Rosuvastatin: malangizo, ntchito, zikuonetsa
- Imakhazikika pamisempha ya shuga kwa nthawi yayitali
- Imabwezeretsa kapangidwe ka insulin
Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.
Rosuvastatin SZ (North Star) ndi m'gulu la ma statins omwe ali ndi lipid-kuchepetsa.
Mankhwalawa amagwiritsidwa ntchito moyenera pa matenda omwe amaphatikizana ndi vuto la lipid metabolism, komanso kupewa zina za mtima. Zambiri pazamankhwala zimatha kupezeka pazomwezi.
Pa msika wama pharmacological, mutha kupeza mankhwala ambiri okhala ndi mankhwala a rosuvastatin, pansi pazina zosiyanasiyana. Rosuvastatin SZ wopangidwa ndi woweta zoweta Severnaya Zvezda.
Piritsi limodzi limakhala ndi calcium, 5, 10, 20 kapena 40 mg ya calcium ya rosuvastatin. Pakatikati pake mumaphatikizapo shuga mkaka, povidone, sodium stearyl fumarate, primellose, MCC, aerosil ndi calcium hydrophosphate dihydrate. Mapiritsi a Rosuvastatin SZ ndi biconvex, ali ndi mawonekedwe ozungulira ndipo amaphimbidwa ndi chipolopolo cha pinki.
Gawo lolimbikira ndi choletsa cha HMG-CoA reductase. Kuchita kwake ndikufuna kuwonjezera kuchuluka kwa ma enzymes a hepatic LDL, kupititsa patsogolo kuphatikizika kwa LDL ndikuchepetsa chiwerengero chawo.
Chifukwa chogwiritsa ntchito mankhwalawa, wodwalayo amatha kutsitsa cholesterol "yoyipa" ndikuwonjezera kuchuluka kwa "zabwino". Zotsatira zabwino zitha kuonedwa kale patadutsa masiku 7 chiyambireni chithandizo, ndipo pakatha masiku 14 ndizotheka kukwaniritsa 90% ya zotsatira zabwino. Pambuyo masiku 28, zamadzimadzi metabolism amabwerera mwakale, pambuyo pake mankhwala othandizira amafunikira.
Zapamwamba kwambiri za rosuvastatin zimawonedwa patatha maola 5 mutatsitsidwa pakamwa.
Pafupifupi 90% yazinthu zomwe zimagwira ntchito zimangofunika ku albin. Kuchotsa kwake mthupi kumachitika ndi matumbo ndi impso.
Zizindikiro ndi contraindication kuti mugwiritse ntchito
Rosuvastatin-SZ amalembedwa kuti azidwala matenda a lipid komanso kupewa matenda a mtima.
Monga lamulo, kugwiritsa ntchito mapiritsiwa kumafunikira kuti azitsatira zakudya zama hypocholesterol ndikuchita masewera olimbitsa thupi.
Tsamba lophunzitsira lili ndi zisonyezo zotsatirazi:
- chachikulu, banja homozygous kapena osakaniza hypercholesterolemia (monga njira zina zosagwiritsa ntchito mankhwala),
- hypertriglyceridemia (IV) kuwonjezera pa zakudya zapadera,
- atherosulinosis (kuletsa kutsimikiza kwa cholesterol malo ndi kusintha mulingo wa cholesterol wathunthu ndi LDL),
- kupewa matenda opha ziwopsezo, kuchepa kwa masinthidwe am'mimba komanso kugunda kwamtima (ngati pali zinthu monga kukalamba, kuchuluka kwa mapuloteni a C-reaction, kusuta, ma genetics komanso kuthamanga kwa magazi)
Dokotala amaletsa kumwa mankhwalawa Rosuvastatin SZ 10mg, 20mg ndi 40mg ngati apeza wodwala:
- Hypersensitivity payekha pazinthu zosiyanasiyana.
- Kulephera kwakukulu kwa aimpso (ndi QC; Malangizo ogwiritsira ntchito mankhwalawa
Mapiritsi ayenera kumeza lonse ndi kapu ya madzi akumwa. Amatengedwa mosasamala chakudyacho nthawi ina iliyonse masana.
Asanayambe komanso kugwiritsa ntchito mankhwala, wodwala amakana zinthu monga mafinya (impso, ubongo), mazira, nkhumba, mafuta anyama, zakudya zina zamafuta, zinthu zophika mkate kuchokera ku ufa wa premium, chokoleti ndi maswiti.
Dokotala amawona mlingo wa mankhwalawa malinga ndi kuchuluka kwa cholesterol, zolinga zamankhwala komanso machitidwe a wodwala.
Mlingo woyambirira wa rosuvastatin ndi 5-10 mg patsiku. Ngati sizotheka kukwaniritsa zomwe mukufuna, mulingo umachulukitsidwa mpaka 20 mg moyang'aniridwa ndi katswiri. Kusamala mosamala ndikofunikanso popereka mankhwala a 40 mg, wodwalayo akapezeka ndi vuto lalikulu la hypercholesterolemia komanso mwayi wokhudzana ndi mtima.
Masiku 14-28 atayamba kugwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anira kagayidwe ka lipid.
Palibe chifukwa chosinthira kuchuluka kwa mankhwalawa kwa odwala okalamba komanso odwala matendawa. Ndi genetic polyformism, chizolowezi cha myopathy kapena cha mtundu wa a Mongoloid, mlingo wa wothandizira wokhala ndi lipid sayenera kupitirira 20 mg.
Mphamvu yotentha yosungiramo mankhwala si yoposa 25 digiri Celsius. Moyo wa alumali ndi zaka zitatu. Sungani malondawo pamalo otetezedwa ku chinyezi ndi dzuwa.
Zotsatira zoyipa ndi Kugwirizana
Mndandanda wonse wazotsatira zoyipa zomwe zimachitika mukamagwiritsa ntchito mankhwalawa zimafotokozedwa mu malangizo ogwiritsira ntchito.
Monga lamulo, zotsatira zoyipa mukamamwa mankhwalawa ndizosowa kwambiri.
Ngakhale akuwoneka ngati alibe zoyipa, amakhala ofatsa ndipo amapita okha.
Mu malangizo ogwiritsira ntchito, mndandanda wazotsatira zoyipa zimaperekedwa:
- Endocrine dongosolo: chitukuko cha osakhudzana ndi insulin-wodwala matenda a shuga (mtundu 2).
- Dongosolo lachitetezo: Quincke edema ndi zina zomwe hypersensitivity zimachitika.
- CNS: chizungulire komanso migraine.
- Dongosolo la kwamikodzo: proteinuria.
- M`mimba thirakiti: dyspeptic matenda, kupweteka kwa epigastric.
- Matenda a minofu ndi mafupa: myalgia, myositis, myopathy, rhabdomyolysis.
- Khungu: kuyabwa, ming'oma, ndi zotupa.
- Biliary dongosolo: kapamba, ntchito yayitali ya hepatic transaminases.
- Zizindikiro zasayansi: Hyperglycemia, milirubin yayikulu, phosphatase ya alkal, ntchito ya GGT, ntchito ya chithokomiro.
Chifukwa cha kafukufuku wam'mbuyo wakugulitsa, zotsutsa zoyipa zidadziwika:
- thrombocytopenia
- jaundice ndi hepatitis
- Matenda a Stevens-Johnson
- kusokonezeka kwa kukumbukira
- kufalikira kwamphepo,
- matenda ashuga polyneuropathy,
- gynecomastia
- hematuria
- kupuma pang'ono ndi chifuwa chowuma,
- arthralgia.
Nthawi zina, kugwiritsa ntchito Rosuvastatin SZ ndi mankhwala ena kumatha kubweretsa zotsatirapo zosayembekezeka. Pansipa pali mawonekedwe a mankhwalawa munthawi yomweyo.
- Ma protein protein blockers - kuwonjezereka kwa mwayi wa myopathy ndi kuwonjezeka kwa kuchuluka kwa rosuvastatin.
- HIV proteinase blockers - kuwonetsedwa kowonjezereka kwa ntchito yogwira ntchito.
- Cyclosporine - kuchuluka kwa rosuvastatin mopitilira kasanu ndi kawiri.
- Gemfibrozil, fenofibrate ndi mafupa ena, nicotinic acid - gawo lochulukirapo lazogwiritsa ntchito komanso chiwopsezo cha myopathy.
- Erythromycin ndi maacacid okhala ndi aluminium ndi magnesium hydroxide - kuchepa kwa zomwe zili rosuvastatin.
- Ezetimibe - kuwonjezeka kwazinthu zomwe zikugwira ntchito.
Popewa kukula kwa zovuta zomwe zimachitika chifukwa chogwiritsa ntchito munthawi yomweyo mankhwala osagwirizana, ndikofunikira kudziwitsa dokotala zamatenda onse omwe amafanana.
Mtengo, ndemanga ndi fanizo
Popeza mankhwalawa Rosuvastatin amapangidwa ndi fakitale yapafakitale "North Star", mtengo wake siwokwera kwambiri. Mutha kugula mankhwala pa mankhwala aliwonse am'mudzimo.
Mtengo wa phukusi limodzi lokhala ndi mapiritsi 30 a 5 mg aliyense ndi ma ruble 190, 10 mg aliyense ndi ma ruble 320, 20 mg aliyense ndi 400 rubles, ndipo 40 mg iliyonse ndi ma ruble 740.
Pakati pa odwala ndi madokotala, mutha kupeza ndemanga zambiri zabwino za mankhwalawa. Kuphatikiza kwakukulu ndi mtengo wotsika mtengo komanso wamphamvu othandizira. Komabe, nthawi zina pamakhala ndemanga zoyipa zomwe zimagwirizanitsidwa ndi kupezeka kwa zoyipa.
Eugene: “Ndinazindikira kuti kalekale kunali kuphwanya kagayidwe kazachilengedwe. Kwa nthawi yonseyi ndinayesa mankhwala ambiri. Choyamba adatenga Liprimar, koma adasiya, chifukwa mtengo wake unali wowerengeka. Koma chaka chilichonse ndimayenera kupanga ma dontho odyetsa ziwiya zaubongo. Kenako dotolo adandiuza Krestor, koma sanathenso mankhwala otsika mtengo. Ndidadzipeza ndindende, pomwe panali Rosuvastatin SZ. Ndimamwa ma mapiritsiwa, ndikumva bwino, cholesterol yanga yabwerera mwakale. ”
Tatyana: “M'chilimwe, mafuta a cholesterol anakwera kufika pa 10, pomwe ali 5.8. Anatembenukira kwa owerenga, ndipo adandiuza kuti ndi Rosuvastatin. Dotolo adati mankhwalawa samapsa mtima pachiwindi. Ndikutenga Rosuvastatin SZ pakadali pano, zonse zili bwino, koma pamakhala "koma" - mutu wovuta nthawi zina. ”
Chosakaniza chothandizira cha rosuvastatin chimapezeka m'mankhwala ambiri opangidwa ndi opanga osiyanasiyana. Mayina ophatikizidwa ndi:
- Akorta,
- Crestor
- Mertenil
- Rosart,
- Ro statin
- Rosistark,
- Rosuvastatin Canon,
- Roxer
- Rustor.
Ndi hypersensitivity payekha ku rosuvastatin, dokotala amasankha analogue yothandiza, i.e. wothandizira wokhala ndi chinthu china chogwira ntchito, koma kupanga zomwezi zimachepetsa lipid yomweyo. Mu pharmac mungagule mankhwala ngati awa:
Chinthu chachikulu pa chithandizo cha cholesterol yayikulu ndikutsatira malingaliro onse a katswiri, kutsatira zakudya ndi kukhala ndi moyo wokangalika. Chifukwa chake, ndizotheka kuthana ndi matenda ndikuletsa mavuto osiyanasiyana.
Mankhwala Rosuvastatin SZ akufotokozedwa mwatsatanetsatane mu kanema munkhaniyi.
- Imakhazikika pamisempha ya shuga kwa nthawi yayitali
- Imabwezeretsa kapangidwe ka insulin
Kuwunikanso kwa mankhwala omwe amachepetsa cholesterol yamagazi
Cholesterol okwera m'magazi ndi chimodzi mwazomwe zimayambitsa matenda a mtima. Cholesterol ndi chinthu chonga mafuta, gawo lalikulu lomwe limapangidwa m'chiwindi (pafupifupi 80%) ndipo gawo limabwera ndi chakudya (pafupifupi 20%). Amapereka ma antioxidants ku thupi, amatenga nawo mbali popanga ma steroid a mahomoni ndi ma acid a bile, amawongolera zochitika zamanjenje, ndikofunikira pomanga maselo a cell.
Pang'onopang'ono, cholesterol imadziunjikira m'thupi ndipo imakhazikika pamakoma amitsempha. Zotsatira zake, kuunikira kwa ziwiya kumacheperachepera, kufalikira kwa magazi kumakhala kovuta, kuyenda kwa mpweya ndi michere kwa minyewa ndi ziwalo, kuphatikiza ubongo ndi minofu ya mtima, kusokonezedwa. Umu ndi momwe ischemia, myocardial infarction ndi stroke zimakhalira.
Cholesterol imalowa m'magazi ngati ikuphatikiza ndi mapuloteni otchedwa lipoproteins. Zotsirizirazi ndi zamitundu iwiri ya HDL (high density) ndi LDL (otsika kachulukidwe). Yoyamba ndi mafuta m'thupi. LDL ndi yoyipa, ndizochulukirapo zomwe zimakhala zowopsa mthupi.
Ndani ayenera kumwa mapiritsi a cholesterol?
Madokotala ali ndi malingaliro osiyanasiyana pakugwiritsa ntchito mankhwalawa, ambiri amakhulupirira kuti chifukwa cha kuchuluka kwa zotsatira zoyipa, kugwiritsa ntchito kwawo sikuyenera. Musanayambe kumwa mankhwalawa, muyenera kuyesetsa kukwaniritsa zotsatirazi mothandizidwa ndi zakudya, kusiya zizolowezi zoyipa, masewera olimbitsa thupi. Komabe, nthawi zina, kumwa mankhwalawa ndikofunikira. Gululi limaphatikizapo anthu omwe ali ndi matenda amitsempha yamagazi, omwe ali ndi chiopsezo cha kugunda kwamtima, ali ndi chiyembekezo chokhala ndi cholesterol yayikulu, omwe adadwala matenda a mtima kapena stroko.
Mankhwala a Cholesterol
Chithandizo chimachitika pogwiritsa ntchito mankhwala a magulu awiri: ma statins ndi ma fibrate. Pofuna kutsitsa cholesterol yamagazi, ma statins amagwiritsidwa ntchito nthawi zambiri. Masiku ano ndi njira yothandiza kwambiri. Zochita zawo ndikuti amaletsa kupanga cholesterol choyipa pochepetsa ma enzyme ofunikira pamenepa. Chifukwa chake, amaletsa mapangidwe a atherosulinotic plaque ndi blockage mitsempha yamagazi, zomwe zikutanthauza kuti amachepetsa chiopsezo cha matenda a mtima ndi mtima.
Ma Statin ndi mankhwala omwe amachepetsa cholesterol yoyipa ndikukula bwino. Pambuyo pakudya, gawo la onse limatsika ndi 35-45 peresenti, ndipo mulingo woyipa - mwa 40-60 peresenti.
Muyenera kudziwa kuti mankhwalawa ali ndi zotsatira zoyipa zambiri, chifukwa chake muyenera kumwa kokha moyang'aniridwa ndi madokotala. Mitengo imakhudza madongosolo ambiri, pomwe zovuta zina sizingawoneke pambuyo pa utsogoleri, koma patapita nthawi. Zina mwazotsatira zazikulu ndi izi:
- chizungulire
- zosokoneza tulo
- mutu
- kusokonezeka kwa kukumbukira
- parasthesia
- amnesia
- kugunda kwa mtima
- kudzimbidwa,
- nseru
- chiwindi
- vuto la maso
- kapamba
- kupweteka kwa minofu
- thupi lawo siligwirizana monga zotupa pakhungu ndi kuyabwa,
- zotumphukira edema,
- kuphwanya zogonana,
- kagayidwe kachakudya matenda.
- kukonzekera pakati, nthawi ya bere ndi kuyamwitsa,
- ana ochepera zaka 18
- matenda a chiwindi
- matenda a impso
- matenda a chithokomiro
- kusalolera payekha.
Ma Statin ndi mitundu yawo
Amawagawidwa potengera zomwe zimagwira zomwe zimalepheretsa kupanga cholesterol. M'mazamba oyamba, chinthu ichi ndi lovastatin. Pambuyo pake, mankhwala adawoneka ndi fluvastafin, simvastain ndi pravastain. Mankhwala obwera mwatsopano omwe ali ndi rosuvastatin ndi atorvastatin ali ndi tanthauzo lotchulika, amachepetsa kwambiri LDL m'magazi ndikuwonjezera cholesterol yabwino. Ngati mankhwala omwe ali ndi lovastine amachepetsa LDL ndi 25%, ndiye kuti m'badwo watsopano wamapiritsi okhala ndi rosuvastine - ndi 55%.
Ma Statin ndi awa:
Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.
- ndi lovastatin - "Choletar", "Cardiostatin",
- ndi simvastatin - "Vasilip", "Ariescore", "Sinkard", "Simvastol", "Zokor",
- ndi fluvastatin - "Leskol Forte",
- ndi atorvastatin - "Tulip", "Liptonorm", "Atoris", "Liprimar", "Canon", "Liprimar",
- ndi rosuvastatin - "Roxer", "Mertenil", "Tavastor", "Crestor", "Rosulip".
Zomwe muyenera kudziwa za statins?
- Amatengedwa kwa nthawi yayitali ndikuyang'aniridwa ndi dokotala.
- Cholesterol imapangidwa usiku, chifukwa chake muyenera kumwa gulu ili lamankhwala madzulo.
- Ngati muli ndi kufooka kwa minofu ndi kupweteka, muyenera kufunsa dokotala nthawi yomweyo.
- Mosamala, amawalemba kwa anthu omwe ali ndi vuto latsoka nthawi iliyonse.
- Amayi azaka zoyenera kubereka azigwiritsa ntchito mankhwala oletsa kubereka pamene akutenga ma statin.
- Pa chithandizo, kuyezetsa magazi kuyenera kuchitika kuti athe kuwunika momwe mankhwalawo amathandizira komanso kudziwa zoyipa za mankhwala.
Gulu lina la mankhwala omwe amachepetsa cholesterol ndi zotumphukira za fibroic acid. Mankhwalawa amagwira ntchito motsutsana ndi LDL kuposa ma statins. Amachulukitsa HDL ndi kuchepa kwamafuta osalowerera, kapena triglycerides. Mwambiri, cholesterol imachepetsedwa ndi 15%, pomwe khoma lamitsempha limalimbitsidwa.
Mankhwala otsatirawa ndi a gulu lino:
Zotsatira zoyipa zimaphatikizapo:
- zotupa pakhungu
- kusokoneza kwam'mimba,
- myopathy
- chifuwa
- chitukuko cha kapamba,
- kuchuluka kwa michere ya chiwindi,
- kukula kwa thrombosis.
Pomaliza
Zithandizo za cholesterol yayikulu zimakhala ndi zovuta zambiri zomwe zingawononge thanzi lanu pogwiritsa ntchito nthawi yayitali. Madokotala sagwirizana pankhani yoika mankhwalawa. Amuna achichepere (mpaka zaka 35) ndi azimayi azaka zakubadwa omwe sakhala okhudzidwa ndi matenda a mtima amalangizidwe kuti achepetse cholesterol yawo popanda mankhwala, ndiye kuti, asinthe zakudya zawo ndi moyo wawo. Komabe, mapiritsi sangathe kugawidwa nthawi zonse. Ndikofunika kukumbukira kuti ayenera kumwedwa kokha monga adokotala akuwalangiza. Kuphatikiza pa kumwa mankhwala, muyenera kusintha moyo wanu, ndiko kuti, kutsatira kadyedwe, masewera olimbitsa thupi, kupatula kusuta.
Rosuvastatin - zikuonetsa kuti mugwiritse ntchito
Kodi rosuvastatin amawerengedwa kuti? Mndandanda wa matenda ndi zikhalidwe ndizochepa kwambiri:
- Hypercholesterolemia (mtundu IIa, kuphatikizapo heterozygous hypercholesterolemia) kapena hypercholesterolemia (mtundu IIb) monga chowonjezera chakudya,
- Family homozygous hypercholesterolemia monga chowonjezera pa chakudya,
- Coronary, ubongo kapena aimpso atherosclerosis, occlusive artery lumen,
- Atherosulinosis yam'mitsempha yam'munsi, kuphatikiza matenda a Lerish, matenda oopsa, omwe ali ndi mapuloteni ochulukirapo a C m'mbiri ya mabanja,
- Hypertriglyceridemia (mtundu IV malinga ndi Fredrickson),
- Chithandizo cha myocardial infarction ndi ubongo, kuyambira nthawi yovuta kwambiri,
- Kupewa myocardial infarction ndi stroke.
Monga mukuwonera, simuyenera kutenga Rosuvastatin ngati mapiritsi a cholesterol omwe mungagwiritse ntchito nokha.
Mlingo - momwe mungatenge rosuvastatin?
Mapiritsi a Rosuvastatin amatengedwa pakamwa ndi madzi. Mlingo woyambira wabwino kwa akulu ndi piritsi limodzi la rosuvastatin 10 - 1 nthawi patsiku.
Malinga ndi zotsatira za kusanthula, mlingo ungathe kuwonjezeka mpaka 20 mg pambuyo pa masabata 4 (osati kale).
Kuchulukitsa kwa 40 mg ya rosuvastatin ndikotheka kokha mwa odwala omwe ali ndi vuto lalikulu la hypercholesterolemia ndi chiwopsezo cha zovuta zamtima (makamaka kwa odwala omwe ali ndi achibale a hypercholesterolemia) ndi chithandizo chochepa kwambiri pa 20 mg, ndikuyang'aniridwa ndi achipatala.
Kupewa kwa matenda a CVS
Mu maphunziro a kupewa kwa rosuvastatin, mlingo wa 20 mg / tsiku unagwiritsidwa ntchito. Iyenera kuganiziridwanso - mlingo woyambira uyenera kukhala wocheperako ndikuyenera kudziwa zomwe wodwala akuwonetsa kuyambira 5 mpaka 10 mg / tsiku.
Mawonekedwe
Kwa odwala azaka 70, mankhwalawa ndi rosuvastatin ndi mankhwala a 5 mg / tsiku. Kusintha kwa mankhwalawa kumachitika ndi dokotala, ngati kuli kotheka, poganizira kuchuluka kwa cholesterol ndi mwayi wa pathologies a mtima dongosolo.
Mukamagwiritsa ntchito rosuvastatin mu 40 mg, tikulimbikitsidwa kuwunikira zizindikiro za ntchito zaimpso. Zowonjezera zotsutsana ndi rosuvastatin ndizotheka.
Nthawi zambiri, proteinuria imachepa kapena kutha pakumachitika mankhwala ndipo sizitanthauza kuti pakubwera matenda okhalitsa kapena impso.
Odwala ndi hypercholesterolemia chifukwa cha hypothyroidism kapena nephrotic syndrome, chithandizo chachikulu cha matenda chiyenera kuchitika musanayambe mankhwala ndi rosuvastatin.
Ndemanga zonse: 27 Lembani ndemanga
Ndili ndi cholesterol 6.17 - Ndidalembedwa mapiritsi a rosuvastatin awa, koma m'mene ndimawerenga malangizowa, pamakhala zotsutsana kotero kuti zimawopsa kuyambitsa kumwa. Mwinanso ndimdala kwambiri kuti nditha kumwa mankhwalawa ndi cholesterol ngati imeneyi.
Elena, yesani kaye chakudyacho, ngati simunayesekobe. Idyani zamitundu yambiri ... Satin ndi njira yomaliza.
njira yabwino kwambiri yopitilira ??
Tengani monga momwe zalembedwera mogwirizana ndi malangizo omwe mungagwiritse ntchito, kapena monga adokotala omwe akuwuzani rosuvastatin.
Rosuvastatin wayamba kulembedwa ndi dokotala posachedwapa. Zotsatira zoyeserazi zikuwonetsa ntchito yake posachedwa, koma mokomera Rosuvastatin ndikufuna kunena kuti alibe matendawa, monga mankhwala ena onse.
Panali zitsulo mkamwa ndi ma goosebumps, ngakhale mlingo wa 10mg ndi mankhwala osafunikira komanso okwera mtengo.
Ndidatenga rosuvastatin-s3 40 mg pachaka chapitacho (adotolo adamulamula) panali cholesterol yambiri, mwezi umodzi pambuyo pake idakhala yabwinobwino. Zinali zofunika kuti muchepetse zochepa.
Ndidatenganso rosuvastatin-sz, pamlingo wa 10 mg, komanso ndimada nkhawa kwambiri ndi zovuta - sindinakhalepo ndi mavuto okwanira ndi chiwindi kuti nditenge cholesterol yayikulu, koma ndinali ndi nkhawa pachabe - Ndimamva bwino, cholesterol yanga idachepa.
Mukawona kuti malangizowo ali ndi zotsatila zambiri, izi zikuwonetsa kuti mankhwalawo adawerengedwa mwatsatanetsatane ndipo kafukufuku wambiri wazachipatala adachitidwa. Musaganize kuti kugula mankhwala ena “ozizwitsa” ndikungowalangiza mwachidule ndikuwonetsa "matenda onse" ndizowona. Bizinesi yamankhwala ndi imodzi mwazikulu padziko lapansi ndipo ikufunika "kupititsidwa patsogolo". Ndili bwino kugula zapakhomo, zotsimikizika, ndipo koposa zonse, Rozuvastatin-SZ wochita dokotala, yemwe ndakhala ndikuchita kwa miyezi 7 yapitayo. Zotsatira zake, cholesterol idatsika kuchoka pa 6.9 mpaka 5.3. Osangodzinyengerera - choyamba kwa dokotala!
Rosuvastatin ndi yoyenera cholesterol yambiri, koma ngati hypercholesterolemia imakhala yothina, mutha kudwala mosavuta ndi zakudya ndi dibicor, kupewa kupewa kwakutali komanso kosakhala kotetezeka kwa statin m'thupi.
Rosuvatin-sz (monga chithunzi) ndiwotsika mtengo kwambiri kuposa ma statin onse. Ndikutsimikizira - zimagwira. Zotsatira zoyipa - chizungulire m'masiku oyamba ovomerezeka, ndiye kuti zonse zidapita. Cholesterol kuyambira 7.5 mpaka 5.3 m'miyezi 1.5.
Agogo anga amamwa rosuvastatin sz, ndipo amayi anga adalembedwa atorvastatin sz, sanawope kumwa, chifukwa mukapanda kumwa, zonse zitha kutha. Mwa njira, mankhwalawa siokwera mtengo.
Mankhwala abwino kwambiri, rosuvastatin-sz, ndimatsimikizira mwatsatanetsatane - m'mwezi wogwiritsidwa ntchito, cholesterol idagwa kuchokera ku 8.8 mpaka 5.1, ndipo izi pakusowa kwa chakudya (ndikulapa, sindingathe kutsatira). Nthawi zambiri ndimakhala ndi malingaliro akuti akunja ndiwabwino, sindine wokonda kwambiri dziko lapansi, koma zikuwoneka kuti mankhwala athu amatha, osakhala ovuta kwambiri
Ndakhala ndikumwa atorvastatin-sz kwa nthawi yayitali, Mlingo salinso waukulu, koma salola kuti cholesterol iwonjezeke pamanambala oopsa.
Ndikugwirizana ndi ndemanga zabwino za rosuvastatin-sz! Ndakhala ndikulimbana ndi cholesterol kwa zaka zisanu, ndayesera zinthu zosiyanasiyana - zakunja ndi zathu. Tsopano, zowona, zakunja sizingakwanitse konse, rosuvastatin-sz idabwera bwino kuchokera kwa antchito apakhomo, ndipo koposa zonse, nthawi zambiri imakhala mu mankhwala
Ali ndi zaka 33, atamuyeza, adapezeka mosayembekezeka kuti cholesterol idakwezedwa! Zambiri 8.1, zoyipa - 6.7! Manambala owopsa. Ndinayamba kutenga rosuvastatin-sz, ndimawopa kwambiri kuti pakhala zotsatila. Pazomwe ndamva, mankhwalawa ndi abwinobwino, chofunikira kwambiri ndikuti mafuta a cholesterol amachepetsa.
Ndakhala ndikutenga rosuvastatin-sz kwa zaka zitatu. Pambuyo pa vuto la mtima, adasankhidwa kuti akhale ndi moyo. Palibe zotsatirapo zoyipa, kupatula ngati poyamba panali chizungulire pang'ono, cholesterol imatha 4.5-4.8. Ndidakondwera ndi mtengo.
Mankhwala abwino ndi rosuvastatin. Ndinaikidwa rosuvastatin-sz, ndiotsika mtengo pang'ono kuposa enawo, koma nditha kunena kuti ndamwa mwezi wachitatu ndipo ndikumva bwino. Panalibe zotsatirapo zoyipa, ngakhale ndikuuzeni nkhani yoopsa. Cholesterol yatsika kuchoka pa 8.5 mpaka 4,3.
Anayamba kumwa rosuvastatin-sz pambuyo pa maphunziro awiri a atorvastatin - adotolo adati asintha kukhala mankhwala amakono. Cholesterol ndichabwinobwino. Sindinawone zotsatira zoyipa. Ndidakondwera ndi mtengo.
Nditha kutamandanso rosuvastatin-sz, komanso ndemanga pamwambapa - ndidakhudzidwa kwambiri ndi mtengo wake, sichinawone kusiyana ndi mankhwala ena, ndipo aku Russia adavomereza ndikuitanitsa, onse amagwira ntchito yomweyo. Chifukwa chake, mutha kusankha pamtengo.
Pali njira za wowerengeka, koma sizingathandize. Thupi lathu lomwe limatulutsa cholesterol, kapena makamaka yambiri yake. Mutha kuichepetsa ndi ma statins, mwachitsanzo, rosuvastatin-sz, yomwe idafotokozedwa pamwambapa. Mfundo zoyenera kuchita - mankhwalawa amaletsa kupanga cholesterol m'chiwindi (uku ndikulongosola kopitilira muyeso, werengani tsamba lambiri). Osanyalanyaza madokotala konse, okhawo ndiwo angasankhe chithandizo choyenera.
Zomwe zimapangitsa kukhala kosavuta kutenga ma statins ndikuti pali piritsi limodzi lokha patsiku. Sindikudziwa ngati muli ndi cholesterol mpaka 7 ndiyofunikira, koma ngati ndiyokwera, ndiye kuti ndiyofunikira. Atherosclerosis, stroko ndi kugunda kwa mtima zimakhala zoyipa kwambiri kuposa mantha akuyerekeza chiwindi ndi impso. Mwa njira, pambuyo pa vuto la mtima, ma statin adayikidwa kuti akhale ndi moyo ndipo asapange chilichonse, anthu amakhala mosangalala kuyambira pamenepo. Ine ndekha ndimatsutsa mankhwala okwera mtengo, ngati alipo otsika mtengo, ndi ma analogi apakhomo, ngati mutayikiridwa mankhwala, yesani kufunsa dokotala za rosuvastatin-sz. Ndipo pamiyeso ndi ma tevastors osiyanasiyana amasankhidwa zikwi zingapo phukusi, koma pali chinthu chomwecho pa ma ruble 400.
Tandiuzeni, kodi magazi wamba a cholesterol mwa munthu wachikulire ali ndi zaka 67 bwanji? Zotsatira zake, nkhambakamwa ndi 3.5)
Pakadali pano, zikhalidwe zimadziwika kuti ndizachokera pa 4,4 mpaka 7.8. Koma ndibwino kusunga cholesterol m'malire ake otsika. Mwachitsanzo, azaka za 30, chizolowezi chimachokera ku 3.3 mpaka 5.9. Ngati cholesterol ndi yokwera, ma statin ndi omwe amapatsidwa. Mwachitsanzo, omwewo rosuvastatin-sz omwe adalemba pamwambapa.
Ndimatenga analogue, rosuvastatin-sz muyezo wa 40 mg, motero zimatenga piritsi limodzi patsiku, lomwe ndilabwino kwambiri. Pamtengo wotsikirapo kuposa oitanitsa rosuvastatin.
Miyezi isanu ndi umodzi atatha kuchita opaleshoni yodutsa, adapeza zikwangwani m'matumbo ena awiri.Rosuvastatin amatenga nthawi yonseyi mamilimita 20. Choyamba, chiritsani chiwindi ndi impso, msana, minofu pachifuwa, mwina mlingo waukulu? Ndipo ndikuuzeni, munthu wina adachiritsidwa kalendodi nthawi inayake ndimankhwala awa .... . ndipo zitatha zochuluka motani?
Ndakhala ndikutenga rosuvastatin kwa nthawi yayitali, pafupifupi zaka 4. Sindidandaula za cholesterol 5.9-6.2 sichikwera pamwamba, kupanikizika kunachepa, kale kunali 160-170, tsopano kuli 130-140. M'miyezi yoyambirira, zotsatira zake zinali zowonekera kwambiri kuyambira kupuma movutikira kunayamba kuchepa mphamvu zolimbitsa thupi komanso chizungulire sabata iliyonse kunachepa. Chotsatira, miyezi isanu ndi umodzi iliyonse, magazi.
Malangizo ogwiritsira ntchito rosuvastatin
Mankhwala Rosuvastatin (Rosuvastatin) ali ndi lipid-kutsitsa, ali ndi zinthu zomwezi. Mankhwalawa amapangidwa ndi makampani ambiri - Russian Canon ndi North Star, Israeli Teva. Kugwiritsa ntchito mankhwalawa kumakhala koyenera ndi lipids ndi cholesterol yambiri m'magazi. Chida chimasinthanso kuchuluka kwa zinthuzi, kubwezeretsa thanzi la munthu.
Kupanga ndi mawonekedwe a kumasulidwa
Rosuvastatin imapezeka kokha piritsi; palibenso mitundu ina yotulutsira. Zomwe zalembedwera:
Mapiritsi ofiira owala a pinki mkati oyera
The kuchuluka kwa rosuvastatin mu mawonekedwe a calcium calcium, mg pa pc.
Utoto wofiira carmine, microcrystalline cellulose, triacetin, pregelatinized starch, magnesium stearate, titanium dioxide, colloidal silicon dioxide, hypromellose, lactose monohydrate
Mapaketi a ma PC 10, 3 kapena 6 pa paketi iliyonse
Pharmacodynamics ndi pharmacokinetics
Mankhwala ochepetsa lipid ochepetsa lipu Rosuvastatin ndi choletsa kusankha kwa enzyme gamma-glutamyltranspeptidase, yomwe imalimbikitsa maonekedwe a mevalonate, wolowa m'malo mwa cholesterol. Chithandizo chogwira ntchito cha mankhwalawa chimagwira ntchito mu chiwindi, pali kaphatikizidwe wa cholesterol ndi catabolism ya lipoproteins a kachulukidwe kalikonse. Mankhwala kumawonjezera kuchuluka kwa zolandilira pambuyo maselo a chiwindi, kumawonjezera mphamvu ndi catabolism, zomwe zimalepheretsa kuphatikizika kwa lipoproteins ochepa kwambiri.
Kamodzi m'magazi, rosuvastatin inhibitor ndi efflux transporter imakhala ndi ndende yozizira patatha maola 5. Kupanga kwake kokhudzana ndi cytochrome isoenzymes kumachitika m'chiwindi, ndipo kumachitika ku albumin ndi 90%. Pambuyo pakutha, metabolites amapangidwa m'chiwindi chomwe chimagwira pang'ono, sichikhudza kayendedwe ka anion organic ndi polypeptides, creatinine ndi creatine phosphokinase chilolezo, ndi cholesterol biosynthesis.
Pafupifupi mlingo wonse wa mankhwalawo umachoka m'matumbo osasinthika, chotsalira - ndi impso ndi mkodzo. Hafu ya moyo ndi maola 19. Ma pharmacokinetics omwe amagwira ntchito pophatikizira samakhudzidwa ndi jenda, zaka, koma pali kusiyana pakumka pazowonjezera pazoyimira anthu amtundu wina (pochulukirapo ku Mongoloids ndi Amwenye kuposa ku Caucasians ndi Negroids).
The yogwira thunthu wa rosuvastatin
Chida chogwiritsa ntchito chophatikizika cha inhibitor chimachepetsa kuchuluka kwa cholesterol, triglycerides, lipoproteins otsika, apolipoprotein, kumakulitsa kuchuluka kwakukulu kwa lipoproteins yapamwamba. Zotsatira zake, mwa odwala omwe ali ndi hypercholesterolemia, mbiri ya lipid imayenda bwino ndipo index ya atherogenicity imachepa. The achire zotsatira za mankhwalawa amakula mkati mwa sabata, ukufika pazofika mwezi wa mankhwala. Mankhwalawa akuwonetsedwa kwa akuluakulu omwe ali ndi hypercholesterolemia wokhala ndi kapena wopanda triglyceridemia, amene amakonda kugwidwa ndi matenda a mtima.
Zizindikiro zogwiritsidwa ntchito
Zomwe zimagwiritsidwa ntchito pogwiritsa ntchito mankhwala a Rosuvastatin ndi matenda omwe amalumikizidwa ndi milingo yayitali. Zowonetsa:
- hypercholesterolemia yoyamba, kuphatikiza mtundu wa heterozygous, kapena hypercholesterolemia yosakanikirana ndi zakudya, masewera olimbitsa thupi,
- banja homozygous hypercholesterolemia kuphatikiza zakudya ndi lipid-kutsitsa mankhwala,
- hypertriglyceridemia,
- Kuchepetsa makulidwe a atherosulinosis,
- kupewa kwakukulu kwa stroke, kugunda kwa mtima, kusintha kwa zina popanda chizindikiro cha matenda amtima, koma ndi chiopsezo cha kukula kwake (ukalamba, matenda oopsa, kusuta, mbiri yabanja).
Momwe mungatenge rosuvastatin
Mapiritsi amatengedwa pakamwa, kutsukidwa ndi madzi. Sizingathe kutafunidwa kapena kuphwanyidwa. Mankhwala amatengedwa nthawi iliyonse masana, alibe chakudya. Asanayambe chithandizo, wodwalayo ayenera kutsatira zakudya zoletsedwa ndi zakudya zamafuta owopsa. Mlingo woyambirira wa odwala ndi 5 kapena 10 mg wa rosuvastatin kamodzi / tsiku. Pambuyo pa milungu 4, mlingo umatha kuchuluka.
Mlingo wa 40 mg wa rosuvastatin amalembedwa mosamala, kuwunika koteroko ndikofunikira kwa odwala. Pakadutsa milungu iwiri ndi iwiri yamankhwala, odwala amapereka magazi kuti azindikire zigawo za lipid. Kwa odwala okalamba, kumwa mankhwalawa sasinthidwa, ndi kulephera kwambiri kwaimpso, kumwa mapiritsi kumatsutsana. Mwa kuwonongeka koyenera kwa hepatic, mlingo umatha kupitirira 5 mg.
Malangizo apadera
Rosuvastatin imathandizira magwiridwe antchito a chiwindi ndi impso, machitidwe ena a thupi, kotero chithandizo chake chimatsatiridwa ndi malangizo apadera. Malamulo omwera mapiritsi:
- Mlingo waukulu wa mankhwalawa ungayambitse kuchepa kwa proteinular protein. Pa chithandizo, ntchito ya impso iyenera kuyang'aniridwa.
- Mlingo wopitirira 20 mg / tsiku ungayambitse myalgia, myopathy, rhabdomyolysis, komanso kupatuka kwina pakugwira ntchito kwa minofu ndi mafupa. Ngati odwala ali ndi chiopsezo chotukula matendawa, mankhwalawa amayikidwa mosamala.
- Ngati munthawi ya chithandizo wodwalayo amakhala ndi ululu wamisempha, kufooka kapena kukokana chifukwa cha kudontha kapena kutentha thupi, kufunika kofunsa kuti mukaonane ndi dokotala. Milandu ya myopathy yolimbana ndi minyewa (kufooka kwa minofu, zochitika zowonjezera) sizimachitika kawirikawiri. Kuti muthane ndi malingaliro osautsa pambuyo pakuwunika kwa serological, chithandizo cha immunosuppressive chikuchitika.
- Kutenga mapiritsi a rosuvastatin sikukhudza kuwonjezeka kwa minofu.
- Ngati hypercholesterolemia imayambitsidwa ndi hypothyroidism kapena nephrotic syndrome, ndiye kuti muyenera kuchotsa kaye matendawa, kenako ndi kutenga Rosuvastatin.
- Mankhwalawa amathetsedwa ndikuwonjezereka kwa ntchito ya hepatic transaminases katatu.
- Mankhwalawa ali ndi lactose, chifukwa chake mawonekedwe ake amatsutsana ngati lactose tsankho, kuperewera kwa lactase, shuga-galactose malabsorption.
- Kuchiza kwa statin kwakanthawi kumatha kuyambitsa matenda am'mapapo, omwe amawonetsedwa ndi kupumira, kutsokomola, kufooka, kuchepa thupi komanso kutentha thupi. Ngati zizindikirozi zapezeka, chithandizo chaletsedwa.
- Pa mankhwala ndi mankhwalawa, chizungulire ndi kufooka zingachitike, motero, tikulimbikitsidwa kupewa kuwongolera njira ndi magalimoto.
- Popereka mankhwala, ma genetic polymorphism ayenera kuganiziridwanso.
Pa nthawi yoyembekezera
Kugwiritsa ntchito rosuvastatin kumapangidwa pakatundu woyembekezera. Ngati mayi wa msinkhu wobereka amwa mapiritsi, ndiye kuti ayenera kugwiritsa ntchito njira zodalirika zakulera. Pozindikira kuti muli ndi pakati, mankhwalawo ayenera kusiyidwa nthawi yomweyo.Sizikudziwika ngati chinthucho chikugwiritsidwa ntchito mkaka wa m'mawere, koma kugwiritsa ntchito mapiritsi kumathetsedwa panthawi yoyamwitsa.
Muubwana
Kugwiritsa ntchito mapiritsi a rosuvastatin kwa ana ndi achinyamata osakwana zaka 18 ndi zotsutsana. Kuletsa kotereku kumalumikizidwa ndi kukhudzika kwa mankhwalawa pachiwindi, komwe kumayambitsa kusasinthika kapena kuwonongeka kwakukulu pantchito ya chiwalochi kapena thupi lonse. Kukhazikitsidwa kwa mankhwala pambuyo pa zaka 18 kuyenera kuyang'aniridwa ndi kufunsa kwa dokotala ndi kufufuza kwathunthu.
Mu vuto laimpso ndi kwa chiwindi ntchito
Odwala omwe ali ndi vuto lambiri laimpso amatsutsana mulingo uliwonse. Mlingo wa tsiku lililonse wa 40 mg wa rosuvastatin ndi woletsedwa kugwiritsidwa ntchito mwa odwala omwe amalephera kupweteka aimpso, Mlingo wa 5, 10 ndi 20 mg umagwiritsidwa ntchito mosamala. Ngati kufooka kwa impso, kusamala kuyenera kuchitika ndi 40 mg ya thunthu.
Kuyanjana kwa mankhwala osokoneza bongo
Rosuvastatin amadziwika ndi mphamvu yogwira ntchito ya mankhwala ena. Kuphatikiza komwe mungathe:
- Kuphatikiza kwa mankhwalawa ndi cyclosporine, proteinase inhibitors a human immunodeficiency virus (HIV), ma fibrate mu 40 mg, inducers ya cytochrome substrate ndi oletsedwa.
- Kuphatikiza kwa mankhwala a 5 mg ndi gemfibrozil, othandizira a hypolipidemic, fenofibrate, nicotinic acid, fluconazole, digoxin, maantibayotiki amaloledwa.
- Chenjezo umalangizidwa kuphatikiza rosuvastatin ndi ezetimibe.
- Pakati pa kumwa mapiritsi ndi kuyimitsidwa kwa maantacid okhala ndi aluminium kapena magnesium hydroxide, maola awiri ayenera kudutsa, apo ayi kugwiritsa ntchito mphamvu yakale kumatha.
- Kuphatikiza kwa mankhwalawa ndi erythromycin kumawonjezera kuchuluka kwa rosuvastatin m'mwazi seramu ndi gawo lachitatu.
- Kuphatikizidwa kwa mankhwalawa ndi fusidic acid kungayambitse kukula kwa rhabdomyolysis.
- Mlingo wa Rosuvastatin amasinthidwa akaphatikizidwa ndi Ritonavir, Atazanavir, Simeprevir, Lopinavir, Clopidogrel, Eltrombopag, Darunavir, Ketoconazole. Kuphatikiza ndi Tipranavir, Dronaronone, Itraconazole, Fosamprenavir, Aleglitazar, Silimarin, Rifampicin, Baikalin amafunanso zomwezi.
- Mankhwala amalimbikitsa kuchuluka kwa njira zakulera zamkamwa molingana ndi mahomoni a ethinyl estradiol ndi norchedrel.
10 ndemanga
Pofuna kuti wodwala wamtima azidziwikire kuti wodwalayo samakhala ndi vuto ladzidzidzi lamatenda - pachimake coronary syndrome, infarction ya myocardial kapena ischemic stroke, adotolo ayenera kuyang'anitsitsa kuchuluka kwa cholesterol yonse "yoyipa", yomwe imaphatikizapo LDL (lowensens lipoproteins ) Mwanjira imeneyi amathandizidwa ndi kuyamikiridwa kwa dziko, komanso malingaliro a European Society of Cardiology.
Amati odwala omwe ali ndi chiopsezo chowonjezereka cha zovuta zamtima ayenera kuyesetsa kuwonetsetsa kuti mulingo wa LDL ndi wochepera 3 mmol pa lita imodzi (yokhala ndi chiopsezo chokwanira), osakwana 2,5 ndi avareji komanso osakwana 1.8 mmol / l ndi chiwopsezo chachikulu (mwachitsanzo, pamaso pa vuto la mtima kapena sitiroko m'mbuyomu).
Kutsatira malangizowa okhazikika mu odwala okalamba (zovuta zamtima, ngakhale "kusinthika kwachangu" komabe, ndizowopsa za okalamba), zambiri zikuyenera kuchitidwa. Ngati kusintha chikhalidwe ndi chakudya kumakhalabe kosavuta kuubwana, ndiye kuti munthu wokalamba, amene amangokhala, wolemedwa kwambiri komanso matenda osiyanasiyana (matenda ashuga), ndizovuta kwambiri kukwaniritsa zomwe mukufuna. Chifukwa chake, mankhwalawa omwe amateteza kagayidwe ka mafuta mwa odwala ndi omwe ali maziko ndi chitetezo cha masoka osokoneza bongo komanso zovuta.
Mwa zina mwa mankhwalawa, ma statins omwe amalepheretsa enzyme ya HMG - CoA - reductase omwe amadziwika kuti ndi atsogoleri. Masiku athu ano alipo ambiri, pali mibadwo ingapo yama statins, ndipo magwiridwe ake amasiyanasiyana kwambiri. Chifukwa chake, simvastatin ("Vazilip") imatchulidwa ngati mankhwala otsika mtengo a m'badwo woyamba. Woimira m'badwo wachiwiri ndi fluvastatin (Leskol), wachitatu - atorvastatin (Liprimar). Mankhwala othandiza kwambiri komanso amakono akuphatikiza rosuvastatin. Mankhwalawa ndi a statin a m'badwo wachinayi, ndipo mankhwalawa omwe adalowa msika woyamba ndi Crestor.
Pakadali pano, mumafakitala aku Russia mutha kugula osati rosuvastatin yoyambirira, komanso ma analogu ake angapo - pafupifupi 10 mankhwala osiyanasiyana, ndipo ngati mungawerengere zamagetsi omwe alibe chizindikiro (wokhala ndi dzina lazamalonda), ndiye kuti chiwerengero cha omwe akupanga mankhwalawa chidzaposa angapo. Msika mochenjera amamva kufunikira, ndipo palibe amene angatulutse mankhwala osagwira ntchito. Kodi chimapangitsa Rosuvastatin kukhala chosangalatsa, ndi chiyani?
Limagwirira zake rosuvastatin
choyambirira mankhwala ndi analogues
Monga tafotokozera pamwambapa, ma statins onse amalepheretsa HMG - CoA - reductase, yomwe imagwira gawo lalikulu pakuphatikizidwa kwa cholesterol ndi kachigawo kake "koyipa". Koma molekyu ya rosuvastatin imasinthidwa mwanjira yoti singasungunuke m'mafine, chifukwa chake imakhala ndi mgwirizano waukulu kwa enzyme yomwe mukufuna (nthawi 4 kuposa momwe zachilengedwe zimapangidwira). Chifukwa cha izi, kulumikizidwa kwa rosuvastatin ndi wolandila wofunikayo kumachitika mwachangu, mosasinthika komanso "mosagwirizana". Zotsatira zake, kuphatikiza kwa mevalonic acid, cholesterol precursor, kumachepetsedwa m'chiwindi.
Maselo a chiwindi amayankha pamenepa pakuwonjezeka kwa zigawo za cholesterol tinthu tosiyanasiyana, tizigawo ting'onoting'ono "tomwe timakhala bwino timakhala ndikuchotsa magazi.
Mutatha kumwa mankhwalawa, kuchuluka kwambiri m'magazi kumachitika pambuyo pa maola 5 - 5.5 mutamwa kamodzi, ndikugwiritsa ntchito nthawi yayitali, ndende yolingana imachitika patatha maola 4 mutatha kugwiritsa ntchito. Izi ndizofunikira, popeza kuchulukitsa kwa phwando kumadalira. Ponena za chinyezi kuchokera mthupi, kuthamanga kwake sikudalira mlingo ndipo kumatenga nthawi yayitali - mpaka maola 20.
Malangizo ogwiritsira ntchito ndi mtundu wa mankhwala
Rosuvastatin woyambayo, Krestor, komabe, monga ma statins ena onse, amapezeka kokha mu mawonekedwe apiritsi. Pali mlingo wa 10, 20 ndi 40 mg. Mitundu ina yamagetsi imakhala ndi mlingo wotsikirapo. Chifukwa chake, "Mertenil" wopangidwa ndi "Gideon Richter", Hungary, ali ndi muyeso wina "woyamba" wa 5 mg.
Mosavuta, mankhwala osokoneza bongo ndi chakudya samalumikizidwa mwanjira iliyonse. Mutha kumwa Rosuvastatin pamimba yopanda kanthu, nthawi yakudya kapena itatha.
Zomwe mulingo wake - umasankhidwa payekha, ndipo maziko owonjezera mlingo ndikuwerengera koyang'anira kuchuluka kwa lipids yamagazi, okhala ndi zidziwitso zatsatanetsatane. Kafukufuku momwe tanthauzo limodzi lokha - cholesterol yathunthu - siyothandiza.
Mlingo woyambirira wa rosuvastatin nthawi zambiri umakhala 10 mg, nthawi zina, wokhala ndi chiopsezo chochepa komanso kusowa kwa kunenepa kwambiri, 5 mg ndi mankhwala. Kukula mulingo wololedwa sikunaperekedwe kuposa mwezi wotsatira. Mlingo wapamwamba ndi 40 mg, ndipo mutha kuwukitsa pachizindikirocho pokhapokha mukuwonetsa: cholowa kwambiri hypercholesterolemia kapena chiopsezo chachikulu. Palibe chifukwa chake muyenera kusankha 40 mg kwa wodwala yemwe amayamba kumwa ma statins. Pambuyo pa masabata awiri kapena mwezi wovomereza, kuphunzira kwa ma lipids wamagazi ndi magawo akuluakulu azachipatala ndi zamankhwala amodzi amachitika, ndipo adotolo amasankha njira zina zoyendetsera wodwalayo.
Contraindication ndi zoyipa
Ndi mankhwala molondola komanso moyenera a mankhwalawa, makamaka ndi mfundo yofutukuka pang'onopang'ono, rosuvastatin awonetsa chitetezo chake muzochitika zambiri za dokotala. Zachidziwikire, mankhwalawa amakhalanso ndi contraindication ndi zotsatira zosayenera, zomwe zimadalira mlingo. Koma rosuvastatin ali ndi peculiarity - osati zotsatira zoyipa zimadalira mlingo, komanso contraindication. Kwa odwala omwe amatha kumwa 10 mg kwa nthawi yayitali, sizotheka nthawi zonse kuwonjezera mlingo mpaka 20, mwachitsanzo, mpaka 40 mg, mwachitsanzo, mankhwala omwe amapezeka mu 5 mg oposa ophatikizidwa:
- odwala omwe ali ndi kutupa kwa chiwindi komanso kuchuluka kwa transaminases (cholangitis, hepatitis),
- kulephera kwambiri kwa aimpso (creatinine clearance (CC) osakwana 30 ml mphindi imodzi),
- ndi myopathy,
- ngati wodwala wavomera ndipo sangathe kuletsa cyclosporine,
- mwa amayi apakati, amayi oyamwitsa ndi ana.
Kugwiritsa ntchito 40 mg ya rosuvastatin ndi kuphwanya, kuwonjezera pa matenda omwe ali pamwambawa, komanso:
- ndi kulephera kwa aimpso ndi mawonekedwe a creatinine pansi pa 60 ml mphindi imodzi,
- pamaso pa myxedema ndi hypothyroidism,
- pamaso pa matenda a minofu mu anamnesis kapena abale (myasthenia gravis, myopathy),
- uchidakwa
- Odwala a Mongoloid (ma metabolic),
- kugwiritsa ntchito mafupa.
Mwachilengedwe, mankhwalawa amatsutsana mu chifuwa.
Zotsatira zoyipa, kupweteka kwa mutu ndi minofu, zotupa pakhungu, komanso kamvekedwe ka minofu. Mukamayesa mayeso olamulira, gawo la transaminases nthawi zina limakwera. Odwala omwe amamwa mankhwalawa ndikudandaula za kupweteka kwa minofu, ndikofunikira kuyang'ana kuchuluka kwa CPK (popeza kuwonongeka kwa minofu kapena rhabdomyolysis ndikotheka).
Mu malangizo ogwiritsira ntchito Rosuvastatin, gawo lazisonyezero zapadera ndi kuyanjana kwa mankhwala komwe kumayenera kuganiziridwapo musanayambe mankhwala amafotokozedwa mwatsatanetsatane.
Analogs ndi ma genetic a Rosuvastatin
Pakadali pano, chiwonetsero chachikulu cha ma rosuvastatin oyambilira adawonekera pamitengo yosiyanasiyana, ndi malingaliro osiyanasiyana, koma ndi malangizo amodzi kuti agwiritse ntchito. Ndipo izi mosakayikira zikuwonetsa mtundu wina wa zinthu zomwe zimagwiritsidwa ntchito. "Crestor" yoyambirira ikhoza kugulidwa pa "mtengo wolira": mulingo wocheperako wa 0.005 g No. 28 ungagulidwe kwa ma ruble 1299, ndipo mapiritsi okhala ndi mlingo waukulu wa 40 mg mulingo womwewo amagulitsidwa kuchokera ku ruble 4475. Koma mtsogoleriyo ndi phukusi la mapiritsi 126 a "Crestor" 10 mg aliyense, mtengo wake ndi ma ruble 8920. Pankhaniyi, mtengo wa piritsi limodzi ndi ma ruble 70.
Ma analogi angapo ndi otsika mtengo: mapiritsi a canon rosuvastatin kuchokera ku Canonfarm Production ndi fakitale ku Schelkovo, Moscow Region, angagulidwe kwa ma ruble 355. (10 mg No. 28). Quint wolemba "genertilil" wabwino kwambiri kuchokera ku kampani "Gedeon Richter" (Hungary) mu 20 mg, omwe ndi avareji, mutha kugula ma ruble 800 No. 30, ndipo ma CD ndi okwanira pamwezi.
Otsika kwambiri pamtengo wotsika kwambiri, rosuvastatin (mosasamala kuchuluka kwa mapiritsi ndi kumwa) amaperekedwa ndi FP Obolenskoye - rubles 244 pakompyuta 10 mg No. 28. Mwanjira ina, mtengo wa piritsi limodzi la generic yotsika mtengo ndi ma ruble 8.7, omwe ndi otsika mtengo mapiritsi enieni koposa nthawi 8.
Pomaliza, ndikufuna kunena za kudzipereka kwamphamvu kwa wodwala yemwe amadya zakudya zokhala ngati za lipid. Amathandizanso kuti muchepetse thupi, muchotse zizolowezi zoyipa, komanso mukumwa mankhwalawa - yang'anirani kuchuluka kwa ma transpase a hepatic ndikuwunika kuyesedwa kwa mawonekedwe owonjezedwa a lipid.
Kutulutsa mawonekedwe ndi kapangidwe kake
Mankhwalawa amapangidwa mwanjira ya mapiritsi okhala ndi mawonekedwe a filimu: biconvex, yozungulira, yapinki pamtundu, pakati pamtanda pali pafupifupi yoyera kapena yoyera (ma PC 10. M'matumba a chithuza, pamatumba ojambula 3 kapena 6 mapaketi, ma PC 14. chithuza chotchinga, pamakatoni a pakatoni 2 kapena 4, ma PC 30. Mutanyamula matuza, mu kakhadakhadi 2, 3 kapena 4, ma PC 20 kapena 90, mu botolo la polymer 1 / botolo mtsuko, paketi iliyonse ilinso ndi malangizo ogwiritsira ntchito Rose Vastatin-SZ).
Piritsi limodzi lili:
- yogwira mankhwala: rosuvastatin (munthawi ya calcium ya rosuvastatin) - 5, 10, 20 kapena 40 mg,
- zina zowonjezera: calcium hydrogen phosphate dihydrate, lactose monohydrate (shuga ya mkaka), povidone (ochepa molekyulu polyvinylpyrrolidone), sodium stearyl fumarate, croscarmellose sodium (primellose), microcrystalline cellulose, colloidal silicon dioxide (aerosil),
- kujambula kwama filimu: Opadry II macrogol (polyethylene glycol) 3350, mowa wa polyvinyl, pang'ono hydrolyzed, titanium dioxide (E171), talc, soy lecithin (E322), varnish ya aluminium yochokera ku utoto wazovala, aluminium varnish yochokera pa utoto wazipale, aluminium varnish yochokera pa utoto wazipale, aluminiyamu. kapezi (Ponceau 4R).
Zotsatira zoyipa
Pakumwa mankhwala ndi mapiritsi, zotsatira zake zimakhala zofewa, nthawi zambiri zimatha pazokha. Zotsatira zoyipa za mankhwala a Rosuvastatin ndi:
- matenda ashuga
- mutu, chizungulire, kuiwala kukumbukira, zotumphukira neuropathy,
- kudzimbidwa, kapamba, nseru, kupweteka kwam'mimba, chiwindi, kutsekula m'mimba,
- pruritus, urticaria, zidzolo, matenda a Stevens-Johnson,
- myalgia, rhabdomyolysis, myopathy, myositis, arthralgia,
- asthenic syndrome
- zotupa zamitsempha
- zodzala
- proteinuria, hematuria,
- kuchuluka kwa hepatic transaminases, shuga, bilirubin (jaundice),
- thrombocytopenia
- chifuwa, kufupika,
- gynecomastia
- zotumphukira edema,
- kukhumudwa, kugona tulo, zolakwika,
- kuphwanya chithokomiro, chogonana, mtima
- kuchuluka hemoglobin.
Bongo
Ngati mutenga ma rosuvastatin angapo tsiku lililonse, nthawi yomweyo, pharmacokinetics sasintha. Zizindikiro za bongo wambiri zimatheka. Palibe mankhwala oledzera. Ndi bwino kutsuka m'mimba, kupereka mankhwala othandizira mothandizidwa ndi chiwindi ndi ziwalo zina zofunika. Hemodilais sikuwonetsa kugwira ntchito.
Ma analogs a Rosuvastatin
Mutha kusintha mapiritsi a rosuvastatin ndikukonzekera zomwe zili ndi chinthu chomwecho kapena chofanana. The fanizo la mankhwala akuphatikiza:
- Crestor - mapiritsi ochepetsa lipid okhala ndi zotengera zomwezo,
- Rosart - mapiritsi okhala ndi mawonekedwe ofanana ochizira matenda amtima,
- Roxer - mapiritsi a gulu la statins,
- Tevastor - mapiritsi otengera zomwe zimagwira, kuchepetsa mafuta m'thupi.
Rosuvastatin ndi Atorvastatin - pali kusiyana kotani?
Analogue ya Rosuvastatin - Atorvastatin, imaphatikizidwa mu gulu lomweli la mankhwala a statins ndipo imapezeka mu mawonekedwe a piritsi okhala ndi malo okhala ndi lipid. Mosiyana ndi chinthu chomwe chikufunsidwa, atorvastatin imasungunuka kwambiri m'mafuta, osati m'magazi kapena madzi ena, chifukwa chake imakhudza kapangidwe ka ubongo, osati maselo a chiwindi (hepatocytes).
Mankhwala Rosuvastatin ndi othandiza kwambiri 10% kuposa Atorvastatin, omwe amalola kuti agwiritsidwe ntchito pochiza odwala omwe ali ndi cholesterol yayikulu. Komanso, wothandizira yemwe akuwunikiridwayo ndiwothandiza kwambiri makamaka poletsa kuchepetsa kucheperako m'maselo a chiwindi ndipo amakhala ndi tanthauzo loti achire. Zotsatira zoyipa za mankhwalawa ndizofanana, kotero kusankha kwa mankhwalawo kuli kwa dokotala kwathunthu.
Pharmacokinetics
Kuchuluka kwa rosuvastatin (Cmax) m'magazi am'madzi amawonedwa pafupifupi maola 5 mutayamwa. Mtheradi bioavailability wa mankhwala pafupifupi 20%, kuchuluka kwa magawidwe (Vd) - pafupifupi 134 malita. Rosuvastatin imagwira mapuloteni a plasma, makamaka okhala ndi albumin, pafupifupi 90%. Kuwonetsera kwadongosolo (AUC) kwazomwe zimagwira kumawonjezeka molingana ndi mlingo. Pogwiritsa ntchito tsiku ndi tsiku, mawonekedwe a pharmacokinetic sasintha.
Rosuvastatin imapangidwa makamaka ndi chiwindi - malo akuluakulu opanga cholesterol komanso kusintha kwa metabolic kwa LDL-C.Amapangidwira pamlingo wocheperako (pafupifupi 10%), chinthu chomwe chimagwira ndi gawo lopanda maziko a biotransfform ndi ma enzymes a cytochrome P450 system. Ma isoenzyme akuluakulu omwe amayang'anira kagayidwe kazinthuzo ndi isoenzyme CYP2C9, isoenzymes CYP2C19, CYP3A4 ndi CYP2D6 sakukhudzidwa kwambiri ndi kagayidwe. Ma metabolites okhazikika a rosuvastatin ndi lactone metabolites ndi N-desmethylrosuvastatin. Zotsirizirazi ndi pafupifupi 50% yogwira kuposa rosuvastatin. Lactone metabolites amaonedwa ngati mankhwala osagwira. Kuposa 90% ya zochita zamankhwala kupondaponda kuzungulira kwa HMG-CoA reductase kumaperekedwa ndi rosuvastatin ndi 10% ndi metabolites ake.
Pafupifupi 90% ya dozi ya rosuvastatin imatulutsidwa kudzera m'matumbo mu mawonekedwe osasinthika (kuphatikizapo chinthu cholocha ndi chosamizidwa), chotsalacho chimakhudzidwa ndi impso. Hafu ya moyo (T1/2) kuchokera ku plasma pafupifupi maola 19 ndipo sasintha ndi kuchuluka kwa mankhwala. Kutengera kwa geometric kumatanthauza chilolezo cha plasma pafupifupi 50 l / h (kutalika kwa masinthidwe 21.7%). Phukusi lotulutsa ma membrane a cholesterol, lomwe limagwira ntchito yofunika kwambiri pakuchotsa mankhwalawa, limathandizira pakuyamba kwa rosuvastatin.
Ma paracokinetic magawo a rosuvastatin ali osadalira jenda komanso zaka za wodwalayo.
Rosuvastatin, monga zoletsa zina za HMG-CoA reductase, zimamangiriza kunyamula mapuloteni, monga BCRP (efflux transporter) ndi OATP1B1 (polypeptide yonyamula ma organic anions omwe akukhudzidwa ndi kugwidwa kwa ma statins ndi ma cell a chiwindi). Onyamula a genotypes ABCG2 (BCRP) s.421AA ndi SLC01B1 (OATP1B1) s.521CC adawonetsa kuwonjezeka kwa AUC ya rosuvastatin ndi 2.4 ndi 1.6 nthawi, motero, poyerekeza ndi onyamula ma genotypes ABCG2 c.421CC ndi SLCO1B1 c.521TT.
Rosuvastatin-SZ, malangizo ogwiritsira ntchito: njira ndi mlingo
Rosuvastatin-SZ amatengedwa pakamwa. Mapiritsi, osapwanya ndi kutafuna, ayenera kuwameza kwathunthu, kutsukidwa ndi madzi.
Wothandizila lipid-angagwiritsidwe ntchito mosasamala kanthu za kudya kwakanthawi iliyonse tsiku.
Maphunzirowa asanayambike, wodwalayo ayenera kusintha zakudya zina zomwe zimakhala ndi cholesterol yotsika ndikutsatira nthawi yonse ya chithandizo. Mlingo umasankhidwa payekhapayekha, poganizira yankho la mankhwalawa pakukonzekera mankhwalawa komanso zolinga zamankhwala, komanso malinga ndi malingaliro omwe aperekedwa pakadali pano.
Kwa odwala omwe sanalandiridwepo kale ndi ma statins, kapena omwe adatenga ma HMG-CoA reductase inhibitors asanayambe maphunzirowo, mlingo woyambirira wa Rosuvastatin-SZ ndi 5/10 mg kamodzi patsiku. Koyamba mlingo wakhazikitsidwa, motsogozedwa ndi anthu ambiri kuchuluka kwa mafuta m'thupi komanso amaganiza zovuta zamtima zovuta, komanso kuopseza osafunika zimachitikira. Ngati ndi kotheka, onjezani mlingo pambuyo masabata anayi.
Chifukwa cha zovuta zomwe zimachitika pakakonzedwe ka 40 mg / tsiku, poyerekeza ndi Mlingo wochepetsetsa wa tsiku ndi tsiku, ndizotheka kuwonjezera kuchuluka kwa 40 mg / tsiku (pambuyo poti mwalandira mlingo wowonjezera wa masabata anayi) pokhapokha ngati pali zovuta. kuchuluka kwa Hypercholesterolemia ndi chiopsezo chotenga matenda a mtima. Kufikira 40 mg / tsiku makamaka limaperekedwa kwa odwala omwe ali ndi hypercholesterolemia, omwe sanathe kukwaniritsa zotsatira zofunira chithandizo ndi 20 mg / tsiku, ndipo omwe amayang'aniridwa ndi achipatala mosamala. Makamaka kusamala kwakanthawi kachipatala kumafunika kwa odwala omwe amalandira mlingo wa 40 mg wa Rosuvastatin-SZ.
Odwala omwe sanalumikizane ndi akatswiri sakulimbikitsidwa kuti atenge mapiritsi a Rosuvastatin-SZ 40 mg.
Masabata 2 - 4 pambuyo poyambira maphunziro a mankhwalawa komanso / kapena ndi kuchuluka kwa mankhwalawa, kuwunika kwa lipid metabolism kuyenera kuchitika ndipo ngati kuli koyenera, mlingo uyenera kusintha.
Onyamula a genotypes c.421AA kapena s.521CC ali osavomerezeka kuti agwiritse ntchito rosuvastatin-SZ mu Mlingo wopitirira 20 mg kamodzi patsiku.
Pokonzekera kuphunzira pharmacokinetics a rosuvastatin mwa anthu amitundu yosiyanasiyana, mutamwa mankhwalawo ndi a Japan ndi China, kuwonjezeka kwa dongosolo la rosuvastatin kumaonekera. Vutoli liyenera kukumbukiridwa popereka mankhwala ochepetsa lipid kukhala oimira mtundu wa Mongoloid. Mwa gulu la odwala omwe ali ndi mankhwalawa Mlingo wa 10 ndi 20 mg, wina ayenera kuyamba kumwa 5 mg / tsiku, mapiritsi a 40 mg ali otsutsana.
Odwala omwe ali ndi lingaliro lakukula kwa myopathy Rosuvastatin-SZ tikulimbikitsidwa kuti atenge koyamba mlingo wa 5 mg.
Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka
Kafukufuku wofufuza momwe mphamvu ya Rosuvastatin-SZ imayendera poyendetsa magalimoto ndi kugwiritsa ntchito njira zovuta pantchito sizinachitike. Pochita zinthu zoopsa, odwala amafunika kukhala osamala, chifukwa chizungulire chitha kupezeka nthawi ya chithandizo.
Mimba komanso kuyamwa
Rosuvastatin-SZ ndi contraindicated mu mimba ndi mkaka wa m`mawere. Amayi azaka zoyambira kubereka ayenera kugwiritsa ntchito njira zodalirika zolerera.
Popeza zinthu zamafuta a cholesterol ndi cholesterol biosynthesis ndizofunikira kwambiri pakukula kwa fetal, chiopsezo chopondereza kuchepa kwa HMG-CoA ndichoposa zabwino zotenga Rosuvastatin-SZ mwa amayi apakati. Pakakhala pakati pa mankhwala ndi mankhwalawa, kayendetsedwe kake kamayenera kuyimitsidwa nthawi yomweyo.
Palibe chidziwitso pakugawidwa kwa rosuvastatin mkaka wa m'mawere, chifukwa chake, pakubala, ndikofunikira kusiya kumwa Rosuvastatin-SZ.
Mu vuto laimpso
Odwala omwe amalephera kupweteka pang'ono, kapena aimpso, palibenso kusintha kwakukulu kwa plosma ya rosuvastatin kapena N-desmethylrosezuvastatin. Kulephera kwambiri kwaimpso, kuchuluka kwa rosuvastatin m'magazi am'magazi katatu, ndipo N-desmethylrosuvastatin ndiwokwera kwambiri maulendo 9 kuposa antchito odzipereka athanzi. Kuchuluka kwa plasma ya rosuvastatin mwa odwala omwe akudwala hemodialysis anali pafupifupi 50% kuposa antchito odzipereka athanzi.
Kulandiridwa kwa Rosuvastatin-SZ kumakhudzana chifukwa cha kuwonongeka kwambiri kwa impso (creatinine Cl pansipa 30 ml / min).
Kwa odwala omwe ali ndi vuto lofooka la impso (Cl creatinine 30-60 ml / min), kugwiritsa ntchito rosuvastatin-SZ pa 40 mg ndikutsutsana, ndipo pa mlingo wa 5, 10 ndi 20 mg muyenera kugwiritsidwa ntchito mosamala.
Odwala ofooka aimpso (creatinine Cl pamwamba pa 60 ml / mphindi) ayenera kulandira chithandizo cha 40 mg mosamala, kuwunika ntchito yaimpso. Pogwiritsa ntchito mankhwalawa odwala omwe ali ndi vuto laimpso, koyamba mlingo uyenera kukhala 5 mg.
Ndi chiwindi ntchito
Pamaso pa kulephera kwa chiwindi kuchokera pamfundo 7 komanso pansi pa sikelo ya Mwana-Pugh, kuwonjezeka kwa T1/2 palibe rosuvastatin wapezeka, kuwonjezeka kwa T kudalembedwa m'magulu awiri omwe ali ndi 8 ndi 9 point1/2 osachepera 2 times. Palibe zokumana nazo pakugwiritsidwa ntchito kwa Rosuvastatin-SZ mu odwala omwe ali ndi vutoli lokwera kuposa 9 pamawonekedwe a Mwana-Pugh.
Kuchiza ndi mankhwalawa kuphatikizidwa kwa odwala omwe ali ndi matenda a chiwindi mu gawo lowonjezera, kuphatikiza ndi kuwonjezereka kwa ntchito ya seramu transaminase ndi kuwonjezeka kulikonse kwa ntchito ya transaminase, kupitirira katatu kuposa VGN. Mosamala, tikulimbikitsidwa kuti Rosuvastatin-SZ igwiritsidwe ntchito kwa odwala omwe ali ndi mbiri yovulaza chiwindi. Kudziwitsa zizindikiro za chiwindi ndikofunikira musanalandire chithandizo ndi miyezi itatu mutangoyamba kumene maphunziro.
Ndemanga za Rosuvastatin-SZ
Malinga ndi ndemanga, Rosuvastatin-C3 ndi mankhwala othandiza kuchepetsa lipid wogwiritsidwa ntchito pochiritsa hypercholesterolemia, amachepetsa kupitirira kwa atherosulinosis komanso kupewa mtima. Zotsatira zoyambirira za chithandizo zimawonedwa ndi odwala ambiri sabata litatha, ndipo zotsatira zake zimakhala mwezi umodzi pambuyo poyambira maphunzirowo. Malinga ndi ndemanga, chifukwa cha momwe mankhwalawo amathandizira, kuchuluka kwa cholesterol m'mwazi kumachepa, kuthamanga kwa magazi kumakhazikika, mkhalidwe wambiri umakhala bwino, kupuma movutikira pamene kuyenda kumachepa. Mankhwalawa, nthawi zina, kuchuluka kwa thupi kumachepa chifukwa cha kuphatikiza kwa mankhwala omwe amapezeka ndi mafuta ochepa a cholesterol.
Zoyipa za Rosuvastatin-SZ zimaphatikizapo zotsutsana zambiri komanso zoyipa zomwe zimachitika. M'mawunikidwe ena, odwala akuwonetsa kusakhutira ndi mtengo wa mankhwalawa, chifukwa nthawi zambiri amatengedwa nthawi yayitali, mtengo wa mankhwalawa womwe umafunikira panjira yonse ya chithandizo, pakuganiza kwawo, ndiwokwera kwambiri.
Mtengo wa Rosuvastatin-SZ m'masitolo ogulitsa mankhwala
Mtengo wa rosuvastatin-SZ, mapiritsi okhala ndi mafilimu amatengera kuchuluka ndi kuchuluka kwa phukusili, ndipo pafupifupi ndi:
- Mlingo wa 5 mg: 30 ma PC. - 180 ma ruble.,
- Mlingo wa 10 mg: 30 ma PC. - 350 rub., 90 ma PC. - 800 ma ruble.,
- Mlingo wa 20 mg: 30 zidutswa. - 400 rub., 90 ma PC. - 950 rub.,
- Mlingo wa 40 mg: 30 zidutswa. - 750 rub.