Ndemanga za Crestor

mapiritsi	10 mg	28 ma PC.	≈ 1950.9 ma ruble
	10 mg	98 ma PC.	≈ 5365.1 rubles
	20 mg	28 ma PC.	≈ 4416.5 rub.
	40 mg	28 ma PC.	≈ 5890 rub.
	5 mg	28 ma PC.	≈ 2123 rub.
	5 mg	98 ma PC.	≈ 5595 rub.

Madokotala amawunika za mtanda

Kutalika 1.3 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Imodzi mwamagawo othandiza kwambiri.

Hepatotoxicity. Ndiye kuti, ndi maubwino omwe tili nawo, tatsimikizira kutivulaza.

Kuyambira 70s, njira yodziwitsira zinthu yakhala ikuchitika ku United States kuti akhazikitse moyo wathanzi ku America. Chifukwa chake, olembera aku America amakono amatenga ALT ndi AST miyezi itatu iliyonse ngati atenga ma statins. Tsoka ilo, sitili ndi lamulo lotere.

Kutalika 3.3 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

"Crestor" ndi amodzi mwa maumbidwe oyambilira, cholinga chomwe chiyenera kulingaliridwa pophatikiza kusokonekera kwa erectile ndi dyslipidemia. Osati zoyipa zimasintha mbiri ya lipid. Ndi luso kuphatikiza mankhwala, zotsatira zoyipa zokhudzana ndi kusokonekera kwa erectile kukomoka kumawonedwa pambuyo pa miyezi iwiri ya kudya kawiri. Mlingo umasankhidwa payekha, malinga ndi mbiri ya lipid. Yovomerezeka mankhwala a antioxidants.

Mankhwalawa ndi okwera mtengo, koma zikuwoneka kuti Krestor ndiyofunika. Kuthekera kwa kuwonongeka kwa chiwindi.

Mulingo 4.2 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Zimathandizadi, mulingo wa LDL umachepa, umagwira kokha ndi maphunziro, chifukwa chake simuyenera kusiya kumwa mankhwalawo mukakwaniritsidwa.

Mlingo woganiziridwa bwino wa mankhwalawa umapangitsa kukhala kosavuta komanso kosavuta kuwongolera mafuta m'thupi.

Mulingo 4.6 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Zikondwerero zokonda. Inde okondedwa, koma pachifukwa chabwino. Mankhwala oyamba, i.e. kufufuzidwa bwino. Kuchita bwino ndikwabwino, kuchepetsedwa kwa lipid kumatha ndipo kuyenera kuyembekezeredwa. Osanyalanyaza kuwongolera kwa michere ya chiwindi mutatenga "Crestor" kapena statin ina iliyonse. Inde, ndipo, chabwino, musaiwale kuti kudya kwa statin kuyenera kukhala, kupatulapo kosowa, kosatha, osati kochita.

Kukala 2.9 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Mankhwala enieni, rosuvastastine. Imatsitsa cholesterol bwino. Kutsimikizirika kwa oyamba kupewa matenda a mtima.

Mankhwala okwera mtengo kwambiri, si aliyense amene angakwanitse.

Povomereza, kuyang'anira mbiri ya lipid ndi ALT, AST ndikofunikira. Amatengedwa nthawi imodzi patsiku, madzulo.

Kukala 3.8 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Krestor ndi mankhwala abwino kwambiri a statins onse. Pokhala ndi umboni. Pambuyo pa miyezi 1.5-2 yogwiritsa ntchito mosalekeza, zotsatira zake zimawoneka. Amayikidwa 1 nthawi patsiku, mlingo umasankhidwa payekhapayekha, pakumwa mankhwala, kuyang'anira magazi a lipid sipekitiramu, ALT, AST.

Mtengo ndiwokwera kwambiri, si odwala onse omwe amapezeka.

Mankhwalawa amalekeredwa bwino, ndikulimbikitsa kwa odwala anga.

Kutalika 3.3 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Kwa miyezi iwiri, wobatizira sanasankhidwe, makamaka, "kuti alepheretse zolemba." Krestor anawonetsa kuthekera kuchepetsa kukula kwa pokhapokha patatha zaka 2 za makonzedwe pa 40 mg patsiku. Mwambiri, ngati ndalama zandalama zilola, palibe chabwino kuposa mankhwala oyamba. Ndipo choyambirira rosuvastatin ndi Krestor. Koma ngati funso ndi: mwina kuti asalandidwe konse, kapena asatenge mankhwala apamwamba kwambiri, ndiye kuti, mankhwala opangidwa ndi mtundu wabwino ndi wabwinoko. Ndikofunika kukumbukira kuti zotsatira zonse za nthawi yayitali za rosuvastatin - kuchepa kwaimfa, kuchuluka kwa kuphwanya myocardial ndi sitiroko - zidawonetsedwa kwa a Crestor, chifukwa ena onse a zamagetsi sanaphunzire motere. Ngakhale, zoona, generic yapamwamba iyenera kuyambitsa kuchepa kolesterol m'mwazi, ndipo izi zikuyenera kutsimikiziridwa pakupita maphunziro.

Chojambula chokha ndicho mtengo. Makamaka tsopano, zitatha kusintha kwa kusinthana. Ndani angathe - mulole agule. Muyenera kudziwa kuti chithandizo ndi statin iliyonse sichichita kuti muchepetse cholesterol, koma kuti muchepetse chiopsezo cha kulowerera m'mitsempha, matenda a ischemic ndi kufa chifukwa cha mtima. Ichi ndichifukwa chake ma statins akuyenera kutengedwa zaka. Mukatero mudzatetezedwa mokhulupirika ku mavuto omwe takambiranawa. Ngati mtanda umakukondani, ndiye kuti ndibwino kuyambitsa mtundu wabwino nthawi yomweyo. Chifukwa sipadzakhala phindu lililonse poizitenga mu mwezi umodzi ndi iwiri. Cholesterol mosakayikira idzacheperachepera, koma, kwakukulu, ma statins satengedwa kuti asatsitse cholesterol, koma kuti athetse chiwopsezo chovuta mu mawonekedwe a myocardial infarction, stroke, etc. Ndipo chiwopsezo ichi, monga lamulo, chimayamba kuchepa pokhapokha miyezi yambiri kuchokera poyambira kutenga ma statins.

Zotsatira zoyipa ngati zachitika mwa wodwala m'modzi, sizitanthauza kuti zonse zichitike kwa ena onse. Chifukwa chake, pomvera munthu m'modzi yemwe adalandira mtanda (kapena china chilichonse) ndikulandila zosafunikira, musatengera izi ku akaunti yanu. Nthawi zambiri sizotheka kulosera za zovuta zina mwa wodwala wina. Muyenera kumvetsetsa kuti ndikoyenera kuthandizidwa ndi mtanda pomwe mungakwanitse kugula kwa zaka. Kupanda kutero, gulani generic wapamwamba kwambiri ndikuthandizidwa naye (mwachitsanzo, mertenyl, kapena roxer, kapena tevastor).

Mulingo 4.2 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Mankhwala abwino kwambiri a statins onse. Mofulumira khalani ndi cholesterol pamlingo womwe mukufuna. Mosiyana analogues, achire zotsatira ngakhale otsika Mlingo.

Mtengo, zoona, ndi waukulu! Palibe kutsutsana. Sikuti aliyense angakwanitse.

Mankhwala oyamba. Umboni wake ndiwopatsa chidwi. Koma mtengo umawopseza odwala ambiri omwe akuwafuna.

Kutalika 3.3 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Imadziwonjezera msanga kuchuluka kwa cholesterol (mu sabata imatha kutsitsa zizolobe kukhala zabwinobwino).

Mankhwala amaphunziridwa bwino, okhala ndi umboni waukulu, wabwino kwambiri. Imagwira ntchito muyezo wocheperako poyerekeza ndi mankhwala ena omwe ali mgululi. Wolekeredwa bwino. Nthawi zambiri, zimatengedwa mosalekeza.

Ndemanga za odwala

Nditatenga Krestor kwa masabata awiri, minyewa yanga yamiyendo inayamba kupweteka, sindimatha kugona, ndinamwa mankhwala opweteka, sabata linadutsa. Pambuyo pa kuthetseratu ululu, panali zopindika zopweteka za m'misempha, ndipo ululu wamkhungu ukakhudzidwa, ndidikirira sabata ina mpaka mankhwalawo atachotsedwa m'thupi, ndipo ngati ululuwo suupita kwa wodwala wamitsempha. Kutenga, muyenera kuyang'anira zomwe zalembedwa m'malangizo, ndipo sizikudziwika momwe chiwindi chilili. Samalani, zikuwoneka kuti mankhwalawo sanafufuzidwe kwathunthu.

Mnzake ku Canada adamwalira ndi khansa ya pancreatic. Chinthu choyambirira chomwe katswiri wa oncologist atapanga atapezeka kuti alembe mankhwala onse omwe amamwa. Pakati pawo panali mtanda. Nthawi yomweyo adamuletsa. Zinapezeka kuti ku Canada akuyesera kuti asamuike. Pali zokayikitsa kwambiri kuti mankhwalawa amayambitsa khansa.

Abambo anamwa Krestor kwa zaka zitatu. Mankhwala mwachangu komanso moyenera adatsitsa cholesterol. Adafuna kusiya kumwa mankhwalawo, koma atalephera, cholesterol idadzukanso. Chifukwa chake, ndidayenera kuyambiranso kumwa mapiritsiwo. Pambuyo pake, abambo adayamba kudandaula za kupweteka kwa mutu, thanzi lakusowa, kugona tulo. Tidazindikira zifukwa zazitali, tidadutsa mayeso osiyanasiyana. Mapeto ake, bambo ake anali ndi mavuto a chiwindi. Kugwiritsa ntchito mankhwalawa kwakhala kosatheka.

Kusangalala kwambiri ndi mankhwalawa, kumachepetsa mwachangu komanso pafupifupi popanda zovuta. Pakupuma kokha ndimamwa Zofunikira Forte N.

Dotoloyu adatulutsa miyezi iwiri kuti ateteze kukula kwa zolembera. Wogulidwa (monga wapachiyambi). Sindinakhalepo ndi zotsekemera m'moyo wanga! Mtundu wina wa zotupa pustular thupi lonse. Ndinkamwa tsiku 4, chifukwa ndimaganiza kuti ndizotheka kuti a Magnerot adavomerezedwa. Ndidazindikira kuti pa Krestor zidachitika kale. Momwe mungakhalire? Mosamala anasiya zotsatirapo zake.

Kuphwanya Myocardial kunandipangitsa kuganiza ndikuganiza zomwe ndidachita ndi thanzi langa! Ngakhale adapita kwa simulator. Cholesterol changa chinakwezedwa mopweteka, chifukwa chake adapereka zakudya zokhwima, zophika ndiwotcha chokha, ndine wokondwa kuti nditha kudya zipatso, kuletsa kusuta, sizovuta zonsezi. Ndayesa Krestor - Ndikuvomereza monga momwe adanenera, koma sindinawone zomwe zimachitika. Zinakhala zosavuta kupuma, kuphatikiza apo ndimathamangathamanga, kuchita masewera olimbitsa thupi ndi ophunzitsa. Mapiritsi amathandizira, koma masewera olimbitsa thupi alinso abwino. Sindikudziwa, koma ndimachita bwino kuthana ndi mapiritsi, nthawi ndi nthawi, kuti ndisazolowere, ndimayimitsa chithandizo.

Mtanda unasankhidwa kwa amuna anga pambuyo pa vuto la mtima. Kafukufuku akuwonetsa kuti anali ndi cholesterol yambiri m'magazi motero kunali kofunikira kuti muchepetse izi mwachangu. Pogwiritsa ntchito mankhwalawa pafupipafupi komanso zakudya zofunikira kwambiri, mafuta a cholesterol adayamba kuchepa. Pambuyo pa mwezi umodzi pomwe maunikidwewo adawonetsa kuti kuchuluka kwa cholesterol yamagazi kudafika pamlingo wovomerezeka. Dotolo adalimbikitsa kuti amwe pambuyo pake, koma ndi mankhwala okwera mtengo ndipo si aliyense angathe kumamwa kwa nthawi yayitali.

Kufotokozera kwapfupi

Krestor (chinthu chogwira ntchito ndi rosuvastatin) ndi mankhwala apachiyambi a lipid omwe amachokera m'gulu laosankha zoletsa za enzyme HMG-CoA reductase, odziwika bwino monga ma statins. Ulemelero wa "nkhokwe" yamatenda oopsa kwayamba kalekale m'dziko lathu. Kuthamanga kwa magazi kumapeto kwake kumakhala chimodzi mwazomwe zimayambitsa kulumala ndi kufa kwa matenda amtima. Si chinsinsi kuti kukhazikika kwa matenda oopsa kumayendera limodzi ndi mavuto osiyanasiyana a metabolic, monga glucose tsankho, hyperinsulinemia (chitetezo chambiri cha insulin), hypeuricemia (kuchuluka kwa uric acid m'magazi), kunenepa kwambiri ndi dyslipidemia (kuperewera kwa lipid metabolism). Mlandu wotsiriza, matenda oopsa amatha chifukwa cha kuchuluka kwa atherogenic lipid tizigawo ndipo, chifukwa chake, chitukuko cha atherosclerosis. Malinga ndi zotsatira za kafukufuku, hypercholesterolemia imapezeka oposa 40% ya milandu yamatenda othamanga magazi. Chosangalatsa ndichakuti, mwa amuna omwe ali ndi matenda oopsa, malembedwe a lipid amakhala atherogenic kwambiri poyerekeza ndi azimayi. Kusamalidwa kosakwanira komwe kumayendetsedwa pakuwongolera kuthamanga kwa magazi, komanso kuchotsedwa kwa ziwopsezo zamtima, kuphatikizapo dyslipidemia, kumabweretsa chitukuko ndikupititsa patsogolo kupititsa patsogolo kwa matenda a mtima. Motere, kufalikira kwa lipid metabolism ndi chimodzi mwazolinga zazikulu zowongolera odwala omwe ali ndi matenda oopsa, njira yopezera yomwe, limodzi ndi kukonza moyo, ndikugwiritsa ntchito ma statins. Zotsatira za mayeso azachipatala zazikulu zimawonetsa bwino kuti ma statins amachepetsa kwambiri chiopsezo cha zochitika zamtima. Malo apadera pakati pa oimira gulu lachipatalachi amakhala ndi rosuvastatin (mtanda), chifukwa cha kupezeka kwa zabwino pakati pa "ogwira nawo ntchito ogulitsa". Krestor ndi mankhwala opangira omwe amagwiritsidwa ntchito mu mtima kuyambira 2003. Kuchita kwake bwino kwachipatala kwaphunziridwa bwino mu mayeso angapo, kuphatikizidwa pansi pa dzina wamba GALAXY ndikuwaphimba ophunzira oposa 45,000.

Mkati mwa pulogalamuyi, zotsatira zabwino za mankhwalawa pa lipid mbiri, zodzikongoletsera zamatenda otupa, chikhalidwe cha njira ya atherosulinotic chatsimikizidwa. Mukamagwiritsa ntchito mtanda pamlingo wovomerezeka, kuchepa kwa cholesterol "yoipa" (LDL) ndi 52-63% kumawonedwa, komwe kumapitilira zomwe zimafanana ndi ma statins ena. Kuphatikiza apo, pamankhwala omwe ali ndi mtanda, cholesterol "yabwino" (HDL) imakhala yotsimikizika kuti iwonjezeke - ndi 14%, ndi kutsika kwamtundu umodzi triglycerides. Popeza gawo lodziwika bwino la zotupa pakatikati ya atherosclerosis silikukayikira pakali pano, chidwi chapadera chimaperekedwa pazifukwa zoonekeratu pakutsutsana ndi kutupa kwa mtanda. Kafukufuku adachitika momwe mankhwalawa adawonetsera bwino momwe amagwirira ntchito mu coronary atherosulinosis: zaka ziwiri zammbuyo Chifukwa chake, mtanda umawerengedwa ngati mankhwala olimbikitsa kwambiri osati mokhudzana ndi kukonza kwa lipid mbiri, komanso poletsa kukula kwa atherosulinosis. Kugwiritsa ntchito mtanda kudali kothandiza popewa matenda a mtima. Mphamvu ya mankhwalawa imayamba pakadutsa masiku 7, ndipo pakatha mwezi umodzi wa sabata la pharmacotherapy imafika pachimake.

Mtanda umapangidwa m'mapiritsi, omwe amayenera kumezedwa kwathunthu, osaphwanyidwa, osambitsidwa ndi madzi okwanira. Mankhwala amatha kumwedwa nthawi iliyonse ya tsiku. Asanayambe kapena chithandizo, wodwala ayenera kutsatira chikhalidwe cha hypocholesterolemic. Mlingo wa mtanda umasankhidwa payekha kutengera zolinga za mankhwalawo, zotsatira zake komanso kuleza mtima kwa odwala.

Crestor: malangizo ogwiritsira ntchito

Zotsatira za pharmacological	Krestor amachepetsa cholesterol ya "yoyipa" ya LDL m'magazi, ndikuletsa gawo lake kupanga chiwindi. Amachepetsa ndende ya triglycerides, apolipoprotein B, otsika kwambiri osalimba a lipoproteins (VLDL). Kweza cholesterol "yabwino" ya HDL. Amachepetsa kutupa m'matumbo. Amasintha C-yogwira mapuloteni komanso zofunikira zina za kutupa. Zotsatira za kuyesedwa kwa magazi zimayamba kuyenda bwino pambuyo pa masabata 1-2, mphamvu yayikulu - pambuyo pa masabata 2-4.
Pharmacokinetics	Mapiritsi a Rosuvastatin amatha kumwa ndi chakudya kapena pamimba yopanda kanthu, mphamvu ya izi sizisintha. Rosuvastatin wachotsedwa m'thupi ndi 90% ndi chiwindi kudzera m'matumbo, ndi 10% - ndi impso. Ndi yocheperako kuposa ma statin ena, imakweza ziwindi zomwe zimagwira ntchito yoyeretsa magazi a zinthu zomwe zimagwiritsidwa ntchito ndi mankhwala. Chifukwa cha izi, amatha kuyanjana pang'ono ndi mankhwala ena kuposa maumbidwe akale.
Zizindikiro zogwiritsidwa ntchito	Kukwezedwa cholesterol mwa akulu ndi achinyamata. Kuletsa kukula kwa atherosulinosis. Kupewa matenda oyamba ndi kubwereza kwa mtima, ischemic stroke ndi zovuta zina za atherosulinosis. Pambuyo pa opaleshoni kuti mubwezeretse magazi mu ziwiya zomwe zimakhudzidwa ndi atherosulinosis. Kuchulukitsa kwa C-yogwira mapuloteni m'magazi pakakhala zinthu zina zomwe zingayambitse matenda ena, ngakhale cholesterol ndiyabwino. Kutenga mapiritsi a Krestor sikulowa m'malo ndi moyo wathanzi. Werengani nkhani ya mutu wakuti “kupewa matenda a mtima ndi sitiroko” ndikuchita zomwe ukunena. Kupanda kutero, mankhwalawa athandizira pang'ono.

Onaninso vidiyo:

Mlingo	Yambani ndi kuchuluka kwa 5 kapena 10 mg patsiku. Pambuyo pa milungu 4, mlingo wa Krestor ungakulidwe, malinga ndi momwe kuchuluka kwa cholesterol kwasinthira panthawiyi komanso momwe wodwalayo amalolera chithandizo. Phunzirani cholesterol yamagazi kwa abambo ndi akazi pazaka. Nthawi zambiri, odwala amatenga rosuvastatin 10-20 mg patsiku. Mlingo waukulu kwambiri wa 40 mg umaperekedwa makamaka kwa anthu omwe cholesterol yake ndiyokwera kwambiri chifukwa cha majini. Okalamba, komanso odwala omwe ali ndi vuto lowonda la impso kapena kwa chiwindi, amadwala rosuvastatin muyezo waukulu.
Zotsatira zoyipa	Mapiritsi a Krestor, monga ma statin ena, amatha kupweteketsa minofu, kufooka, kufooka, kukumbukira komanso kusamaganiza, zotupa, komanso kugaya chakudya.Onani nkhani "Zotsatira zoyipa" - pezani momwe mungachepetsere zizindikiro zosasangalatsa kapena kuzichotsa kwathunthu. Kukonzekera kwa Rosuvastatin kuli ndi zovuta zina zapadera. Werengani zambiri momwe rosuvastatin amatetezeka. Kwa anthu omwe ali ndi chiopsezo chachikulu cha matenda a mtima komanso sitiroko, ma statin amachita zabwino zambiri kuposa kuvulaza. Mankhwalawa ayenera kusiyidwa pokhapokha ngati mavuto omwe sanawagwiritse ntchito sangathe kuwathetsa. Kuopsa kwa mavuto a chiwindi ndi kukokomeza. Osadandaula za iwo ngati simumamwa mowa kwambiri.
Contraindication	Matenda a chiwindi mu gawo yogwira. Kuwonjezeka kwakukulu kwa michere ya chiwindi ALT ndi AST m'magazi. Kulephera kwa aimpso - kulengedwa kwa creatinine kosakwana 30 ml / min. Hypersensitivity to rosuvastatin kapena maipi omwe amapanga mapiritsi. M'mayiko olankhula Chirasha, zaka zosakwana 18 zimawonedwa ngati zachinyengo, ngakhale kuti zakunja, kukonzekera kwa rosuvastatin ndi komwe achinyamata amakonzekera kuyambira zaka 10.
Mimba komanso Kuyamwitsa	Krestor, mankhwala ena a rosuvastatin ndi ma statin ena onse amakhala ndi pakati pa mimba. Amayi azaka zoyambira kubereka omwe amathandizidwa ndi ma statins ayenera kugwiritsa ntchito njira zodalirika zolerera. Ngati mimba yosakonzekera yachitika, ndiye kuti kumwa mapiritsi a cholesterol kuyenera kuyimitsidwa nthawi yomweyo. Potengera momwe mankhwalawo amathandizira ndi mankhwalawa, simungathe kuyamwitsa.
Kuyanjana kwa mankhwala osokoneza bongo	Mapiritsi a Krestor amapereka kuyanjana kocheperako ndi mankhwala ena kuposa ma statins akale. Komabe ngoziyo idatsalabe. Pangakhale mavuto ndi maantibayotiki, ma modifera okhala ndi chitetezo chamthupi, mapiritsi othandizira kubereka, magazi ochepa mphamvu, komanso mankhwala ena ambiri. Izi zimatha kuyambitsa mavuto akulu - chiwindi ndi impso. Lankhulani ndi dokotala wanu! Musanakhazikitsidwe ma statin, auzeni dokotala za mankhwala onse, zowonjezera zakudya, komanso zitsamba zomwe mukumwa.
Bongo	Palibe mankhwala ena alionse a bongo omwe ali ndi Krestor. Madokotala amatipatsa chithandizo chamankhwala komanso chothandizira, kuwunika ntchito ya chiwindi komanso kuchuluka kwa ntchito ya creatinine phosphokinase. Hemodialysis sichithandiza kuchotsa rosuvastatin m'thupi.
Malangizo apadera	Kuyamba kuthandizidwa ndi ma statins, pitilizani kutsatira zakudya ndikumakhala ndi moyo wathanzi. Ndikulimbikitsidwa kuyang'anira ntchito ya impso pogwiritsa ntchito magazi ndi mkodzo. Ngati mapuloteni amapezeka mumkodzo kapena kuchuluka kwake kumawonjezeka, yang'anani kwa dokotala. Ngati mukusowa mahomoni a chithokomiro, ndiye kuti musathamangire kutenga ma protein, koma samalani hypothyroidism kuti mubwezeretse cholesterol. Krestor ndi mankhwala ena a rosuvastatin amachulukitsa shuga wamagazi mwa odwala omwe ali ndi matenda ashuga komanso prediabetes.
Kutulutsa Fomu	Mapiritsi okhala ndi mafilimu a 10, 20 ndi 40 mg. Mu matuza kuchokera ku aluminium lamine kapena zojambulazo, mapiritsi 7 kapena 14. Mu paketi okhala ndi makatoni, 1, 2 kapena 4 matuza.
Migwirizano ndi magwiritsidwe akusungidwa	Kusunga pouma, kutetezedwa ku kuwala, malowa, osapezeka kwa ana, pamtunda wosaposa 30 ° C. Moyo wa alumali ndi zaka zitatu.
Kupanga	Zomwe zimagwira ndi calcium wa rosuvastatin. Zabwino - lactose monohydrate, MCC, calcium phosphate, crospovidone, magnesium stearate. Chipolopolo cha piritsi ndi lactose monohydrate, hypromellose, triacetin (glycerol triacetate), titanium dioxide, utoto wofiira wachitsulo.

Odwala ambiri amafuna m'malo mwa mankhwala a Krestor ndi analogue, okwera mtengo kwambiri, okhala ndi chinthu chomwecho. Kanemayo pansipa adzakuthandizani. Onani kuti apange chisankho chabwino pakati pa mapiritsi ambiri a rosuvastatin omwe amapezeka ku pharmacy.

Crestor: ndemanga

Patsamba lolankhula ku Russia mutha kupeza ndemanga zambiri za mankhwala a Krestor. Mapiritsi awa ndi otchuka, ngakhale ali okwera mtengo. Anthu akalemba ndemanga za mankhwala ena a rosuvastatin (Mertenil, Roxer, Rosucard), amadandaula kwambiri pazotsatira zawo. Ndemanga za mankhwala a Krestor ali ndi zodandaula zambiri zodula mtengo wake. Koma olemba ochepa amatchula zotsatirapo zake. Ndemanga pamasamba azachipatala nthawi zambiri amasangalala kuti mankhwala oyambirira a rosuvastatin adatsitsa cholesterol yawo. Amakhumudwa kokha chifukwa cha kuchuluka kwa ndalama zomwe amayenera kulipirira.

Odwala akutsimikiza kuti popeza akutenga rosuvastatin yotsika mtengo kwambiri, sizikhala ndi zotsatira zoyipa kapena sizikhala zochepa. M'malo mosankha mankhwala a Krestor, kusankha ma analogi ake otsika mtengo - Mertenil, Roxer, Rosucard kapena ena - anthu amasunga ndalama. Komabe, ali ndi chidaliro kuti chifukwa chakusunga ndalama adzakumana ndi zovuta zina. Ngakhale maphunziro oyendetsedwa ndi placebo atsimikizira kuti izi siziri choncho. Zotsatira zoyipa zambiri za ma statins omwe anthu amadandaula nazo pakuwunika kwawo amayamba chifukwa cha malingaliro omwe odwala amawaganizira, m'malo moipa omwe amapezeka ndi mankhwala.

Zizindikiro zogwiritsidwa ntchito

pulayimale Fredrickson hypercholesterolemia (mtundu IIa, kuphatikizira heterozygous hypercholesterolemia) kapena hypercholesterolemia (mtundu IIb) monga zowonjezera pazakudyazo, pamene zakudya ndi zina zosagwiritsa ntchito mankhwala (mwachitsanzo, masewera olimbitsa thupi, kuchepa thupi) sizokwanira,

banja homozygous hypercholesterolemia monga njira yowonjezera pakudya ndi mankhwala ena ochepetsa lipid-mwachitsanzo, LDL-apheresis) kapena ngati chithandizo chotere sichikugwira ntchito mokwanira,

hypertriglyceridemia (mtundu IV malinga ndi Fredrickson) monga chowonjezera chakudya,

Kuchepetsa kukula kwa atherosulinosis, kuwonjezera pa chakudya mwa odwala omwe akuwonetsedwa kuti amachepetsa kuchuluka kwa cholesterol ndi LDL-C,

kupewa kwakukulu kwa mtima wamavuto akulu (stroko, kugunda kwa mtima, masinthidwe a mtima) mwa odwala omwe alibe zizindikiro zamatenda a mtima, koma ali ndi chiopsezo chotukuka (zaka zopitilira 50 kwa amuna ndi zaka zopitilira 60 kwa azimayi, kuchuluka kwa C-yogwira ntchito mapuloteni (≥2 mg / l) pamaso pa zinthu zina zowonjezera, monga kuwopsa kwa matenda oopsa, kuchuluka kwa HDL-C, kusuta, mbiri ya banja poyambira matenda a mtima.

Kukambirana kwa mankhwala a Crestor mu zolembedwa za amayi

Poyerekeza, atsikana amafalitsa mankhwala angapo kuti achepetse cholesterol yamagazi Krestor 10 mg mapiritsi a 28 - 1337 ma ruble, chinthu chogwira ntchito ndi rosuvastatin, wopanga - AstraZeneca-IPR Pharmaceuticals Tevastor 10 mg mapiritsi a 30 - 471 rubles, chinthu chogwira ntchito ndi rosuvastatin, wopanga - TEVA / TEVA PHARMA Nthawi yomweyo. komwe timalipira mtunduwo. Zambiri kuchokera ku pharmacy & n.

. mi anawerenga mabuku ambiri pankhaniyi tsopano. Rosehip ndikwabwino kupangira thermos usiku, pali vitamini wambiri, umathandiza mtima ndi mitsempha yamagazi. . ndipo poyamba ankamwa mapiritsi, tsopano timamwa mtanda.

Tili ndi Plavix (kawiri pa tsiku), Krestor, Kleksan (majekeseni), sindikukumbukira kuti ena onse, amamwekonso m'manja. Plavix mu polycl. ku Tatarstan imasinthidwa ndi Zilt - ndipo ku Moscow ndizoletsedwa kumwa cholowa m'malo, chifukwa chake chimamwa zonse zomwe zinali zoyambirira - tili kwinakwake m'chigawo cha rubles 20,000. amapita mwezi uliwonse kukalandira mankhwala.

Tengani angapo mankhwala Krestor ndi Tevastor, njira yochepetsera cholesterol yamagazi mwa odwala atherosulinosis. Tevastor ndi generic ya Krestor ndipo onse awiri ndi okhudzana ndi Rosuvastatin, Tevastor ndi wotsika mtengo katatu ndipo alibe wotsika mtengo ku Krestor, koma ali ndi mtundu. Apa za iye ndi.

Cholesterol imakwezedwa pang'ono (chifukwa chake, Krestor imamwanso), imatsitsidwa kwambiri kukakamizidwa kuposa 100/60 kapena 110/70, ngati yanga. Gawo loyamba la atherosulinosis mwa iye. Omega anakakamizidwa kumwa mwezi wapitawu, zakumwa. Calcium d3 iyenso imamwa mankhwalawa. Ndikuganiza, kodi Krestor ali ndi Aspirin?

O, atsikana, ndizabwino bwanji kuti ndinawona izi poyerekeza. Ndizizindikira. Tithokoze chifukwa chazothandiza. Abambo anga amalandira mtanda ndipo mwina ndi wokwera mtengo kwa ife. Jessica, ndipo simukudziwa kuti Tevastor angagwiritsidwe ntchito pano popanda mankhwala a dokotala, kusiyanitsa kwa mtengo kumadziwika kwambiri. Ndipo zotsatira zake mutatha kugwiritsa ntchito Tevastor ndizofanana ndi p.

. Oy - izi ndi zabwino kale. Zikuwoneka kuti palibe cholakwika ndi kuphatikiza kwa mankhwalawa. Osachepera ine ndidapatsidwa mankhwala a atherosulinosis ndi vasilip ndi aspirin palimodzi. Ndipo momwe ndikumvera, mtanda ndi vasilip kuchokera ku opera imodzi. Zowona, sindinamwe - vasilip si mankhwala omwe mungatenge pakati :-)

Kuchita bwino kwa Tevastor ndikofanana ndi kwa Crestor. Kupatula apo, onsewa ali ndi mankhwala omwe ali ndi rosuvastatin, koma Anya ayenera kumwedwa kokha ngati akuwuzidwa ndi dokotala!

Amamwa mtanda (tevastor). kupewa kwakukulu kwa mtima wamavuto akulu (stroko, kugunda kwa mtima, masinthidwe a mtima) mwa odwala omwe alibe zizindikiro zamatenda a mtima, koma ali ndi chiopsezo chotukuka (zaka zopitilira 50 kwa amuna ndi zaka zopitilira 60 kwa azimayi, kuchuluka kwa C-yogwira ntchito mapuloteni (≥2 mg / l) pamaso pazinthu zosowa zina zowonjezera, monga matenda oopsa, kuchepa kwa HDL-C, kusuta, Fam.

Sindinadwale. Ndikuwerenga pa ukonde, momwemo, ma fibrinogen ake ndi okwera, ngakhale okalamba. ndipo tonse tili ndi mavuto am'banja. aliyense amwalira ndi izi, kapena khansa. osalankhula: (Ndikuganiza kuti titha kuwonjezera Aspirin-Cardio ku Krestor? Sizimva kuwawa. Palibe thrombosis prophylaxis mu krestor. Ali ndi cholesterol yayikulu ndipo ali ku atherossteosis)

Pharmacology

Wothandizira wa hypolipidemic kuchokera ku gulu la ma statins, choletsa wa HMG-CoA reductase. Malinga ndi lingaliro la kupikisana kwa mpikisano, molekyu ya statin imamangiriza mbali yomweyo ya coenzyme A receptor komwe enzyme iyi imafikira. Gawo lina la molekyu ya statin imalepheretsa kusintha kwa hydroxymethylglutarate kukhala mevalonate, wapakatikati mwa kapangidwe ka mamolekyulu a cholesterol. Kuletsa kwa ntchito ya HMG-CoA reductase kumabweretsa zotsatizana zotsatizana, zomwe zimapangitsa kutsika kwa zinthu zamafuta a cholesterol komanso kuwonjezereka kwa ntchito ya LDL receptors ndipo, motero, inapititsa katemera wa LDL cholesterol (Xc).

Hypolipidemic zotsatira za ma statins zimalumikizidwa ndi kuchepa kwa cholesterol yathunthu chifukwa cha LDL cholesterol. Kuchepa kwa LDL kumadalira mlingo ndipo sikwachizere, koma kokwanira.

Ma Statin samakhudza zochitika za lipoprotein ndi hepatic lipases, sizikhudza kwambiri kaphatikizidwe ndi katemera wa mafuta aulere acids, chifukwa chake, zotsatira zawo pamlingo wa TG ndizachiwiri komanso mosazungulira kudzera pazotsatira zawo zazikulu pakuchepetsa LDL-C. Kutsika kwapakati pa TG pamankhwala omwe amapezeka ndi ma statins akuwoneka kuti kumalumikizidwa ndi ma protein a hepatocytes omwe amaphatikizidwa ndi catabolism ya STDs, yomwe ili pafupifupi 30% TG.

Kuphatikiza pa kuchepetsa lipid-kuchepetsa, ma statins ali ndi zotsatira zabwino pa endothelial dysfunction (preclinical sign of atherosclerosis oyambirira), pakhoma la mtima, atheroma state, kusintha magazi m'thupi, kukhala ndi antioxidant, antiproliferative katundu.

The achire zotsatira kuwonekera mkati 1 sabata. pambuyo pa kuyamba kwa mankhwala ndipo pakatha milungu iwiri ya chithandizo ndi 90% ya momwe mungathere, zomwe nthawi zambiri zimakwaniritsidwa ndi masabata anayi ndipo pambuyo pake zimakhalabe.

Pharmacokinetics

Pambuyo pakamwa makonzedwe a C_max plasma rosuvastatin imafikiridwa pafupifupi maola 5. Bioavailability pafupifupi 20%.

Rosuvastatin amadziunjikira m'chiwindi. V_d - pafupifupi 134 malita. Kulumikizana ndi mapuloteni a plasma (makamaka okhala ndi albumin) kuli pafupifupi 90%.

Ma biotransforms pamlingo wocheperako (pafupifupi 10%), kukhala gawo lopanda chapakati pazesoenzymes za cytochrome P system₄₅₀. Isoenzyme yayikulu yomwe imakhudzidwa mu metabolism ya rosuvastatin ndi CYP2C9. Isoenzymes CYP2C19, CYP3A4 ndi CYP2D6 sakukhudzidwa kwambiri ndi metabolism.

Ma metabolites odziwika kwambiri a rosuvastatin ndi N-dismethyl ndi lactone metabolites. N-dismethyl ndi pafupifupi 50% yotsika kuposa rosuvastatin, lactone metabolites ndi pharmacologic yogwira.

Pafupifupi 90% ya mlingo wa rosuvastatin wamasulidwa osasinthika ndi ndowe. Chotsalazo chimatulutsidwa mkodzo. Plasma T_1/2 - pafupifupi maola 19 T_1/2 sasintha ndi kuchuluka kwa mankhwala. Kuvomerezeka kwamadzi a plasma kuli pafupifupi 50 l / h (kutalika kwa masinthidwe 21.7%).

Monga momwe zimakhalira ndi ma inhibitors ena a HMG-CoA reductase, membala wa membrane Xc amatenga nawo gawo pokhudzana ndi mankhwalawa a rosuvastatin, omwe amathandiza kwambiri pakuchotsa kwa rosuvastatin.

Kuwonetsera kwadongosolo kwa rosuvastatin kumawonjezeka molingana ndi mlingo.

Odwala kwambiri aimpso kulephera (QC onse

Analogs Crestor

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 54. Analogue ndiotsika mtengo ndi 606 rubles

Machesi molingana ndi mawonekedwe

Mtengo kuchokera 324 rubles. Analogue ndiotsika mtengo ndi ma ruble 336

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku 345 rubles. Analogue ndiyotsika mtengo ndi ma ruble 315

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 369. Analogue ndiyotsika mtengo ndi ma ruble 291

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 418. Analogue ndiotsika mtengo ndi ma ruble 242

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 438. The analogue ndiotsika mtengo ndi 222 rubles

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ma ruble 604. Analogue ndiotsika mtengo ndi ma ruble 56

Machesi molingana ndi mawonekedwe

Mtengo kuchokera 737 ma ruble. The analogue ndi okwera mtengo kwambiri pa ma ruble a 77

Machesi molingana ndi mawonekedwe

Mtengo wake umachokera ku ruble 865. Analogue ndiokwera mtengo kwambiri ndi ma ruble 205

Fomu ya Mlingo:

Piritsi lililonse lili ndi chinthu chogwira ntchito: rosuvastatin 10, 20 kapena 40 mg mu mawonekedwe a calcium rosuvastatin.
Othandizira: lactose monohydrate 89.50 mg (kwa mulingo wa 10 mg), 179,00 (kwa mulingo wa 20 mg), 164.72 mg (kwa mlingo wa 40 mg), microcrystalline cellulose 29.82 mg (pa mulingo wa 10 mg), 59.64 mg (wa mulingo wa 20 mg), 54.92 mg (pa mulingo wa 40 mg), calcium phosphate 10,90 mg (pa mulingo wa 10 mg), 21.80 mg (pa mulingo wa 20 mg), 2000 mg (pa mlingo 40 mg), crospovidone 7.50 mg (kwa 10 mg), 15,00 mg (pa mulingo wa 20 mg), 15.00 mg (kwa mulingo wa 40 mg), magnesium stearate 1.88 mg (kwa mulingo wa 10 mg) 3.76 mg (kwa 20 mg), 3,76 mg (kwa 40 mg), piritsi: lactose monohydrate 1.80 mg (kwa 10 mg), 3,60 mg (kwa 20 mg), 3,60 mg (kwa mlingo wa 40 mg), hypromellose 1.26 mg (kwa mulingo wa 10 mg), 2.52 mg (wa mulingo wa 20 mg), 2,52 mg (kwa mulingo wa 40 mg), triacetin (glycerol triacetate) 0,36 mg (kwa mulingo wa 10 mg), 0,72 mg (pa mulingo wa 20 mg), 0,72 mg (kwa muyezo wa 40 mg), titanium dioxide 1.06 mg (kwa 10 mg), 2.11 mg (kwa mulingo wa 20 mg), 2.11 mg (kwa mulingo wa 40 mg), utoto wa okusayidi wa ironide 0,02 mg (pa mulingo wa 10 mg), 0,05 mg (wa 20 mg), 0,05 mg (pa mulingo wa 40 mg).

Kufotokozera

Mapiritsi 10 mg: ozungulira, mapiritsi a biconvex, wokutira ndi utoto wapinki wa pinki, wolemba "ZD4522 10" mbali imodzi.
Mapiritsi 20 mg: mapiritsi ozungulira a biconvex, opakidwa utoto wapinki wa pinki, wolemba "ZD4522 20" mbali imodzi.
Mapiritsi a 40 mg: mapiritsi ozungulira, a biconvex, ophimbidwa ndi nembira yapinki ya pinki, olembedwa "ZD4522" mbali imodzi ndi 40 mbali inayo.

Mankhwala

Njira yamachitidwe
Rosuvastatin ndi chosankha, chopikisana pa HMG-CoA reductase, enzyme yomwe imatembenuza 3-hydroxy-3-methylglutaryl coenzyme A to mevalonate, presteror cholesterol. Cholinga chachikulu cha ntchito ya rosuvastatin ndi chiwindi, pomwe kaphatikizidwe ka cholesterol (cholesterol) ndi katemera wa otsika kachulukidwe lipoproteins (LDL) amachitika.
Rosuvastatin imakulitsa kuchuluka kwa "hepatic" LDL pama cell, ndikumakulitsa kukhudzika ndi mphamvu ya LDL, yomwe imayambitsa kulepheretsa kaphatikizidwe kachulukidwe kakang'ono kwambiri ka lipoproteins (VLDL), potero kumachepetsa kuchuluka kwathunthu kwa LDL ndi VLDL.

Mankhwala
Krestor ® imatsitsa kwambiri kuchuluka kwa LDL cholesterol (cholesterol-LDL), cholesterol yathunthu, triglycerides (TG), imakulitsa kuchuluka kwa kuchuluka kwa lipoprotein cholesterol (HDL-C), komanso kuchepetsa kuchuluka kwa apolipoprotein B (ApoV), non-HDL cholesterol, -LVONP, TG-VLDLP ndikuwonjezera kuchuluka kwa apolipoprotein AI (ApoA-I) (onani matebulo 1 ndi 2), kumachepetsa kuchuluka kwa LDL-C / HDL-HDL, cholesterol yathunthu / HDL-C ndi HDL-C / HDL-C ndi Chiyero cha ApoB / ApoA-I.
The achire zotsatira amakula mkati mwa sabata limodzi atayamba mankhwala ndi Krestor ®, pambuyo 2 milungu chithandizo ukufika 90% ya pazotheka kwambiri.
Achire achire kwambiri nthawi zambiri amakwaniritsidwa ndi sabata la 4 ndikuchiritsira ndikugwiritsidwa ntchito pafupipafupi.

Gome 1 . Mphamvu yodalira Mlingo kwa odwala omwe ali ndi hypercholesterolemia (Fredrickson mtundu IIa ndi IIb) (amatanthauza kusintha kosinthika kuchokera ku chiyambi).

Mlingo	Qty la odwala	HS-LDL	General cholesterol	HS-HDL	TG	HS-non-HDL	ApoV	ApoA-I
Malo	13	-7	-5	3	-3	-7	-3	0
10 mg	17	-52	-36	14	-10	-48	-42	4
20 mg	17	-55	-40	8	-23	-51	-46	5
40 mg	18	-63	-46	10	-28	-60	-54	0

Gawo 2 . Mphamvu yodalira Mlingo kwa odwala omwe ali ndi hypertriglyceridemia (mtundu IIb ndi IV malinga ndi Fredrickson) (kusintha kwapakati poyerekeza ndi mtengo woyambira).

Mlingo	Qty la odwala	TG	HS-LDL	General cholesterol	HS-HDL	HS-non-HDL	HS-VLDLP	TG-lponp
Malo	26	1	5	1	-3	2	2	6
10 mg	23	-37	-45	-40	8	-49	-48	-39
20 mg	27	-37	-31	-34	22	-43	-49	-40
40 mg	25	-43	-43	-40	17	-51	-56	-48

Mphamvu zamankhwala Krestor ® imagwira ntchito kwa odwala akuluakulu omwe ali ndi hypercholesterolemia kapena popanda hypertriglyceridemia, osatengera mtundu, jenda kapena msinkhu, kuphatikiza odwala omwe ali ndi matenda osokoneza bongo komanso hypercholesterolemia. Mu 80% ya odwala omwe ali ndi mtundu wa IIa ndi IIb hypercholesterolemia malinga ndi Fredrickson (kuchuluka koyambirira kwa LDL-C ndi pafupifupi 4.8 mmol / L), pomwe akumamwa mankhwalawa pa 10 mg, kuchuluka kwa LDL-C kumafika pochepera 3 mmol / L.
Odwala omwe ali ndi heterozygous Famer hypercholesterolemia akulandira Krestor ® pa mlingo wa 20-80 mg, mawonekedwe abwino a mbiri ya lipid adawonedwa (kafukufuku wokhudza odwala 435). Pambuyo titration kwa tsiku lililonse 40 mg (12 milungu mankhwala), kuchepa kwa ndende ya LDL-C ndi 53% amadziwika. Mu 33% ya odwala, kuchuluka kwa LDL-C kosakwana 3 mmol / L kumatheka.
Odwala omwe ali ndi homozygous Famer hypercholesterolemia akutenga Krestor ® pa 20 mg ndi 40 mg, kutsika kwapakati pa ndende ya LDL-C ndi 22%.
Odwala omwe ali ndi hypertriglyceridemia omwe amakhala ndi TG kuyambira 273 mpaka 817 mg / dl omwe adalandira Krestor ® mu 5 mg mpaka 40 mg kamodzi patsiku kwa masabata a 6, kuchuluka kwa TG m'magazi a magazi kunachepetsedwa kwambiri (onani tebulo 2 )
Mphamvu yowonjezera imawonedwa limodzi ndi fenofibrate pokhudzana ndi kuchuluka kwa triglycerides komanso nicotinic acid pamilingo yotsitsa milomo mokhudzana ndi kuchuluka kwa HDL-C (onaninso gawo "Malangizo Apadera").
Pakufufuza kwa METEOR, komwe kumaphatikizapo odwala 984 azaka za pakati pa 45-70 zaka ndi chiopsezo chochepa chotenga matenda a mtima (CHD) (chiwopsezo cha zaka 10 pamlingo wa Framingham osakwana 10%), pafupifupi LDL cholesterol concentration ya 4.0 mmol / L (154,5 mg / dl) ndi subclinical atherosulinosis (yomwe imayesedwa ndi makulidwe a carotid artery intima-media tata - TCIM) adawerengera zamtundu wa rosuvastatin pa makulidwe a intima-media tata. Odwala adalandira rosuvastatin pa mlingo wa 40 mg / tsiku kapena placebo kwa zaka ziwiri.
Mankhwala a Rosuvastatin anachepetsa kwambiri kupitilira kwa TCIM yayikulu pazigawo 12 za chotupa cha carotid poyerekeza ndi placebo ndi kusiyana kwa -0.0145 mm / chaka 95% chodalirika kuyambira -0.0196 mpaka -0.0093, p ® 40 mg sichilimbikitsidwa. Mlingo wa 40 mg uyenera kugwiritsidwa ntchito kwa odwala omwe ali ndi vuto lalikulu la hypercholesterolemia komanso chiopsezo cha matenda a mtima (CVD).
Zotsatira za kafukufuku wa JUPITER (Chidziwitso chogwiritsira ntchito ma statins popewa chachikulu: kafukufuku wokhazikika yemwe amawunika rosuvastatin) mu 17802 odwala adawonetsa kuti rosuvastatin adachepetsa kwambiri zovuta zamatumbo (252 pagulu la placebo poyerekeza ndi 142 pagulu la rosuvastatin) (p Kuchita bwino kwa mankhwalawa kunadziwika Pambuyo pa miyezi isanu ndi umodzi yoyambirira yogwiritsira ntchito mankhwalawa, panali kuchepa kwakukulu kwa 48% mu mawonekedwe a kuphatikiza, kuphatikizapo kufa chifukwa cha mtima, insulin mamita ndi m'mnyewa wamtima infarction (ngozi chiŵerengero: 0,52, 95% chidaliro imeneyi 0,40-0,68, p ® ana osaposa zaka 18.

Odwala omwe ali ndi vuto la chiwindi
Palibe deta kapena chidziwitso chogwiritsa ntchito mankhwalawa kwa odwala omwe ali ndi chiwerengero chokwanira kuposa 9 pa Child-Pugh lonse (onani magawo "Pharmacodynamics" ndi "Maupangiri Apadera").

Mlingo ndi makonzedwe

Mkati, osatafuna kapena kupera piritsi, kumeza lonse, kutsukidwa ndi madzi. Mankhwala amatha kutumikiridwa nthawi iliyonse ya tsiku, mosasamala kanthu za kudya.
Asanayambe chithandizo ndi Krestor ®, wodwalayo ayenera kuyamba kutsatira zakudya zapamwamba za hypocholesterolemic ndikupitiliza kuzitsatira panthawi yamankhwala. Mlingo wa mankhwalawa amayenera kusankhidwa payekha kutengera zolinga zamankhwala ndi njira yothandizira odwala, mukumvera zomwe zikuwoneka pakalipano.
Mlingo woyambira wa odwala omwe ayamba kumwa mankhwalawa, kapena kwa odwala omwe atengedwa kuchokera ku kutenga zina za HMG-CoA reductase, azikhala 5 kapena 10 mg wa Krestor ® kamodzi patsiku. Mukamasankha koyamba mlingo, munthu akuyenera kutsogoleredwa ndi cholesterol yomwe munthu ali nayo ndikuwunika kuopsa kwa zovuta zamtima, komanso ndikofunikira kuwunika kuopsa kwa zotsatira zoyipa. Ngati ndi kotheka, mankhwalawa atha kuwonjezeka pambuyo pa masabata anayi (onani gawo la "Pharmacodynamics").
Chifukwa cha kukula kwa zoyipa mukamamwa mlingo wa 40 mg, poyerekeza ndi Mlingo wocheperako (onani gawo "Zotsatira zoyipa"), ndikuwonjezera mlingo mpaka 40 mg pambuyo poti mlingo wowonjezereka ukhale wapamwamba kuposa momwe mankhwalawa amayambira milungu 4 Mankhwala amatha kuchitika kokha mwa odwala kwambiri hypercholesterolemia ndi chiwopsezo cha matenda a mtima (makamaka odwala omwe ali ndi achibale a hypercholesterolemia) omwe sanakwaniritse zotsatira zofunika za mankhwala akamamwa 20 mg, ndipo ndi ndani amene kukhala moyang'aniridwa ndi katswiri (onani. "Special Malangizo" gawo).
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 ndi kuchuluka kwa kukonzekera kwa Krestor ®, kuwunika kwa metabolidi ya lipid ndikofunikira (kusintha kwa mankhwalawa ndikofunikira ngati kuli kofunikira).

Odwala okalamba
Kusintha kwa Mlingo sikofunikira.

Odwala omwe ali ndi vuto la impso
Odwala omwe ali ndi vuto la aimpso wofatsa kapena pakati, kusintha sikofunikira. Odwala omwe ali ndi vuto lalikulu la impso (CC ochepera 30 ml / min.), Kugwiritsa ntchito mankhwala Krestor ® ndi kotsutsana.
Kugwiritsa ntchito mankhwalawa mu 40 mg ndi kuphatikizidwa kwa odwala omwe ali ndi vuto laimpso (CC ochepera 30-60 ml / min.) (Onani gawo "Malangizo Apadera" ndi "Pharmacodynamics"). Kwa odwala omwe ali ndi vuto laimpso lokwanira, koyamba mlingo wa 5 mg umalimbikitsidwa.

Odwala omwe ali ndi vuto la chiwindi
Krestor ® imaphatikizidwa kwa odwala omwe ali ndi matenda a chiwindi omwe amagwira gawo (onani gawo "Contraindication").

Anthu apadera. Mitundu
Mukamaphunzira ma paracokinetic magawo a rosuvastatin mwa anthu amitundu yosiyanasiyana, kuchuluka kwakukula kwa rosuvastatin pakati pa Japan ndi China kudadziwika (onani gawo "Special Instructions"). Izi zikuyenera kukumbukiridwa popereka Krestor ® m'magulu odwala. Popereka mankhwala a 10 ndi 20 mg, muyeso woyenera wa odwala a mtundu wa Mongoloid ndi 5 mg. The mankhwala a mankhwala mu mg 40 mg amalephera kwa odwala a mtundu wa Mongoloid (onani gawo "Contraindication").

Ma polymorphism
Amonyamula ma genotypes SLC01B1 (OATP1B1) c.521CC ndi ABCG2 (BCRP) c.421AA adawonetsa kuwonjezeka (AUC) kupita ku rosuvastatin kuyerekeza ndi onyamula genotypes SLC01B1 c.521TT ndi ABCG2 c.421CC. Kwa odwala omwe ali ndi genotypes c.521CC kapena c.421AA, mulingo woyenera kwambiri wa Crestor ® ndi 20 mg kamodzi patsiku (onani zigawo "Pharmacokinetics", "Maupangiri Apadera" ndi "Kuyanjana ndi Mankhwala Omwe Ndi Mitundu Yina Yogwiritsira Ntchito Mankhwala" )

Odwala a Myopathy
The mankhwala pa mlingo wa 40 mg ndi ophatikizidwa odwala ndi zinthu zomwe zingasonyeze lingaliro la chitukuko cha myopathy (onani gawo "Contraindication"). Popereka mankhwala a 10 ndi 20 mg, muyeso woyenera wa gululi ndi 5 mg (onani gawo "Contraindication")

Chithandizo chothandizirana
Rosuvastatin imamangiriza mapuloteni osiyanasiyana oyendetsa (makamaka, OATP1B1 ndi BCRP). Akaphatikizidwa ndi Krestor ®, ndimankhwala (monga cyclosporine, ma protein ena a HIV protease inhibitors, kuphatikizapo kuphatikiza kwa ritonavir ndi atazanavir, lopinavir ndi / kapena tipranavir), zomwe zimakulitsa kuchuluka kwa rosuvastatin mu plasma chifukwa chogwirizana ndi mapuloteni oyendetsa, chiopsezo cha myopathy (kuphatikizapo rhabdomyolysis) (onani magawo "Malangizo apadera" ndi "Kuyanjana ndi mankhwala ena ndi mitundu ina yogwiritsira ntchito mankhwala"). Muyenera kuwerengera malangizo ogwiritsira ntchito mankhwalawa musanakhazikitsidwe molumikizana ndi mankhwala Krestor ®. Zikatero, muyenera kuwunika mwayi wopereka mankhwala ena kapena kusiya kwakanthawi kugwiritsa ntchito mankhwalawa Krestor ®. Ngati kugwiritsa ntchito mankhwala omwe ali pamwambawa ndikofunikira, muyenera kuwunika kuchuluka kwa phindu ndi chiopsezo chogwirizana ndi mankhwala a Crestor ® ndikuwona mwayi wochepetsera mlingo wake (onani gawo "Kuyanjana ndi mankhwala ena ndi mitundu ina yamagulu osokoneza bongo").

Zotsatira zoyipa

Zotsatira zoyipa zomwe zimapezeka pakumwa mankhwala Krestor ® nthawi zambiri zimakhala zofatsa ndipo zimapita zokha. Monga momwe ziliri ndi HMG-COL reductase inhibitors, zomwe zimachitika ndizotsatira zoyipa zimadalira kwambiri kumwa.
Pafupipafupi pamakhala zotsatirazi zimaperekedwa motere:
Nthawi zambiri (> 1/100, 1/1000, 1/10000, ®, proteinuria imatha kupezeka. Kusintha kwa kuchuluka kwamapuloteni mumkodzo (kuchokera pomwe kulibe kapena kufunafuna kuchuluka kwa ++ kapena zina) kumawonedwa osakwana 1% ya odwala omwe amalandira 10-20 mg mankhwala, ndipo pafupifupi 3% ya odwala omwe amalandira 40 mg ya mankhwalawa.
Kusintha pang'ono kwa kuchuluka kwamapuloteni mumkodzo kunawonedwa pakudya 20 mg. Nthawi zambiri, proteinuria imatsika kapena kutha nthawi ya mankhwalawa ndipo sizitanthauza kuti kumachitika matenda a impso kapena opita patsogolo.
Kuchokera ku minculoskeletal system
Mukamagwiritsa ntchito mankhwala a Krestor ® pamiyeso yonse, ndipo makamaka mukamatenga Mlingo wa mankhwala ochulukirapo 20 mg, zotsatirazi zimanenedwa pamankhwala amisculoskeletal adanenedwa kuti: myalgia, myopathy (kuphatikizapo myositis), nthawi zina, rhabdomyolysis kapena kulephera kwa impso. iye.
Kukula kokhazikika kwa ntchito ya creatine phosphokinase (CPK) kumaonekera mwa odwala ochepa omwe akutenga rosuvastatin. Nthawi zambiri, anali ofatsa, asymptomatic komanso osakhalitsa. Pankhani ya kuchuluka kwa ntchito za CPK (nthawi zopitilira 5 poyerekeza ndi malire apamwamba), mankhwalawa amayenera kuyimitsidwa (onani gawo "Maupangiri Apadera").
Kuchokera ku chiwindi
Mukamagwiritsa ntchito rosuvastatin, kuwonjezeka kwamankhwala okhudzana ndi "chiwindi" transaminases amawonedwa ochepa odwala. Nthawi zambiri, imakhala yochepa, yokhala yochepa komanso yongoyembekezera.
Zizindikiro zasayansi
Mukamagwiritsa ntchito mankhwala a Krestor ®, zosintha zotsatirazi mu labotale zimawonedwanso: kuwonjezeka kwa kuchuluka kwa shuga, bilirubin, ntchito ya gamma-glutamyl transpeptidase, alkaline phosphatase, ndi kusowa kwa chithokomiro cha chithokomiro.

Ntchito yotsatsa
Zotsatira zotsatirazi zanenedwapo pakugulitsa pambuyo pa Krestor ®:
Kuchokera pa hematopoietic dongosolo
Mafupipafupi osadziwika: thrombocytopenia
Kuchokera mmimba
Osowa kwambiri: jaundice, hepatitis
Pafupipafupi: kuchuluka kwama transaminase a "chiwindi"
Pafupipafupi osatchulidwa: kutsekula m'mimba
Kuchokera ku minculoskeletal system
Osowa kwambiri: arthralgia
Pafupipafupi osadziwika: immuno-mediated necrotizing myopathy
Kuchokera ku dongosolo lamanjenje lamkati
Zosowa kwambiri: kukumbukira kapena kutayika
Kuyenda mosatsimikizika: zotumphukira za m'mitsempha
Kuchokera ku kupuma
Mafupipafupi osadziwika: chifuwa, kupuma movutikira
Kuchokera kwamikodzo
Osowa kwambiri: hematuria
Pa khungu ndi mafuta onunkhira
Mafupipafupi osadziwika: Matenda a Stevens-Johnson
Kuchokera ku kubereka ndi chithokomole
Mafupipafupi osadziwika: gynecomastia
Zina
Pafupipafupi osadziwika: edema yodutsa

Mukamagwiritsa ntchito ma statin ena, zotsatirazi zoyipa zidanenedwa:
kupsinjika, kusokonezeka kwa kugona, kuphatikizapo kusowa tulo komanso "maloto" osokoneza bongo, kusowa kwa kugonana, hyperglycemia, kuchuluka kwa hemoglobin ya glycosylated.
Milandu yakutali yamatenda a m'mapapo amanenedwa, makamaka kugwiritsa ntchito mankhwala kwa nthawi yayitali (onani gawo "Malangizo apadera").

Bongo

Ndi munthawi yomweyo makonzedwe angapo tsiku lililonse, ma pharmacokinetic magawo a rosuvastatin sasintha.
Palibe chithandizo chamankhwala osokoneza bongo a rosuvastatin. Pankhani ya bongo, tikulimbikitsidwa kuchita zozizwitsa mankhwalawa ndi miyeso umalimbikira ntchito za ziwalo zofunika. Kuwunikira ntchito ya chiwindi ndi milingo ya CPK ndikofunikira. Hemodialysis ndiyokayikitsa kuti singagwire ntchito.

Kuyanjana ndi mankhwala ena ndi mitundu ina yogwiritsira ntchito mankhwalawa

Zotsatira zakugwiritsa ntchito mankhwala ena pa rosuvastatin
Zoletsa zama protein: rosuvastatin imamangiriza mapuloteni ena onyamula, makamaka, OATP1B1 ndi BCRP. Kugwiritsanso ntchito kwa mankhwala omwe amalepheretsa mapuloteni amtunduwu kungayende limodzi ndi kuwonjezeka kwa plasma ndende ya rosuvastatin komanso chiwopsezo cha myopathy (onani tebulo 3 ndi magawo "Mlingo ndi makonzedwe" ndi "Malangizo apadera").
Cyclosporin: Pogwiritsa ntchito munthawi yomweyo rosuvastatin ndi cyclosporine, AUC ya rosuvastatin inali yayitali kwambiri kuposa 7 poyerekeza ndi odzipereka athanzi (onani tsamba 3). Sichikukhudza plasma ndende ya cyclosporine. Krestor ® imaphatikizidwa kwa odwala omwe amatenga cyclosporine (onani gawo "Contraindication").
Human Immunodeficiency Virus (HIV) proteinase zoletsa: ngakhale njira yeniyeni yolumikizirana sichikudziwika, kuphatikiza kwa HIV proteinase inhibitors kungapangitse kuwonjezeka kwakukulu kwa kuwonekera kwa rosuvastatin (onani tebulo 3).
Kafukufuku wa pharmacokinetic wokhudzana ndi kugwiritsa ntchito nthawi imodzi 20 mg ya rosuvastatip ndi kuphatikiza komwe kumakhala ndi ma protein awiri a HIVasease (400 mg ya lopinavir / 100 mg ya ritonavir) mwa odzipereka omwe ali ndi thanzi labwino kunapangitsa kuwonjezeka kwapawiri komanso kasanu ku AUC (0-24) ndi Cmax ya rosuvastatin, motsatana. Chifukwa chake, makonzedwe apanthawi yomweyo a rosuvastatin ndi HIV proteinase inhibitors ali osavomerezeka (onani magawo "Mlingo ndi Ulamuliro", "Malangizo Apadera", tebulo 3).
Gemfibrozil ndi mankhwala ena otsitsa a lipid: kuphatikiza kwa rosuvastatin ndi gemfibrozil kumapangitsa kuti chiwonetsero cha rosuvastatin chiwonjezeke kawiri mu plasma yamagazi ndi AUC ya rosuvastatin (onani gawo "Malangizo apadera"). Kutengera ndi data yokhudzana ndi zochitika zina, kukhudzana kwakukulu ndi fenofibrate sikuyembekezereka, kuyanjana kwa pharmacodynamic ndizotheka.
Gemfibrozil, fenofibrate, michere ina, komanso kuchepetsa lipid-kuchepetsa matenda a nicotinic acid adakulitsa chiopsezo cha myopathy akamagwiritsidwa ntchito limodzi ndi HMG-CoA reductase inhibitors, mwina chifukwa chakuti amatha kuyambitsa myopathy akagwiritsidwa ntchito ku monotherapy (onani gawo "Maupangiri Apadera") . Mukumwa mankhwalawa ndi gemfibrozil, fibrate, nicotinic acid mu lipid kutsitsa Mlingo (wopitilira 1 g / tsiku), odwala amalimbikitsidwa ndi koyamba mlingo wa 5 mg, mlingo wa 40 mg umaphatikizidwa molumikizana ndi ma fiber (onani magawo "Contraindication", " Mlingo ndi makonzedwe "," Malangizo apadera ").
Ezetimibe: kugwiritsa ntchito munthawi yomweyo mankhwala a Krestor ® 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 kukhudzana kwa pharmacodynamic pakati pa mankhwala a Krestor ® ndi ezetimibe.
Maantacid okhala: kugwiritsa ntchito munthawi yomweyo rosuvastatin ndi kuyimitsidwa kwa maantacid okhala ndi magnesium ndi aluminium hydroxide, kumabweretsa kutsika kwa plasma ndende ya rosuvastatin ndi pafupifupi 50%. Izi sizitchulidwa kwenikweni ngati maacacid amagwiritsidwa ntchito maola 2 mutatha rosuvastatin. Kufunika kwachipatala pakuyanjanaku sikunaphunzire.
Erythromycin: kugwiritsa ntchito munthawi yomweyo rosuvastatin ndi erythromycin kumabweretsa kutsika kwa AUC ya rosuvastatin ndi 20% ndi Cmax wa rosuvastatin ndi 30%. Kuyanjana kotereku kumatha kuchitika chifukwa cha kuchuluka kwa matumbo chifukwa cha kukoka kwa erythromycin.
Cytochrome P450 Isofermeitis: Zotsatira za kafukufuku wa vivo ndi vitro zikuwonetsa kuti rosuvastatin si choletsa kapena wochititsa isoenzymes wa cytochrome P450. Kuphatikiza apo, rosuvastatin ndi gawo lochepera la awaenzenzes. Chifukwa chake, kuyanjana kwa rosuvastatin ndi mankhwala ena pamlingo wa metabolic wophatikizira cytochrome P450 isoenzymes sikuyembekezeredwa.
Panalibe kuyanjana kwakukulu kwa rosuvastatin ndi fluconazole (choletsa wa isoenzymes CYP2C9 ndi CYP3A4) ndi ketoconazole (choletsa ma isoenzymes CYP2A6 ndi CYP3A4).
Fusidic acid: maphunziro owerengera rosuvastatin ndi fusidic acid sizinachitike. Monga ma statin ena, malipoti otsatsa a rhabdomyolysis ogwirizana ndi rosuvastatin ndi fusidic acid adalandiridwa. Ndikofunikira kuyang'anitsitsa odwala. Ngati ndi kotheka, kuleka kwakanthawi kwa rosuvastatin ndikotheka.

Mogwirizana ndi mankhwala omwe amafunikira kusintha kwa rosuvastatin (onani tebulo 3)
Mlingo wa mankhwala Krestor ® uyenera kusinthidwa ngati kuli kofunikira, kugwiritsa ntchito kwake palimodzi ndi mankhwala omwe amathandizira kuwonetsa rosuvastatin. Muyenera kuwerengera malangizo ogwiritsira ntchito mankhwalawa musanakhazikitsidwe molumikizana ndi mankhwala Krestor ®. Ngati chiwonetsero chowonjezera cha 2 nthawi kapena kupitirira chikuyembekezeka, mlingo woyambirira wa kukonzekera kwa Crestor ® uyenera kukhala 5 mg kamodzi patsiku. Mlingo wambiri watsiku ndi tsiku wa Krestor ® uyeneranso kusinthidwa kuti chiwonetsero cha rosuvastatin chisawonjezeke kuti pamtengo wa 40 mg wotengedwa popanda kugwiritsa ntchito munthawi yomweyo mankhwala omwe amalumikizana ndi rosuvastatin. Mwachitsanzo, muyezo wapamwamba wa tsiku ndi tsiku wa mankhwala a Crestor ® omwe amagwiritsidwa ntchito nthawi yomweyo ndi gemfibrozil ndi 20 mg (kuchuluka kowonetsedwa ndi nthawi 1.9), ndi ritonavir / atazanavir - 10 mg (kuchuluka kwawonetsedwa nthawi 3.1).

Gawo 3 . Zotsatira zamankhwala othandizira kuwonekera kwa rosuvastatin (AUC, zambiri zimawonetsedwa pang'onopang'ono) - zotsatira za mayesero azachipatala

Njira zogwirizana mankhwalawa	Njira yolandirira rosuvastatin	Sinthani AUC rosuvastatin
Cycloporin 75-200 mg 2 pa tsiku., Miyezi 6.	10 mg 1 nthawi patsiku., Masiku 10	Kuchulukitsa kwa 7.1x
Atazanavir 300 mg / ritonavir 100 mg 1 nthawi patsiku., Masiku 8	10 mg limodzi mlingo	Kuchulukitsa kwa 3.1x
Simeprevir 152 mg 1 nthawi patsiku., Masiku 7	10 mg limodzi mlingo	Kuchulukitsa 2.8x
Lopinavir 400 mg / ritonavir 100 mg 2 pa tsiku., Masiku 17	20 mg 1 nthawi patsiku., Masiku 7	2.1 nthawi kuchuluka
Clopidogrel 300 mg (Kweza mlingo) ndiye 75 mg pambuyo pa maola 24	20 mg limodzi mlingo	2x kuchuluka
Gemfibrozil 600 mg 2 pa tsiku., Masiku 7	80 mg imodzi mlingo	Kuchulukitsa 1.9x
Eltrombopag 75 mg 1 nthawi patsiku. Masiku 10	10 mg limodzi mlingo	Kuchuluka kwa 1.6x
Darunavir 600 mg / ritonavir 100 mg 2 pa tsiku., Masiku 7	10 mg 1 nthawi patsiku., Masiku 7	1.5 nthawi kuchuluka
Tipranavir 500 mg / ritonavir 200 mg 2 pa tsiku., Masiku 11	10 mg limodzi mlingo	Nthawi 1.4 kuwonjezeka
Dronaronop 400 mg 2 pa tsiku.	Palibe deta	Nthawi 1.4 kuwonjezeka
Itraconazole 200 mg 1 nthawi patsiku., Masiku 5	10 mg kapena 80 mg kamodzi	Nthawi 1.4 kuwonjezeka
Ezetimibe 10 mg 1 nthawi patsiku., Masiku 14	10 mg kamodzi patsiku, masiku 14	Nthawi zowonjezera 1.2
Fosamprenavir 700 mg / ritonavir 100 mg 2 pa 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 patsiku. Masiku 5	10 mg limodzi mlingo	Palibe kusintha
Fenofibrate 67 mg Katatu patsiku., Masiku 7	10 mg, masiku 7	Palibe kusintha
Rifampin 450 mg Kamodzi patsiku. Masiku 7	20 mg limodzi mlingo	Palibe kusintha
Ketoconazole 200 mg 2 pa tsiku., Masiku 7	80 mg imodzi mlingo	Palibe kusintha
Fluconazole 200 mg 1 nthawi patsiku., Masiku 11	80 mg imodzi mlingo	Palibe kusintha
Erythromycin 500 mg 4 pa tsiku., Masiku 7	80 mg imodzi mlingo	28% kuchepetsa
Baikalin 50 mg Katatu patsiku., Masiku 14	20 mg limodzi mlingo	47% kuchepetsa

Zotsatira za rosuvastatin pa mankhwala ena
Vitamin K Antagonists: kuyambitsidwa kwa chithandizo cha rosuvastatin kapena kuwonjezeka kwa odwala omwe amalandila munthawi yomweyo vitamini K motsutsana (mwachitsanzo warfarin) kungayambitse kuwonjezeka kwa International Normalized Relationship (MHO). Kuchoka kwa rosuvastatin kapena kuchepetsa mlingo wa mankhwalawa kungayambitse kuchepa kwa MHO. Zikatero, kuwongolera MHO kumalimbikitsidwa.
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.
Zambiri za Pharmacokinetic pakugwiritsa ntchito nthawi yomweyo mankhwala a Krestor ® ndi mankhwala omwe amadzimitsa mahomoni, kulibe, kotero, sizofanana ndi izi. Komabe, kuphatikiza uku kunagwiritsidwa ntchito kwambiri panthawi ya mayesero azachipatala ndipo kunavomerezedwa bwino ndi odwala.
Mankhwala ena: palibe machitidwe amakani a rosuvastatin omwe ali ndi digoxin amayembekezeredwa.

Malangizo apadera

Zotsatira zoyipa
Odwala omwe adalandira mlingo waukulu wa Krestor ® (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.
Kuchokera ku minculoskeletal system
Mukamagwiritsa ntchito mankhwala a Krestor ® pamiyeso yonse, ndipo makamaka mukamamwa Mlingo wa mankhwala ochulukirapo 20 mg, zotsatirazi pazotsatira za minofu yam'mimba zimanenedwa: myalgia, myopathy, nthawi zina, rhabdomyolysis.
Katswiri wa creatine phosphokinase
Kutsimikiza kwa CPK sikuyenera kuchitika pambuyo pakuchita masewera olimbitsa thupi kwambiri kapena ngati pali zifukwa zina zowonjezera za CPK, zomwe zingayambitse kutanthauzira kolakwika kwa zotsatira. Ngati mulingo woyambirira wa CPK ukuwonjezeka kwambiri (kuchulukitsa ka 5 kuposa malire apamwamba), muyeso wobwereza uyenera kuchitika pambuyo masiku 5-7. Mankhwalawa sayenera kuyambitsidwa ngati mayeso obwereza atsimikizira kuchuluka koyambirira kwa CK (kupitirira nthawi 5 kuposa malire apamwamba).
Musanayambe mankhwala
Mukamapereka mankhwala a Krestor ®, komanso pofotokoza zoletsa zina za HMG-CoA reductase, kusamala kuyenera kuchitika mwa odwala omwe ali ndi chiopsezo cha myopathy / rhabdomyolysis (onani gawo la "Chenjerani"), ndikofunikira kulingalira chiopsezo cha kuchuluka ndi phindu lomwe lingachitike pothandizidwa ndi kuyang'ana kwamankhwala.
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 otere, kuchuluka kwa CPK kuyenera kutsimikiziridwa. Therapy iyenera kutha ngati mulingo wa CPK ukuwonjezeka kwambiri (kuchulukitsa nthawi 5 poyerekeza ndi malire apamwamba) kapena ngati minyewa imatchulidwa komanso imayambitsa kusasangalatsa kwa tsiku ndi tsiku (ngakhale mulingo wa CPK ukhale wotsika kasanu kuposa wapamwamba malire a chizolowezi). Ngati zizindikirozo zitha ndipo mlingo wa CPK ubwereranso kwawoko, kuganiziridwa kuyenera kupatsidwanso mankhwala a Krestor ® kapena zoletsa zina za HMG-CoA reductase mu Mlingo wotsika mosamala wodwalayo.
Kuwunikira kwamtundu wa CPK pakalibe zizindikiro sikungathandize.
Milandu yocheperapo kwambiri yokhala ndi mycrathy yokhala ndi chitetezo chochepa kwambiri pakuwonetsa kufooka kwa minofu yowonjezera komanso kuwonjezeka kwa kuchuluka kwa 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 Krestor ® ndi concomitant therapy. Komabe, kuwonjezeka kwa zochitika za myositis ndi myopathy mwa odwala omwe amatenga ma inhibitor ena, HMG-CoA reductase kuphatikiza ndi fibric acid, kuphatikizapo gemfibrozil, cyclosporin, nicotinic acid, azole antifungal agents, proteinase inhibitors ndi macrolide atalembedwa. Gemfibrozil imawonjezera chiopsezo cha myopathy ikaphatikizidwa ndi zoletsa zina za HMG-CoA reductase inhibitors. Chifukwa chake, makonzedwe a munthawi yomweyo a mankhwala a Krestor ® ndi gemfibrozil ali osavomerezeka. Kuyika kwa chiwopsezo kuti mupindule kuyenera kuyesedwa mosamala mukamagwiritsa ntchito kukonzekera kwa Crestor ® limodzi ndi michere kapena milomo yotsitsa ya lipid-nicotinic acid. Kugwiritsa ntchito kwa mankhwala Krestor ® muyezo wa 40 mg pamodzi ndi fibrate amatsutsana. (onani magawo "Kuyanjana ndi mankhwala ena ndi mitundu ina yogwiritsira ntchito mankhwalawa", "Contraindication").
Patatha masabata 2-4 chiyambireni chithandizo ndi / kapena ndikuwonjezereka kwa kukonzekera kwa Krestor ®, kuwunika kwa metabolidi ya lipid ndikofunikira (kusintha kwa lipid ndikofunikira ngati kuli kofunikira).
Chiwindi
Ndikulimbikitsidwa kuti zisonyezo zokhudzana ndi chiwindi zitsimikizidwe musanayambe mankhwala ndi miyezi itatu mutangoyamba chithandizo. Kugwiritsira ntchito kwa mankhwala Krestor ® kuyenera kutha kapena kuti mankhwalawa atha kuchepetsedwa ngati mulingo wa transaminase mu seramu yamagazi ndiwokwera katatu kuposa malire apamwamba.
Odwala omwe ali ndi hypercholesterolemia chifukwa cha hypothyroidism kapena nephrotic syndrome, chithandizo cha matenda oyamba ziyenera kuchitika musanachitike ndi mankhwala a Crestor ®.
Anthu apadera. Mitundu
Mu maphunziro a pharmacokinetic pakati pa odwala achi China ndi achi Japan, kuwonjezeka kwadongosolo la rosuvastatin kudadziwika poyerekeza ndi zizindikiro zomwe zimapezeka pakati pa odwala aku Europe (onani zigawo "Mlingo ndi Administration" ndi "Pharmacokinetics").
Mapuloteni oletsa
Kugwiritsa ntchito kwa mankhwala pamodzi ndi proteinase inhibitors sikulimbikitsidwa (onani gawo "Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana").
Lactose
Mankhwala sayenera kugwiritsidwa ntchito mwa odwala omwe ali ndi kuchepa kwa lactase, galactose tsankho ndi shuga-galactose malabsorption.
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 matenda am'mapapo akuyembekezeka, mankhwala a statin ayenera kusiyidwa.
Type 2 shuga
Odwala omwe ali ndi shuga ya glucose ya 5.6 mpaka 6.9 mmol / L, Crestor ® mankhwala adalumikizidwa ndi chiwopsezo cha matenda a shuga a mtundu wachiwiri.

Kukopa pa kuyendetsa galimoto komanso njira zina

Palibe maphunziro omwe adachitidwa kuti adziwe momwe kukonzekera kwa Krestor ® pakukhudzira kuyendetsa galimoto ndikugwiritsa ntchito njira. Komabe, potengera ndi mankhwala a pharmacodynamic, Krestor ® sayenera kukhala ndi zotere. Chenjezo liyenera kuchitika poyendetsa galimoto kapena kugwira ntchito yokhudzana ndi kuchuluka kwa chidwi ndi psychomotor reaction (chizungulire chitha kuchitika pakubala).

Chifukwa cha cholesterol yayikulu, dokotala wanga adamuuza Krestor koyamba 5

Chifukwa cha cholesterol yayikulu, adokotala adandiuza Krestor koyamba 5 mg, kenako adakulitsa mlingo mpaka 10 mg. Kuchita kwakhala bwino kwambiri. Kwa zaka zitatu, kuyesa kwa chiwindi chokhazikika kunawonetsa kuti zonse zinali zadongosolo. Kenako kudwala kovuta kwambiri, kodziwika ndi kutentha thupi, kupweteka kwa minofu, kupweteka kwa mutu, mkodzo wakuda, kusokonezeka kwa tulo, kuchepa kwa chilakolako cha kugona. Dotolo adatumiza kukayezetsa kokwanira - kuyezetsa magazi, ma x-ray, ma ultrasound ndi compact tomography. Zinadziwika kuti zomwe zimayambitsa sizinali zokhudzana ndi chimfine kapena chimfine. Ndipo mavuto ndi chiwindi adadziwika. Ndinaleka kumutenga Crestor nthawi yomweyo.

Mtanda wanditsitsa cholesterol yanga ndi triglycerides. Koma ndinawona kuwonjezeka

Mtanda wanditsitsa cholesterol yanga ndi triglycerides. Koma ndidawona kuwonjezeka kwa kulemera, kutopa, kutsika kwa mphamvu. Panali kupweteka pachifuwa, kupweteka m'manja, kupweteka pachibwano. Cardiologist adamuyesa ndipo sanadziwe chomwe chimayambitsa matendawa. Ndinaleka kumwa Krestor, ndipo mkati mwa milungu iwiri kapena itatu kulemera kwanga komanso kubwezeretsedwa kunayamba bwino. Ndinawonjezera mafuta am'madzi a nsomba, ndipo ndinayamba kulabadira kwambiri zakudya. Ndikukhulupirira kuti simuyenera kubwerera kukatenga ma statin.

Ndakhala ndikumwa Krestor 10 mg kwazaka zopitilira 10. Adagwira ntchito yabwino,

Ndakhala ndikumwa Krestor 10 mg kwazaka zopitilira 10. Adachita ntchito yabwino kwambiri, adachepetsa cholesterol yanga kukhala yabwinobwino. Koma, kwa zaka zambiri ndimakhala ndi ululu wolumikizika, ndipo madokotala sakanakhoza kufotokoza. Mwanjira ina mnzake wa nthano kuti kupweteka kwanga kophatikizana kungakhale chifukwa cha zomwe Krestor adachita. Kuyang'ana malingaliro ake, ndinasiya kumwa mankhwalawo. Ndipo zowonadi, kupatula miyezi ingapo pomwe ululu wophatikizira udatha. Chifukwa chake tsopano sindikuvomerezanso Krestor.

Ndimamwa 2.5 mg ya Crestor patsiku (iyi ndi theka la piritsi 5 mg). Zidatsika kwenikweni

Ndimamwa 2.5 mg ya Crestor patsiku (iyi ndi theka la piritsi 5 mg). Izi zidachepetsa kwambiri cholesterol yanga kuchokera pa 248 mpaka 193. Si mankhwala odabwitsa, koma abwino. Ndinayamba kumwa ndi 10 mg patsiku, koma ndimatupa am'mimba komanso kukweza kwa michere ya chiwindi.Dokotala anandiuza kuti ndiyesere ma statin ena, koma onse anali ndi zofanana. Chifukwa chake, tidatsitsa mlingo wa Crestor mpaka zotsatira zoyipa zitasiya. Imagwira bwino ntchito ndipo palibe zotsatira zoyipa zomwe zikuwoneka.

Kuphatikiza pa kukhala ndi matenda ashuga, ndimakhalanso ndi cholesterol yapamwamba (yapezeka

Kuphatikiza pa kukhala ndi matenda ashuga, ndimakhalanso ndi cholesterol yapamwamba (yomwe idapezeka zaka 12 zapitazo). Ndili ndi zakudya zochepa, koma osamadya mazira ndi nyama. Komabe, cholesterol yanga inali yokwera. Sindinkafuna kutenga ma statins aliwonse, chifukwa ndinadwala chifukwa chodzidzimutsa kwambiri nditatenga lipitor. Koma chilimwe chatha, zizindikirazo zidakhala zoyipa kwambiri mpaka Krestor adamwa. Komabe, ndinayamba ndi 5 mg kangapo pa sabata. Tsopano, miyezi 8 mtsogolo, cholesterol yanga inali YABWINO yokhazikika ndipo zizindikiro zina zonse zinali zabwino. Endocrinologist wanga adakondwera kwambiri ndipo adati palibe chifukwa chowonjezera mlingo mpaka 10 mg. Zowona, nthawi zina ndimakhala ndi ululu wolumikizana mafupa m'chiuno ndi m'chiuno, koma izi ndizovomerezeka.

Kupanga ndi mawonekedwe a kumasulidwa

Zomwe zimagwira mu Krestor ndi rosuvastatin. Kuphatikizidwa kwa mankhwalawa kumaphatikizanso magawo othandizira: lactose, cellulose, magnesium stearate, calcium phosphate, ndi ena. Crestor imapezeka mu mawonekedwe a mapiritsi a pinki, mawonekedwe ozunguliridwa omwe amafunikira pakamwa. Malinga ndi buku la rada, njira yachilatini imawoneka motere: Rp: Rosuvastatini 0.01 D.t.d.N.10 mu tab.obd. S. 1-1.

Mankhwala amapezeka pamiyeso ingapo:

• Crestor 5 mg
• Crestor 10 mg
• Crestor 20 mg
• Crestor 40 mg.

Kutengera mlingo, pali zolemba mbali imodzi ya piritsi. Mwachitsanzo, pa mlingo wa 10 mg, umati "ZD4522 10" pa iye. Mapiritsi amayikidwa mu blister paketi ya 7 zidutswa. Phukusi limodzi la makatoni pamatha kukhala matuza 1, 4, 14.

Nthawi zambiri, Mlingo wa 10 mg umagulidwa - mapiritsi 98, ndiye kuti, pali matuza 14 mu phukusi. Popeza kuti ma statins amawerengedwa kuti agwiritse ntchito kwa nthawi yayitali, ambiri amapeza phindu kugula mapaketi akuluakulu nthawi imodzi.

Mfundo yogwira ntchito

Mtanda ndi othandizira kutsitsa lipid, ndiye kuti, lipid-kutsitsa. Mphamvu yake yayikulu ndikulinga kuchepetsa kuchuluka kwa lipoproteins a osiyana ma cell m'thupi. Kulowa chiwindi - thupi lomwe limayang'anira kupanga cholesterol, rosuvastatin, chinthu chogwira ntchito cha mankhwala, chimalepheretsa kupanga ma enzyme angapo.

Komabe, cholesterol imalowa m'magazi osati yopangidwa ndi chiwindi. Gawo la chinthu ichi limalowa m'thupi ndi zakudya, makamaka mafuta, zakudya zopanda pake. Kuchita kwa mankhwalawa kumathandizira kuyeretsa kwamitsempha yamagazi ya lipoprotein yotsika kale. Matendawo amatchedwa gawo loyambirira la atherosulinosis.

Ngati atherosulinosis yayamba kale kupanga, mitsempha yamagazi ndi mitsempha imakhudzidwa ndi ma cholesterol amana kapena ma plaque, Krestor ali ndi phindu pa iwo. Imalowa m'madzi ziwiya, ndikuyeretsa ndikuyika zofunikira. Chifukwa cha izi, lumen m'mitsempha ndi mitsempha imachuluka, kuthamanga kwa magazi m'malo omwe akukhudzidwa kumasangalatsa.

Chimodzi mwazovuta za mapangidwe atherosulinotic ndi thrombosis, yomwe imawopseza kuphulika kwa chotengera kapena mtsempha wamagazi. Ma Statins amateteza izi powonjezera chilolezo mwa iwo pochepetsa kukula kwa zolembazo.

Krestor ndi wa m'badwo wachinayi zolengedwa, gululi limawonedwa ngati lothandiza kwambiri. Kupatula kuti kukonzekera kwake kumathandizira kuchepetsa kuchuluka kwa cholesterol yoyipa m'magazi, zimathandizanso kupanga "zabwino". Cholesterol "Chabwino" ndichinthu chofunikira pakugwira bwino ntchito kwamankhwala ambiri amkati, kupanga mahomoni, kulimbitsa ma membrane a maselo ndi machitidwe ena.

Malangizo ogwiritsira ntchito

Malangizo ogwiritsira ntchito mankhwalawa amapezeka phukusi lililonse, ndikofunikira kuti odwala azidziwe bwino asanamwe mapiritsi. Mlingo ndi dongosolo la makonzedwe amayenera kutumizidwa ndi adokotala aliyense payekha. Nthawi zambiri nthawi yaulere imayikidwa, chinthu chachikulu ndikumwa mankhwalawa tsiku lililonse nthawi yomweyo.

Malinga ndi akatswiri ambiri, nthawi yamadzulo ndiyo yabwino kwambiri kutenga ma statins, popeza pofika tsiku tsiku lambiri la cholesterol m'magazi limaposa m'mawa.

Chochita chake chimapangidwira pakamwa, kutsukidwa ndi madzi pang'ono. Simufunikanso kutafuna piritsi. Asanadziwe kuchuluka kwake, wodwalayo amamuwunikira kuti adziwe momwe mitsempha ilili, kuchuluka kwa magazi, ndi ziwalo za mtima.

Nthawi zambiri mlingo woyambira ndi 10 mg. Patatha mwezi umodzi chiyambireni chithandizo, wodwalayo amayenera kukayezetsa magazi, ndipo ngati mankhwalawo ndi othandiza, palibe zotsatira zoyipa, mlingo wake ungathe kuwonjezeka mpaka 20-40 mg wa patsiku. Kenako, munthawi yonse ya chithandizo, ndikofunikira kuti nthawi zonse muzipenda mozama kuti muwone zotsatira zake ndikusintha.

Ngati mankhwalawa amathandizira kupewa matenda amtima, nthawi yoyamba imakhala 5 mg. Popita nthawi, monga momwe adokotala amafotokozera, amathanso kuchuluka.

Nthawi zambiri, ma statin amawerengedwa kuti akhale ndi moyo, ngati sichoncho, ndiye kutalika kwa kudya kwawo ndi miyezi osachepera 3-4. Simungaleke kumwa mapiritsi mwadzidzidzi, dokotala yemwe amakupatsiranipo mankhwala amakupatsani chiwembu malinga ndi kuchuluka kwake komwe kungachepetse, ndipo pokhapokha chithandizo chitha.

Contraindication

Mankhwala aliwonse omwe ali mgululi amakhala ndi zotsutsana zingapo kuti agwiritse ntchito, chifukwa amadziwika kuti ndi wamphamvu. Mtanda sugwiritsa ntchito izi:

• wazaka 18
• mimba ndi kuyamwitsa,
• tsankho lililonse kwa rosuvastatin kapena chinthu chilichonse chophatikizidwa,
• matenda a chiwindi nthawi yayitali,
• myopathy.

Kwa odwala omwe ali pachiwopsezo chotenga myopathy, mlingo wa 40 mg patsiku umatsutsana. Nthawi zambiri amamuika Crestor 20 mg kapena 10 mg woyamba.

Komanso mankhwalawa amaphatikizidwa kwa odwala omwe amamwa mowa wambiri. Popeza machitidwe a ma statins amayang'ana kwambiri chiwindi, ngati ali ndi zakumwa zoledzeretsa, sizingalimbane ndi izi. Wodwala akamasiya kumwa mowa, amapitanso panjira yochira komanso amachira, ayenera kuthandizidwa, koma ayenera kuyamba ndi mitundu yochepa.

Zotsatira zoyipa

Mwa odwala omwe amatenga Krestor, zovuta zoyambirira zimachitika mwa iwo omwe sanatsatire malangizo a dokotala, kupitilira muyeso kapena kunyalanyaza malamulo oponderezedwa. Zotsatira zoyipa zomwe zingakhale ndi:

• mavuto a dyspeptic, kupweteka kwam'mimba,
• mutu, chizungulire,
• mgwirizano wolakwika
• zotupa pakhungu, kuyabwa,
• myalgia
• asthenia
• maonekedwe a kufinya.

Zomwe zili bwino Krestor kapena Rosuvastatin

Mtengo wapakati wa rosuvastatin 20 mg 28 ma PC. ndi ma ruble pafupifupi 550, pomwe mtengo wa Crestor uli pafupifupi kasanu ndi umodzi. Pazifukwa izi, odwala ambiri amakonda kusankha njira yotsika mtengo. Kodi pali kusiyana kotani pakati pa mankhwala, kupatula kusiyanasiyana kotere?

Krestor ndi wa ma statins a m'badwo wachinayi womaliza, ndipo uwu ndiye mwayi waukulu wa mankhwalawo. Ndi njira yabwino, yotetezeka. Malinga ndi madokotala ambiri, ngati muyamba kumwa ma statins, ndipo muyenera kuchita kwa nthawi yayitali, mwina kwa moyo, ndiye izi ziyenera kukhala zapamwamba kwambiri. Ndi mankhwala awa omwe ndi Krestor.

Zopindulitsa za Crestor, zomwe, mosiyana ndi zamagetsi ake ndi zina zomwe zimatsimikiziridwa zovomerezeka, zimaphatikizapo:

• mwachangu
• mankhwala ochepetsa,
• kuchepetsa chiopsezo cha mavuto.

Kusankha zomwe zingakhale bwino ndi cholesterol yayikulu, dokotala yemwe akupezekapo angathandize, powona chithunzi cha momwe wodwalayo alili.