu kapena zingapo zowopsa, kutenga atorvastatin pa mlingo wa 10 mg amachepetsa chiopsezo chodwala matenda amtima wosagwa (owopsa) poyerekeza ndi placebo. Zotsatira zakufufuzira kwa Anglo-Scandinavia pa kuwunika kwa zotsatira za matenda a mtima (ASCOT-LLA) amadziwika, malinga ndi momwe kayendetsedwe ka Liprimar pa 10 mg amachepetsa kuopsa kwa zovuta zina motere:

sitiroko (yosafa / yakupha) - mwa 26%,
zovuta zamatumbo (infalction yam'mimba yopanda matenda ndi mtima wamatumbo, limodzi ndi imfa) - mwa 36%,
matenda amtima - mwa 29%,
ambiri mtima ndi kusinthika njira - 20%.

Malinga ndi zotsatira za kafukufuku wa makonzedwe a atorvastatin a mtundu 2 wa matenda ashuga (CARDS), kugwiritsa ntchito Liprimar kwa odwala omwe ali ndi matendawa kumachepetsa chiopsezo cha zovuta zamtima mosaganizira zaka komanso jenda kapena kupsinjika koyambirira kwa LDL-C motere:

sitiroko (yosafa / yakupha) - mwa 48%,
ischemia yopanda ululu wammbuyo ischemia, wosapha (wakupha) myocardial infarction - mwa 42%,
chachikulu mtima zovuta (sitiroko, revascularization njira, yopweteka myocardial ischemia, nonfatal ndi wakupha myocardial infarction, percutaneous translate coronary angioplasty, imfa chifukwa chowonjezera matenda a mtima, coronary artery bypass grafting, stina angina pectoris - 37.

Kafukufuku wokhudzana ndi kuchuluka kwa mankhwala a hypolipidemic mankhwala obwezeretsa kusintha kwa coronary atherosulinosis (REVERSAL) adawonetsa kuti odwala omwe ali ndi matenda a mtima omwe amatenga atorvastatin tsiku lililonse mlingo wa 80 mg umapangitsa kuchepa kwa kuchuluka konse kwa atheroma ndi 0.4% pambuyo pa miyezi 1.8.

Kuperekera kwa atorvastatin muyezo wa tsiku ndi tsiku wa 80 mg kungachepetse chiwopsezo cha matenda osaphedwa (opha) mwa odwala omwe akumana ndi vuto losakhalitsa ischemic kapena sitiroko yopanda mbiri ya matenda amtima woyerekeza ndi placebo malinga ndi zotsatira za kafukufuku woletsa sitiroko ndi kuchepa kwambiri kwa cholesterol (SPARCL). Izi zimachepetsa kwambiri vuto la mtima ndi kufunikira kwa njira zopumira. Kuchepetsa kwa chiwopsezo cha matenda amtima wamkati pamankhwala a atorvastatin amawonedwa m'magulu onse a odwala, kupatula zomwe zimaphatikizapo odwala omwe ali ndi matenda a hemorrhagic oyambira kapena obwereza.

Odwala omwe ali ndi matenda a mtima a coronary, kumwa Liprimar pa mlingo wa 80 mg poyerekeza ndi mlingo wa 10 mg kwambiri amachepetsa zovuta zovuta motere: (malinga ndi zotsatira za kafukufuku wa zamankhwala a TNT kuti akwaniritse chandamale chatsopano cha lipid):

zolembedwa za angina pectoris - pofika 10.9%,
mtima wamavuto (osagwirizana ndi mtima wam'mimba komanso matenda amkatikati mwa mtima, limodzi ndi imfa) - ndi 8.7%,
coronary artery bypass opaleshoni kapena njira zina zatsopano - mwa 13.4%,
infracation yotsika poyipa, yosayambika ndi njirayi - 4,9%,
kuyikidwa kuchipatala komwe kumayanjana ndi mtima wosakhazikika - mwa 2.4%,
sitiroko (yoopsa) - mwa 2.3%.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa amapezeka m'mapiritsi otsekemera olimbitsa thupi. Mlingo wa magawo uli ndi 10 mg ya calcium wa atorvastatin ngati pawiri yogwira. Pakuthamanga kwa mayamwidwe ndi kuchuluka kwa bioavailability, piritsi ili ndi zinthu zina:

cellcrystalline mapadi,
magnesium wakuba,
shuga mkaka
Hyprolose
sodium croscarmellose,
calcium carbonate.

Zomwe zimapangidwira mapiritsiwa zimaphatikizapo microcrystalline cellulose, magnesium stearate, mkaka wa shuga, hyprolose, croscarmellose sodium, calcium carbonate.

Ulusi wamakanema womwe umakhala ndi sera wa candelilla, hypromellose, polyethylene glycol, talc, emulsion simethicone, titanium dioxide. Pamiyala yoyera ya mawonekedwe a elliptical, cholembedwa "PD 155" ndi muyeso wa zinthu zomwe zimayikidwa zimayikidwa.

Zotsatira za pharmacological

Liprimar ndi m'gulu lamankhwala ochepetsa lipid. The yogwira mankhwala atorvastatin ndi blocker yosankha ya HMG-CoA reductase, puloteni yofunika yofunikira pakusintha kwa 3-hydroxy-3-methylglutaryl coenzyme kukhala mevalonate.

Pamaso pa cholowa cha hypercholesterolemia (cholesterol yowonjezera), dyslipidemia wosakanikirana, ntchito yogwira Liprimara ithandiza kuchepetsa kuchuluka kwa cholesterol (Ch), apolipoprotein B, VLDL ndi LDL (lowensens lipoproteins) ndi kuchuluka kwa triglycerides. Atorvastatin imayambitsa kuwonjezeka kwa osachulukitsa lipoprotein (HDL).

Limagwirira ntchito ndi chifukwa kupsinjika kwa ntchito ya HMG-CoA reductase komanso kuletsa mapangidwe a cholesterol mu hepatocytes.

Atorvastatin imatha kuwonjezera kuchuluka kwa zolimba kwambiri za lipoprotein receptors kunja kwa chiwindi cell membrane, zomwe zimatsogolera pakuwonjezeka ndikuwonongeka kwa LDL.

Mankhwala amatha kuwonjezera kuchuluka kwa otsika osalimba lipoprotein zolandilira kunja kwa chiwindi cell nembanemba.

Pulogalamu yogwira imachepetsa kapangidwe ka cholesterol ya LDL ndi kuchuluka kwa lipoproteins, chifukwa chomwe pali kuwonjezeka kwa ntchito ya LDL receptors. Odwala omwe ali ndi homozygous cholowa hypercholesterolemia osagwirizana ndi mankhwala a lipid-kutsitsa, mayunitsi a LDL amachepa. The achire zotsatira zimawonedwa pakatha masabata awiri atayamba kugwiritsa ntchito mankhwala. Kuchuluka kwake kunalembedwa patatha mwezi umodzi chithandizo ndi Liprimar.

Pharmacokinetics

Pambuyo pakamwa, mapiritsi sasungunuka pansi pa hydrochloric acid m'mimba, akugwera jejunum. Mu gawo ili la chakudya chamagaya, nembanemba wamafilimuwo amakhala ndi hydrolysis.

Piritsi imasweka, michere ndi mankhwala amayamba kumizidwa kudzera mwa microvilli yapadera.

Atorvastatin amalowa m'magazi kuchokera kukhoma lamatumbo, pomwe amafikira kuchuluka kwa plasma mkati mwa maola 1-2. Mwa akazi, kugwiritsidwa ntchito komwe kumakhala ndi 20% ndizokwera kuposa amuna.

Pambuyo pakamwa, mapiritsi sasungunuka pansi pa zochita za hydrochloric acid m'mimba.Liprimar 10 imalowa m'magazi kuchokera kukhoma lamatumbo.
Zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimagwirira ku albumin ndi 98%, chifukwa chake hemodialysis siyothandiza.

Bioavailability ukufika 14-30%. Zizindikiro zochepa zimayamba chifukwa cha parietal metabolism ya atorvastatin mu mucous membrane yamatumbo ndi kusintha kwa maselo a chiwindi ndi isoenzyme ya cytochrome CYP3A4. Zinthu zomwe zimagwira ntchito zimangokhala ndi albumin ndi 98%, chifukwa chake hemodialysis siyothandiza. Kutha kwa theka moyo kumafika maola 14. Achire zotsatira kumatenga 20-30 maola. Kudzera mu kwamikodzo, atorvastatin imachoka m'thupi pang'onopang'ono - mkodzo, mutangotenga kamodzi, ndi 2% yokha ya mankhwalawa yomwe imapezeka.

Zizindikiro zogwiritsidwa ntchito

Mankhwala amagwiritsidwa ntchito kuzipatala:

chachikulu hypercholesterolemia cha chibadwa komanso chosakhala cholowa,
kuchuluka kwa amkati a triglycerides kugonjetsedwa ndi zakudya,
cholowa homozygous hypercholesterolemia ndi mphamvu yochepa ya zakudya ndi njira zina zosagwiritsa ntchito mankhwala
kuphatikiza kwa Hyperlipidemia.

Mankhwala amatchulidwa ngati njira yothandizira matenda a mtima kwa odwala omwe alibe chizindikiro cha matenda a mtima, koma ndi zinthu zoopsa: ukalamba, zizolowezi zoyipa, kuthamanga kwa magazi, matenda a shuga. Gulu lowopsa limaphatikizapo anthu omwe ali ndi vuto la hypercholesterolemia komanso otsika HDL.

Mankhwala amatchulidwa ngati njira yolepheretsa matenda a mtima.

Mankhwala amagwiritsidwa ntchito ngati njira yowonjezera pothandizira pakudya kwa dysbetalipoproteinemia. Liprimar imagwiritsidwa ntchito ngati njira yolepheretsa kukula kwa zovuta kwa odwala omwe ali ndi myocardial ischemia kuti achepetse kufa, vuto la mtima, sitiroko komanso kuchipatala kwa angina pectoris.

Contraindication

Matenda a chiwindi ogwira ntchito kapena kuwonjezeka kwa ntchito ya seramu ya transaminases (koposa nthawi 3 poyerekeza ndi malire apamwamba) a etiology osadziwika,
Okalamba kufikira zaka 18 (chifukwa cha kuchuluka kwakanthawi kachipatala pazotetezeka ndi kugwira ntchito kwa Liprimar kwa gulu la zaka lino),
Mimba komanso kuyamwa
Hypersensitivity mankhwala.

Wachibale (Liprimar iyenera kulembedwa mosamala):

Mowa
Zisonyezo za mbiri ya matenda a chiwindi.

Pa mankhwala, amayi a msinkhu wobereka ayenera kugwiritsa ntchito njira zokwanira zakulera.

Malangizo ogwiritsira ntchito Liprimar: njira ndi mlingo

Musanagwiritse ntchito Liprimar, ndikofunikira kuyesa kukwaniritsa kuwongolera kwa hypercholesterolemia mothandizidwa ndi zakudya, zolimbitsa thupi ndi kuchepa thupi kwa odwala omwe ali ndi kunenepa kwambiri, komanso chithandizo cha matenda omwe amayambitsidwa.

Popereka mankhwala, wodwalayo ayenera kulangizidwa kuti azitsatira zakudya zapamwamba za hypocholesterolemic nthawi yonseyi.

Liprimar amatengedwa pakamwa, nthawi 1 patsiku, mosasamala kanthu za kudya ndi nthawi ya tsiku.

Kutengera ndi zoyambirira za LDL-C, cholinga cha mankhwalawo komanso kuyankha kwa munthu payekha, mlingo umatha kukhala 10 mg mpaka 80 mg (pazambiri).

Kumayambiriro kwa mankhwalawa komanso / kapena pakukula kwa kuchuluka kwa masabata onse a 2-4, ndikofunikira kuyendetsa zamadzimadzi zam'mapapo am'madzi ndipo, molingana ndi izi, konzani kusintha kwa mlingo.

Kwa odwala ambiri, tsiku ndi tsiku Mlomo wa Liprimar wophatikizika (wosakanikirana) hyperlipidemia ndi hypercholesterolemia woyambira ndi 10 mg. Monga lamulo, achire zotsatira zimawonekera kwa masiku 14, kufikira pazofika mwezi umodzi. Ndi chithandizo chakanthawi, zotsatira zake zimapitirira.

Ndi homozygous achibale hypercholesterolemia, Liprimar ndi mankhwala tsiku lililonse 80 mg.

Odwala ndi hepatic kusowa, mlingo wa mankhwalawa amachepetsa kuyanʻanila zochitika za aspartate aminotransferase ndi alanine aminotransferase.

Kuwonongeka kwa impso sikukhudzanso kuchuluka kwa atorvastatin m'magazi am'magazi kapena kuchepa kwa zomwe LDL-C, chifukwa chake, odwala otere safunika kusintha kwa mlingo.

Ndi makonzedwe a munthawi yomweyo ndi cyclosporine, mlingo waukulu wa Liprimar ndi 10 mg.

Zotsatira zoyipa

Monga lamulo, Liprimar imalekeredwa bwino, mavuto omwe akutuluka ndi osakhalitsa komanso ofatsa.

Pa mankhwala, zotsatirazi zimayamba kukhala ndi (≥1% - nthawi zambiri, ≤1% - mowerengeka):

Pakati mantha dongosolo: Nthawi zambiri - mutu, kusowa tulo, asthenic syndrome, infrequent - zotumphukira neuropathy, chizungulire, malaise, paresthesia, amnesia, hypesthesia,
Matumbo dongosolo: Nthawi zambiri - kudzimbidwa, dyspepsia, mseru, m'mimba kupweteka, kutsegula m'mimba, kusefukira kwamatumbo, pafupipafupi - anorexia, kusanza, kapamba, hepatitis, cholestatic jaundice,
Matenda a minofu ndi mafupa: nthawi zambiri - myalgia, pafupipafupi - myopathy, kupweteka kwa msana, kukokana kwa minofu, arthralgia, myositis, rhabdomyolysis
Hematopoietic dongosolo: mokulira - thrombocytopenia,
Metabolism: pafupipafupi - hyperglycemia, hypoglycemia, kuchuluka kwa serum creatine phosphokinase,
Zotsatira zoyipa: pafupipafupi - poizoni wa epermermal necrolysis (matenda a Lyell), zotupa pakhungu, urticaria, pruritus, zidzolo zazing'onoting'ono, zotupa za anaphylactic, erythema multiforme exudative (kuphatikizapo Stevens-Johnson syndrome),
Zina: infrequent - kuchuluka kutopa, zotumphukira edema, kusabala, kulemera, tinnitus, kupweteka pachifuwa, kulephera kwachiwiri kwaimpso, alopecia.

Bongo

Zizindikiro za bongo wa atorvastatin ndizochulukirapo.

Ngati ndi kotheka, mankhwala othandizira, kuyang'anira ntchito ya creatine phosphokinase ndi mayesero amtundu wa chiwindi amalimbikitsidwa. Popeza chinthu chomwe chikugwiridwayo chimagwira nawo mbali zomangira mapuloteni a plasma, kugwiritsa ntchito hemodialysis chifukwa cha kutulutsa kwake kumawoneka ngati kosathandiza.

Mankhwala enieni a atorvastatin sakudziwika.

Malangizo apadera

Mukatha kugwiritsa ntchito Liprimar, kuwonjezeka kwapang'onopang'ono kwa ntchito za seramu za alanine aminotransferase, kuwonjezereka kwamphamvu kwa seramu ya hepatic transaminases (popanda chitukuko cha jaundice kapena chiwonetsero china chazachipatala) zitha kudziwika. Ndi kuchepa kwa mlingo, kuchoka kwa mankhwala (osakhalitsa kapena athunthu), zochitika za hepatic transaminases nthawi zambiri zimabweza gawo loyambirira. Nthawi zambiri, odwala amatha kupitiliza kulandira chithandizo mu mankhwala ochepetsedwa popanda zovuta zina.

Zizindikiro za ntchito ya chiwindi ziyenera kuyang'aniridwa musanayambe kulandira chithandizo, masabata 6 ndi 12 atangoyambira Liprimar kapena atatha kuchuluka kwa mankhwalawa komanso nthawi yonse ya mankhwala.

Mankhwalawa amathetsedwa ndikuwonjezereka kwa ntchito ya creatine phosphokinase, pamaso pa anthu omwe akuwakayikira kapena kuwatsimikizira. Mukapereka mankhwala a Liprimar nthawi yomweyo ndi ma immunosuppressants, ma fibrate, erythromycin, mankhwala antifungal (azole derivatives) kapena nicotinic acid mu Mlingo wa hypolipidemic, ziyenera kukumbukiridwa kuti izi zimawonjezera mwayi wokhala ndi myopathy. Kuyang'anira wodwalayo pafupipafupi ndikofunikira kuti muwone kufooka kapena kupweteka kwa minyewa, makamaka m'miyezi yoyambirira ya chithandizo komanso nthawi yowonjezera Mlingo wa mankhwala. Ngati ndi kotheka kugwiritsa ntchito mankhwala ophatikizira, ndikofunikira kulingalira za kugwiritsa ntchito mankhwalawa m'munsi koyambirira ndikukonzekera Mlingo.

Mukamagwiritsa ntchito Liprimar, kawirikawiri milandu ya rhabdomyolysis yovuta kulephera chifukwa cha myoglobinuria yalongosoledwa. Ngati pali zizindikiro za myopathy zotheka kapena kupezeka kwa zinthu zomwe zingayambitse matenda a impso chifukwa cha rhabdomyolysis (mwachitsanzo, ndi matenda owopsa, kuwonongeka kwa magazi, kuvulala kwambiri, metabolic, endocrine komanso vuto la elekitiroma komanso kukokana kosagwirizana, kuchitira opaleshoni yayikulu), tikulimbikitsidwa kuthetseratu .

Ngati mukumva kufooka kopanda kufotokozerako kapena kupweteka kwa minofu, makamaka ngati limodzi ndi malungo kapena malaise, muyenera kufunsa katswiri.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Palibe chidziwitso pazokhudza Liprimar pakutha kuyendetsa magalimoto ndikugwira ntchito zowopsa zomwe zimafuna kuwonjezereka kwa chidwi komanso kugwiritsidwa ntchito kwakanthawi yayitali kwa psychomotor. Komabe, chifukwa cha chizungulire, kusamala kuyenera kuchitidwa pochita zinthu zomwe zili pamwambapa.

Mimba komanso kuyamwa

Panthawi yamankhwala, azimayi azaka zoyambira kutenga Liprimar ayenera kugwiritsa ntchito njira zodalirika zolerera. Cholinga cha mankhwalawa chimaperekedwa kwa odwala omwe satetezedwa ku mimba. Pali zambiri zokhudzana ndi zovuta zapakati pobwera pambuyo podziwonetsa kwa HMG-CoA reductase inhibitors (ma statins) pa mwana wosabadwayo. Kafukufuku wazinyama amatsimikizira kuwopsa kwa chonde.

Sizovomerezeka kusankha Liprimar kukhala amayi oyamwitsa, chifukwa chidziwitso chodalirika cha malowedwe a atorvastatin kulowa mkaka wa m'mawere sichikupezeka. Ngati ndi kotheka kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa, yoyamwitsa iyenera kuthetsedwa, kuti mupewe chiwopsezo cha zotsatira zoyipa makanda.

Gwiritsani ntchito paubwana

Muzochita za ana, Liprimar imaperekedwa pochiza ana ndi achinyamata osakwana zaka 18, chifukwa cha kusowa kwa chidziwitso chachipatala chakuchita bwino komanso chitetezo cha mankhwalawa. Chosiyana ndi chithandizo cha heterozygous Famer hypercholesterolemia, chomwe chimawonetsa kugwiritsa ntchito ana atorvastatin kuyambira azaka 10.

Ndi chiwindi ntchito

Iwo contraindicated kumwa mankhwala odwala matenda a chiwindi mu gawo yogwira, komanso kuwonjezeka kwa zochita za kwa chiwindi transaminases osadziwika mu magazi plasma koposa 3 zina poyerekeza ndi malire apamwamba ambiri.

Mosamala, Liprimar imalembedwa kwa odwala omwe ali ndi mbiri yamatenda a chiwindi ndi / kapena oledzera.

Gwiritsani ntchito mu ukalamba

Pogwiritsa ntchito Liprimar mwa odwala okalamba, palibe kusiyana kulikonse pakukhwimitsa chitetezo komanso kuchita bwino poyerekeza ndi anthu onse adadziwika, motero, palibe chifukwa chosinthira mlingo.

Popeza chiopsezo cha rhabdomyolysis chikuwonjezeka pazaka zopitilira 70, Liprimar iyenera kugwiritsidwa ntchito mosamala.

Kuyanjana kwa mankhwala osokoneza bongo

Pogwiritsa ntchito nthawi yomweyo Liprimar ndi mankhwala ena, zotsatirazi zingachitike:

Cyclosporine, fibrate, erythromycin, clarithromycin, mankhwala antifungal (azole derivatives) ndi nicotinic acid mu hypolipidemic Mlingo: chiwopsezo cha myopathy,
CYP3A4 isoenzyme zoletsa: kuchuluka plasma wozungulira atorvastatin,
OATP1B1 inhibitors (mwachitsanzo, cyclosporine): kuchuluka bioavailability wa atorvastatin,
Erythromycin, clarithromycin, CYP3A4 zoletsa, diltiazem, madzi a mphesa: kuchuluka kwa plasma ndende ya atorvastatin,
Itraconazole: kuchuluka kwa AUC (kuchuluka kwa plasma ndende) ya atorvastatin,
Zisonyezo za cytochrome CYP3A4 isoenzyme: kutsika kwa kuchuluka kwa atorvastatin m'madzi am'magazi,
Colestipol: kuchepa kwa kuchuluka kwa atorvastatin mu plasma, komabe, lipid-kutsitsa mphamvu ya kuphatikiza kwa mankhwala imaposa ya aliyense wa iwo payekhapayekha,
Digoxin: kuwonjezeka kwa kuchuluka kwake pamene akutenga Liprimar muyezo waukulu (ndikofunikira kuyang'anira momwe odwala alili),
Kulera kwapakamwa komwe kumakhala ndi norethisterone ndi ethinyl estradiol: kuchuluka kwa AUC kwa zinthu izi.

Zofanizira za Liprimar ndi: Atorvastatin, Atorvastatin-Teva, Atoris, Liptonorm, Torvakard, Atorvoks, Tribestan, Krestor.

Ndemanga pa Liprimar

Mankhwalawa nthawi zambiri amawagwiritsa ntchito odwala omwe ali ndi mavuto osiyanasiyana pakugwiritsidwa ntchito kwa mtima. Pali ndemanga zosiyanasiyana za Liprimar, makamaka, odwala ambiri amapereka chithandizo chofunikira kwambiri chamankhwala. Komabe, odwala ena samvetsa molondola momwe amamwa mankhwalawa chifukwa chosafotokozera bwino momwe dokotala amathandizira. Chifukwa chake, amayesa kudzisankhira pawokha kapena kusintha Mlingo wa atorvastatin, womwe umabweretsa mawonekedwe osafunikira (kupezeka kwa kuvulala ndi kupweteketsa, kuponda magazi, ndi zina).

Akatswiri amaganiza kuti Liprimar ndi imodzi mwamankhwala abwino kwambiri omwe amaperekedwa kuti kuchuluka kwa nthawi ya maphunziridwe kuyang'aniridwa mosamalitsa. Amalangizanso pa mankhwalawa kuti azichita masewera olimbitsa thupi, kutsatira zakudya komanso kuyezetsa magazi pafupipafupi.

Momwe mungatenge Liprimar 10

Mapiritsi amayikidwa kukonzekera pakamwa, mosasamala nthawi ya tsiku kapena chakudya. Mankhwala osokoneza bongo amachitika pokhapokha ngati ntchito ya hypocholesterolemic idatha, kuchepetsa thupi motsutsana ndi maziko a kunenepa kwambiri, zolimbitsa thupi. Ngati kuchuluka kwa cholesterol kumayambitsidwa ndi matenda oyambitsidwa, musanagwiritse ntchito Liprimar, muyenera kuyesa kuthetsa njira yayikulu ya pathological. Munthawi yonse ya mankhwalawa, muyenera kutsatira zakudya zapadera.

Mankhwala osokoneza bongo omwe ali ndi Liprimar 10 amachitika pokhapokha pogwiritsa ntchito mphamvu ya hypocholesterolemic.

Mlingo watsiku ndi tsiku ndi 10-80 mg pakugwiritsidwa ntchito kamodzi ndipo umasinthidwa malinga ndi momwe LDL-C ikuthandizira komanso pakuwaniritsa njira zochizira.

Mlingo woyenera wovomerezeka ndi 80 mg.

Mankhwalawa ndi Liprimar, ndikofunikira kuyang'anira kuchuluka kwa ma lipids masabata onse a 2-4, pambuyo pake muyenera kufunsa dokotala za kusintha kwa mankhwalawa.

Kuthetsa njira yosakanikirana ya hyperlipidemia, m`pofunika kutenga 10 mg kamodzi patsiku, pomwe homozygous cholowa hypercholesterolemia imafuna mlingo wokwanira wa 80 mg. Potsirizira pake, kuchuluka kwa cholesterol kumachepetsedwa ndi 20-45%.

Kumwa mankhwala a shuga

Odwala omwe ali ndi matenda ashuga ayenera kusamala pamene hypercholesterolemia ipezeka. Anthu oterewa ali pachiwopsezo chotenga matenda a mtima. Liprimar imagwiritsidwa ntchito ngati njira yolepheretsa kulowetsedwa kwa myocardial. Mlingowo umatsimikiziridwa ndi dokotala wopita kutengera mlingo wa cholesterol.

Odwala omwe ali ndi matenda ashuga ayenera kusamala pamene hypercholesterolemia ipezeka.

Pakati mantha dongosolo

Zotsatira zoyipa ndi kuwonongeka kwa dongosolo lamanjenje zimawonekera monga:

kusowa tulo
general malaise
asthenic syndrome
mutu ndi chizungulire,
kuchepa ndi kuwonongeka kwathunthu kwa chidwi,
zotumphukira mantha dongosolo
amnesia.

Kuchokera ku kupuma

Dyspnea ikhoza kuchitika.

Ndi chizolowezi chowonetsa anaphylactic zimachitika, zotupa pakhungu, redness, kuyabwa, exryative erythema, necrosis wa subcutaneous mafuta wosanjikiza zingaoneke. M'mavuto akulu, edema ya Quincke ndi anaphylactic zimayamba.

Kupita kwa mankhwala omwe mukufunsidwa kumatha kuyambitsa mawonekedwe a totupa pakhungu.

Kuyenderana ndi mowa

Mankhwala sayenera kuphatikizidwa ndi zakumwa zoledzeretsa. Mowa wa Ethyl umalepheretsa dongosolo lamkati lamanjenje, hepatobiliary ndi circulatory system, chifukwa chake hypocholesterolemic mphamvu ya Liprimar imachepetsedwa. Kutheka kwa mapangidwe a atherosselotic zolembera pamitsempha yamagazi kumawonjezeka.

Mankhwala sayenera kuphatikizidwa ndi zakumwa zoledzeretsa.

Kuphatikiza sikofunikira

Chifukwa cha chiwopsezo cha ma neuromuscular pathologies, kayendedwe ka Liprimar sikulimbikitsidwa:

ma cyclosporin mankhwala
nicotinic acid zotumphukira,
Erythromycin
mankhwala a antifungal
mafupa.

Makonzedwe a Liprimar ndi Erythromycin osavomerezeka.

Kuphatikiza kwamankhwala kotereku kumatha kubweretsa myopathy.

Ndi chisamaliro

Ndikulimbikitsidwa kusamala mukamagwiritsa ntchito Liprimar ndi mankhwala ena:

Atorvastatin amatha kuwonjezera AUC ya kulera kwapakamwa ndi 20-30%, kutengera mahomoni omwe ali pakukonzekera.
Atorvastatin ndi mlingo wa 40 mg wophatikizidwa ndi 240 mg wa Diltiazem kumabweretsa kuwonjezeka kwa plasma ndende ya atorvastatin m'magazi. Mukatenga 200 mg ya Itraconazole ndi 20-40 mg wa Liprimar, kuwonjezeka kwa AUC ya atorvastatin kunawonedwa.
Rifampicin amachepetsa plasma kuchuluka kwa atorvastatin.
Colestipol imayambitsa kuchepa kwa plasma cholesterol-kupunguza mankhwala.
Ndi kuphatikiza mankhwala ndi digoxin, kugwiritsidwa ntchito kotsiriza kumawonjezeka ndi 20%.

Madzi a mphesa amachepetsa mphamvu ya cytochrome isoenzyme CYP3A4, ndichifukwa chake mukamagwiritsa ntchito malita oposa 1.2 a zipatso tsiku lililonse, kuchuluka kwa plasma kwa atorvastatin kumawonjezeka. Zofananazo zimawonedwa mutatenga CYP3A4 inhibitors (Ritonavir, Ketoconazole).

Liprimar amaletsedwa kugwiritsa ntchito kwa amayi 10 oyembekezera.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Amayi oyembekezera saloledwa kugwiritsa ntchito mankhwalawa, chifukwa pali chiopsezo chophwanya kuyika koyenera kwa minofu ndi ziwalo pa nthawi ya kakulidwe ka mazira. Palibe deta pa kuthekera kwa Liprimar kudutsa chotchinga cha hematoplacental.

Pa mankhwala othandizira, kuyamwitsa kuyenera kuthetsedwa.

Magawo a mankhwala omwe ali ndi vuto lofananalo akuphatikizapo:

Kusinthanitsa kumachitika pambuyo pofunsa kuchipatala.

Kanema wotsatsira "Liprimar" Liprimar malangizoAtoris malangizo

Mlingo ndi makonzedwe

Musanalembe Liprimar, ndikofunikira kukwaniritsa kuwongolera kwa hypercholesterolemia pochiza matendawo, komanso njira zina zopanda mankhwala (kudya, kuchita masewera olimbitsa thupi komanso kuchepetsa thupi kwa odwala omwe ali ndi kunenepa kwambiri).

Pa mankhwala, wodwala amakulimbikitsidwa kuti azitsatira zakudya zapamwamba za hypocholesterolemic.

Liprimar amapangidwira kukonzekera pakamwa, mosasamala nthawi yatsiku kapena chakudya.

Mlingo umasiyanasiyana 10 mpaka 80 mg kamodzi patsiku. Kusankhidwa kwa Mlingo kumachitika poganizira koyambira kotsika kwa lipoprotein cholesterol (LDL-C), momwe munthu amathandizira ndi cholinga chamankhwala. Mlingo wapamwamba tsiku lililonse ndi 80 mg kamodzi.

Kumayambiriro kwa mankhwalawa, komanso ndi Mlingo wowonjezereka, ndikofunikira kudziwa kuchuluka kwa zamadzimadzi mu plasma masabata onse a 2-4, ndikuganizira zomwe zachitika, kusintha mlingo.

Ndi hyperlipidemia yosakanikirana (yophatikiza) ndi hypocholesterolemia, mlingo wa Liprimar kwa odwala ambiri ndi 10 mg kamodzi patsiku. Mphamvu ya achire imawonekera m'milungu iwiri yoyambilira ndipo imafika pazovomerezeka za 4 milungu. Ndi chithandizo chakanthawi, zotsatira zake zimapitirira.

Kwa odwala omwe ali ndi homozygous Famer hypercholesterolemia, Liprimar imayikidwa pa mlingo wa 80 mg kamodzi patsiku (mulingo wa LDL-C umachepetsedwa ndi 18-45%).

Ngati vuto la impso ndi okalamba, kusintha kwa mankhwala sikofunikira.

Kulephera kwa chiwindi, mlingo umachepetsedwa poyang'anira zochitika za michere alanine aminotransferase ndi aspartate aminotransferase.

Pogwiritsa ntchito munthawi yomweyo cyclosporine, mlingo wa Liprimar suyenera kupitilira 10 mg patsiku.