Ndemanga za Rosucard

Chofunikira chachikulu cha Rosucard ndi rosuvastatin. Makamaka zotsatira za mankhwalawa zimachitika m'chiwindi - chofunikira kwambiri pakuphatikizidwa kwa cholesterol. Rosucard imatsitsa kuchuluka kwa lipoproteins otsika (LDL), ndiye kuti, "yoyipa" cholesterol ndikuwonjezera cholesterol "yabwino" (HDL - high density lipoproteins).

Patatha sabata limodzi atayamba kumwa Rosucard, chithandizo chake chodziwika bwino chimadziwika. Kusintha kwakukulu kumatheka patatha masabata awiri atayamba chithandizo ndi Rosucard. Kuti mukwaniritse bwino, njira yochiritsira iyenera kupitilira mwezi umodzi.

Chizindikiro chakugwiritsa ntchito Rosucard ndi:

• hypercholesterolemia yoyamba,
• dyslipidemia,
• cholowa cholowa,
• atherosulinosis.

Komanso, mankhwalawa adapangidwa kuti aletse kukula kwa matenda amtima mwa odwala omwe ali pachiwopsezo.

Chomwe chimagwiritsidwa ntchito ndi Rosucard ndikuti asanayambe kumwa mankhwalawa, wodwalayo ayenera kuyamba kutsatira zakudya zochepa zopatsa mphamvu ndikutsatira nthawi yonse ya chithandizo. Malinga ndi malangizo, Rosucard imatha kutengedwa nthawi iliyonse masana, mosasamala kanthu za kudya.

Mlingo wa mankhwalawa amasankhidwa ndi dokotala payekha, poganizira zolinga ndi zomwe wodwalayo amachita. Nthawi zambiri, mlingo woyambirira wa Rosucard ndi 10 mg. Pakatha mwezi umodzi, imatha kuwonjezeka mpaka 20 mg. Mwazovuta kwambiri, 40 mg wa Rosucard ndi mankhwala. Mankhwala ndi contraindified ana osakwana zaka 10.

Mukutenga Rosucard, zovuta zina zitha kudziwika. Chifukwa cha chizungulire ndi mutu wake, kusapeza bwino kwam'mimba, monga kupweteka kwam'mimba, nseru, kudzimbidwa, khungu la khungu. Zosowa kwambiri ndizovuta za kugona, komanso njira zotupa za chiwindi - hepatitis. Zotsatira zoyipa za Rosucard, monga lamulo, zimadalira mlingo.

Zoyipa pa kutenga Rosucard ndi:

• tsankho
• matenda osiyanasiyana a chiwindi, kuphatikizapo kuchuluka kwa transaminase,
• matenda a impso
• kumwa cyclosporine,
• Mimba ndi kuyamwa
• myopathies.

Ndi chisamaliro chapadera, Rosucard imalembedwa kwa odwala amtundu wa Asia kapena achikulire kuposa zaka 70, komanso ndi hypothyroidism, uchidakwa, chithandizo ndi fibrate komanso matenda am'mimba pambuyo. Mukamamwa Rosucard, anthu omwe ali ndi shuga wambiri magazi ali pachiwopsezo cha matenda a shuga.

M'magulu a odwala, musanapange mankhwala a Rosucard, ndikofunikira kuyerekeza zoopsa zomwe zilipo ndi chithandizo chomwe chimaloseredwa. Popereka mankhwala kwa iwo, ndikofunikira kuti chithandizo chithandizike kuchipatala moyang'aniridwa ndi achipatala mosalekeza.

Asanayambe maphunziro ndi Rosucard, odwala amachenjezedwa za kufunika kodziwitsa dokotala za mawonekedwe a kupweteka kwa minofu, kukokana, kufooka, makamaka ndi malaise ndi hyperthermia. Lingaliro la kusiya kapena kupitiliza kumwa mankhwalawa limapangidwa pamaziko a zidziwitso zasayansi.

Analogs a Rosucard

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 54. Analogue ndiyotsika mtengo ndi ma ruble 811

Machesi molingana ndi mawonekedwe

Mtengo kuchokera 324 rubles. Analogue ndiotsika mtengo ndi ma ruble 541

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku 345 rubles. Analogue ndiyotsika mtengo ndi ma ruble 520

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 369. Analogue ndiotsika mtengo ndi ma ruble 496

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 418. Analogue ndiyotsika mtengo ndi ma ruble 447

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 438. Analogue ndiotsika mtengo ndi ma ruble 427

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 604. Analogue ndiotsika mtengo ndi ma ruble 261

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ruble 660. Analogue ndiyotsika mtengo ndi ma ruble 205

Machesi molingana ndi mawonekedwe

Mtengo kuchokera 737 ma ruble. Analogue ndiotsika mtengo ndi ma ruble 128

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Mapiritsi okhala ndi mafilimu pinki, oblong, biconvex, wokhala ndi chiwopsezo.

1 tabu
calcium wa rosuvastatin	10,4 mg
zomwe zimafanana ndi zomwe zili rosuvastatin	10 mg

Omwe amathandizira: lactose monohydrate - 60 mg, cellcrystalline cellulose - 45.4 mg, croscarmellose sodium - 1,2 mg, colloidal silicon dioxide - 600 μg, magnesium stearate - 2.4 mg.

Zomwe zimapangidwa ndi chipolopolo: hypromellose 2910/5 - 2,5 mg, macrogol 6000 - 400 μg, titanium dioxide - 325 μg, talc - 475 μg, utoto wofiirira wachitsulo - 13 μg.

Ma PC 10 - matuza (3) - mapaketi a makatoni.
Ma PC 10 - matuza (6) - mapaketi a makatoni.
Ma PC 10 - matuza (9) - mapaketi a makatoni.

Zotsatira za pharmacological

Hypolipidemic mankhwala ochokera pagulu la statins. Kusankha mpikisano wosankha wa HMG-CoA reductase, enzyme yomwe imatembenuza HMG-CoA kukhala mevalonate, woyang'anira cholesterol (Ch).

Kuchulukitsa kuchuluka kwa zolandirira za LDL pamtunda wa hepatocytes, zomwe zimapangitsa kuti pakhale kuchuluka kwamphamvu ndi kupatsirana kwa LDL, kuletsa kaphatikizidwe ka VLDL, kuchepetsa kuchuluka kwa LDL ndi VLDL. Imachepetsa kuchuluka kwa LDL-C, HDL cholesterol-non-lipoproteins (HDL-non-HDL), HDL-V, Xc, TG, TG-VLDL, apolipoprotein B (ApoV), kutsitsa kuchuluka kwa LDL-C / Lc-HDL HDL-C, Chs-not HDL-C / HDL-C, ApoB / apolipoprotein A-1 (ApoA-1), imachulukitsa kuchuluka kwa HDL-C ndi ApoA-1.

Kuchulukitsa kwa lipid kumachitika mwachindunji molingana ndi kuchuluka kwa mlingo womwe umaperekedwa. Mankhwala othandizira amawonekera pakatha sabata limodzi atangoyamba kumene chithandizo, pakatha masabata awiri kufika 90% pazowonjezereka, amafika pakadutsa masabata anayi kenako amakhala osasintha.

Tebulo 1. Mphamvu yodalira Mlingo wa odwala omwe ali ndi hypercholesterolemia yoyamba (mtundu IIa ndi IIb malinga ndi gulu la Fredrickson) (kusintha kosinthidwa kwapakati poyerekeza ndi mtengo woyambira)

Mlingo	Chiwerengero cha odwala	HS-LDL	Chonse	HS-HDL
Malo	13	-7	-5	3
10 mg	17	-52	-36	14
20 mg	17	-55	-40	8
40 mg	18	-63	-46	10
Mlingo	Chiwerengero cha odwala	TG	Xc- osakhala HDL	Apo v	Apo AI
Malo	13	-3	-7	-3	0
10 mg	17	-10	-48	-42	4
20 mg	17	-23	-51	-46	5
40 mg	18	-28	-60	-54	0

Tebulo 2. Kutengera kudalira kwa odwala omwe ali ndi hypertriglyceridemia (mtundu IIb ndi IV malinga ndi gulu la Fredrickson) (kusintha kwapakati poyerekeza ndi mtengo woyambira)

Mlingo	Chiwerengero cha odwala	TG	HS-LDL	Chonse
Malo	26	1	5	1
10 mg	23	-37	-45	-40
20 mg	27	-37	-31	-34
40 mg	25	-43	-43	-40
Mlingo	Chiwerengero cha odwala	HS-HDL	Xc- osakhala HDL	Xc- VLDL	TG- VLDL
Malo	26	-3	2	2	6
10 mg	23	8	-49	-48	-39
20 mg	27	22	-43	-49	-40
40 mg	25	17	-51	-56	-48

Mphamvu zamankhwala

Kugwiritsa ntchito kwa odwala achikulire omwe ali ndi hypercholesterolemia wokhala ndi kapena wopanda hypertriglyceridemia, mosaganizira mtundu, jenda kapena msinkhu, incl. Odwala matenda a shuga ndi matenda am'magazi. Mu 80% ya odwala omwe ali ndi mtundu wa IIa ndi IIb hypercholesterolemia (malinga ndi gulu la Fredrickson) omwe amakhala ndi LDL-C pafupifupi 4,8 mmol / L, pamene akumwa mankhwalawa pa 10 mg, kuchuluka kwa LDL-C kumafika zosakwana 3 mmol / L.

Odwala omwe ali ndi heterozygous Famer hypercholesterolemia akulandira rosuvastatin pa mlingo wa 20-80 mg / tsiku, kusintha kwakukulu kwa lipid mbiri. Pambuyo titration kwa tsiku lililonse 40 mg (12 milungu mankhwala), kuchepa kwa ndende ya LDL-C ndi 53% anati. Mu 33% ya odwala, kuchuluka kwa LDL-C kosakwana 3 mmol / L kunakwaniritsidwa.

Odwala omwe ali ndi homozygous Famer hypercholesterolemia akulandira rosuvastatin pa 20 mg ndi 40 mg, kutsika kwapakati pa LDL-C kunali 22%.

Odwala omwe ali ndi hypertriglyceridemia ndi ndende yoyambirira ya TG kuchokera ku 273 mg / dL mpaka 817 mg / dL, kulandira rosuvastatin mu Mlingo wa 5 mg mpaka 40 mg 1 nthawi / tsiku kwa masabata 6, kuchuluka kwa TG m'magazi a magazi kunachepetsedwa (onani tebulo 2) )

Mphamvu yowonjezera imawonedwa limodzi ndi fenofibrate pokhudzana ndi kuchuluka kwa TG komanso nicotinic acid mu lipid kutsitsa Mlingo (woposa 1 g / tsiku) pokhudzana ndi kuchuluka kwa HDL-C.

Pakufufuza kwa METEOR, chithandizo cha rosuvastatin chinachepetsa kwambiri kupita patsogolo kwa makulidwe apamwamba a intima-media tata (TCIM) magawo 12 a chotupa cha carotid poyerekeza ndi placebo. Poyerekeza ndi zoyambira mu gulu la rosuvastatin, kuchepa kwa TCIM yokwanira ndi 0.0014 mm / chaka kudadziwika poyerekeza ndi chiwonetsero ichi ndi 0.0131 mm / chaka pagulu la placebo. Mpaka pano, ubale wolunjika pakati pa kuchepa kwa TCIM ndi kuchepa kwa chiwopsezo cha zochitika zam'mtima sizinawonetsedwe.

Zotsatira za kafukufuku wa JUPITER zidawonetsa kuti rosuvastatin adachepetsa kwambiri ngozi yokhala ndi mtima ndi kuchepetsedwa kwa chiwopsezo cha 44%. Kuchita bwino kwa mankhwalawa kunadziwika pambuyo pa miyezi 6 yoyambirira yogwiritsa ntchito mankhwalawa. Panali kuchepa kwakukulu kwa 48% mwa zotsimikizika zophatikizika, kuphatikiza kufa chifukwa cha mtima, kuponderezana ndi kuphwanya kwa chifuwa cha infrality, komanso kuchepa kwa 48% pangozi yakupha kapena yosavulala. Chiwerengero chakufa chatsika ndi 20% mgulu la rosuvastatin. Mbiri ya chitetezo kwa odwala omwe amatenga 20 mg rosuvastatin nthawi zambiri inali yofanana ndi mbiri yotetezeka yomwe ili mgulu la placebo.

Pharmacokinetics

Pambuyo kumwa mankhwalawo mkati C_max plasma rosuvastatin imafikiridwa pafupifupi maola 5. Mtheradi wa bioavailability pafupifupi 20%.

Kulumikizana ndi mapuloteni a plasma (makamaka okhala ndi albumin) kuli pafupifupi 90%. V_d - 134 l.

Rosuvastatin imagwiritsidwa ntchito kwambiri ndi chiwindi, chomwe ndi malo akuluakulu opangira Chs ndi metabolism ya Chs-LDL.

Imalowa mkati mwa chotchinga chachikulu.

Biotransformed mu chiwindi mpaka pang'ono (pafupifupi 10%), kukhala gawo lopanda chapakati pazesoenzymes za cytochrome P450 system.

Isoenzyme yayikulu ikuphatikizidwa mu metabolism ya rosuvastatin ndi isoenzyme CYP2C9. Isoenzymes CYP2C19, CYP3A4 ndi CYP2D6 sakukhudzidwa kwambiri ndi metabolism.

Ma metabolites apamwamba a rosuvastatin ndi N-dismethyl ndi lactone metabolites. N-dismethyl ndi pafupifupi 50% yotsika kuposa rosuvastatin, lactone metabolites ndi pharmacologic yogwira. Kuposa 90% ya zochitika zamankhwala zoletsa kufalitsa kwa HMG-CoA reductase zimaperekedwa ndi rosuvastatin, zotsalazo ndi metabolites.

Monga momwe zimakhalira ndi ma inhibitors ena a HMG-CoA reductase, gawo lina lonyamula membrane limaphatikizidwa ndi kuthana kwa mankhwalawa - polypeptide yonyamula organic anion (OATP) 1B1, yomwe imachita mbali yofunika kwambiri pakuchotsa kwake kwa hepatic.

T_1/2 - pafupifupi maola 19, sasintha ndi kuchuluka kwa mankhwala. Kuvomerezeka kwamadzi a plasma kuli pafupifupi 50 l / h (kutalika kwa masinthidwe 21.7%). Pafupifupi 90% ya mlingo wa rosuvastatin wamasulidwa osatembenuka m'matumbo, ena ndi impso.

Kuwonetsera kwadongosolo kwa rosuvastatin kumawonjezeka molingana ndi mlingo.

Ma paracokinetic magawo samasintha ndikugwiritsa ntchito tsiku ndi tsiku.

Pharmacokinetics mu milandu yapadera yamankhwala

Odwala omwe amachepetsa kwambiri aimpso, kuchuluka kwa plasma kwa rosuvastatin kapena N-dysmethyl sikusintha kwambiri. Odwala omwe ali ndi vuto lambiri laimpso (CC ochepera 30 ml / min), kuchuluka kwa rosuvastatin m'madzi am'magazi kumakhala katatu kwambiri, ndipo N-dismethyl ndiokwera kwambiri maulendo 9 kuposa odzipereka athanzi. Kuchuluka kwa plasma ya rosuvastatin mwa odwala hemodialysis ndi pafupifupi 50% kuposa kuposa odzipereka athanzi.

Odwala omwe ali ndi vuto la chiwindi lomwe ali ndi vuto la 7 point kapena otsika pa sikelo ya Mwana-Pugh, palibe kuchuluka kwa T_1/2 rosuvastatin, odwala omwe ali ndi vuto la chiwindi 8 ndi 9 pamawonekedwe a Mwana-Pugh, kuchuluka kwa T kunadziwika_1/2 2 nthawi. Palibe chochitika ndi kugwiritsa ntchito mankhwalawa odwala omwe ali ndi vuto la chiwindi kwambiri.

Jenda ndi zaka sizikhala ndi vuto lalikulu pa pharmacokinetics ya rosuvastatin.

Ma paracokinetic magawo a rosuvastatin amadalira mtundu. AUC ya nthumwi za mtundu wa Mongoloid (Japan, Chinese, Filipinos, Vietnamese and Koreans) ndiwonjeza nthawi ziwiri kuposa mpikisano wa ku Caucasian. Amwenye pafupifupi AUC ndi C_max kuchuluka ndi nthawi 1.3.

HMG-CoA reductase inhibitors, kuphatikiza rosuvastatin amamangiriza mapuloteni oyendetsa OATP1B1 (organic anion transport polypeptide yomwe ikukhudzana ndimatenda a hepatocyte a statins) ndi BCRP (efflux transporter). Onyamula a genotypes SLCO1B1 (OATP1B1) s.521CC ndi ABCG2 (BCRP) s.421AA adawonetsa kuwonjezeka (AUC) ku rosuvastatin 1.6 ndi 2.4 nthawi, motsatana, poyerekeza ndi onyamula a genotypes SLCO1B1 s.521TT ndi ABCG2 s.421 s.421.

- hypercholesterolemia yoyamba (mtundu IIa malinga ndi Fredrickson), kuphatikizapo heterozygous hypercholesterolemia kapena hypercholesterolemia (mtundu IIb malinga ndi Fredrickson) - monga kuwonjezera pazakudya, zakudya kapena njira zina zosagwiritsa ntchito mankhwala (mwachitsanzo, masewera olimbitsa thupi, kuchepa thupi) ndizosakwanira

- homozygous hypercholesterolemia - monga chakudya komanso njira zina zochepetsera lipid (mwachitsanzo, LDL-apheresis), kapena ngati chithandizo chotere sichikugwira ntchito mokwanira,

- hypertriglyceridemia (mtundu IV malinga ndi Fredrickson) - kuwonjezera pa zakudya,

- Kuchepetsa kupitilira kwa atherosulinosis - monga kuwonjezera pa zakudya kwa odwala omwe awonetsedwa chithandizo chochepetsera kuchuluka kwa ma Chs ndi Chs-LDL,

- kupewa kwakukulu kwa mtima wamavuto (a stroke, kugunda kwa mtima, kusintha kwa matenda) kwa odwala omwe alibe zizindikiro za matenda amitsempha yamagazi, koma ali ndi chiopsezo cha kukula kwake (zaka zopitilira 50 kwa azibambo ndi zaka zopitilira 60 kwa azimayi, kuchuluka kwa protein yayitali (≥ 2 mg / l) pamaso pa zinthu zina zowonjezera, monga kuwopsa kwa matenda oopsa, kusungunuka pang'ono kwa HDL-C, kusuta, mbiri ya mabanja poyambika kwa CHD).

Mlingo

Mankhwala amatengedwa pakamwa. Mapiritsi amayenera kumezedwa kwathunthu, osatafuna komanso osaphwanya, kutsuka ndi madzi, nthawi iliyonse masana, mosasamala kanthu za kudya.

Asanayambe chithandizo ndi Rosucard ®, wodwalayo ayenera kuyamba kutsatira zakudya zomwe zimachepetsa lipid ndikupitiliza kutsatira panthawi ya chithandizo.

Mlingo wa mankhwalawa amayenera kusankhidwa payekha kutengera zomwe akuwonetsa komanso njira zochizira, poganizira zomwe zikuvomerezedwa masiku ano pazomwe zikuyimira.

Mlingo woyamba wa Rosucard ® kwa odwala omwe amayamba kumwa mankhwalawo, kapena kwa odwala omwe atengedwa kuti atenge ma HMG-CoA reductase inhibitors, ndi 5 kapena 10 mg 1 nthawi / tsiku.

Mukamasankha koyamba mlingo, munthu ayenera kutsogoleredwa ndi cholesterol ya wodwalayo ndikuwunika ngozi yokhala ndi zovuta zamtima, komanso ndikofunikira kuwunika chiopsezo cha mavuto. Ngati ndi kotheka, pakatha milungu 4, mankhwalawa akhoza kuchuluka.

Chifukwa chakukula kwa zotsatira zoyipa mukamamwa mankhwalawa 40 mg, poyerekeza ndi mlingo wochepa wa mankhwalawa, kupereka gawo lomaliza mpaka 40 mg liyenera kuchitidwa mwa odwala omwe ali ndi vuto lalikulu la mtima ndi chiopsezo cha zovuta zamtima (makamaka odwala ndi cholowa hypercholesterolemia), momwe mumamwa mankhwala 20 mg, cholesterol yomwe mukufuna sichinakwaniritsidwe. Odwala otere ayenera kuyang'aniridwa ndi achipatala. Makamaka kuwunika mosamala odwala omwe akulandira mankhwalawa 40 mg akulimbikitsidwa.

Mlingo wa 40 mg ndi osavomerezeka kwa odwala omwe sanakumaneko ndi dokotala. Pambuyo pamankhwala a 2-4 milungu komanso / kapena kuwonjezeka kwa mlingo wa Rosucard ®, ndikofunikira kuyang'anira metabolidi ya lipid (kusintha kwa mlingo ndikofunikira ngati pakufunika).

At okalamba odwala opitilira 65 kusintha kwa mlingo sikofunikira.

At odwala ndi chiwindi kulephera ndi mfundo pansipa mfundo 7 pamakwerero a Mwana-Pugh kusintha kwa mlingo wa Rosucard sikofunikira.

At odwala ndi wofatsa aimpso kulepherakusintha kwa mankhwala Rosucard ® safunikira, koyamba mlingo wa 5 mg / tsiku tikulimbikitsidwa. At odwala aimpso kulephera kwapakati (CC 30-60 ml / min) kugwiritsa ntchito mankhwala a Rosucard ® pa mlingo wa 40 mg / tsiku amatsutsana. At kulephera kwambiri kwaimpso (CC zosakwana 30 ml / min) kugwiritsa ntchito mankhwala a Rosucard ® amatsutsana.

At odwala omwe ali ndi chiyembekezo cha myopathy kugwiritsa ntchito mankhwala a Rosucard ® pa mlingo wa 40 mg / tsiku amatsutsana. Popereka mankhwala muyezo wa 10 mg ndi 20 mg / tsiku, mlingo woyambirira wa gulu la odwala ndi 5 mg / tsiku.

Mukamaphunzira mankhwalawa a pharmacokinetic a rosuvastatin, kuwonjezereka kwa kuchuluka kwa mankhwalawa kwa oyimira kunadziwika. Mtundu wa Mongoloid. Izi zikuyenera kukumbukiridwa popereka mankhwala a Rosucard ® kwa odwala a mtundu wa Mongoloid. Popereka mankhwala mu 10 mg ndi 20 mg, muyezo wa gulu la odwala ndi 5 mg / tsiku. Kugwiritsa ntchito mankhwala a Rosucard ® pa 40 mg / tsiku kwa oimira mpikisano wa Mongoloid ndiwotsutsana.

Ma polymorphism. Onyamula a genotypes SLCO1B1 (OATP1B1) c.521CC ndi ABCG2 (BCRP) c.421AA adawonetsa kuwonjezeka (AUC) kwa rosuvastatin poyerekeza ndi onyamula genotypes SLC01B1 s.521TT ndi ABCG2 s.421CC. Kwa odwala omwe ali ndi genotypes c.521SS kapena c.421AA, mlingo woyenera wa Rosucard ® ndi 20 mg / tsiku.

Chithandizo chothandizirana. Rosuvastatin imamangiriza mapuloteni osiyanasiyana oyendetsa (makamaka, OATP1B1 ndi BCRP). Mankhwala a Rosucard ® akagwiritsidwa ntchito limodzi ndi mankhwalawa (monga cyclosporine, ma virus ena a HIV proteinase, kuphatikiza kuphatikiza kwa ritonavir ndi atazanavir, lopinavir ndi / kapena tipranavir), zomwe zimakulitsa kuchuluka kwa rosuvastatin m'magazi am'magazi chifukwa chogwirizana ndi mapuloteni oyendetsa, chiopsezo cha myopathy chitha kuchuluka (kuphatikizapo rhabdomyolysis). Zikatero, muyenera kuwunikira mwayi womwe ungapatsidwe mankhwala ena kapena kusiya kwakanthawi kugwiritsa ntchito Rosucard ®. Ngati kugwiritsa ntchito mankhwalawa kuli kofunikira, muyenera kudziwa bwino momwe mungagwiritsire ntchito mankhwalawa musanawafotokoze nthawi yomweyo ndi Rosucard ®, onetsetsani kuchuluka kwa zoopsa zamankhwala othandizira ndikuganizira kuchepetsa kuchuluka kwa Rosucard ®.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimadziwika ndi rosuvastatin nthawi zambiri zimakhala zofatsa ndipo zimangoyenda zokha. Monga momwe zilili zoletsa zina za HMG-CoA reductase, zomwe zimayambitsa mavuto zimadalira mlingo.

Pansipa pali mbiri yovuta ya rosuvastatin, potengera kafukufuku wazachipatala komanso zambiri zolembetsa pambuyo polembetsa.

Kutsimikiza kwamafotokozedwe azovuta (gulu la WHO): Nthawi zambiri (> 1/10), nthawi zambiri (kuyambira 1/100 mpaka 1/1000 mpaka 1/10 000 mpaka 20 mg / tsiku), kawirikawiri - arthralgia, tendopathy, mwina ndi kupindika kwa tendon, pafupipafupi sikudziwika - immuno-mediated necrotizing myopathy.

Zotsatira zoyipa: pafupipafupi - khungu kuyabwa, urticaria, zidzolo, osowa - hypersensitivity zimachitika, kuphatikizapo angioedema.

Pa khungu ndi subcutaneous minofu: pafupipafupi osadziwika - matenda a Stevens-Johnson.

Kuchokera pamifupa ya kwamikodzo: Nthawi zambiri - proteinuria, kawirikawiri - hematuria. Zosintha mu kuchuluka kwa mapuloteni mu mkodzo (kuchokera pomwe palibe kapena kufunafuna kuchuluka kwa ++ kapena zochulukirapo) kumawonedwa mu zosakwana 1% za odwala omwe amalandira mlingo wa 10-20 mg / tsiku, ndipo pafupifupi 3% ya odwala omwe amalandira 40 mg / tsiku. Proteinuria amachepetsa nthawi ya mankhwala ndipo samayenderana ndi kupezeka kwa matenda a impso kapena matenda a kwamikodzo.

Kuchokera kumaliseche ndi zonyansa zamamayi: kawirikawiri - gynecomastia.

Zizindikiro zasayansi: pafupipafupi - kuwonjezeka kwa mlingo wa seramu CPK (nthawi zambiri, yaying'ono, asymptomatic komanso kwakanthawi). Ndi kuwonjezeka kwa nthawi zopitilira 5 poyerekeza ndi VGN, chithandizo ndi Rosucard ® ziyenera kuyimitsidwa kwakanthawi. Kuchuluka kwa plasma glycosylated hemoglobin.

Zina: nthawi zambiri - asthenia, pafupipafupi osadziwika - edema yodutsa.

Mukamagwiritsa ntchito Rosucard ®, kusintha kunawoneka m'magawo a labotale otsatirawa: kuwonjezereka kwa kuchuluka kwa glucose, bilirubin, alkaline phosphatase shughuli, ndi GGT.

Kukula kwa zochitika zotsatirazi kunanenedwa pakugwiritsidwa ntchito kwa ma statins ena: kukomoka kwa erectile, zochitika zapadera za matenda am'mapapo ochepa (makamaka kugwiritsa ntchito nthawi yayitali), lembani matenda ashuga a 2, kuchuluka kwa chitukuko komwe kumadalira kupezeka kapena kusapezeka kwa zinthu zoopsa (kusala kwa shuga ndende ya 5.6- 6.9 mmol / l, BMI> 30 kg / m 2, hypertriglyceridemia, mbiri yokhudza matenda oopsa a arterial).

Contraindication

Mapiritsi a 10 ndi 20 mg

- Hypersensitivity pazigawo za mankhwala,

- matenda a chiwindi mu gawo yogwira kapena kuwonjezereka kwa ntchito ya hepatic transaminases mu seramu (nthawi zopitilira 3 poyerekeza ndi VGN) zosachokera,

- Kulephera kwa chiwindi (kuopsa kuyambira 7 mpaka 9 pamasamba a Mwana-Pugh),

- kuchuluka kwa kuchuluka kwa CPK m'mwazi ndi nthawi zoposa 5 poyerekeza ndi VGN,

- kukanika kwa impso (CC zosakwana 30 ml / min),

- odwala omwe akukonzekera kukonzekera zovuta za myotoxic,

- munthawi yomweyo cyclosporine,

- kuphatikiza wogwiritsa ntchito ndi proteinase inhibitors,

- matenda obadwa nawo, monga lactose tsankho, kuchepa kwa lactase kapena malabsorption a glucose (chifukwa cha kupezeka kwa lactose mu kapangidwe kake),

- azimayi a msinkhu wobereka omwe sagwiritsa ntchito njira zokwanira zakulera,

- mkaka wa m'mawere (yoyamwitsa),

- zaka mpaka 18 (kuchita bwino ndi chitetezo sizinakhazikitsidwe),

Mapiritsi a 40 mg (kuwonjezera pa contraindication a 10 ndi 20 mg mapiritsi)

Kukhalapo kwa zinthu zotsatirazi zowopsa za chitukuko cha myopathy / rhabdomyolysis:

- myotoxicity motsutsana ndi maziko ogwiritsa ntchito zoletsa zina za HMG-CoA reductase kapena ma fibrate m'mbiri,

- Kulephera kwakanthawi kwamankhwala (CC 30-60 ml / min),

- kumwa kwambiri mowa,

- machitidwe omwe angapangitse kuwonjezeka kwa plasma ndende ya rosuvastatin,

- Kulandila munthawi yomweyo kwa ma fiber.

Odwala a mtundu wa Mongoloid.

Zisonyezero zamatenda am'mimba mbanja.

Mapiritsi a 10 ndi 20 mg: ndi mbiri ya matenda a chiwindi, sepsis, ochepa hypotension, opaleshoni yayikulu, kuvulala, kupweteka kwakukulu, endocrine kapena electrolyte kusokonezeka, kugwirira mosagwirizana, mofatsa komanso kulephera kwapakati, a hypothyroidism, pogwiritsa ntchito zina za HMG-CoA reductase inhibitors kapena ma fibrate, zikuwonetsa mbiri ya kawopsedwe wa minofu, matenda amtundu wamafupa mu anamnesis, ndi munthawi yomweyo makonzedwe okhala ndi mafupa, mikhalidwe yomwe kuchuluka kwa kuchuluka ndipo rosuvastatin mu madzi a m'magazi odwala zaka zaka 65, wa Mongoloid mtundu odwala ndi mowa kwambiri.

Mapiritsi 40 mg: ndi kulephera kwapang'onopang'ono kwaimpso (CC yoposa 60 ml / min), mbiri yodwala matenda a chiwindi, sepsis, hypotension yokhudzana ndi ma arterial, kuchuluka kwa maopaleshoni, kuvulala, metabolic yayikulu, endocrine kapena kusokonezeka kwa elekitirodi, kudwala kosalamulirika, mwa odwala azaka zopitilira 65.

Mimba komanso kuyamwa

Rosucard ® imaphatikizidwa mu mimba ndi mkaka wa m'mawere (yoyamwitsa).

Kugwiritsa ntchito Rosucard ® azimayi amsinkhu woberekaZimatheka pokhapokha njira zodalirika zakulera zikugwiritsidwa ntchito komanso ngati wodwalayo akudziwitsa za kuopsa kwa chithandizo cha mwana wosabadwayo.

Popeza cholesterol ndi zinthu zopangidwa kuchokera ku cholesterol ndizofunikira pakukula kwa fetus, chiwopsezo choteteza HMG-CoA reductase chimaposa zabwino zogwiritsira ntchito mankhwalawa panthawi yapakati. Ngati amayi apezeka ndi pakati pa mankhwala ndi mankhwala, Rosucard ® iyenera kusiyidwa pomwepo, ndipo wodwalayo ayenera kuchenjezedwa za chiwopsezo chomwe chingakhalepo kwa mwana wosabadwayo.

Ngati ndi kotheka kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa, chifukwa cha zovuta za makanda, nkhani yoletsa kuyamwitsa iyenera kuthetsedwa.

Malangizo apadera

Zotsatira pa impso

Odwala omwe amalandira mlingo waukulu wa rosuvastatin (makamaka 40 mg), proteinuria ya tubular imawonedwa, yomwe nthawi zambiri imakhala yochepa. Proteinuria yoteroyo sinasonyeze matenda owopsa a impso kapena kupitirira kwa matenda a impso. Odwala kumwa mankhwala 40 mg, tikulimbikitsidwa kuwunika ntchito aimpso a mankhwalawa.

Zokhudza mphamvu ya masculoskeletal system

Mukamagwiritsa ntchito rosuvastatin mu Mlingo wonse, komanso makamaka Mlingo woposa 20 mg, zotsatira zotsatirazi pa minofu yam'mimba zimanenedwa: myalgia, myopathy, nthawi zina, rhabdomyolysis.

Kudziwitsa za ntchito za CPK

Kutsimikiza kwa ntchito za CPK sikuyenera kuchitika pambuyo pakuchita zolimbitsa thupi kwambiri kapena pamaso pa zifukwa zina zowonjezera za ntchito za CPK, zomwe zingayambitse kutanthauzira kolakwika kwa zotsatira. Ngati ntchito yoyambirira ya CPK ichulukitsa kwambiri (maulendo 5 kuposa VGN), patatha masiku 5-7, muyeso wachiwiri uyenera kuchitika. Mankhwalawa sayenera kuyambitsidwa ngati mayeso obwereza atsimikizira ntchito yoyambirira ya KFK (kuposa nthawi 5 kuposa VGN).

Musanayambe mankhwala

Mukamagwiritsa ntchito Rosucard ®, komanso mukamagwiritsa ntchito ma inhibitors ena a HMG-CoA reductase, muyenera kusamala odwala omwe ali ndi chiopsezo cha myopathy / rhabdomyolysis. Chiwopsezo chowonjezera cha chiopsezo chiyenera kuyesedwa, ndipo ngati kuli koyenera, kuyang'anira wodwalayo kuyenera kuchitika nthawi ya chithandizo.

Pa mankhwala

Dziwitsani wodwalayo za kufunika kofotokozera dokotalayo nthawi yomweyo za kupweteka kwa minyewa, kufooka kwa minofu kapena kupsinjika, makamaka kuphatikiza ndi malaise ndi malungo. Mwa odwala, ntchito za CPK ziyenera kutsimikizika. Mankhwalawa amayenera kutha ngati ntchito ya CPK ikuchulukirachulukira (kuchulukirapo kangapo ka 5 kuposa VGN) kapena ngati zizindikiro za mbali ya minofu zikutchulidwa ndikupangitsa kusasangalala tsiku ndi tsiku (ngakhale ngati ntchito ya KFK ndiyosachepera kasanu poyerekeza ndi VGN). Ngati zizindikiro zimasowa, ndipo ntchito ya CPK ibwerera mwakale, kuganiziridwanso kuyenera kulembedwanso Rosucard ® kapena HMG-CoA reductase inhibitors mumadontho apansi mosamala wodwalayo.

Kuwunikira kwamtundu wa ntchito za CPK pakalibe zizindikiro sikungathandize. Nthawi zapafupipafupi zamankhwala ogwedeza a neopotizing myopathy pakuwonetsa kufooka kwa minofu yowonjezera komanso kuwonjezeka kwa ntchito ya CPK mu seramu yamagazi panthawi yamankhwala kapena pamene ma statins, kuphatikizapo rosuvastatin, adadziwika. Maphunziro owonjezera a minofu ndi dongosolo lamanjenje, maphunziro a serological, komanso mankhwala a immunosuppress angafunike. Panalibe zisonyezo zakuchuluka kwa minofu yamafupa mukamamwa mankhwala a rosuvastatin ndi concomitant. Komabe, kuwonjezeka kwa zochitika za myositis ndi myopathy akuti kwa odwala omwe akutenga mitundu ina ya HMG-CoA reductase inhibitors kuphatikiza ndi fibric acid, kuphatikizapo gemfibrozil, cyclosporine, nicotinic acid mu hypolipidemic doses (oposa 1 g / tsiku), azole antifungal agents, ma inhibitors Mapuloteni a HIV ndi ma macrolide. Gemfibrozil imawonjezera chiopsezo cha myopathy ikagwiritsidwa ntchito palimodzi ndi zina za HMG-CoA reductase inhibitors. Chifukwa chake, kugwiritsa ntchito munthawi yomweyo mankhwala a Rosucard ® ndi gemfibrozil osavomerezeka. Mlingo wa chiwopsezo ndi phindu lomwe mungapeze ziyenera kuyesedwa mosamala pamene rosucard ® imagwiritsidwa ntchito limodzi ndi micrate kapena hypolipidemic Mlingo wa nicotinic acid. Kugwiritsa ntchito mankhwala a Rosucard ® muyezo wa 40 mg pamodzi ndi ma fibrate amatsutsana. Patatha masabata 2-4 chiyambireni chithandizo ndi / kapena ndi kuchuluka kwa msana wa Rosucard ®, kuyang'anira kagayidwe ka lipid ndikofunikira (kusintha kwa mankhwalawa ndikofunikira ngati kuli koyenera).

Ndikulimbikitsidwa kuti zisonyezo zokhudzana ndi chiwindi zitsimikizidwe musanayambe mankhwala ndi miyezi itatu mutangoyamba chithandizo. Kugwiritsira ntchito kwa mankhwala a Rosucard ® kuyenera kutha kapena kuti mankhwalawa azitha kuchepetsedwa ngati ntchito ya hepatic transaminases mu plasma yamagazi ndi 3 katatu kuposa VGN.

Odwala omwe ali ndi hypercholesterolemia chifukwa cha hypothyroidism kapena nephrotic syndrome, chithandizo chachikulu cha matenda chachikulu chiyenera kuchitika musanayambe chithandizo ndi Rosucard ®.

HIV protease zoletsa

Kugwiritsa ntchito kwa mankhwala a Rosucard ® omwe ali ndi HIV proteinase inhibitors sikulimbikitsidwa.

Matenda am'mapapo

Pogwiritsa ntchito ma statin ena, makamaka kwa nthawi yayitali, milandu yokhazikika yamatenda a m'mapapo imanenedwa. Kuwonetsedwa kwa matendawa kumatha kuphatikizira kupuma pang'ono, chifuwa chosabereka, komanso thanzi labwino (kufooka, kuchepa thupi, komanso kutentha thupi). Ngati mukukayikira matenda am'mapapo ochepa, ndikofunikira kusiya mankhwala ndi Rosucard ®.

Type 2 shuga

Mankhwala a Statin angayambitse kuchuluka kwa shuga m'magazi. Mwa odwala ena omwe ali ndi chiopsezo chachikulu chokhala ndi matenda a shuga, kusintha koteroko kumatha kuwonetsa, komwe ndi chizindikiro cha kupatsidwa mankhwala a hypoglycemic. Komabe, kuchepa kwa chiwopsezo cha matenda am'mitsempha okhala ndi ma statins kumawonjezera mwayi wokhala ndi matenda a shuga, chifukwa chake, izi siziyenera kukhala maziko ochepetsa mankhwala a statin. Odwala omwe ali pachiwopsezo (kusala kudya kwa glucose m'magazi a 5.6-6.9 mmol / L, BMI> 30 kg / m 2, mbiri ya hypertriglyceridemia, ndi matenda oopsa) ayenera kuyang'aniridwa ndi madokotala ndikuwonetsetsa pafupipafupi magawo a biochemical.

Rosucard ® sayenera kugwiritsidwa ntchito mwa odwala omwe ali ndi vuto la lactase, galactose tsankho ndi shuga-galactose malabsorption.

Mu maphunziro a pharmacokinetic pakati pa odwala achi China ndi achi Japan, kuwonjezereka kwa dongosolo la rosuvastatin kudadziwika poyerekeza ndi zisonyezo zomwe zimapezeka pakati pa odwala a mpikisano waku Caucasian.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Chenjezo liyenera kuchitika poyendetsa magalimoto ndi zochitika zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor (chizungulire chikhoza kuchitika pakubala).

Bongo

Ndi munthawi yomweyo makonzedwe angapo tsiku lililonse, ma pharmacokinetic magawo a rosuvastatin sasintha.

Chithandizo: Palibe chithandizo chamankhwala, chothandizira chaumwini chimachitika kuti thupi likhale ndi ziwalo zofunika. Ndikofunikira kuyang'anira zizindikiro za ntchito ya chiwindi ndi ntchito za CPK. Hemodialysis siyothandiza.

Kuyanjana kwa mankhwala osokoneza bongo

Zotsatira za mankhwala ena pa rosuvastatin

Zoletsa zama protein: rosuvastatin imamangiriza mapuloteni ena onyamula, makamaka OATP1B1 ndi BCRP.Kugwiritsidwa ntchito mosiyanasiyana kwa mankhwala omwe amayendetsedwa ndi mapuloteni othandizira kungakhale limodzi ndi kuwonjezeka kwa rosuvastatin mu plasma yamagazi ndi chiwopsezo cha myopathy (onani tebulo 3).

Cyclosporin: Pogwiritsa ntchito munthawi yomweyo rosuvastatin ndi cyclosporine, AUC ya rosuvastatin inali yokwera kwambiri kasanu ndi kawiri kuposa momwe amawonera odzipereka athanzi. Sichikukhudza plasma ndende ya cyclosporine. Rosuvastatin amatsutsana mu odwala omwe amatenga cyclosporine.

HIV protease zoletsa: ngakhale njira yeniyeni yolumikizirana sichikudziwika, kugwiritsa ntchito kwa HIV proteinase inhibitors kungapangitse kuti chiwonetsero chachikulu cha rosuvastatin (onani tebulo 3). Kafukufuku wa pharmacokinetic wokhudzana ndi kugwiritsa ntchito nthawi yomweyo rosuvastatin pa 20 mg ndi kaphatikizidwe kamene kamakhala ndi ma protein awiri a HIVasease (400 mg ya lopinavir / 100 mg wa ritonavir) mwa odzipereka athanzi kunapangitsa kuwonjezeka kwapawiri komanso kasanu mu AUC (_0-24) ndi C_max rosuvastatin, motero. Chifukwa chake, kugwiritsa ntchito munthawi yomweyo mankhwala a Rosucard ® ndi ma proteinase inhibitors sikulimbikitsidwa (onani tebulo 3).

Gemfibrozil ndi mankhwala ena otsitsa a lipid: kuphatikiza kwa rosuvastatin ndi gemfibrozil kumabweretsa kuwonjezeka kwapawiri kwa C_max ndi AUC wa rosuvastatin. Kutengera ndi data yokhudzana ndi zochitika zina, kukhudzana kwakukulu ndi fenofibrate sikuyembekezereka, kuyanjana kwa pharmacodynamic ndizotheka. Gemfibrozil, fenofibrate, michere ina, ndi nicotinic acid mu lipid kutsitsa Mlingo (woposa 1 g / tsiku) amawonjezera chiopsezo cha myopathy akagwiritsidwa ntchito ndi HMG-CoA reductase inhibitors, mwina chifukwa chakuti amatha kuyambitsa myopathy akagwiritsidwa ntchito mu monga monotherapy. Mukumwa mankhwalawa ndi gemfibrozil, fibrate, nicotinic acid mu lipid yotsitsa Mlingo, odwala amalimbikitsidwa ndi koyamba mlingo wa Rosucard ® 5 mg, mlingo wa 40 mg umapikisidwa molumikizana ndi mafupa.

Fusidic acid: palibe maphunziro apadera omwe adachitika pokhudzana ndi mankhwala a fusidic acid ndi rosuvastatin, koma pakhala pali malipoti osiyana a milandu ya rhabdomyolysis.

Ezetimibe: kugwiritsa ntchito munthawi yomweyo mankhwala a Rosucard ® pa 10 mg ndi ezetimibe pa mlingo wa 10 mg limodzi ndi kuwonjezeka kwa AUC ya rosuvastatin kwa odwala omwe ali ndi hypercholesterolemia (onani tebulo 3). Ndizosatheka kupatula chiwopsezo chowonjezereka cha zoyipa chifukwa cha kukondana kwa pharmacodynamic pakati pa mankhwala a Rosucard ® ndi ezetimibe.

Erythromycin: Kugwiritsidwa ntchito kwa rosuvastatin ndi erythromycin kumapangitsa kutsika kwa AUC_(0-t) 20% rosuvastatin ndi C_max rosuvastatin 30%. Kuyanjana kotereku kumatha kuchitika chifukwa cha kuchuluka kwa matumbo chifukwa chotenga erythromycin.

Maantacid okhala: kugwiritsa ntchito munthawi yomweyo rosuvastatin ndi kuyimitsidwa kwa maantacid okhala ndi aluminiyamu kapena magnesium hydroxide, kumabweretsa kuchepa kwa plasma ndende ya rosuvastatin ndi 50%. Izi sizitchulidwa kwenikweni ngati maacacid amagwiritsidwa ntchito maola 2 mutatha rosuvastatin. Kufunika kwachipatala pakuyanjanaku sikunaphunzire.

Ma Isoenzymes a cytochrome P450 system: Mu maphunziro a vivo ndi a vitro awonetsa kuti rosuvastatin sakhala choletsa kapena wochititsa cytochrome P450 isoenzymes. Kuphatikiza apo, rosuvastatin ndi gawo lofooka la michere iyi. Chifukwa chake, kuyanjana kwa rosuvastatin ndi mankhwala ena pamlingo wa metabolic wophatikizira cytochrome P450 isoenzymes sikuyembekezeredwa. Panalibe kuyanjana kwakukulu pachipatala pakati pa rosuvastatin ndi fluconazole (choletsa ma isoenzymes CYP2C9 ndi CYP3A4) ndi ketoconazole (choletsa ma isoenzymes CYP2A6 ndi CYP3A4).

Mogwirizana ndi mankhwala omwe amafunikira kusintha kwa rosuvastatin (onani tebulo 3)

Mlingo wa rosuvastatin uyenera kusinthidwa ngati kuli kofunikira, kugwiritsa ntchito kwake palimodzi ndi mankhwala omwe amathandizira kuwonetsa kwa rosuvastatin. Ngati chiwonetsero chowonjezera cha 2 kapena kuposa chikuyembekezeka, mlingo woyambirira wa Rosucard ® uyenera kukhala 5 mg 1 nthawi / tsiku. Mlingo wambiri watsiku ndi tsiku wa Rosucard ® uyeneranso kusinthidwa kuti chiwonetsero cha rosuvastatin chisadutse kuti pamtengo wa 40 mg wotengedwa popanda kugwiritsa ntchito munthawi yomweyo mankhwala omwe amagwirizana ndi rosuvastatin. Mwachitsanzo, mlingo waukulu wa tsiku ndi tsiku wa rosuvastatin wogwiritsidwa ntchito nthawi yomweyo ndi gemfibrozil ndi 20 mg (kuchuluka kowonetsedwa ndi 1.9 nthawi), ndi ritonavir / atazanavir - 10 mg (kuchuluka kwa kuwonetsedwa nthawi 3.1).

Gome 3. Zotsatira za chithandizo chothandizirana pakuwonekera kwa rosuvastatin (AUC, zambiri zimawonetsedwa potsatira dongosolo) - zotsatira za mayeso azachipatala osindikizidwa

Njira yothandizira	Malangizo a Rosuvastatin	Kusintha kwa AUC mu rosuvastatin
Cyclosporin 75-200 mg 2 nthawi / tsiku, miyezi 6	10 mg 1 nthawi / tsiku, masiku 10	Kukula kwa 7.1x
Atazanavir 300 mg / ritonavir 100 mg 1 nthawi / tsiku, masiku 8	10 mg limodzi mlingo	Kuchulukitsa kwa 3.1x
Simeprevir 150 mg 1 nthawi / tsiku, masiku 7	10 mg limodzi mlingo	Kukula kwa 2.8x
Lopinavir 400 mg / ritonavir 100 mg 2 nthawi / tsiku, masiku 17	20 mg 1 nthawi / tsiku, masiku 7	Kuchulukitsa kwa 2.1x
Clopidogrel 300 mg (mlingo wokweza), ndiye 75 mg pambuyo pa maola 24	20 mg limodzi mlingo	2x kuchuluka
Gemfibrozil 600 mg 2 nthawi / tsiku, masiku 7	80 mg imodzi mlingo	Kukula 1.9x
Eltrombopag 75 mg 1 nthawi / tsiku, masiku 10	10 mg limodzi mlingo	Kukula kwa 1.6x
Darunavir 600 mg / ritonavir 100 mg 2 nthawi / tsiku, masiku 7	10 mg 1 nthawi / tsiku, masiku 7	Kukula kwa 1.5x
Tipranavir 500 mg / ritonavir 200 mg 2 nthawi / tsiku, masiku 11	10 mg limodzi mlingo	Nthawi 1.4 kuwonjezeka
Dronwoodone 400 mg 2 nthawi / tsiku	Palibe deta	Nthawi 1.4 kuwonjezeka
Itraconazole 200 mg 1 nthawi / tsiku, masiku 5	10 mg kapena 80 mg kamodzi	Nthawi 1.4 kuwonjezeka
Ezetimibe 10 mg 1 nthawi / tsiku, masiku 14	10 mg 1 nthawi / tsiku, masiku 14	Kukula kwa 1.2x
Fosamprenavir 700 mg / ritonavir 100 mg 2 nthawi / tsiku, masiku 8	10 mg limodzi mlingo	Palibe kusintha
Aleglitazar 0,3 mg, masiku 7	40 mg, masiku 7	Palibe kusintha
Silymarin 140 mg katatu / tsiku, masiku 5	10 mg limodzi mlingo	Palibe kusintha
Fenofibrate 67 mg katatu / tsiku, masiku 7	10 mg, masiku 7	Palibe kusintha
Rifampin 450 mg 1 nthawi / tsiku, masiku 7	20 mg limodzi mlingo	Palibe kusintha
Ketoconazole 200 mg 2 / tsiku, masiku 7	80 mg imodzi mlingo	Palibe kusintha
Fluconazole 200 mg 1 nthawi / tsiku, masiku 11	80 mg imodzi mlingo	Palibe kusintha
Erythromycin 500 mg 4 / tsiku, masiku 7	80 mg imodzi mlingo	28% kuchepetsa
Baikalin 50 mg katatu / tsiku, masiku 14	20 mg limodzi mlingo	47% kuchepetsa

Zotsatira za rosuvastatin pa mankhwala ena

Vitamin K Antagonists: kuyambitsa mankhwala a rosuvastatin kapena kuwonjezera mlingo wa rosuvastatin mwa odwala omwe amalandila vitamini K motsutsana nthawi yomweyo (mwachitsanzo, warfarin kapena coumarin anticoagulants) zitha kubweretsa kuwonjezeka kwa INR. Kuletsa kapena kuchepetsa mlingo wa Rosucard ® kungayambitse kuchepa kwa INR. Zikatero, kuwongolera kwa INR ndikulimbikitsidwa.

Njira zakulera:kugwiritsa ntchito munthawi yomweyo rosuvastatin ndi njira zakulera zamkamwa kumawonjezera AUC ya ethinyl estradiol ndi AUC ya Norgestrel ndi 26% ndi 34%, motero. Kuwonjezeka koteroko kwa plasma kuyenera kuganiziridwanso posankha njira yolerera pakamwa.

Palibe data ya pharmacokinetic pakugwiritsa ntchito nthawi yomweyo ya rosuvastatin ndi mankhwala obwezeretsa mahomoni. Zotsatira zomwezi sizingafanane ndi kugwiritsa ntchito munthawi yomweyo rosuvastatin ndi mankhwala obwezeretsanso mahomoni. Komabe, kuphatikiza uku kunagwiritsidwa ntchito kwambiri panthawi ya mayesero azachipatala ndipo kunavomerezedwa ndi odwala.

Mankhwala ena: palibe machitidwe amakani a rosuvastatin omwe ali ndi digoxin amayembekezeredwa.

Pharmacodynamics ndi pharmacokinetics

Rosucard ndi m'gulululi ma statins. Imalepheretsa HMG-CoA reductase - enzyme yomwe imatembenuza GMG-CoA mu kupitilira.

Kuphatikiza apo, chida ichi chimakulitsa kuchuluka kwa Ma LDL receptors pa hepatocyteszomwe zimakulitsa kukula kwa catabolism ndi kugwidwa LDL ndipo zimayambitsa kaphatikizidwe VLDLkuchepetsa zonse VLDL ndi LDL. Mankhwala amachepetsa ndende HS-LDL, kachulukidwe kakakulu kosakhala lipoprotein cholesterol, HS-VLDLP, TG, apolipoprotein B, TG-VLDLP, okwana xc, komanso zimawonjezera zomwe zili ApoA-1 ndi HS-HDL. Kuphatikiza apo, amachepetsa chiwerengero ApoVndi ApoA-1, HS-non-HDL ndi HS-HDL, HS-LDL ndi HS-HDL, okwana xc ndi HS-HDL.

Zotsatira zazikulu za Rosucard zimagwirizana mwachindunji ndi mlingo womwe waperekedwa. Zithandizo zochizira pambuyo poyambira chithandizo zimawonekera pakatha sabata, pambuyo mwezi wathunthu zimakhala zochuluka, kenako zimalimbikitsidwa ndikukhazikika.

Pazitali zazikulu za yogwira plasma zimakhazikitsidwa pambuyo 5 maola. Mtheradi bioavailability amapanga 20%. Mlingo wolumikizana ndi mapuloteni am'madzi am'magazi ndi pafupifupi 90%.

Pogwiritsa ntchito pafupipafupi, ma pharmacokinetics sasintha.

Wopangidwira Rosucard kudzera pachiwindi. Imalowa bwino chotchinga. Chachikulu metabolites – N-dismethyl ndi lactone metabolites.

Hafu ya moyo imakhala pafupifupi maola 19, pomwe sasintha ngati mulingo wa mankhwalawo ukuwonjezereka. Chilolezo cha Plasma pafupifupi - 50 l / h. Pafupifupi 90% ya zomwe zimagwiritsidwa ntchito zimatulutsidwa m'matumbo osasinthika, zina kudzera mu impso.

Kugonana ndi zaka sizimakhudza ma pharmacokinetics a Rosucard. Komabe, zimatengera mtundu. Amwenye amakhala ndi chidwi chambiri komanso pafupifupi Auc 1,3 kutalika kuposa kuja kwa mpikisano wa Caucasus. Aucmwa anthu a mtundu wa Mongoloid, nthawi ziwiri.

Zisonyezero zogwiritsira ntchito Rosucard

Zowonetsa kugwiritsa ntchito Rosucard ndi izi:

• chachikulu hypercholesterolemia kapena wosakanizidwa dyslipidemia - mankhwalawa amagwiritsidwa ntchito ngati kuwonjezera zakudya ngati zakudya zomwe zili zokha sizokwanira,
• kufunika kopita pang'onopang'ono atherosulinosis - mankhwalawa amagwiritsidwa ntchito ngati wowonjezera zakudya monga gawo lamankhwala kuti achepetse milingo cholesterol yathunthu ndi Cholesterol pamitengo yanthawi zonse
• banja homozygous hypercholesterolemia - mankhwalawa amagwiritsidwa ntchito ngati chakudya kapena monga chinthu lipid kutsika mankhwala
• kufunika kwa kupewa zovuta pakugwira ntchito kwa mtima ndi chiopsezo chowonjezerekaatherosulinotic matenda a mtima - mankhwalawa amagwiritsidwa ntchito ngati gawo la mankhwala.

Zotsatira zoyipa

Zotsatira zoyipa zogwiritsa ntchito mankhwalawa zitha kukhala motere:

• dongosolo lamanjenje: mutu, asthenic syndrome, chizungulire,
• kupuma dongosolo: chifuwa, dyspnea,
• minofu: myalgia,
• khungu ndi minyewa yodutsa: zotumphukira edema, Matenda a Stevens-Johnson,
• Zizindikiro zasayansi: kuwonjezereka kwa pang'onopang'ono kwa ntchito seramu CPK kutengera mlingo
• thupi lawo siligwirizana: kuyabwa, urticariazotupa
• zam'mimba dongosolo: nseru, kupweteka pamimba, kudzimbidwakusanza kutsegula m'mimba,
• dongosolo la endocrine: mtundu II matenda ashuga,
• kwamikodzo: proteinuriamatenda a kwamkodzo thirakiti.

Nthawi zina, ndizotheka zotumphukira neuropathy, kapambakusokonezeka kwa kukumbukirachiwindi, jaundice, myopathy, rhabdomyolysis, angioedema, hematuria, wosakhalitsa kuchuluka Ntchito ya AST ndi ALT.

Kuchita

Cyclosporin kuphatikiza ndi rosucard kumawonjezera mtengo wake Auc pafupifupi nthawi 7. Kutenga zoposa 5 mg sikulimbikitsidwa.

Gemfibrozilndi ena lipid-kutsitsa mankhwala osakanikirana ndi rosucard amachititsa kuwonjezeka kwake kwakukulu komanso Auc pafupifupi kawiri. Chiwopsezo cha myopathies. Mlingo wapamwamba mukaphatikizidwa Gemfibrozil - 20 mg. Mukamacheza ndi mafupa Mlingo wa mankhwala mu 40 mg saloledwa, muyeso woyamba ndi 5 mg.

Kugwiritsa ntchito mankhwala osokoneza bongo proteinase zoletsa zitha kuchuluka kukhudzika Rosuvastatin. Kugwiritsa ntchito kuphatikiza sikulimbikitsidwa HIV kachilombo kwa odwala.

Kuphatikiza Erythromycin ndipo rosucard amachepetsa Aucomaliza ndi 20%, ndipo pazowonjezera pazowonjezera - ndi 30%.

Mukaphatikiza mankhwalawa ndi Lopinavir ndipo ritonavir imakulitsa kufanana kwake Auc ndi kuzama kwakukulu.

Vitamin K Antagonists mukamacheza ndi rosucard mumawonjezera kukonza ubale wapadziko lonse lapansi.

Ezetimibe munthawi yomweyo ndi rosuvastatin angayambitse mavuto ena.

Antacid mankhwala ndi aluminium hydroxide kapena magnesium imachepetsa kuchuluka kwa mankhwala m'thupi ndi theka. Chifukwa cha kulandira kwawo muyenera kupuma osachepera maola 2.

Mukamphatikiza ndi Rosucard ndi kulera kwamlomo amatanthauza kuwunika momwe odwala aliri.

Ndemanga za Rosucard

Ndemanga za Rosucard ndizabwino. Chida ichi nthawi zambiri chimalangizidwa ndi madokotala. Ndizokwera mtengo, kotero kugula kugula ndikolunjika. Iwo omwe adachitapo kale mankhwala ndi mankhwalawa amasiya ndemanga za Rosucard, pomwe akuti mankhwalawo adawathandiza kukhalabe ndi cholesterol yeniyeni ndikuletsa kupitilira kwa matendawa.

Mtengo wa Rosucard

Mtengo wa Rosucard umawonedwa kuti ndi wotsika mtengo kwambiri poyerekeza ndi ma analogi ambiri. Mtengo wofanana wa mankhwalawa umatengera zomwe zili piritsi. Chifukwa chake, mtengo wa rosucard wa 10 mg phukusi lomwe lili ndi ma mbale atatu ndi pafupifupi ma ruble 500 ku Russia kapena 100 h scrollnias ku Ukraine. Ndipo mtengo wa Rosucard 20 mg phukusi lomwe lili ndi ma mbale atatu ndi pafupifupi ma ruble 640 ku Russia kapena ma h hpnias a 150 ku Ukraine.

Mankhwala

Yogwira ntchito pakukonzekera kwa Rosucard, rosuvastatin, ali ndi mphamvu zoletsa kuchepetsa ntchito ndikuchepetsa kapangidwe ka mamolekyulu a mevalonate, omwe amachititsa kuphatikizira kwa cholesterol poyambira magawo a maselo a chiwindi.

Mankhwalawa ali ndi kutanthauzira kwachulukidwe ka lipoproteins, kuchepetsa kapangidwe kake ndi maselo a chiwindi, omwe amachepetsa kwambiri kuchuluka kwa maselo olemera a lipoprotein m'magazi ndikuwonjezera kuchuluka kwa maselo osapindulitsa a lipoproteins.

Pharmacokinetics wa mankhwala a Rosucard:

• Kuchuluka kwamphamvu kwa magawo a madzi a m'magazi, mutatha kumwa mapiritsi, kumachitika pambuyo pa maola 5,
• The bioavailability ya mankhwalawa ndi 20,0%,
• Kuwonekera kwa Rosucard m'dongosolo kumadalira kuchuluka kwa mulingo,
• 90.0% ya mankhwala a Rosucard amamangilira mapuloteni a plasma, nthawi zambiri, ndimapulogalamu a albumin,
• Kagayidwe kake ka mankhwala a m'magazi a chiwindi koyamba ndi pafupi 10,0%,
• Kwa cytochrome isoenzyme No. P450, yogwira popangira rosuvastatin ndi gawo lapansi,
• Mankhwala amatsitsidwa ndi 90.0% ndi ndowe, ndipo maselo am'mimba ndi omwe amachititsa,
• 10,0 imachotsedwa pogwiritsa ntchito maselo a impso ndi mkodzo,
• Pharmacokinetics ya mankhwala Rosucard sizitengera gulu la odwala, komanso jenda. Mankhwalawa amagwiranso ntchito chimodzimodzi, mthupi la wachichepere komanso mu thupi lokalamba, mu ukalamba okha muyenera kukhala ndi mlingo wochepa wothandizira mankhwalawa a cholesterol m'magazi.

Achire achire zotsatira za mankhwala a Rosacard gulu la statins akhoza kumva pambuyo kumwa kwa masiku 7. Kuchuluka kwa mapangidwe a chithandizo kumatha kuonekera mutamwa mapiritsi kwa masiku 14.

Mtengo wa mankhwala a Rosucard umatengera wopanga mankhwalawo, dziko lomwe mankhwalawo amapangidwira. Kufanizira kwa Russia kwa mankhwalawa ndikotsika mtengo, koma zotsatira za mankhwalawa sizimadalira mtengo wa mankhwalawo.

Analog ya ku Russia ya Rosucard, monga momwe amachepetsa mndandanda mu cholesterol yamagazi, komanso mankhwala akunja.

Mtengo wa mankhwala a Rosucard ku Russian Federation:

• Mtengo wa rosucard 10,0 mg (mapiritsi 30) - 550.00 ma ruble,
• Mankhwala Rosucard 10,0 mg (ma 90 ma PC.) - 1540.00 ma ruble,
• Mankhwala enieni a Rosucard 20,0 mg. (30 tabu.) - 860.00 ma ruble.

Moyo wa alumali ndi kugwiritsa ntchito mapiritsi a Rosucard ndi chaka chimodzi kuyambira tsiku lomwe amamasulidwa. Tsiku lotha litatha, mankhwalawa ndibwino kuti asamwe.

Mitengo ya Rosucard m'mafakisi ku Moscow

mapiritsi	10 mg	30 ma PC	≈ 625 rub.
	10 mg	Ma PC 60.	≈ 1070 rub.
	10 mg	Ma PC 90.	≈ 1468 rub.
	20 mg	30 ma PC	≈ 918 rub.
	20 mg	Ma PC 60.	≈ 1570 rub.
	20 mg	Ma PC 90.	≈ 2194.5 rub.
	40 mg	30 ma PC	≈ 1125 rub.
	40 mg	Ma PC 90.	≈ 2824 rub.

Madokotala amawunika za rosacea

Kutalika 3.3 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Analogue yabwino kwambiri yaku Czech, yopangidwa kuchokera ku zopangira zapamwamba kwambiri, adawonetsa luso labwino kwambiri.

Monga lamulo, rosuvastatin silivomerezeka pamitengo, ndipo mlanduwu ndiwopadera, mwatsoka.

Mankhwalawa amagwiradi ntchito, amagwira ntchito pokhapokha atakumana ndi katswiri.

Mulingo 3.8 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Anayamika mphamvu ya mankhwala ophatikizidwa ndi mtunduwu - amatulutsa kagayidwe ka lipid bwino ndimatenda ang'onoang'ono komanso njira zina zosakhala zonunkhira, kuphatikiza - izi ndiye mtengo wake, poyerekeza ndi mtanda.

Pali zovuta zoyipa, koma sichiwonetsedwa kwambiri, chifukwa ndimapereka mankhwala pafupipafupi ndikuphwanya - Mlingo wa 5-10 mg.

Kuyeza 2.5 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Pankhani yofikira: ma statins si mankhwala otsika mtengo. Koma ali m'gulu la mankhwalawa omwe amapulumutsadi miyoyo. Zachidziwikire, ndi potata - pulumutsani miyoyo ya iwo omwe ali ndi matenda okhudzana ndi atherosclerosis - myocardial infarction, angina pectoris, atherosulinosis ya mitsempha yam'munsi. Ngati statin imalipira ma ruble 100-200, ndikuopa kupereka.

Zambiri zamagetsi (zojambula zokonzedwanso) za ma statins, koma, sichoncho, zonse sizothandiza. Dokotala woyang'anira adzalemba majenito okhawo omwe ali ndi chidziwitso chokwanira kuchokera ku maphunziro othandizira ofanana ndi mankhwala oyamba (kwa ife, ndi mtanda). Ogwira ntchito zama pharmac mu zinthu izi, monga lamulo, samangoyang'ana konse komanso kuwafunsa za "malo ena alionse", komanso kugwiritsa ntchito malingaliro awo "m'malo mwa ena", ndiyo njira yokhumudwitsa pamankhwala.

Ndemanga za Odwala a Rosucard

Sindikudziwa kuti sizinayambitse mavuto anu kwa abale anu. Rosucard ndiyodabwitsa. Ine ndi mwamuna wanga titangomwa mankhwalawa tinayamba kutsegula m'mimba, patapita nthawi pang'ono, kusowa tulo komanso zachilendo zomwe mtima wathu umalumikizana. Chifukwa chake, tsopano tiganiza ndi adotolo zamtsogolo za kuvomereza kwake.

Ndinagula Rosucard ma ruble 508. Ndinkamwa mwezi pambuyo pa tsiku, cholesterol imatsika kuchoka pa 7 mpaka 4.6. Sindinamwe ndipo nditatha miyezi iwiri 6.8. Ndinakana kwa nthawi yayitali, koma anaganiza: ndikamwa. Ndinayesa zitsamba zosiyanasiyana, kumwa atherocliphite, sizinathandize.

"Mtengo ndi wotchipa" - 900 re (!?) Izi ndi zotchipa. Ndimamvetsetsa kuti apa mukuwona ena mamiliyoni ambiri akuchiritsidwa.

Rosucard ndi mankhwala abwino. Ndidasankha dokotala wanga kwa agogo anga kuti andipewe. Mankhwalawa adawonetsa zotsatira zake atatha kugwiritsa ntchito mwezi umodzi. M'malo mwathu, ndikofunikira kuti rosucard imatengedwe ndi mankhwala ena. Amamvanso bwino, koposa zonse, sizinakhale ndi zotsatirapo zake. Sitinazindikire zolakwika zilizonse.

Agogo anga aamuna (a zaka 72) akhala ndi mavuto amtima kwa zaka khumi, mwina. Pokhudzana ndi kuwonongeka, tinapita kwa dokotala wamtima, yemwe adatilangiza kuti tiyambe kumwa rosacea. Mtengo ndi wokwera mtengo, takhala tikumwa mwezi wachitatu. Mwa njira, pakuwongolera magazi, cholesterol idachepa kwambiri. Ndife okondwa ndi rosacea!

Kufotokozera kwapfupi

Rosucard (pophika - rosuvastatin) - mankhwala ochepetsa lipid ochepetsa gulu la ma statins. Masiku ano, pafupifupi 80-95% ya odwala omwe ali ndi matenda a mtima (ngati titenga maiko otukuka) amatenga ma statins. Kutchuka kotere kwa gulu la mankhwalawa kumawonetsa kudalira kwathunthu ndi akatswiri a mtima, omwe akuyenera kuwonedwa kuti ndi achilungamo: m'zaka zaposachedwa, zotsatira za mayeso angapo azachipatala aperekedwa ku khothi lachipatala, kutsimikizira kuperewera kwa kufa kwa mtima pa nthawi yamankhwala. Kuphatikiza apo, zotsatira zowonjezereka za mankhwalawa, zomwe zimadzidalira zokha, zidawululidwa: mwachitsanzo, anti-ischemic athari yawo. Ndipo mphamvu yotsutsa-yotupa ya ma statins imatchuka kwambiri kotero kuti madokotala ena akuyesera kale kuchitira ena nyamakazi. Rosucard ndi mankhwala opangidwa mokwanira kuchokera ku gulu la statin, lovomerezeka kuti ligwiritsidwe ntchito kumayambiriro kwa 2000s omaliza. Ngakhale mpikisano wochokera ku maina ena asanu omwe ali pamsika wogulitsa mankhwala lero, rosucard ndi imodzi mwazomwe (ngati sizotchuka kwambiri) mankhwala m'gululi potengera kukula kwa chiwerengero cha malangizo azachipatala. Mutatenga kamodzi muyezo wa mankhwalawa, nsonga ya plasma yake imawonedwa patatha maola pafupifupi asanu. Rosucard amakhala ndi moyo wautali kwambiri wa maola 19. Mankhwala a pharmacokinetic a mankhwalawa samakhudzidwa ndi zinthu monga zaka, jenda, kuchuluka kwa matumbo, kukhalapo kwa chiwindi kulephera (kupatula mitundu yake yayikulu). Molekyu ya rosuvastatin - yogwira mankhwala - ndi hydrophilic, zomwe zimapangitsa kuchepa kwake pa kaphatikizidwe wa cholesterol m'maselo a minofu. Chifukwa cha izi, rosucard samatchulidwa zotsatira zoyipa zamagulu ena. Ubwino wina wa mankhwalawa kuposa "anzawo" omwe ali m'gulu la pharmacological (makamaka pa atorvastatin ndi simvastatin) ndikuti sizichitika ndi ma enzymes a cytochrome P450 system, yomwe imalola kuti rosucard ikhale pamodzi ndi mankhwala ena ambiri (maantibayotiki, antihistamines, antiulcer mankhwala, othandizira antifungal, etc.

e.) popanda chiwopsezo cha kulumikizana kwawo kosafunikira. Kuchita bwino kwa rosuvastatin (rosucard) kwaphunziridwa ndipo kukuphunziridwabe mayeso ambiri azachipatala. Mwa kuchuluka kwa maphunziro omwe adamalizidwa mpaka pano, kafukufuku wa MERCURY, yemwe adawonetsa mwayi wopezeka ndi mankhwalawo pazinthu zina pazomwe zimakhudza mawonekedwe a lipid, ndizothandiza kwambiri. Kuchuluka kwa cholesterol yoyipa (LDL) mutatenga rosucard kumatheka mwa odwala 85% (ogwiritsa ntchito mlingo wofanana wa atorvastatin adapereka zotsatira zofunikira mu 80% yokha). Nthawi yomweyo, mulingo wa "zabwino" cholesterol (HDL) unali waukulu kwambiri kuposa momwe amagwiritsira ntchito atorvastatin. Kuchepetsa kuchuluka kwa mankhwala a atherogenic cholesterol (makamaka LDL) sicholinga chokhacho cha lipid-kuchepetsa mankhwala. Ayeneranso kukhala ndi cholinga chowonjezera zomwe zili m'magawo a antiopetogen a HDL lipoproteins, omwe, monga lamulo, amachepetsedwa. Ndipo rosucard amatha kuthana ndi izi: momwe zimakhudzira kapangidwe ka lipoproteins, zidapitilira simvastatin ndi pravastatin. Mpaka pano, mankhwalawa akulimbikitsidwa kuti atengedwe mu 10 mg mg pa tsiku.

Chitetezo pamankhwala sichinthu chofunikira kwambiri kuposa chitetezo, makamaka ngati mankhwalawa adakonzera odwala osiyanasiyana. Kuyang'anitsitsa zovuta za chitetezo cha statin zidaperekedwa ndi momwe zinthu zilili ndi cerivastatin, yomwe idachotsedwa pamsika chifukwa cha kuchuluka kwakubwera. Pamenepa, rosuvastatin (rosucard) wapita kafukufuku wokhazikika molingana ndi mbiri yake yachitetezo. Ndipo, monga momwe zidatsimikizidwira pakuyesa kwachipatala, chiopsezo cha mavuto mukamamwa mankhwalawa (mothandizidwa ndi Mlingo woyenera) sichikukwera kuposa ma statins omwe amagwiritsidwa ntchito pano.

Pharmacology

Hypolipidemic mankhwala ochokera pagulu la statins. Kusankha mpikisano wosankha wa HMG-CoA reductase, enzyme yomwe imatembenuza HMG-CoA kukhala mevalonate, woyang'anira cholesterol (Ch).

Kuchulukitsa kuchuluka kwa zolandirira za LDL pamtunda wa hepatocytes, zomwe zimapangitsa kuti pakhale kuchuluka kwamphamvu ndi kupatsirana kwa LDL, kuletsa kaphatikizidwe ka VLDL, kuchepetsa kuchuluka kwa LDL ndi VLDL. Kuchepetsa kuchuluka kwa LDL-C, HDL cholesterol-non-lipoproteins (HDL-non-HDL), HDL-V, cholesterol okwanira, TG, TG-VLDL, apolipoprotein B (ApoV), kumachepetsa kuchuluka kwa LDL-C / LDL-C, kwathunthu - HDL, Chs-not HDL / Chs-HDL, ApoV / apolipoprotein A-1 (ApoA-1), imakulitsa kuchuluka kwa Chs-HDL ndi ApoA-1.

Kuchulukitsa kwa lipid kumachitika mwachindunji molingana ndi kuchuluka kwa mlingo womwe umaperekedwa. Mankhwala othandizira amawonekera pakatha sabata limodzi atangoyamba kumene chithandizo, pakatha masabata awiri kufika 90% pazowonjezereka, amafika pakadutsa masabata anayi kenako amakhala osasintha. Mankhwala ndi othandiza odwala achikulire omwe ali ndi hypercholesterolemia wokhala ndi kapena wopanda hypertriglyceridemia (osatengera mtundu, jenda kapena zaka), kuphatikiza Odwala matenda a shuga ndi matenda am'magazi. Mu 80% ya odwala omwe ali ndi mtundu wa IIa ndi IIb hypercholesterolemia (gulu la Fredrickson) omwe amakhala ndi LDL-C pafupifupi pafupifupi 4.8 mmol / L, pamene akumwa mankhwalawa pa 10 mg, ndende ya LDL-C imafika ochepera 3 mmol / L. Odwala omwe ali ndi homozygous Famer hypercholesterolemia akulandira mankhwalawa 20 mg ndi 40 mg, kutsika kwapakati pa LDL-C ndi 22%.

Zowonjezera zimawonedwa ndikuphatikizidwa ndi fenofibrate (mogwirizana ndi kuchepa kwa ndende ya TG komanso nicotinic acid mu milid-kuchepetsa milingo (osachepera 1 g / tsiku) (pokhudzana ndi kuchepa kwa kuchuluka kwa HDL-C).

Momwe mungatenge rosucard?

Mankhwala Rosucard ayenera kumwedwa pakamwa ndi madzi okwanira. Kutafuna piritsi sikuletsedwa, chifukwa amaphimbidwa ndi nembanemba yomwe imasungunuka m'matumbo.

Asanayambe njira yothandizira achire ndi mankhwala a Rosucard, wodwalayo ayenera kutsatira zakudya za anticholesterol, ndipo zakudya ziyenera kutsagana ndi chithandizo chonse ndi ma statins, kutengera zomwe zimaphatikizira - rosuvastatin.

Dokotalayo amasankha payekha mlingo wa wodwala aliyense, kutengera zotsatira za mayeso a labotale, komanso kuvomereza kwa thupi la wodwalayo.

Ndi dokotala yekha, ngati pakufunika kutero, amadziwa momwe angasinthe mapiritsi a Rosucard. Kusintha kwa Mlingo ndi kusintha kwina kwa mankhwalawa ndi mankhwala ena kumachitika osapitirira masabata awiri kuchokera nthawi ya makonzedwe.

Mlingo woyambirira wa mankhwala a Rosucard sayenera kupitirira milimita 10,0 kamodzi pa tsiku.

Pang'onopang'ono, mothandizidwa ndi mankhwalawa, ngati kuli kotheka, mkati mwa masiku 30, adokotala asankha kuwonjezera kuchuluka kwake.

Kuti muwonjezere mlingo wa tsiku lililonse wa mankhwala a Rosucard, zifukwa zotsatirazi ndizofunikira:

• Hypercholesterolemia yayikulu kwambiri, yomwe imafunika mlingo waukulu wa mamiligalamu 40.0,
• Ngati pa mlingo wa mamiligamu 10,0, lipogram imawonetsa kuchepa kwa mafuta m'thupi. Dotolo amawonjezera mlingo wa mamilimita 20.0, kapena yomweyo mlingo waukulu,
• Ndi zovuta zazikulu za mtima Kulephera,
• Ndi gawo lapamwamba la matenda, atherosulinosis.

Odwala ena, asanachulukane, amafunika zinthu zapadera:

• Ngati zisonyezero za cell cell za chiwindi zikufanana ndi kuchuluka kwa ana a P 7.0, ndiye kuti kuchuluka kwa Rosucard sikokwanira.
• Ngati mukulephera kwa impso, mutha kuyambitsa maphunziro a mankhwalawa ndi mapiritsi 0,5 patsiku, ndipo pambuyo pake mutha kuwonjezera pang'onopang'ono mamiligalamu 20,0, kapenanso mpaka mulingo waukulu.
• Kulephera kwambiri kwa aimpso, ma statin saloledwa,
• The zolimba kukula kwa aimpso ziwalo kulephera. Mlingo wambiri wa mankhwala a Rosucard sanalembedwe ndi madokotala,
• Ngati pali chiopsezo cha matenda, myopathy amafunikanso kuyamba ndi mapiritsi a 0.5 ndipo mlingo wa mamiligalamu 40.0 ndi woletsedwa.

Mlingo kusintha pa mankhwalaku nkhani zake ↑

Pomaliza

Mankhwala a Rosucard angagwiritsidwe ntchito pochizira cholesterol yayikulu m'magazi, pokhapokha pothandizidwa ndi zakudya za anticholesterol.

Kulephera kutsatira zakudya kumachedwetsa kuchira ndikukulitsa zotsatira zoyipa za mankhwala m'thupi.

Mankhwala a Rosucard sangathe kugwiritsidwa ntchito ngati mankhwala omwe mungamwe, ndipo ngati mukuletsedwa ndikuletsedwa kusintha payekha mapiritsi, komanso kusintha njira yochizira.

Yuri, wazaka 50, Kaliningrad: ma statin adatsitsa cholesterol yanga kukhala yabwinobwino mu masabata atatu. Koma zitatha izi, chindoko chidawukanso, ndipo ndidayenera kumwa mankhwalawo ndimapiritsi a statin kachiwiri.

Ndi pokhapokha pomwe dokotala atasintha mankhwala anga akale kukhala ku Rosucard, ndinazindikira kuti mapiritsiwa sangangobweretsa cholesterol yanga mwabwinobwino, komanso osangowonjezera kwambiri pambuyo popita kuchipatala.

Natalia, wazaka 57, Ekaterinburg: cholesterol inayamba kutuluka nthawi ya kusintha kwa thupi, ndipo zakudya sizingachepetse. Ndakhala ndikumwa mankhwala a rosuvastatin kwa zaka ziwiri. Miyezi itatu yapitayo, adotolo adasinthanitsa mankhwala anga akale ndi mapiritsi a Rosucard.

Ndinamva mphamvu yake nthawi yomweyo - ndinamva bwino ndipo ndinadabwa kuti ndimatha kutaya ma kilogalamu 4 a kunenepa kwambiri.

Nesterenko N.A., cardiologist, Novosibirsk - Ndimapereka ma statins a odwala anga pokhapokha njira zonse zochepetsera cholesterol zakhala zikuyesedwa kale ndipo pali chiwopsezo chachikulu cha kukulitsa matenda a cardio, komanso atherosulinosis.

Ma Statin ali ndi zotsatira zoyipa zambiri mthupi, zomwe zimakhudza moyo wa odwala.

Koma pogwiritsa ntchito mankhwala a Rosucard machitidwe anga, ndidazindikira kuti odwala adasiya kudandaula za zovuta za ma statins. Kuthana ndi malingaliro onse ogwiritsira ntchito kupatsa wodwalayo mphamvu zochepa zoyipa za thupi.