Liprimar mapiritsi 10, 20 mg: malangizo ndi kuwunika pa mankhwalawa

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Zotsatira zoyipa

Zotheka kuchitidwa:

• Hematopoietic dongosolo: kawirikawiri - thrombocytopenia,
• Pakati mantha dongosolo: mutu, kusowa tulo, asthenic syndrome,
• Matumbo: Nthawi zambiri - kupweteka kwam'mimba, kugona, kutsekemera, kutsegula m'mimba, kudzimbidwa, kawirikawiri - kusanza, cholestatic jaundice, kapamba, hepatitis, anorexia,
• Thupi lawo siligwirizana: zotupa pakhungu, zotupa pakhungu, pruritus, urticaria, erythema multiforme, anaphylactic zochita, poyizoni epermermal necrolysis,
• Matenda a minofu ndi mafupa: nthawi zambiri - myalgia, kawirikawiri - myositis, minofu kukokana, myopathy, rhabdomyolysis, kupweteka kumbuyo, arthralgia,
• Metabolism: hyperglycemia, hypoglycemia, kuchuluka kwa serum creatine phosphokinase,
• Zina: kawirikawiri - kupweteka pachifuwa, kusabala, kuchuluka kwa kutopa, kunenepa kwambiri, tinnitus, alopecia, kulephera kwa impso, edema.

Kwenikweni, mankhwalawa amalekeredwa bwino. Zotsatira zoyipa, ngati zimachitika, nthawi zambiri zimakhala zowuma pang'ono komanso zimasinthasintha. Ngati muli ndi kufooka kwa minofu kapena ululu wosakudziwika, makamaka wothandizidwa ndi kutentha thupi kapena kudwala, wodwala amafunikira kukaonana ndi dokotala.

Analogs of Liprimar

Zofanana muzochitika zamagulu:

• Anvistat
• Atocord
• Atomax
• Ator
• Atorvastatin
• Atorvox
• Atoris
• Vazator
• Lipona
• Lipoford
• Liptonorm,
• Novostat,
• Torvazin
• Thorvacard
• Torvalip
• Torvas
• Tulip.

Chidwi: kugwiritsa ntchito ma fanizo kuyenera kuvomerezana ndi adokotala.

Mtengo wapakati wa LIPRIMAR, mapiritsi mumafakisi (Moscow) ndi ma ruble 730.

Mitengo ya lypimar m'masitolo ogulitsa mankhwala ku Moscow

Ndemanga za madokotala za lypimar

Ndimagwiritsa ntchito Liprimar yoyambirira yothandiza mokwanira panjira yovuta ya erectile kukanika chifukwa cha atherossteosis, dyslipidemia. Patatha miyezi yochepa kutenga zabwino amadziwika. Mlingo wothandiza kwambiri ndi 20 mg tsiku lililonse. Kuyang'anira kuyamwa kwa lipid mankhwala! Mtengo wabwino kwambiri wa ndalama.

Kufunika kovomerezedwa nthawi yayitali, nthawi zambiri, kuvomerezedwa. Kuchepa kwa chiwindi cholipira ntchito, kukhumudwa. Nthawi zina - kukulira kwa zizindikilo pazinthu zomwe zimapanga erection. Koma ziyenera kuzindikirika kuti mavuto omwe amabwera chifukwa cha Liprimar amakhala osakwana 1%.

Payenera kukhala kumvetsetsa kwa njira yotsatira ya pathophysiological: kuwonongeka kwa erection mu atherosulinosis kumalumikizidwa osati kokha ndi kuwonongeka kwa kulowetsedwa - kutuluka kwa mbolo kudzera m'mitsempha yamagazi, komanso ndi kuwonongeka kwa testicle, komwe ma testosterone ofunika kwambiri a amuna, testosterone, amapangidwa.

Zotsatira zoyipa ndizosowa kwambiri. Mavuto a hepatic enzymes ndi osowa kwambiri. Palibe milandu yokhudzana ndi matenda ashuga m'machitidwe anga.

Atorvastatin ndi woipa komanso wotetezeka, poganizira kukwera kwambiri, kavalo wamtima wamakono. Mlingo wogwira ndi 2040 mg patsiku, makamaka kwa odwala omwe ali ndi vuto la mtsempha wamagazi. Mlingo wa 80 mg umatha kugwiritsidwa ntchito ngati gawo lochotsetsa kukhazikika kwa odwala omwe ali ndi ACS. Ndifunsira ogwira nawo ntchito mwamphamvu kuti asagwiritse ntchito malingaliro oyang'ana pa utopian pakugwiritsa ntchito mlingo waukulu wa atorvastatin pafupipafupi. Kuchita bwino kwa njirayi sikunatsimikizidwe, ndipo chitetezo chimabutsa mafunso ambiri. M'matenda ambiri, atorva amakonda rosuvastatin mu chitetezo chake.

Imayesedwa ndi anthu komanso mankhwala, dzina losavuta komanso losaiwalika.

Kwa nthawi yayitali sindinathe kumvetsetsa chifukwa chomwe sindimatha kugwiritsa ntchito Atorvastatin yosavuta m'malo mwake, zotsatira za pulogalamuyi zidatsimikiza.

Posachedwa ndidazindikira za mankhwalawa, koma kwa ine ndimakhala m'gulu la malo otsogolera nthawi.

Liprimar ndiye atorvastatin woyambirira wa kampani ya Pfizer. Ali ndi maphunziro ambiri omwe amawonetsa zotsatira zake zochizira: kuchepetsa chiopsezo cha myocardial infarction, stroke, kufa kwa omwe amachititsa chifukwa cha mtima ndi kufa kwathunthu. Zowonadi, kuchuluka kwa zochitika izi kumachepa kokha kwa iwo omwe ali ndi chiopsezo choyambirira - omwe akudwala kale matenda a mtima, komanso anthu omwe ali ndi chiopsezo chachikulu: cholesterol yayikulu, kuthamanga kwa magazi, shuga, kusuta, ndi zina zambiri.

Monga chilichonse.Zokhumudwitsa zimachitika ngati pali ziyembekezo zopanda nzeru. Sindikonda mfundo yoti media ndi kampeni yopusa "yowonetsa" ndi "kuwonetsa" ma statins omwe ali ndi zopanda pake zambiri komanso nthano. Ma statins “sawononga” chiwindi kapena impso, komanso sayambitsa matenda a Alzheimer's kapena khansa. Statin ndi ena mwa mankhwala omwe amaphunziridwa kwambiri komanso otetezeka kwambiri m'mbiri ya zamankhwala.

Aliyense amene angalole Liprimar ngati mankhwala a atorvastatin akhoza kutenga Liprimar ngati muyezo wake. Ngati palibe ndalama yolandirira Liprimar kwa nthawi yayitali, mutha kutenga ma jeniki, koma apamwamba kwambiri. Atoris ndi amodzi mwa iwo.

Mankhwala oyamba kuchokera ku gulu la ma statins (atorvastatin). Amachepetsa bwino LDL. Amayikidwa ndi dokotala malinga ndi zikuwonetsa, kutengera chiopsezo cha mtima.

Kuwonjezeka kwa milingo ya ma transaminases ndikotheka, mogwirizana ndi momwe kuwongolera kwa ALT, AST mu mphamvu ndikofunikira. Amawerengedwa kuti ndi ovomerezeka kumwa mankhwalawa pamlingo wa ALT, AST mpaka 3 mikhalidwe.

Pogwiritsa ntchito nthawi yayitali, kuchuluka kwa stenosis kumachepa, kuyesedwa pawokha ndi ultrasound. Pafupifupi palibe mavuto. Mtengo wokhala ndi khadi ndi zomveka bwino ngati mutenga phukusi lalikulu. Ndikupangira ngati atorvastatin wabwino kwambiri.

Ndikupangira izi kwa odwala onse, indedi, ngati ndizokwera mtengo - ndikufuna njira ina.

Zotsatira! Ndi zolembera zofewa, pakatha miyezi itatu ndizotheka kuchepetsa kuchuluka kwa ICA stenosis, mitsempha yam'mimba mwa 10-20%!

Mtengo, koma kwa mtundu wa mankhwala ndizosatheka kuchita ndi zochepa. Chilichonse chimadziwika poyerekeza - ndi rosuvastatin, ma enics ndi okwera mtengo kwambiri kuposa Liprimar wamba.

Kwa okondedwa anu - umu ndi mankhwala osankhira!

Pharmacology

Zopangira lipid-kutsitsa mankhwala. Atorvastatin ndi mpikisano wosankha wa HMG-CoA reductase, ma enzyme ofunikira omwe amasintha 3-hydroxy-3-methylglutaryl-CoA kukhala mevalonate, choyambirira kwa ma steroid, kuphatikiza cholesterol.

Odwala omwe ali ndi homozygous ndi heterozygous Famer hypercholesterolemia, osakhala a mabanja a hypercholesterolemia ndi dyslipidemia, atorvastatin otsika okwana cholesterol (Ch) mu plasma, cholesterol-LDL ndi apolipoprotein B (apo-B), komanso amayambitsa LH kuchuluka kwa HDL-C.

Atorvastatin amachepetsa kuchuluka kwa cholesterol ndi lipoproteins m'magazi am'magazi, kuletsa HMG-CoA reductase ndi kaphatikizidwe kolesterol mu chiwindi ndikuwonjezera kuchuluka kwa hepatic LDL receptors pamaselo a cell, zomwe zimayambitsa kuwonjezeka ndikuwonetsa kwa LDL-C.

Atorvastatin amachepetsa kupangika kwa LDL-C ndi kuchuluka kwa tinthu ta LDL. Zimayambitsa kuwonjezeka kosalekeza kwa zochitika za LDL receptors, kuphatikiza pakusintha koyenera mu zinthu za LDL. Amachepetsa mulingo wa LDL-C odwala omwe ali ndi homozygous cholowa hypercholesterolemia, osagwirizana ndi mankhwala ena okhala ndi lipid-kuchepetsa.

Atorvastatin mu Mlingo wa 10-80 mg amachepetsa cholesterol yathunthu ndi 30-46%, LDL-C ndi 41-61%, apo-B ndi 34-50% ndi TG ndi 14-33%. Zotsatira zamankhwala ndizofanana kwa odwala omwe ali ndi heterozygous Famer hypercholesterolemia, omwe siabanja mitundu ya hypercholesterolemia ndi hyperlipidemia kuphatikizapo Odwala odwala matenda a shuga omwe amadalira insulin.

Odwala omwe ali ndi hypertriglyceridemia yotsala, ma atorvastatin amatsitsa cholesterol yonse, Chs-LDL, Chs-VLDL, apo-B ndi TG ndikuwonjezera kuchuluka kwa Chs-HDL. Odwala omwe ali ndi dysbetalipoproteinemia, cholesterol imachepetsa wapakati kachulukidwe lipoprotein.

Odwala omwe ali ndi mtundu wa IIa ndi IIb hyperlipoproteinemia malinga ndi gulu la Fredrickson, mtengo wowonjezereka wa HDL-C panthawi ya chithandizo ndi atorvastatin (10-80 mg), poyerekeza ndi mtengo woyambira, ndi 5.1-8.7% ndipo sizimatengera mlingo. Pali kuchepa kwakukulu kosadalira mlingo: cholesterol / Chs-HDL ndi Chs-LDL / Chs-HDL ndi 29-44% ndi 37-55%, motsatana.

Liprimar ® pa mlingo wa 80 mg umachepetsa kwambiri zovuta za ischemic ndi kufa ndi 16% pambuyo pa maphunziro a sabata 16, ndi chiopsezo chakugonekedwanso kuchipatala kwa angina pectoris, limodzi ndi zizindikiro za myocardial ischemia, ndi 26%. Odwala omwe ali ndi misinkhu yosiyanasiyana ya LDL-C, Liprimar ® amachepetsa chiwopsezo cha ischemic zovuta ndi kufa (mwa odwala omwe ali ndi myocardial infarction popanda Q wave ndi angina osakhazikika, amuna ndi akazi, odwala osakwanitsa zaka 65).

Kutsika kwa plasma m'magazi a LDL-C kumalumikizidwa bwino ndi mlingo wa mankhwalawo kuposa momwe amapangidwira m'magazi am'magazi.

The achire zotsatira zimatheka patatha masabata awiri chiyambireni kuyambika kwa mankhwalawa, chimafika pakatha masabata 4 ndipo chimapitilira nthawi yonse ya chithandizo.

Mtima Kupewa matenda

Mu kafukufuku wa Anglo-Scandinavia wokhudzana ndi zovuta zamtima, lipid-lowering nthambi (ASCOT-LLA), zotsatira za atorvastatin pa matenda oopsa a mtima komanso osapweteka, zidapezeka kuti zotsatira za chithandizo cha atorvastatin pamlingo wa 10 mg zimadutsa kwambiri zotsatira za placebo, ndipo chifukwa chake lingaliro lidachitika kuimitsidwa koyambirira kwa kafukufukuyu patatha zaka 3.3 mmalo mwa zaka 5 zomwe zikuyembekezeka.

Atorvastatin kwambiri adachepetsa kukula kwa zovuta zotsatirazi:

Panalibe kuchepa kwakukulu kokuwonetsa za kufa kwathunthu ndi kufa kwa anthu omwe adayamba chifukwa cha mtima, ngakhale panali zochitika zina zabwino.

Pa kafukufuku wophatikizidwa wokhudzana ndi zotsatira za atorvastatin mwa odwala omwe ali ndi mtundu wa 2 shuga mellitus (CARDS) pazotsatira zakupha komanso zopanda pake zamatenda amtima, zidawonetsedwa kuti chithandizo chamankhwala atorvastatin, mosasamala za jenda la wodwala, zaka, kapena msambo wa LDL-C, idachepetsa chiopsezo chokhala ndi zovuta zamtima zotsatirazi :

Pakufufuza kwakukonzanso kwa kusintha kwa coronary atherosulinosis ndi hypolipidemic tiba (REVersAL) ndi atorvastatin pa mlingo wa 80 mg mwa odwala omwe ali ndi matenda amitsempha yamagazi, tapezeka kuti kuchepa kwapakati pa voliyumu yonse ya atheroma (gawo lalikulu la chidziwitso) kuyambira pachiyambire kafukufukuyo panali 0.4%.

Intensive Cholesterol Reduction Programme (SPARCL) idapeza kuti atorvastatin pa mlingo wa 80 mg / tsiku amachepetsa chiwopsezo chobwereza kapena chosapweteka mwa odwala omwe ali ndi mbiri ya matenda otupa kapena osakhalitsa a ischemic popanda matenda a coronary artery by 15% poyerekeza ndi placebo. Nthawi yomweyo, chiopsezo cha zovuta zazikuluzikulu za mtima ndi njira zotsitsimutsira magazi zinachepetsedwa kwambiri. Kuchepetsa chiopsezo cha matenda amkati pamtima pa atorvastatin adawonedwa m'magulu onse kupatula okhawo omwe amaphatikiza odwala omwe ali ndi vuto loyambira kapena lozungulira hemorrhagic stroke (7 pagulu la atorvastatin motsutsana ndi 2 mu gulu la placebo).

Odwala omwe amathandizidwa ndi atorvastatin mankhwala pa mlingo wa 80 mg, kuchuluka kwa hemorrhagic kapena ischemic stroke (265 motsutsana 311) kapena IHD (123 motsutsana 204) kunali kochepa poyerekeza ndi gulu lolamulira.

Kupewa kwachiwiri kwa mtima wamavuto

Malinga ndi New Target Study (TNT), zotsatira za atorvastatin pa Mlingo wa 80 mg / tsiku ndi 10 mg / tsiku pachiwopsezo chokhala ndi zovuta zamtima mwa odwala omwe ali ndi matenda amitsempha yamagetsi otsimikizika.

Atorvastatin pa mlingo wa 80 mg kwambiri adachepetsa kukula kwa zovuta zotsatirazi:

Kutulutsa Fomu

Mapiritsi, omwe adaphimbidwa ndi utoto wa filimu yoyera, amalembedwa amodzi, amalemba "10" mbali imodzi ndi "PD 155" mbali inayo, pamapaziwo pali chozungulira choyera.

Omwe amathandizira: calcium carbonate - 33 mg, cellcrystalline cellulose - 60 mg, lactose monohydrate - 32,8 mg, croscarmellose sodium - 9 mg, polysorbate 80 - 0.6 mg, hyprolose - 3 mg, magnesium stearate - 0,75 mg.

Kuphatikizidwa kwa chovala cha filimuyi: opadry yoyera YS-1-7040 (hypromellose - 66.12%, polyethylene glycol - 18.9%, titanium dioxide - 13.08%, talc - 1.9%) - 4.47 mg, simethicone emulsion (simethicone - 30%, stearic emulsifier - 0,075% , sorbic acid, madzi) - 0,03 mg, candelila sera - 0,08 mg.

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

Asanayambe chithandizo ndi Liprimar ®, munthu ayenera kuyesa kupeza mphamvu ya hypercholesterolemia kudzera mu chakudya, masewera olimbitsa thupi komanso kuchepa thupi kwa odwala omwe ali ndi kunenepa kwambiri, komanso chithandizo cha matenda oyambitsidwa.

Popereka mankhwala, wodwalayo ayenera kulimbikitsa mtundu wa zakudya zomwe ayenera kutsatira pakumwa.

Mankhwala amatengedwa pakamwa nthawi iliyonse ya tsiku, mosasamala kanthu za kudya.

Mlingo wa mankhwalawa umasiyanasiyana 10 mg mpaka 80 mg 1 nthawi / tsiku, kusankha kwa mankhwalawa kuyenera kuchitika poganizira zomwe zili zoyambirira za LDL-C, cholinga cha mankhwala ndi zotsatira zake. Mlingo wapamwamba ndi 80 mg 1 nthawi / tsiku.

Kumayambiriro kwa chithandizo chamankhwala komanso / kapena pakuwonjezeka kwa mlingo wa Liprimar ®, ndikofunikira kuyang'anitsitsa zomwe zili m'magazi a plasma masabata onse a 2-4 ndikusintha mankhwalawo moyenerera.

Mu hypercholesterolemia yoyamba komanso yophatikizika (yophatikiza) hyperlipidemia kwa odwala ambiri, mlingo wa Liprimar ndi 10 mg 1 nthawi / tsiku. Zotsatira zakuchiritsika zimawonekera mkati mwa masabata awiri ndipo nthawi zambiri zimafika pakadutsa masabata anayi. Ndi chithandizo chakanthawi, zotsatira zake zimapitilira.

Ndi homozygous Famer hypercholesterolemia, mankhwala amamuika pa mlingo wa 80 mg 1 nthawi / tsiku (kutsika kwa LDL-C ndi 18-45%.

Ngati vuto la chiwindi likulephera, mlingo wa Liprimar ® uyenera kuchepetsedwa poyang'aniridwa nthawi zonse ndi ntchito za Act ndi ALT.

Ntchito yaimpso yolakwika siyikhudza kuchuluka kwa atorvastatin m'madzi am'magazi kapena kuchepa kwa zomwe LDL-C ikugwiritsa ntchito Liprimar, motero, kusintha kwa mankhwalawa sikofunikira.

Mukamagwiritsa ntchito mankhwalawa odwala okalamba, kusiyana pakukwaniritsa ndi chitetezo poyerekeza ndi anthu ambiri sikunapezeke, ndipo kusintha kwa mlingo sikofunikira.

Ngati ndi kotheka, kugwiritsa ntchito pamodzi ndi cyclosporine, mlingo wa Liprimar ® sayenera kupitirira 10 mg.

Malangizo othandiza kudziwa tanthauzo la mankhwalawa

A. Malangizo kuchokera ku National NCEP Cholesterol Education Program, USA

Ndi makonzedwe apakati pa Liprimar ndi kuyimitsidwa komwe kuli ndi magnesium ndi aluminium hydroxides, kuchuluka kwa atorvastatin mu plasma kunatsika ndi pafupifupi 35%, komabe, kuchepa kwa mulingo wa LDL-C sikunasinthe.

Kugwiritsa ntchito pamodzi kwa Liprimar ® sikukhudza ma pharmacokinetics a phenazone, chifukwa chake, kuyanjana ndi mankhwala ena omwe amapangidwa ndi cytochrome isoenzymes yomwe siikuyembekezeka.

Ndi munthawi yomweyo kugwiritsa ntchito colestipol, kuchuluka kwa atorvastatin mu plasma kumachepa pafupifupi 25%. Komabe, lipid-kutsitsa mphamvu ya kuphatikiza kwa atorvastatin ndi colestipol imaposa ya aliyense mankhwala payekhapayekha.

Pogwiritsa ntchito mobwerezabwereza digoxin ndi Liprimar pa 10 mg, kuchuluka kwa magawo a digoxin m'madzi a m'magazi sikunasinthe. Komabe, pamene digoxin idagwiritsidwa ntchito limodzi ndi Liprimar pa mlingo wa 80 mg / tsiku, kuchuluka kwa digoxin kumawonjezeka pafupifupi 20%. Odwala omwe amalandira digoxin osakanikirana ndi Liprimar amafunikira kuwunika kwamankhwala.

Ndi munthawi yomweyo kugwiritsa ntchito Liprimar pa 10 mg 1 nthawi / tsiku ndipo azithromycin pa mlingo wa 500 mg 1 nthawi / tsiku, kuchuluka kwa atorvastatin mu plasma sikunasinthe.

Pogwiritsa ntchito munthawi yomweyo Liprimar ndi kulera kwapakamwa komwe kumakhala ndi norethisterone ndi ethinyl estradiol, kuwonjezeka kwakukulu mu AUC ya norethisterone ndi ethinyl estradiol kumawonedwa ndi pafupifupi 30% ndi 20%, motero. Izi zimayenera kuganiziridwa posankha njira yakulera yoletsera pakamwa kwa mayi yemwe amalandira Liprimar ®.

Liprimar ® yogwiritsidwa ntchito munthawi yomweyo sinakhale ndi chiyambukiro chachikulu pa pharmacokinetics ya terfenadine.

Zizindikiro zakugwirizana kwakukulu kwa atorvastatin ndi warfarin sikunapezeke.

Ndi munthawi yomweyo kugwiritsa ntchito Liprimar pa mlingo wa 80 mg ndi amlodipine pa 10 mg, ma pharmacokinetics a atorvastatin sanasinthe pakufanana.

Mankhwala ena ophatikizika

M'maphunziro azachipatala, Liprimar ® idagwiritsidwa ntchito limodzi ndi mankhwala a antihypertensive ndi estrogens, omwe adalembedwa kuti alowe m'malo mwamankhwala, palibe zofunikira zazidziwitso zosafunikira zomwe zimadziwika. Kafukufuku wochita mogwirizana ndi mankhwala enaake sanachitike.

Mimba komanso kuyamwa

Liprimar ® imalekanitsidwa kuti igwiritsidwe ntchito pa nthawi ya pakati komanso pakameta.

Amayi a msinkhu wobereka ayenera kugwiritsa ntchito njira zokwanira zolerera panthawi ya chithandizo. Liprimar ® imatha kulembedwa kwa azimayi azaka zakubadwa pokhapokha ngati mwayi wokhala ndi pakati ndi wochepa kwambiri, ndipo wodwalayo akudziwitsidwa za chiopsezo chotheka kwa mwana wosabadwayo panthawi ya chithandizo.

Sizikudziwika ngati atorvastatin amachotsedwa mkaka wa m'mawere. Ngati ndi kotheka kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa, yoyamwitsa iyenera kusiyidwa kuti tipewe chiwopsezo cha zochitika zoyipa makanda.

Gwiritsani ntchito ntchito yolakwika ya chiwindi

Kugwiritsira ntchito mankhwalawa kumapangidwa chifukwa cha matenda a chiwindi kapena kuwonjezeka kwa ntchito ya seramu ya transaminases (koposa nthawi 3 poyerekeza ndi VGN) yosachokera.

Ngati vuto la chiwindi likulephera, mlingo wa Liprimar ® uyenera kuchepetsedwa poyang'aniridwa nthawi zonse ndi ntchito za Act ndi ALT.

Mosamala, mankhwalawa ayenera kuikidwa ngati pali mbiri ya matenda a chiwindi.

Malangizo apadera

Zochita pa chiwindi

Monga mankhwala ena otsitsa a lipid a kalasi imodzi, atalandira chithandizo ndi Liprimar ®, kuchuluka kwapakati (kangapo katatu poyerekeza ndi VGN) kukuwonjezereka kwa seramu ntchito ya AST ndi ALT idadziwika. Kuchulukirachulukira kosalekera kwamasamu ambiri a hepatic transaminases (ochulukirapo nthawi 3 poyerekeza ndi VGN) amawonedwa mu 0.7% ya odwala omwe amalandira Liprimar ® m'mayesero azachipatala. Pafupipafupi kusintha koteroko kugwiritsa ntchito mankhwala Mlingo wa 10 mg, 20 mg, 40 mg ndi 80 mg anali 0,2%, 0,2%, 0,6% ndi 2.3%. Kuwonjezeka kwa hepatic transaminase ntchito nthawi zambiri sikumayendetsedwa ndi jaundice kapena mawonekedwe ena achipatala. Ndi kuchepa kwa mlingo wa Liprimar ®, kusiya kwakanthawi kapena kokwanira kwa mankhwalawo, zochitika za hepatic transaminases zibwerera ku gawo lake loyambirira.Odwala ambiri anapitiliza kumwa Liprimar ® mu mlingo wochepetsedwa popanda zovuta zina.

Asanayambe, milungu isanu ndi umodzi ndi milungu 12 atatha mankhwalawa kapena atatha kuchuluka, komanso munthawi yonse ya chithandizo, ndikofunikira kuwunika zizindikiro za chiwindi. Kugwiritsidwa ntchito kwa chiwindi kuyeneranso kuyesedwa ngati zizindikiro zakuchipatala za kuwonongeka kwa chiwindi zikuwonekera. Ngati chiwopsezo cha ntchito ya hepatic transaminases, ntchito zawo ziyenera kuyang'aniridwa mpaka zitasintha. Ngati kuchuluka kwa ntchito ya AST kapena ALT mwa kuchulukitsa katatu poyerekeza ndi VGN ndikulimbikira, ndikulimbikitsidwa kuti muchepetse mlingo kapena kusiya Liprimar ®.

Mafupa a minofu

Odwala omwe amalandira Liprimar ®, myalgia adadziwika. Kuzindikiritsa kwa myopathy (kupweteka kwa minofu ndi kufooka kophatikiza ndi kuwonjezeka kwa zochitika za CPK nthawi zopitilira 10 poyerekeza ndi VGN) kuyenera kuganiziridwa kwa odwala omwe atulutsa myalgia, kufooka kwa minofu kapena kufooka komanso / kapena kuwonjezeka kwakukulu kwa ntchito ya CPK. Mankhwala a Liprimar ® ayenera kusiyidwa pokhapokha pakuwonetsa kutchulidwa kwa ntchito za KFK, pamaso pa myopathy yotsimikizika. Chiwopsezo cha myopathy mu mankhwalawa ndimankhwala ena a mkalasi iyi chinachulukana ndikugwiritsa ntchito munthawi yomweyo cyclosporine, fibrate, erythromycin, nicotinic acid mu hypolipidemic doses (oposa 1 g) kapena mankhwala antifungal (azole derivatives). Ambiri mwa mankhwalawa amalepheretsa CYP3A4 isoenzyme metabolism ndi / kapena kayendedwe ka mankhwala. Amadziwika kuti cytochrome CYP3A4 isoenzyme ndiye chiwindi chachikulu cha isoenzyme chomwe chimakhudzidwa ndi biotransfform ya atorvastatin. Mukapereka mankhwala a Liprimar ® osakanikirana ndi ma fibrate, erythromycin, immunosuppressants, mankhwala antifungal (azole derivatives) kapena nicotinic acid mu Mlingo wa hypolipidemic, mapindu omwe akuyembekezeredwa ndi chiopsezo chamankhwala ayenera kuyesedwa mosamala. Odwala amayenera kuyang'aniridwa pafupipafupi kuti awone kupweteka kwa minofu kapena kufooka, makamaka m'miyezi yoyambirira ya chithandizo komanso panthawi yowonjezera Mlingo wa mankhwala aliwonse. Ngati ndi kotheka, kuphatikiza mankhwalawa kuyenera kuganiziranso za kugwiritsa ntchito mankhwalawa pang'onopang'ono ndikukonzanso Mlingo. Muzochitika zotere, kutsimikiza kwakanthawi kantchito ya CPK kungalimbikitsidwe, ngakhale kuwunika koteroko sikumalepheretsa kukula kwa myopathy.

Mukamagwiritsa ntchito mankhwala a Liprimar ®, monga ma statin ena, kawirikawiri milandu ya rhabdomyolysis yolephera kupweteka chifukwa cha myoglobinuria yalongosoledwa. Ngati zizindikiro za myopathy zotheka zikuwoneka kapena pali chiopsezo cha kulephera kwa impso chifukwa cha rhabdomyolysis (mwachitsanzo, matenda owopsa pachimake, kusokonekera kwa magazi, kuchitidwa opaleshoni yayikulu, kuvulala, metabolic, endocrine ndi kusokonekera kwa elekitala komanso kugwidwa kosalamulirika), Liprimar ® therapy iyenera kuyimitsidwa kwakanthawi kapena kwathunthu kuletsa.

Odwala akuyenera kuchenjezedwa kuti ayenera kupita kwa dokotala ngati vuto lopanda kufooka kapena kufooka kwa minofu kumachitika, makamaka ngati limodzi ndi malaise kapena malungo.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Palibe zambiri pazokhudzana ndi atorvastatin pa kuyendetsa magalimoto ndi kuchita zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Liprimar imakhudzana ndi pakati.

Amayi a msinkhu wobereka ayenera kugwiritsa ntchito njira zokwanira zolerera panthawi ya chithandizo. Kugwiritsa ntchito Liprimar kumayesedwa pakati pa azimayi amiseche omwe sagwiritsa ntchito njira zoyenera zakulera.

Zochitika zosawerengeka zamalingaliro obadwa nazo zadziwika pambuyo podziwikiridwa kwa fetus mu chiberekero pambuyo pa HMG-CoA reductase inhibitors (statins). Kafukufuku wazinyama adawonetsa poyipa pakubala. Liprimar imakhudzana ndi mkaka wa mkaka. Sizikudziwika ngati atorvastatin amachotsedwa mkaka wa m'mawere. Ngati ndi kotheka kuti mupeze mankhwalawa panthawi yoyamwitsa, yoyamwitsa iyenera kuyimitsidwa kuti ipewe chiopsezo cha zovuta za ana.

Bongo

Palibe mankhwala enieni a mankhwalawa omwe ali ndi liprimar. Pankhani ya bongo, chithandizo chamankhwala chiyenera kuchitidwa pofunikira. Kuyeserera kwa ntchito kwa chiwindi kuyenera kuchitika ndipo ntchito za CPK ziyenera kuyang'aniridwa. Popeza mankhwalawa amamangidwa kumapuloteni amadzi a m'magazi, hemodialysis siyothandiza.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi makonzedwe apakhungu a Laprimar omwe ali ndi cyclosporine, erythromycin, mankhwala antifungal ochokera ku gulu la azole ndi zotumphukira za michere, chiopsezo chotenga myopathy chimakulanso.

Ndi kuphatikiza kwa atorvastatin ndi cytochrome inhibitors (P450 3A4) m'magazi am'magazi, kuchuluka kwa gawo losagwirizana kumawonjezeka.

Pogwiritsa ntchito munthawi yomweyo ndimalandidwe a P450 3A4 isoenzyme, ma antacid, ndi cholestipol, ma plasma wozungulira osasinthika a atorvastatin. Komabe, kutchulidwa kochulukira kwa lipid kumadziwika.

Akaphatikizidwa ndi njira zakulera za pakamwa zomwe zimakhala ndi ethinyl estradiol ndi norethindrone, kuyamwa kwawo (AUC) kumawonjezeka ndi 20-30%.

Zokhudza chiwindi

Momwemonso kugwiritsa ntchito mankhwala ena otsitsa a lipid a mkalasi imeneyi, ndi kugwiritsa ntchito mankhwala a Liprimar, kuchuluka kwapakati (kangapo katatu poyerekeza ndi VGN) pa zochitika za hepatic transaminases AST ndi ALT. Kukula kosalekeza kwa ntchito ya seramu ya hepatic transaminases (nthawi zopitilira 3 poyerekeza ndi VGN) idawonedwa mu 0.7% ya odwala omwe amalandira Liprimar. Pafupipafupi kusintha koteroko kugwiritsa ntchito mankhwala Mlingo wa 10 mg, 20 mg, 40 mg ndi 80 mg anali 0,2%, 0,2%, 0,6% ndi 2.3%. Kuwonjezeka kwa hepatic transaminase ntchito nthawi zambiri sikumayendetsedwa ndi jaundice kapena mawonekedwe ena achipatala. Ndi kuchepa kwa mlingo wa Liprimar, kusiya kwakanthawi kapena kwathunthu kwa mankhwalawo, zochitika za hepatic transaminases zidabwerera momwe zidakhalira. Odwala ambiri anapitiliza kumwa Liprimar muyezo wochepetsera popanda zotsatira zoyipa.

Asanayambe, milungu isanu ndi umodzi ndi milungu 12 atatha mankhwalawa kapena atakulitsa mlingo, ndikofunikira kuwunikira zizindikiro za chiwindi. Kugwiritsidwa ntchito kwa chiwindi kuyeneranso kuyesedwa ngati zizindikiro zakuchipatala za kuwonongeka kwa chiwindi zikuwonekera. Ngati chiwopsezo cha ntchito ya hepatic transaminases, ntchito zawo ziyenera kuyang'aniridwa mpaka zitasintha. Ngati kuchuluka kwa ntchito ya AST kapena ALT mwa kuchulukitsa katatu poyerekeza ndi VGN ndikulimbikira, ndikulimbikitsidwa kuti muchepetse mlingo kapena kusiya Liprimar.

Liprimar iyenera kugwiritsidwa ntchito mosamala odwala omwe amamwa mowa wambiri ndi / kapena omwe ali ndi mbiri yodwala matenda a chiwindi. Matenda a chiwindi omwe amagwira ntchito kapena kuwonjezereka kwa hepatic transaminase yamagazi a osadziwikiratu ndikutsutsana ndi Liprimar.

Zotsatira pa minofu ya mafupa

Myalgia adadziwika mu odwala omwe amalandira Liprimar. Kuzindikiritsa kwa myopathy kuyenera kuganiziridwa kwa odwala omwe akuphwanya myalgia, kupweteka kwa minofu kapena kufooka komanso / kapena kuwonjezeka kodziwika mu ntchito ya KFK (koposa nthawi 10 poyerekeza ndi VGN). Mankhwala a Liprimar amayenera kusiyidwa ngati pakuwoneka kuwonjezeka kwa zochitika za CPK, pamaso pa myopathy yotsimikizika. Chiwopsezo cha myopathy akamagwiritsidwa ntchito ndi mankhwala ena mkalasiyi chikuwonjezeka ndikugwiritsira ntchito munthawi yomweyo zoletsa zamphamvu za CYP3A isoenzyme (mwachitsanzo, cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posraconazole, posraconazole, posraconazole. darunavir), gemfibrozil kapena mafupa ena, boceprevir, erythromycin, nicotinic acid mu lipid kutsitsa Mlingo (woposa 1 g / tsiku), ezetimibe, azole antifungal agents, colchicine, telaprevir, boceprevir, kapena kuphatikiza kwa tipranavir / ritonavir. Ambiri mwa mankhwalawa amalepheretsa CYP3A4 isoenzyme metabolism ndi / kapena kayendedwe ka mankhwala. Amadziwika kuti cytochrome CYP3A4 isoenzyme ndiye chiwindi chachikulu cha isoenzyme chomwe chimakhudzidwa ndi biotransfform ya atorvastatin. Kulemba Liprimar molumikizana ndi ma fibrate, erythromycin, immunosuppressants, mankhwala antifungal (azole derivatives) kapena nicotinic acid mu Mlingo wa hypolipidemic (wopitilira 1 g / tsiku), mwayi woyembekezeredwa ndi chiopsezo chamankhwala ziyenera kuyesedwa. Odwala amayenera kuyang'aniridwa pafupipafupi kuti awone kupweteka kwa minofu kapena kufooka, makamaka m'miyezi yoyambirira ya chithandizo komanso panthawi yowonjezera Mlingo wa mankhwala aliwonse. Ngati ndi kotheka, kuphatikiza mankhwalawa kuyenera kuganiziranso za kugwiritsa ntchito mankhwalawa pang'onopang'ono ndikukonzanso Mlingo. Kugwiritsa ntchito munthawi yomweyo mankhwala a atorvastatin ndi fusidic acid osavomerezeka, chifukwa chake, kuchoka kwa atorvastatin ndikulimbikitsidwa panthawi ya mankhwala a fusidic acid. Muzochitika zotere, kutsimikiza kwakanthawi kantchito ya CPK kungalimbikitsidwe, ngakhale kuwunika koteroko sikumalepheretsa kukula kwa myopathy.

Pamaso mankhwala

Liprimar iyenera kugwiritsidwa ntchito mosamala mu odwala omwe ali ndi vuto la rhabdomyolysis. Kuwongolera kwa ntchito za CPK kuyenera kuchitika pazochitika zotsatirazi musanayambe chithandizo cha atorvastatin:

• kuwonongeka kwaimpso,
• hypothyroidism
• zovuta zam'badwa zamavuto m'mbiri ya wodwalayo kapena mbiri ya banja,
• anasamutsa kale poizoni wa HMG-CoA reductase inhibitors (ma statins) kapena ma fiber pamisempha minofu,
• mbiri yodwala matenda a chiwindi ndi / kapena odwala omwe amamwa mowa wambiri,
• mwa odwala omwe ali ndi zaka zopitilira 70, kuwunika kwa CPK kuyenera kuwunikiridwa, popeza kuti odwalawa ali ndi zinthu zomwe zikuwonetseratu kukula kwa rhabdomyolysis,
• nthawi yomwe kuchuluka kwa plasma wozungulira atorvastatin amayembekezeredwa, monga kuchita ndi mankhwala ena. Zikatero, chiwopsezo / phindu limayenera kuwunikidwa ndikuwunika momwe wodwalayo alili. Pankhani yakuwonjezereka kwa ntchito za CPK (zochulukirapo ka 5 kuposa VGN), chithandizo cha atorvastatin sichiyenera kuyamba.

Mukamagwiritsa ntchito mankhwala a Liprimar, komanso zoletsa zina za HMG-CoA reductase, kawirikawiri milandu ya rhabdomyolysis yolephera pachaka chifukwa cha myoglobinuria imafotokozedwa. Chiwopsezo cha rhabdomyolysis chitha kukhala choperewera chaimpso. Odwala otere ayenera kuperekedwa mosamala kwambiri kuti adziwe kuti matenda a musculoskeletal system. Ngati zizindikiro za myopathy zotheka zikuwoneka kapena pali zovuta zomwe zingayambike chifukwa cha kulephera kwa impso chifukwa cha rhabdomyolysis (mwachitsanzo, kupweteka kwambiri pachimake, hypotension ya arterial, opaleshoni yayikulu, kuvulala, metabolic, endocrine ndi kusokonezeka kwa madzi-electrolyte, kugwirira mosagwirizana), Liprimar iyenera kutha kwakanthawi kapena kuletsa kwathunthu.

Odwala akuyenera kuchenjezedwa kuti ayenera kupita kwa dokotala ngati vuto lopanda kufooka kapena kufooka kwa minofu kumachitika, makamaka ngati akuphatikizidwa ndi malaise kapena malungo.

Kuteteza kwa Stroko kudzera Kuchepetsa kwa Cholesterol

Mukuwunikanso mozama ma subtypes a odwala omwe alibe matenda am'mitsempha, omwe adangokhala ndi stroke kapena kuvulala kwa ischemic, poyambira gawo lomwe adalandira atorvastatin pa mlingo wa 80 mg, chiwopsezo chachikulu cha hemorrhagic stroke chidadziwika poyerekeza ndi odwala omwe akulandira placebo. Chiwopsezo chowonjezeka chinali chowonekera kwambiri mwa odwala omwe ali ndi mbiri ya kukomoka kwa hemorrhagic kapena infarction ya lacunar koyambirira kwamaphunziro. Mu gululi la odwala, phindu / chiopsezo cha kumwa atorvastatin muyezo wa 80 mg sichinafotokozedwe bwino, pankhaniyi, musanayambe chithandizo, chiopsezo chokhala ndi matenda a hemorrhagic mwa odwalawa amayenera kuwunikira mosamala.

Pambuyo pa kusanthula kwapadera kwa kafukufuku wamankhwala okhudzana ndi odwala 4731 opanda matenda amitsempha yamagazi omwe anali ndi stroke kapena ofulumira ischemic attack (TIA) m'miyezi 6 yapitayi omwe adalembedwa atorvastatin 80 mg / tsiku, zochitika zapamwamba za hemorrhagic stroke ku gulu la atorvastatin la 80 mg poyerekeza ndi gulu la placebo (55 pagulu la atorvastatin motsutsana ndi 33 pagulu la placebo). Odwala omwe ali ndi vuto la hemorrhagic panthawi yophatikizidwa phunziroli anali ndi chiopsezo chobwereza hemorrhagic pafupipafupi (7 pagulu la atorvastatin motsutsana ndi 2 mgulu la placebo). Komabe, odwala omwe amalandira atorvastatin 80 mg / tsiku anali ndi mikwingwirima yocheperako yamtundu uliwonse (265 motsutsana 311) komanso zochitika zochepa zamtima (123 motsutsana 204).

Matenda a shuga

Zina zimatsimikizira kuti HMG-CoA reductase inhibitors (statins), monga kalasi, imatha kubweretsa kuchuluka kwa plasma glucose, ndipo mwa odwala ena omwe ali ndi chiopsezo chokhala ndi matenda a shuga mellitus, mkhalidwe wa hyperglycemia ungayambike womwe umafunikira kukonza monga matenda a shuga. Komabe, chiwopsezo sichidutsa phindu la chithandizo ndi HMG-CoA reductase inhibitors (ma statins) malinga ndi ziwopsezo zam'mitsempha, chifukwa chake ichi sichingakhale chifukwa choletsa kuchira. Odwala omwe ali m'gulu la anthu omwe ali pachiwopsezo (kusala kudya kwa glucose magazi kuchokera ku 5.6 mpaka 6.9 mmol / l, BMI> 30 kg / m, kuchuluka kwa plasma triglycerides, matenda oopsa) ayenera kuyang'aniridwa ndi achipatala, kuphatikizapo kuwunika magawo amomwe amachititsa magazi, malinga ndi malingaliro am'deralo.

Matenda am'mapapo

Pochita mankhwala ndi ena a HMG-CoA reductase inhibitors (ma statins), makamaka panthawi yayitali, milandu yokhazikika yamatenda a m'mapapo imanenedwapo. Kupuma pang'ono, chifuwa chosabereka, komanso thanzi lofooka (kutopa, kuchepa thupi, komanso kutentha thupi) kumatha kuchitika. Ngati wodwala akuganiza kuti matenda am'mapapo apakati, chithandizo cha atorvastatin ziyenera kusiyidwa.

Ntchito ya endocrine

Mukamagwiritsa ntchito zoletsa za HMG-CoA reductase (statins), kuphatikizapo atorvastatin, pakhala pali kuchuluka kwa glycosylated hemoglobin (HbA1) ndi kusala kwama protein glucose. Komabe, chiopsezo cha hyperglycemia ndi chotsika poyerekeza ndi kuchepetsedwa kwa chiwopsezo cha zovuta zam'mimba mutatenga HMG-CoA reductase inhibitors (ma statins).

Zokhudza mphamvu pakuyendetsa magalimoto

Palibe deta pazokhudza Liprimar pa kuyendetsa magalimoto ndi kuchita zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor. Komabe, poganizira kuti mungakulitse chizungulire, muyenera kusamala pochita izi

Malo osungira

Sungani pamalo owuma, amdima, osatheka ndi ana, pamtunda wosaposa 25 ° C. Alumali moyo zaka zitatu.Pambuyo pa nthawi imeneyi, kugwiritsa ntchito mankhwalawo kumaletsedwa.

Mtengo wapakati wa mapiritsi 30 a Liprimar 20 mg m'masitolo ogulitsa mankhwala ku Moscow ndi ma ruble 420-460.

Liprimar analogues yothandizira achire ndi mankhwala: