Atorvastatin-Teva amapangidwa ngati mapiritsi okhala ndi utoto wapa kanema: wooneka ngati kapisozi, mwina oyera kapena oyera, wolembedwa "93" mbali imodzi, ndikulemba pamwambo wolemba mbali inayo: "7310" kwa 10 mg, ndi 7310 kwa 20 mg "7311", 40 mg - "7312", 80 mg - "7313" (ma PC 10. M'matumba, mu bokosi lamatoni a matuza atatu kapena 9).

Piritsi 1:

• yogwira mankhwala: atorvastatin calcium - 10,36, 20.72, 41.44 kapena 82.88 mg, womwe ndi wofanana ndi 10, 20, 40 kapena 80 mg wa atorvastatin,
• zina zowonjezera: povidone, lactose monohydrate, eudragit (E100) (methyl methacrylate, butyl methacrylate ndi dimethylaminoethyl methacrylate Copolymer), sodium stearyl fumarate, croscarmellose sodium, alpha-tocopherol macrogol.
• zokutira filimu: opadry YS-1R-7003 hypromellose 2910 3cP (E464), polysorbate 80, hypromellose 2910 5cP (E464), macrogol 400, titanium dioxide.

Zizindikiro zogwiritsidwa ntchito

• heterozygous achibale komanso osakhala achiberekera hypercholesterolemia, chachikulu hypercholesterolemia, yosakanikirana (yophatikiza) hyperlipidemia (mitundu IIa ndi IIb malinga ndi gulu la Fredrickson) - kuphatikiza zakudya zomwe zimachepetsa lipid-kupendekera kotsitsa cholesterol yotsika, kutsika kwa lipoprotein cholesterol. komanso kuwonjezeka kwa cholesterol yapamwamba kwambiri (HDL),
• homozygous Famer hypercholesterolemia - kuti muchepetse cholesterol yathunthu ndi LDL cholesterol, osakwanira pakumupatsa mankhwala komanso munjira zina zosagwiritsa ntchito mankhwala
• kumtunda kwa seramu triglycerides (mtundu wa IV malinga ndi gulu la Fredrickson) dysbetalipoproteinemia (mtundu wa III malinga ndi gulu la Fredrickson) - pakagwiritsidwe ntchito ka mankhwala osathandiza.

Contraindication

• Mimba ndi kuyamwa
• azaka zapakati pa 18 (mbiri ya chitetezo cha atorvastatin mwa ana ndi achinyamata sichinaphunzire),
• odwala matenda a chiwindi, kuchuluka kwa ntchito za michere ya chiwindi chosadziwika, yoposa malire a masiku (VGN) koposa katatu,
• kulephera kwa chiwindi (Makasi a ana-Pugh A ndi B),
• Hypersensitivity pamagawo a mankhwala.

Wachibale (amafunika kugwiritsa ntchito malonda mosamala):

• endocrine ndi kagayidwe kachakudya matenda,
• kutchulidwa kukondera kwa electrolyte,
• ochepa hypotension,
• mbiri ya matenda a chiwindi,
• khunyu yosalamulirika,
• matenda opweteka kwambiri (kuphatikizapo sepsis),
• zotupa zamafupa,
• kuvulala, maopaleshoni ambiri,
• uchidakwa.

Mlingo ndi makonzedwe

Atorvastatin-Teva amagwiritsidwa ntchito pakamwa, 1 nthawi patsiku. Kudya sikukhudza kutha kwa mankhwalawa.

Mlingo woyamba, monga lamulo, ndi 10 mg, mapiritsi amatengedwa nthawi iliyonse masana. Mlingo amasankhidwa ndi dokotala payekha, kutengera kuchuluka kwa cholesterol, cholinga chamankhwala komanso yankho la wodwalayo pakuchiza. Mlingo wa tsiku ndi tsiku umatha kukhala 10 mpaka 80 mg, uyenera kukonzedwa pakapita masabata anayi kapena kupitilira. Pazipita mlingo tsiku lililonse sayenera kupitirira 80 mg.

Mankhwala, ndi kuchuluka kwa mankhwalawa, amafunika milungu iwiri iliyonse ya 2 kuti ayang'anire kuchuluka kwa plasma lipid, molingana ndi deta yomwe yapezeka, sinthani mlingo.

Mlingo woyenera:

• homozygous achibale hypercholesterolemia: 80 mg patsiku,
• heterozygous achibale hypercholesterolemia: kumayambiriro kwa maphunzirowa, kutenga 10 mg patsiku, munthawi ya chithandizo pakatha milungu 4 aliyense kuchuluka kwa mankhwalawa, kubweretsa 40 mg pa tsiku, wopezeka limodzi ndi sequestrant ya bile, mukamagwiritsa ntchito mankhwala a atorvastatin ngati mankhwalawa. mfundo - 80 mg patsiku,
• chachikulu hypercholesterolemia ndi chosakanikirana (chophatikiza) hyperlipidemia: 10 mg patsiku, mlingo uyu mwa odwala ambiri amakupatsani mwayi wowunikira kuchuluka kwa lipid, monga lamulo, njira yothandizira kwambiri imawonedwa masabata 4 pambuyo poyambira kukhazikitsa ndipo imatenga nthawi yayitali kugwiritsa ntchito mankhwalawa.

Pamaso pa kulephera kwa chiwindi, ngati kuli kotheka, mlingo wa Atorvastatin-Teva ungachepetse kapena kulandiridwa kwake. Kwa odwala omwe ali ndi matenda a impso, kusintha kwa mlingo sikofunikira.

Pa matenda a mtima kapena omwe ali ndi vuto lalikulu la mtima, tikulimbikitsidwa kuti chithandizo chamankhwala chichitike ndi zotsatirazi zakukonzekera kwa milomo ya lipid: chonse cholesterol

Kupanga ndi mawonekedwe a kumasulidwa

Malinga ndi chidziwitso choperekedwa ndi radar, Atorvastatin Teva ndi woimira mankhwala omwe ali m'gulu la ma statins. Mankhwala amakhudzidwa mwachindunji ndi enzyme reductase, yomwe imalepheretsa. Mankhwalawa amapezeka mu mawonekedwe a piritsi, atakulungidwa ndi chipolopolo kuchokera mufilimu yapadera, yomwe imapatsa makinidwe oyera.

Yogwira gawo yogwira Teor ya Atorvastatin - Atorvastatin calcium calcium. Kutengera ndi kuzunzidwa kwa chinthu chomwe chimagwira, mapiritsiwo amakhala ndi Mlingo wa 21.7 kapena 10,85 mg. Mukasamukira ku atorvastatin ndi 20 ndi 10 mg, motero.

Kuphatikiza pa chinthu chachikulu chomwe chimagwira ntchito yochiritsa, piritsi lililonse limakhala ndi zinthu zina zothandizira. Izi ndi monga: calcium carbonate, utoto wa opadray, utoto wa magnesium, cellulose, wowuma. Wopangayo amapaka mankhwalawo m'matumba a blister ndi makatoni.

Zotsatira zoyipa

Odwala ambiri omwe akuphatikizidwa ndi kuphatikizidwa kwa Atorvastatin-Teva, adanena za kulolera kwake. Ngakhale izi, monga zina zilizonse, mankhwalawa ali ndi zovuta zina. Mwa kugaya chakudya Matenda a dyspeptic (kutsegula m'mimba kapena kudzimbidwa, kutentha kwa mtima, nseru, kusanza, kupindika), zotupa zam'mimba ndi matumbo, matenda otupa a kapamba, m'mimba.

Mwa ziwalo zoyenda akhoza kukhala myositis, myalgia, arthralgia, myopathy, rhabdomyolysis. Atopvastatin-induction myopathy imatha kukhala yovuta chifukwa cha kulephera kwaimpso chifukwa cha myoglobinuria (kuchotserera kwa zinthu zomwe zimasokonekera mu minyewa).

Ndizachilendo kwambiri kuti mankhwalawa amayambitsa matupi awo sagwirizana (urticaria, edema ya Quincke, dermatitis, zotupa za erythematous).

Nthawi zina kuwonongeka kwazidziwitso, kukhazikika kwa thupi, kugona mtulo ndi kukhala maso, kusokonezeka kwa mawonekedwe kapena malingaliro.

Malangizo ogwiritsira ntchito

Asanayambe kumwa Atorvastatin Teva, kupatula, odwala onse amafunikira zakudya zapamwamba za hypocholesterol. Mfundo iyi yazakudya iyenera kuchitika osati motsutsana ndi maziko a mankhwala, komanso moyo wonse. Njirayi ithandizanso kukwaniritsa cholinga chachikulu cha mankhwala - LDL ndi cholesterol yathunthu idzafika pazabwino, ndipo mulingo wa HDL ukuwonjezeka.

Teva ya Atorvastatin imatha kutengedwa mosasamala kanthu nthawi yakudya. Kuyambitsa chithandizo, muyenera kuyang'anira mwezi ndi mwezi mawonekedwe a lipid kuti musankhe ndikuwongolera mlingo wa mankhwalawo.

Mlingo woyambira nthawi zambiri umaposa 10 mg wa atorvastatin patsiku. Ngati ndi kotheka, mutha kubweretsa mlingo waukulu wa 80 mg patsiku, womwe ungagawidwe mu 2 Mlingo (m'mawa ndi madzulo). Ngati wodwala amathandizidwa nthawi yomweyo ndi cyclosporiomas, mlingo wa tsiku lililonse wa Atorvastatin Teva uyenera kukhala wochepa (10 mg patsiku). Kuwonjezeka kwa kuchuluka kwa atorvastatin m'magazi am'magazi (kuphatikiza kusintha koyenera mu kuzungulira kwa zigawo za lipid) kumadziwika patatha masiku 10 mpaka 14 atayamba chithandizo.

Gwiritsani ntchito pa nthawi yoyembekezera

Mimba ndi chikhalidwe cha akazi momwe Atorvastatin Teva amatsutsana kwathunthu. Kugwiritsa ntchito mankhwalawa ndizotheka pokhapokha ngati phindu kwa mayi limaposa chiwopsezo kwa wolandira mwana wosabadwa. Chifukwa chosowa deta yakufufuza zamankhwala kuti Atorvastatin Teva adutsa mkaka wa m'mawere, ndizoletsedwa kuitenga ikadyetsedwa mwachilengedwe. Ngati mankhwala a atorvastatin ndi ofunika, mkaka wa mkaka uyenera kutha.

Ngati woyimira kugonana woyenera atadziwa za pakati pake, atayamba kulandira chithandizo ndi Atorvastatin Teva, kuvomerezedwa kwake kuyenera kuyimitsidwa posachedwa. Amayi omwe amamwa mankhwalawa amayenera kusamalira njira zodalirika zotetezedwa kuti mwana asatenge pakati. Amayi amisinkhu yobala, asanayambe chithandizo ndi Atorvastatin Teva, ndikofunikira kuti azikumana ndi a gynecologist.

Kugwiritsa ntchito kwa Atorvastatin Teva sikuvomerezeka makamaka pagulu la anthu osakwana zaka zambiri. Izi ndichifukwa choti mayesero azachipatala pokhudzana ndi chitetezo ndi mankhwalawa kwa ana sanachitike, chifukwa chake izi sizipezeka.

Kuchita ndi mankhwala ena

Kuti musatenge zotsatira zosafunikira m'thupi, muyenera kudziwa momwe Atorvastatin Teva amakhudzana ndi mankhwala ena. Pogwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo omwe ali ndi norethisterone ndi ethinyl estradiol (njira zakulera zamkamwa), kuchuluka kwa plasma kwa zinthu zomwe timagwira timadzi timene timachitika. Vutoli liyenera kukumbukiridwa popereka mankhwala oletsa kubereka kwa amayi omwe akufuna chithandizo ndi Atorvastatin Teva.

Kusagwirizana kosayenera ndi atorvastatin ndi ma statin ena kumawonedwa mu cyclosporine, antimycotic mankhwala, antibacterial othandizira ochokera ku gulu la macrolide, ndi nicotinic acid. Kugwiritsa ntchito limodzi ndi zinthu izi kumachulukitsa mwayi wa myopathy ndi zovuta zonse zotsatirapo (rhabdomyolysis, kulephera kwaimpso).

Ndi munthawi yomweyo makonzedwe a Atorvastatin Teva ndi digoxin, kuchuluka kwa mtima glycoside m'magazi amwazi kumachulukitsa pokhapokha ngati tsiku lililonse la statin linali 80 mg. Chifukwa chake, mwa odwala omwe amalandira digoxin, kuti apewe glycoside kuledzera, mlingo wa lipid wotsitsa umayenera kukhala wochepera 80 mg patsiku.

Mtengo wa mankhwala

Pogula Atorvastatin Teva, mtengo wake umatengera mlingo wa zomwe zimagwiritsidwa ntchito, komanso maukonde aupangiri wa mankhwala omwe kugula kwa mankhwalawa kwakonzekera. Ndondomeko yamitengo ya mankhwalawa siyosiyana makamaka ndi mtengo wa mankhwalawa ofanana ndi zomwe amachita.

• M'gawo Russian Federation Mtengo wapakati pa paketi ya Atorvastatin Teva ndi ma ruble 200.
• Chiyukireniya mankhwala amapereka 20 mg mapiritsi pamtengo wa 250 UAH.

Ma analogi a Atorvastatin-Teva

Makampani amakono opanga zamankhwala amapereka kugula Atorvastatin Teva analogues onse apabanja ndi akunja. Mankhwalawa amasiyana m'mazina amalonda okha, koma malinga ndi zomwe zimagwiritsidwa ntchito ndizofanana ndendende. Zofananira zofala kwambiri za Atorvastatin Teva ndi Atoris, Liprimar, Tulip, Torvakard, Atomax.

Kugwiritsa Ntchito

Ndemanga zambiri zamankhwala, zomwe amagawana ndi madokotala ndi odwala, ndi zabwino. Anthu omwe adatenga Atorvastatin Teva adawona kuleza mtima kwake, zotsatira zake mwachangu, zimadziwika ndi nthawi yayitali, komanso kusintha kwazomwe zikuchitika. Madokotala omwe amawona odwala omwe akuchitidwa ndi Atorvastatin Teva, amalankhula zaubwino wake wazachipatala, zomwe zimatsimikiziridwa ndi zotsatira za njira zosiyanasiyana zofufuzira.

Atorvastatin Teva ndi mankhwala ochepetsa mphamvu ya lipid omwe amapangidwira matenda a lipid metabolism mwa thupi, potero amateteza ku zotsatira zoyipa za cholesterol pamatumbo ofunikira ziwalo zofunika. Komabe, odwala ayenera kukumbukira kuti Atorvastatin Teva makamaka ndi mankhwala, kulandiridwa kwake komwe kuyenera kuvomerezedwa ndi dokotala atayeza mayeso athunthu!

Mlingo

Mapiritsi Ovomerezeka, 10 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg

Piritsi limodzi lili

yogwira mankhwala - atorvastatin calcium calcium hydrocrate 10,3625 mg, 20,725 mg, 31.0875 mg, 41.450 mg, 62.175 mg, 82.900 mg, ofanana ndi atorvastatin 10 mg, 20 mg, 30 mg, 40 mg, 60 mg 80 mg,

zotuluka: microcrystalline cellulose (GR M102), sodium carbonate, maltose, croscarmellose sodium, magnesium stearate,

makanema ophatikizira amakanema: hypromellose (Pharmacoat Gr.606), hydroxypropyl cellulose, triethyl citrate, polysorbate 80, titanium dioxide (E 171).

Mapiritsiwa amakhala ndi zokutira kuchokera ku zoyera mpaka pafupi zoyera, chowumbirira, ndi biconvex pamwamba (pazipata za 10 mg, 20 mg, 40 mg, 80 mg).

Mapiritsiwo anali atakulungidwa ndi chipolopolo kuyambira kuyera mpaka kuyera, yoyera, yokhala ndi biconvex ndikuyika "30" kumbali imodzi (kwa mulingo wa 30 mg).

Mapiritsiwo anali atakulungidwa ndi chipolopolo kuyambira kuyera mpaka kuyera, yoyera, yokhala ndi biconvex pamwamba ndikulemba "60" kumbali imodzi (pamlingo wa 60 mg).

Mankhwala

Pambuyo pakukonzekera pakamwa, atorvastatin imalowa mwachangu. Kuzindikira kwakukulu kumatheka pambuyo pa maola 1-2. Chifukwa cha kutsimikizika kwawonekera kwa mucous membrane wamatumbo ndi zotsatira za "gawo loyambirira" kudzera pachiwindi, kutsimikizika kwakukulu kwa atorvastatin ndi 12%, ndipo dongosolo la bioavailability ndi 30%. Kuchulukitsa kwapakati pakugawa kwa atorvastatin ndi pafupifupi 381 malita. Kumangiriza kwa mapuloteni a plasma - 98%. Atorvastatin imapangidwa pang'onopang'ono ndi cytochrome P450 ndikupanga ma ortho- ndi para-hydroxylated zotumphukira ndi zinthu zosiyanasiyana za beta oxidation. Ntchito ya inhibitory motsutsana ndi HMG-CoA reductase mu plasma ili pafupifupi 70% chifukwa cha metabolites yogwira. Atorvastatin ndi metabolites ake amachotseredwa makamaka ndi bile pambuyo pa hepatic ndi extrahepatic metabolism. Hafu ya moyo wa atorvastatin ndi maola 14. Hafu ya moyo wa inhibitory zochita za HMG-CoA reductase ndi maola 20-30 chifukwa cha metabolites yogwira.

Odwala okalamba, kuchuluka kwa atorvastatin mu plasma kumakhala kwakukulu.

Ngati chiwindi ntchito, chiwonetsero cha atorvastatin ndi metabolites ukuwonjezeka nthawi 16.

Kupanga kwamachitidwe kumalumikizidwa ndi kuphwanya kapangidwe ka cholesterol m'chiwindi pakumatha mevalonic acid chifukwa chosankha mpikisano wa HMG-CoA reductase. Atorvastatin amachepetsa plasma cholesterol ndi lipoprotein chifukwa cha kuwonongeka kwa hepatic cholesterol synthesis ndi kuchuluka kwa chiwopsezo cha hepatic low density lipoprotein receptors (LDL) cell cell, zomwe zimapangitsa kukulira komanso kuchuluka kwa LDL. Atorvastatin imathandizira kuchepetsa milingo ya LDL mwa odwala omwe ali ndi homozygous cholowa hypercholesterolemia omwe nthawi zambiri samayankha chithandizo cha lipid-kuchepetsa. Kutsika kwa milingo ya LDL kumachepetsa chiopsezo cha matenda a mtima.

Mlingo ndi makonzedwe

Musanayambe chithandizo, muyenera kuyesa kuthana ndi vuto la hypercholesterolemia pogwiritsa ntchito zakudya, 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.

Mankhwalawa amatengedwa nthawi iliyonse masana, mosasamala za kudya. Mlingo wa mankhwalawa amasankhidwa kuchokera 10 mpaka 80 mg kamodzi patsiku, poganizira zomwe zili LDL-C, cholinga cha mankhwala ndi zotsatira zake. Kumayambiriro kwa mankhwalawa komanso / kapena pakuwonjezeka kwa mlingo wa mankhwalawa, ndikofunikira kuyang'anira zomwe zili m'magazi a plasma sabata iliyonse ya 2-4 ndikusintha mlingo wa mankhwala ngati pakufunika.

Hypercholesterolemia yoyamba komanso yophatikiza (yophatikiza) yophatikizika: kwa odwala ambiri - 10 mg kamodzi patsiku, njira zochizira zimadziwonekera pakatha masabata awiri ndipo nthawi zambiri zimafika mpaka pakadutsa masabata anayi, ndikulandira chithandizo kwa nthawi yayitali, zotsatira zake zimapitirira.

Homozygous Famer hypercholesterolemia: 80 mg kamodzi patsiku (nthawi zambiri, chithandizo chamankhwala chidayambitsa kutsika kwa zomwe LDL-C ndi 18-45%).

Kwambiri dyslipidemia: mlingo woyambira wa 10 mg kamodzi patsiku. Mlingo umatha kuwonjezeka mpaka 80 mg tsiku lililonse malinga ndi kuyankha kwa chipatala ndi kulolera. Mlingo uyenera kusankhidwa payekha poganizira cholinga cha mankhwala.

Gwiritsani ntchito odwala omwe ali ndi matenda a chiwindi: onani.

Mlingo wa odwala omwe ali ndi vuto la aimpso: matenda a impso sasokoneza kukhudzana kwa Atorvastatin-Teva mu plasma kapena kuchepa kwa LDL-C, chifukwa chake, kusintha kwa mankhwalawa sikofunikira.

Kugwiritsa ntchito okalamba: palibe kusiyana pakutetezeka, kuchita bwino, kapena kukwaniritsa zolinga za lipid-kuchepetsa mankhwala okalamba poyerekeza ndi anthu ambiri.

Atorvastatin-Teva - chida chamakono chochepetsera cholesterol

Atorvastatin-Teva ndi mankhwala omwe amathandiza odwala omwe ali ndi cholesterol yambiri omwe ali ndi ziwonetsero zolemba pazotengera zawo. Ndemanga za madokotala akuti uku ndi m'badwo watsopano wamankhwala, wopangidwa mosiyanasiyana.

Kodi mungamwe bwanji mankhwala a cholesterol a Atorvastatin-Teva?

Mankhwalawa ndi a gulu la ma statins, koma akuwonetsa kuchita bwino kwambiri kuposa mankhwala omwewo.

Chizindikiro cha Atorvastatin-Teva ndichofunikira kwambiri pakugwirira ntchito limodzi ndi mankhwala ena.

Malangizo ogwiritsira ntchito mankhwala a cholesterol ali ndi zidziwitso ndi zomwe zikuwonetsa pazochitikazo. Thupi limalembedwa mwanjira ya mapiritsi, pamene cholesterol imayamba kuwopseza thanzi la wodwalayo, imayambitsa kukula kwa matenda ambiri. Mapiritsi a Atorvastatin amawonetsedwa ngati pali mawonekedwe amomwe mungagwiritsire ntchito:

• Matenda a mtima omwe angayambike chifukwa chakubadwa kwamunthu komanso matenda okhudzana ndi zaka, moyo wosayenera, kumwa mowa ndi kusuta,
• kuthamanga kwa magazi
• myocardial infaration ndi stroke,
• kuyambiranso kuchipatala chifukwa cha angina pectoris,
• hypercholesterolemia yoyamba komanso cholowa,
• kufunika kowonjezera zakudya zapadera zamagulu a zakudya zoperekedwa kwa hyperlipidemia, dysbetalinoproteinemia, hypertriglyceridemia.

Cholesterol m'matenda oterewa amawopseza munthu, amawonjezera ngozi yakufa mwadzidzidzi chifukwa cha zovuta. Makina a zochita za mankhwalawa cholinga chake ndikulepheretsa chinthu monga HMG-CoA reductase, kutembenuza gawo lake lalikulu 3-hydroxy-3-methylglutarin-CoA kukhala mevalonic acid. Zotsatira zake, ma lipoproteins otsika kwambiri amayamba kupanga, omwe amathandiza kuchepetsa mwayi wokhala ndi matenda amtima, atherosclerosis, komanso amachepetsa kuchuluka kwa cholesterol m'makoma amitsempha yamagazi.

Zotsatira zoyipa

Nthawi zambiri (> 1/100 mpaka ˂1 / 10)

- kupweteka m'mimba ndi pharynx, nosebleeds

- flatulence, dyspepsia, nseru, kutsegula m'mimba, kudzimbidwa

- myalgia, arthralgia, kupweteka kwa miyendo, kukokana kwa minofu, mafupa otupa, kupweteka kumbuyo

- kusintha kwa zikuwonetsa ntchito ya chiwindi, kuchuluka kwa creatine phosphokinase (CPK) m'magazi (kuchuluka kwachulukidwe ka creatine phosphokinase kopitilira katatu kuposa malire apamwamba) kunawonedwa mu 2,5% ya odwala omwe amatenga atorvastatin komanso maulendo 10 kuposa malire apamwamba a chizolowezi 0,4% ya odwala)

Nthawi zina (> 1/1000 mpaka ˂1 / 100)

- zoopsa, kugona

- chizungulire, paresthesia, Hypesthesia, dysgeusia

- kusanza, kupweteka pamimba, kupindika

- kupweteka m'khosi, kufooka kwa minofu

- urticaria, zotupa pakhungu, kuyabwa, alopecia

- malaise, asthenia, kupweteka pachifuwa, zotumphukira edema, kutopa, kutentha thupi

- zotsatira zabwino za kukhalapo kwa maselo oyera amkodzo

- kuchuluka kwama transaminase. Kusintha kochepa, kudutsa osati kufuna kusokonezeka kwa chithandizo. Kwambiri zamankhwala (kuchulukitsidwa katatu kuposa malire abwinobwino) kuchuluka kwa ma seramu transaminases kunawonedwa mu 0.8% ya odwala omwe amalandira atorvastatin. Kuchulukaku kudalira mlingo komanso kusintha kwa odwala onse.

Pafupipafupi (> 1/10000 mpaka ˂1 / 1000)

- Edema ya Quincke, dermatitis yodwala, matenda a Stevens-Johnson, poyidermerm necrolysis, erythema multiforme

- myopathy, myositis, rhabdomyolysis, tendinopathy, tendon rupture

- kuchuluka kwa thupi

Zosowa kwambiri (> 1/10000 mpaka ˂1 / 1000)

- kuiwalika, kuiwala kukumbukira, amnesia, chisokonezo

Zotsatira zotsatirazi zidanenedwapo, kuchuluka kwa komwe sikunakhazikitsidwe

- matenda apamtima a m'mapapo (ndi chithandizo cha nthawi yayitali)

- shuga mellitus, pafupipafupi kumadalira kupezeka kapena kusapezeka kwa zinthu zoopsa (kusala kudya kwa glucose> 5.6 mmol / l, BMI> 30 kg / m2, triglycerides okwera, mbiri ya matenda oopsa)

- Immuno-Mediated necrotizing myopathy

Zochita zamankhwala

Mphamvu ya mankhwala a atorvastatin

Atorvastatin imapangidwa ndi kutenga nawo gawo la cytochrome P450 3A4 (CYP3A4) ndipo ndi gawo lonyamula mapuloteni, mwachitsanzo, transporter transporter OATP1B1. Kugwiritsa ntchito munthawi yomweyo mankhwala omwe ndi CYP3A4 inhibitors kapena mapuloteni onyamula angakulitse kuchuluka kwa plasma kwa atorvastatin ndikukulitsa chiopsezo cha myopathy. Chiwopsezo chija chikuwonjezeka ndikugwiritsa ntchito munthawi yomweyo atorvastatin ndi mankhwala ena omwe angapangitse myopathy, mwachitsanzo, zotumphukira za fibroic acid ndi ezetimibe.

Ma CYP 3A4 inhibitors amphamvu amadziwika kuti amatsogolera pakuwonjezeka kwakukulu kwa ndende ya atorvastatin. Pomwe zingatheke, kugwiritsa ntchito munthawi yomweyo kugwiritsa ntchito ma CYP 3A4 ma inhibitors amphamvu (mwachitsanzo, ndi cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posaconazole, komanso proteekitrate ya HIV, kuphatikiza ndi matenda a vutovinvir. etc.). Ngati ndizosatheka kupewa kugwiritsa ntchito mankhwalawa pamodzi ndi atorvastatin, muyenera kuganizira za kumwa kwa atorvastatin mosamala kwambiri, ndikuwunika koyenera kwamankhwala odwala.

Ma CYP 3A4 odziletsa (mwachitsanzo, erythromycin, diltiazem, verapamil ndi fluconazole) atha kuwonjezera kuchuluka kwa plasma ya atorvastatin. Kugwiritsa ntchito pamodzi kwa erythromycin ndi ma statins limodzi ndi chiwopsezo cha myopathy. Kafukufuku wokhudzana ndi mankhwala osokoneza bongo kuti ayese zotsatira za amiodarone kapena verapamil pa atorvastatin sizinachitike. Amadziwika kuti amiodarone ndi verapamil amalepheretsa zochitika za CYP 3A4, chifukwa chake, kuyendetsa kwakanthawi kwamankhwala awa ndi atorvastatin kungayambitse kuwonjezeka kwa atorvastatin. Chifukwa chake, pogwiritsa ntchito munthawi yomweyo atorvastatin komanso zolimbitsa CYP 3A4 zoletsa, kuthekera kwa kuchuluka kotsika kwambiri kwa atorvastatin kuyenera kuganiziridwanso, ndikuwonetsetsa momwe odwala akuwathandizira. Pambuyo poyambitsa chithandizo ndi inhibitor kapena mutasintha mlingo wake, kuwunika koyenera kachipatala kumalimbikitsidwa.

Madzi a mphesa amakhala ndi chimodzi kapena zingapo zomwe zimalepheretsa cytochrome CYP 3A4 ndipo zimatha kuwonjezera kuchuluka kwa plasma a atorvstatin, makamaka ndi kumwa kwambiri madzi a mphesa (> 1.2 malita patsiku).

Zolozera CYP 3A4

Kuyang'anira munthawi yomweyo kwa atorvastatin ndi ma cytochrome P450 3A4 inducers (mwachitsanzo, ndi efavirenz, rifampicin, St. wort waku St.) akhoza kuthandizira kuchepa kosasunthika kwa plasma wozungulira atorvastatin. Chifukwa cha kupangika kwa mgwirizano wachiwiri wa rifampicin (kukondoweza kwa cytochrome P450 3A ndi kuletsa kwa chiwindi transporter OATP1B1), kuyang'anira munthawi yomweyo atorvastatin ndi rifampicin ndikulimbikitsidwa, popeza kutenga atorvastatin kwa nthawi yayitali pambuyo pa rifampicin yokhudzana ndi kuchepa kwakukulu kwa potrapaz. Komabe, mphamvu ya rifampicin pakuwonekera kwa atorvastatin m'maselo a chiwindi sichikudziwika, ndipo ngati ndizosatheka kupewa kugwiritsa ntchito nthawi yomweyo, kugwiritsa ntchito bwino kwa wodwalayo kuyenera kuyang'aniridwa mosamala.

Mapuloteni Oletsa

Zoletsa zamapuloteni oyendetsa (mwachitsanzo, cyclosporine) amatha kupititsa patsogolo zotsatira zamachitidwe a atorvastatin. Zotsatira za kupondereza kwa ma vepatic ogwidwa a chiwindi pa kuchuluka kwa atorvastatin m'maselo a chiwindi sizikudziwika. Ngati nkosatheka kupewetsa munthawi yomweyo kugwiritsa ntchito mankhwalawa, kuchepetsedwa kwa mlingo komanso kuyan'anila kwamankhwala ndikofunikira.

Gemfibrozil / Fiber Acid Derivatives / Ezetimibe

Kugwiritsa ntchito kwa ma fibrate ndi ezetimibe monga monotherapy kumalumikizidwa ndi chitukuko cha zochitika kuchokera ku minofu, kuphatikizapo rhabdomyolysis. Pogwiritsa ntchito nthawi yomweyo za ezetimibe kapena zotumphukira za fibric acid zomwe zili ndi atorvastatin, chiopsezo chokhala ndi izi zitha kuchuluka. Ngati ndizosatheka kupewa kuperekera mankhwala munthawi yomweyo, ndikofunikira kugwiritsa ntchito mlingo wa atorvastatin kuti mukwaniritse cholinga chowunikira, ndikuwunika odwala.

Kuchulukitsa kwa atorvastatin ndi metabolites yake yogwira m'magazi am'magazi kunachepa (pafupifupi 25%) ndikumwa atorvastatin ndi colestipol. Nthawi yomweyo, lipidemic zotsatira za kuphatikiza kwa mankhwalawa actorvastatin ndi colestipol adapitilira mphamvu zomwe zimapatsa aliyense wa mankhwalawa mosiyana.

Kafukufuku wokhudzana ndi atorvastatin ndi fusidic acid sanachitike. Pakhala pali malipoti akusintha kwa minofu, kuphatikizapo rhabdomyolysis, uku akumamwa atorvastatin ndi fusidic acid. Makina a kulumikizanaku sakudziwika. Atorvastatin sayenera kuperekedwa ndi fusidic acid. Ngati ndi kotheka kugwiritsa ntchito zokhudza zonse fusidic acid, mankhwala okhala ndi ma statins ayenera kusiyidwa kwa nthawi yonse ya mankhwalawa ndi fusidic acid. Odwala amalangizidwa kukaonana ndi dokotala nthawi yomweyo ngati akuwona zizindikiro za kufooka kwa minofu, kupweteka, kapena kuwawa.

Mankhwala a Statin amathanso kuyambitsidwanso patatha masiku asanu ndi awiri atatha mlingo womaliza wa fusidic acid. Mu zochitika zapadera, ngati nthawi yayitali kayendetsedwe ka fusidic acid, mwachitsanzo, pochizira matenda opatsirana, kufunika kophatikizana kwa atorvastatin ndi fusidic acid kuyenera kuganiziridwa payekhapayekha ndipo chithandizo chikuyenera kuchitika moyang'aniridwa ndi achipatala.

Ngakhale palibe maphunziro omwe adachitika pokhudzana ndi atorvastatin ndi colchicine, milandu ya myopathy yanenedwa ndikugwiritsa ntchito atorvastatin ndi colchicine, ndipo atorvastatin yokhala ndi colchicine iyenera kugwiritsidwa ntchito mosamala.

Zotsatira za atorvastatin pamankhwala omwe amagwiritsidwa ntchito nthawi yomweyo

Pogwiritsa ntchito munthawi yomweyo 10 mg ya digoxin ndi atorvastatin mu Mlingo wambiri, kuchuluka kwa magawo a digoxin kumawonjezeka pang'ono. Odwala omwe akutenga digoxin amafunikira kuwunika koyenera.

Kugwiritsa ntchito pamodzi kwa atorvastatin ndi kulera kwapakamwa kumapangitsa kuti kuchuluka kwa norethindrone ndi ethinyl estradiol.

Zotsatira zake ziyenera kuganiziridwa posankha njira yolerera ya pakamwa mwa mkazi yemwe akutenga atorvastatin.

Ngakhale milandu yocheperako kwambiri yokhudzana kwambiri ndi ma anticoagulants imanenedwa, odwala omwe atenga coumarin anticoagulants, nthawi ya prothrombin iyenera kutsimikizika musanayambe chithandizo ndi atorvastatin ndipo nthawi zambiri mokwanira m'magawo oyambira othandizira kuti mutsimikizire kuti palibe kusintha kwakukulu kwa nthawi ya prothrombin. Nthawi yokhazikika ya prothrombin ikajambulidwa, imatha kuyang'aniridwa pafupipafupi yomwe amalimbikitsa odwala omwe amalandila coumarin anticoagulants. Ndondomeko yomweyo iyenera kubwerezedwa pakusintha kwa atorvastatin kapena kufalikira. Atorvastatin mankhwala sanali limodzi ndi milandu magazi kapena kusintha kwa prothrombin nthawi odwala osamwa anticoagulants.

Maantacid okhala okhala ndi magnesium kapena aluminium hydroxide

Ndi munthawi yomweyo kugwiritsa ntchito maantacid okhala ndi magnesium kapena aluminium hydroxide wokhala ndi atorvastatin, kugwiritsidwa ntchito kotsiriza kwa plasma ya magazi kumachepa.

Malangizo apadera

Mafupa a minofu

Atorvastatin, monga HMG-CoA reductase inhibitors (hydroxymethylglutaryl coenzyme A reductase), nthawi zina imatha kukhudza minofu ya mafupa ndikupangitsa myalgia, myositis, ndi myopathy, yomwe imatha kukhala ndi rhabdomyolysis, mkhalidwe wowopsa womwe umadziwika ndi magawo okwera kwambiri a choleine. (QC) (> nthawi 10 VPN), myoglobinemia ndi myoglobinuria, zomwe zingayambitse kulephera kwa impso. Mbiri ya wodwalayo yokhudza kuwonongeka kwa impso ingakhalenso chiopsezo cha rhabdomyolysis. Ndi kuphatikiza kwa atorvastatin ndi mankhwala angapo, monga cyclosporine ndi potent CYP 3A4 inhibitors (clarithromycin, intraconazole, HIV protease inhibitors), chiopsezo chotenga myopathy / rhabdomyolysis chikuwonjezeka.

Potumiza Atorvastatin-Teva ndi zamadzimadzi-kutsitsa Mlingo osakaniza ndi ena ofanana fibric asidi, mankhwalawa, cyclosporin, Teli-tromitsinom, immunosuppressants, osakaniza HIV protease zoletsa (saquinavir, ritonavir, lopinavir ndi ritonavir, tipranavir, ritonavir, darunavir ndi ritonavir, fosamprenavir ndi ritonavir) , ndi niacin, mankhwala a anosungol a antifungal kapena nicotinic acid, komanso colchicine, dokotala amayenera kuganizira mozama zaubwino ndi zoopsa za mankhwalawa ndikuyang'anira ululu pafupipafupi m kudziwa ululu kapena kufooka mu minofu, makamaka pa miyezi ingapo ya mankhwala pa nyengo za kuwonjezeka mlingo wa chiphunzitso chilichonse chokhudza chiopsezo myopathy. Mukaphatikizidwa ndi mankhwala omwe ali pamwambawa, mwayi wogwiritsa ntchito Mlingo woyambirira komanso wowonjezera wa atorvastatin uyenera kuganiziridwa. Muzochitika zotere, kutsimikiza kwakanthawi kantchito ya CPK kungalimbikitsidwe, ngakhale kuwunika koteroko sikumalepheretsa kukula kwa myopathy.

Malangizo poika zinthu zomwe azilumikizana amafupikitsidwa pansipa.

Kuchita ndi mankhwala osokoneza bongo omwe amaphatikizidwa ndi chiopsezo chowonjezereka cha myopathy / rhabdomyolysis

Cholinga

Cyclosporin, HIV proteinase inhibitors (tipranavir ndi ritonavir), hepatitis C virusase proteinase inhibitor (telaprevir), fusidic acid

Pewani kugwiritsa ntchito atorvastatin

HIV protease inhibitor (lopinavir ndi ritonavir)

Gwiritsani ntchito mosamala komanso pa mlingo wotsika kwambiri womwe ungafunike.

Clarithromycin, intraconazole, HIV protease inhibitors (saquinavir wokhala ndi ritonavir *, darunavir wokhala ndi ritonavir, fosamprenavir, fosamprenavir ndi ritonavir)

Osapitilira muyeso wa atorvastatin

HIV protease inhibitor (nelfinavir), hepatitis C virusaseaseaseasetihibulase (boceprevir)

Osapitilira muyeso wa atorvastatin 40 mg patsiku

* Gwiritsani ntchito mosamala komanso pa mlingo wotsika kwambiri womwe ungafunike.

Atorvastatin-Teva amalembedwa mosamala kwa odwala omwe ali ndi vuto lodziwika bwino chifukwa cha matenda amitsempha chifukwa cha myoglobinuria ndi myoglobinemia (hypothyroidism, cholowa chamchiberekyu, kulephera kwa impso, mbiri yakale ya vuto lauchidakwa, kugwiritsa ntchito minyewa yambiri mbiri ya statins kapena ma fiber, wodwalayo ali ndi zaka zopitilira 70). Pankhaniyi, ndikofunikira kuti muphunzire kuchuluka kwa creatine phosphokinase (KFK), ndipo ngati mulingo wa KFK upambana nthawi 5, chithandizo sichiyenera kuyamba. Pa chithandizo, ngati pali zodandaula za kupweteka kwa minofu, kukokana, kufooka, kuchepa kwa thupi, ndi kutentha thupi, ndikofunikira kudziwa mulingo wa KFK, ndipo ngati KFK ichurukira nthawi 5, kwakanthawi kapena siyani chithandizo chilichonse ndi atorvastatin.

Odwala omwe atumizidwa ku Atorvastatin-Teva akuyenera kuchenjezedwa kuti ayenera kufunsa dokotala ngati ululu wosaneneka kapena kufooka kwa minofu kumachitika, makamaka ngati akuphatikizidwa ndi malaise kapena malungo.

Zochita pa chiwindi

Pambuyo pa mankhwala a atorvastatin, kuwonjezereka (nthawi zopitilira 3 poyerekeza ndi malire apamwamba) kuwonjezeka kwa seramu ntchito ya "chiwindi" transaminases kunadziwika.

Ndikofunikira kuwunika zizindikiro za chiwindi nthawi yonse ya chithandizo, makamaka ngati zizindikiro za kuwonongeka kwa chiwindi zikuwoneka. Pakuwonjezereka kwa zomwe zili mu hepatic transaminases, ntchito zawo ziyenera kuyang'aniridwa mpaka malire azomwe amapezeka. Ngati kuchuluka kwa ntchito ya AST kapena ALT mwa kuchulukitsa katatu poyerekeza ndi malire apamwamba anakhalabe, tikulimbikitsidwa kuti mankhwalawo athetsedwe kapena kufooketsedwa.

Odwala omwe amatenga Atorvastatin-Teva ayenera kupewa kumwa mowa. Gwiritsani ntchito mosamala odwala omwe amamwa mowa kwambiri komanso / kapena omwe ali ndi matenda a chiwindi (mbiri).

Kuteteza kwa Stroko Kudzera mwa Aggressive Cholesterol Reduction (SPARCL) / Hemorrhagic Stroke

Odwala omwe ali ndi mbiri ya hemorrhagic stroke kapena lacunar infarction, muyeso wa chiwopsezo / phindu la atorvastatin pa mlingo wa 80 mg sutsimikizika, chifukwa chake, kugwiritsa ntchito Atorvastatin-Teva mwa odwala kumatheka pokhapokha atazindikira kuwopsa / phindu. Ganizirani za chiopsezo chobwereza hemorrhagic stroke.

Immuno-Mediated Necrotic Myopathy (IONM)

Nthawi zina, munthawi yamankhwala kapena pambuyo povomerezeka ndi mitundu ina ya ma statins, immuno-mediated necrotic myopathy (IONM) akuti. IONM kwambiri imadziwika ndi kufooka kwa minofu komanso kuchuluka kwa serum creatine kinase, komwe kumapitiliza ngakhale mankhwala atasiya. Ngati mankhwala a atorvastatin amafunikira limodzi ndi mankhwalawa, ndikofunikira kuti muwerenge mosamala za chiopsezo / phindu la mankhwalawa.

Matenda am'mapapo

Zochitika zapadera za matenda am'mapapo am'mimba zimanenedwa ndi ma statins ena, makamaka panthawi yayitali. Ngati pa chithandizo pali zizindikiro za chitukuko cha matenda amkati (kufupika kwa mpweya, chifuwa chosabereka, kutopa, kuchepa thupi, kutentha thupi), mankhwala a statin ayenera kusiyidwa.

Matenda amawonjezera shuga wamagazi, ndipo mwa odwala ena omwe ali pachiwopsezo chachikulu chotenga matenda obwera ndi shuga m'tsogolo, amatha kutsogolera matenda a hyperglycemia, pomwe ndikofunika kuyamba chithandizo cha matenda ashuga. Komabe, chiwopsezochi chikuwonjezeredwa ndi maubwino ochepetsa chiwopsezo ku mitsempha yamagazi ndi ma statins, chifukwa chake sayenera kukhala chifukwa choletsa chithandizo cha statin. Odwala omwe ali pachiwopsezo (kusala kudya kwa glucose a 5.6-6.9 mmol / L, BMI> 30 kg / m2, okwera triglycerides, matenda oopsa) omwe amapezeka ma statins ayenera kuyang'aniridwa mwaukadaulo komanso zamankhwala osokoneza bongo.

Kugwiritsa ntchito munthawi yomweyo mankhwala a atorvastatin ndi fusidic acid osavomerezeka, chifukwa chake, ndikofunikira kulingalira za kutaya kwakanthawi kwa atorvastatin panthawi ya mankhwala ndi fusidic acid.

Tiyenera kukumbukira kuti mutatenga Atorvastatin-Teva ndi madzi a mphesa, kuchuluka kwa atorvastatin mu plasma kumawonjezeka ndipo chiwopsezo cha zotsatirapo chimayamba.

Kugwiritsa ntchito kwa ana

Mwa ana ochepera zaka 18, kuchita bwino ndi chitetezo sizinakhazikitsidwe chifukwa chochepa pakugwiritsa ntchito.

Zomwe zimachitika chifukwa cha mankhwalawa amatha kuyendetsa galimoto kapena njira zoopsa

Poganizira zoyipa za mankhwalawa, kusamala kuyenera kugwiritsidwa ntchito poyendetsa galimoto ndi njira zina zoopsa.

Tulutsani mawonekedwe ndi ma CD

Mapiritsi 10 mu paketi yofikira Alu / Alu, yopanga filimu ya polyvinyl chloride kapena polyvinylidene chloride ndi varnished aluminium foil ndi filimu ya polyvinyl chloride polyamide ndi foil aluminium.

Ma paketi atatu a contour cell limodzi ndi malangizo ogwiritsira ntchito kuchipatala komanso zilankhulo zaku Russia zimayikidwa mkatoni.

Mankhwala a Atorvastatin-Teva: malangizo, contraindication, analogues

Atorvastatin-Teva ndi mankhwala a hypolipidemic. Njira yogwiritsira ntchito mankhwala ochepetsa lipid ndikuchepetsa kuchuluka kwa cholesterol "yoyipa", komanso kuchuluka kwa triglycerides ndi lipoprotein a kachulukidwe kotsika komanso kotsika kwambiri. Nawonso, amachulukitsa kuchuluka kwa lipoprotein yapamwamba kwambiri ndi cholesterol "yabwino".

Atorvastatin-Teva amapezeka mu mawonekedwe a mapiritsi oyera okhala ndi mafilimu. Zolemba ziwiri zidalembedwa pankhope pawo, chimodzi mwa izo ndi "93", ndipo chachiwiri chimatengera mlingo wa mankhwalawo. Ngati mulingo uli 10 mg, ndiye kuti mawu olembedwa "7310" adalembedwa, 20 mg, ndiye "7311", ngati 30 mg, ndiye "7312", ndipo ngati 40 mg, ndiye "7313".

Chofunikira chachikulu cha Atorvastatin-Teva ndi calcium atorvastatin. Komanso, kapangidwe kamankhwala kamaphatikizanso zinthu zina zowonjezera, zothandizira. Izi zimaphatikizapo, mwachitsanzo, lactose monohydrate, titanium dioxide, polysorbate, povidone, alpha-tocopherol.

Limagwirira a Atorvastatin-Teva

Atorvastatin-Teva, monga tafotokozera kale kumayambiriro, ndi wothandizila kutsitsa lipid. Mphamvu zake zonse amakhala ndi zolepheretsa, ndiye kuti, kuletsa kuchita kwa enzyme pansi pa dzina la HMG-CoA reductase.

Udindo waukulu wa enzyme iyi ndikuwongolera mapangidwe a cholesterol, popeza mapangidwe ake owongolera, mevalonate, kuyambira 3-hydroxy-3-methyl-glutaryl-coenzyme A. amapezeka koyamba. Cholesterol yosakanikirana, pamodzi ndi triglycerides, imatumizidwa ku chiwindi, komwe imaphatikizana ndi lipoproteins yotsika kwambiri. . Wopangidwayo amapita m'madzi a m'magazi, kenako ndi mphamvu yake amaperekedwa ku ziwalo zina.

Ma lipoproteins otsika kwambiri amamasulidwa kukhala otsika osalimba lipoproteins polumikizana ndi ma receptor awo. Chifukwa cha kuyanjana kumeneku, kutsata kwawo, i.e., kuwola, kumachitika.

Mankhwala amachepetsa kuchuluka kwa cholesterol ndi lipoprotein m'magazi a odwala, kuletsa mphamvu ya enzyme ndikuchulukitsa kuchuluka kwa zolandilira m'chiwindi kwa lipoproteins yotsika. Izi zimathandizira kuti azigwira komanso kutaya zinthu zambiri. Njira ya kapangidwe ka lipoproteins ya atherogenic imachepetsedwa kwambiri. Kuphatikiza apo, kuchuluka kwa anthu ochulukitsa lipoprotein cholesterol kumawonjezeka ndipo triglycerides imachepa limodzi ndi apolipoprotein B (mapuloteni onyamula).

Kugwiritsidwa ntchito kwa Atorvstatin-Teva kumawonetsa zotsatira zabwino pochizira osati atherosulinosis, komanso matenda ena ogwirizana ndi lipid metabolism, momwe mitundu ina yotsatsira lipid yotsika sikunathandize.

Zakhazikitsidwa kuti chiopsezo chotenga matenda omwe amalumikizana ndi mtima ndi mitsempha ya magazi, monga matenda a mtima ndi stroko, amachepetsa kwambiri.

Pharmacokinetics a Atorvastatin-Teva

Mankhwalawa amatengeka mwachangu. Kwa pafupifupi maola awiri, kuchuluka kwakukulu kwa mankhwalawa kulembedwa m'magazi a wodwala. Mafuta, kapena kuti, mayamwidwe, amatha kusintha liwiro lawo.

Mwachitsanzo, imatha kutsika ndikumwa mapiritsi ndi chakudya. Koma ngati mayamwidwe atachedwa, ndiye kuti sizikhudza mphamvu ya Atorvastatin yokha - cholesterol imapitilirabe kuchepa kutengera mlingo. Mukalowa m'thupi, mankhwalawa amasinthidwa ndimatumbo a m'mimba. Amamangidwa kwambiri ndi mapuloteni a plasma - 98%.

Kusintha kwakukulu kwa metabolic ndi Atorvastatin-Teva kumachitika m'chiwindi chifukwa kukhudzidwa ndi isoenzymes. Zotsatira zake, izi zimapangidwa, zomwe zimayambitsa zoletsa za HMG-CoA. 70% yazotsatira zonse za mankhwalawa zimachitika molondola chifukwa cha ma metabolites awa.

Atorvastatin amachotsedwa m'thupi ndi hepatic bile. Nthawi yomwe kukhazikika kwa magazi m'magazi kudzakhala wofanana ndi theka la zoyambirira (zotchedwa theka-moyo) ndi maola 14. Zotsatira za enzyme zimatha pafupifupi tsiku. Palibe zopitilira ziwiri peresenti ya kuchuluka zovomerezeka zomwe zingatsimikizidwe mwa kupenda mkodzo wa wodwala. Kwa odwala omwe ali ndi vuto la impso, ziyenera kukumbukiridwa kuti pa hemodialysis, Atorvastatin sasiya thupi.

Kuchuluka kwa mankhwalawa kwamankhwala kumaposa zomwe 20% zimachitika mwa amayi, ndipo kuchuluka kwake kumachepetsedwa ndi 10%.

Odwala omwe ali ndi vuto la chiwindi chifukwa chomwa mowa kwambiri, kuchuluka kwambiri kumawonjezeka nthawi 16, ndipo kuchuluka kwa chimbudzi kumatsika ndi 11, mosiyana ndi chizolowezi.

Zizindikiro ndi contraindication kuti mugwiritse ntchito

Atorvastatin-Teva ndi mankhwala omwe amagwiritsidwa ntchito kwambiri masiku ano.

Chithandizo cha matenda aliwonse omwe ali pamwambapa chikuchitika ndikuwonera kudya komwe kumathandiza kuchepetsa magazi a cholesterol (okwera masamba ndi zipatso, nthangala, zitsamba, zipatso, nsomba, nkhuku, mazira), komanso popanda zotsatira zoyambira kale ntchito mankhwala.

Pali zisonyezo zingapo momwe adatsimikizira kuti ndiwothandiza:

• atherosulinosis
• hypercholesterolemia yoyamba,
• heterozygous achibale komanso osakhala achibale
• mtundu wosakanizidwa hypercholesterolemia (mtundu wachiwiri malinga ndi Fredrickson),
• okwera triglycerides (mtundu wachinayi malinga ndi Fredrickson),
• kusagwirizana kwa lipoproteins (mtundu wachitatu malinga ndi Fredrickson),
• homozygous achibale hypercholesterolemia.

Palinso zolakwika zingapo pakugwiritsa ntchito Atorvastatin-Teva:

1. Matenda a chiwindi mu gawo logwira kapena gawo lakuchulukirachulukira.
2. Kuwonjezeka kwa zitsanzo za hepatic sampul (ALT - alanine aminotransferase, AST - aspartate aminotransferase) kuchulukanso katatu, popanda zifukwa zomveka,
3. Kulephera kwa chiwindi.
4. Mimba komanso kuyamwa.
5. Ana a misinkhu yaying'ono.
6. Mawonetseredwe a thupi lawo pamene mutenga chilichonse chomwe chimapanga mankhwalawo.

Nthawi zina, mapiritsiwa ayenera kuikidwa mosamala kwambiri. Izi ndi milandu monga:

• kumwa kwambiri mowa,
• concomitant chiwindi matenda,
• kusasamala kwa mahomoni,
• kukokoloka kwa electrolyte,
• kagayidwe kachakudya matenda
• kuthamanga kwa magazi
• pachimake matenda opatsirana
• khunyu yopanda vuto
• ntchito zochuluka ndi kuvulala koopsa,

Kuphatikiza apo, kusamala mukamwa mankhwalawa kuyenera kuchitidwa pamaso pa matenda a minofu.

Kuchita ndi mankhwala ena

Atorvastatin-Teva amawonda ndikukula kwa myopathy - kufooka kwa minofu, ngati mankhwala onse omwe ali m'gulu la HMG-CoA reductase inhibitors. Ndi kugwiritsa ntchito mankhwala angapo, chiopsezo chokhala ndi matendawa chitha kukula kwambiri. Awa ndimankhwala monga fibrate (imodzi mwa magulu a ma cellacological a anticholesterolemic), maantibayotiki (erythromycin ndi macrolides), mankhwala antifungal, mavitamini (PP, kapena nicotinic acid).

Maguluwa amagwira ntchito pa enzyme yapadera yotchedwa CYP3A4, yomwe imatenga gawo lalikulu mu metabolism ya Atorvastatin-Teva. Ndi mankhwala ophatikiza amtunduwu, kuchuluka kwa atorvastatin m'magazi kumatha kuwonjezeka chifukwa cha kuletsa kwa enzyme yomwe tatchulayi, chifukwa mankhwalawa samapangidwira bwino. Kukonzekera kwa gulu la fibrate, mwachitsanzo, Fenofibrate, kumalepheretsa kusintha kwa Atorvastatin-Teva, chifukwa chomwe kuchuluka kwake m'magazi kumakulanso.

Atorvastatin-Teva imatha kubweretsanso kukhazikitsidwa kwa rhabdomyolysis - ichi ndi matenda oopsa omwe amapezeka chifukwa cha nthawi yayitali ya myopathy. Mwanjira iyi, minyewa yam'mimba imawonongeka kwakukulu, magawidwe awo mkodzo amawonedwa, omwe angayambitse kulephera kwa impso. Rhabdomyolysis nthawi zambiri amakula ndikugwiritsa ntchito Atorvastatin-Teva ndi magulu omwe ali pamwambapa.

Ngati mukupereka mankhwala muyezo wovomerezeka wa tsiku ndi tsiku (80 mg patsiku) limodzi ndi mtima glycoside Digoxin, ndiye kuti chiwopsezo cha Digoxin ndi gawo limodzi mwa magawo asanu a kumwa.

Ndikofunikira kuphatikiza kugwiritsidwa ntchito kwa Atorvastatin-Teva ndi mankhwala oletsa kubereka omwe amakhala ndi estrogen ndi zotumphukira zake, popeza pali kuchuluka kwa mahomoni achikazi. Zili ndi kanthu kwa azimayi amsinkhu wobereka.

Zakudya, zimalimbikitsidwa mosamala kuti muchepetse kugwiritsa ntchito madzi a mphesa, chifukwa mumakhala zinthu zambiri zomwe zimalepheretsa enzyme, mothandizidwa ndi kagayidwe kake ka Atorvastatin-Teva kumachitika ndipo mulingo wake m'magazi umachuluka. Mankhwala angagulidwe ku mankhwala aliwonse omwe mumalandira ndi mankhwala.

Zambiri zokhudzana ndi mankhwala Atorvastatin zimaperekedwa mu kanema munkhaniyi.