Tulip: malangizo ogwiritsira ntchito, ma fanizo ndi ndemanga, mitengo yamafesi ku Russia

Atorvastatin - kusankha inhibitor HMG-CoA reductasenawo kuphatikiza cholesterol mu chiwindi. Kuphatikiza apo, mankhwalawa amathandizira kukulira kuchuluka kwa ma receptor - LDL pama cell, omwe amatsogolera pakuwonjezeka kwa metabolism ya LDL. Imathandizira otsika cholesterol, lipoproteins, LDL cholesterol, apolipoprotein-B.

Odwala hypercholesterolemia (banja, pulayimale) ndi Hyperlipidemia yosakanikirana amachepetsa mulingo VPLL cholesterol ndi TG.

Pa 40 mg, mankhwalawa amachepetsa LDL ndi 50%, cholesterol ndi 37%, triglycerides ndi 29%, ndi apo-B ndi 42%. Kutengera mlingo, amachepetsa mulingo wa LDL m'mabanja hypercholesterolemia, omwe amalimbana ndi mankhwalawa ndi mankhwala ena ochepetsa lipid. Zotsatira zimawonekera sabata lachitatu kuyambira chiyambi cha chithandizo, ndipo kuchuluka kwake kumachitika mu mwezi umodzi.

Pharmacokinetics

Mlingo wa mayamwidwe ndiwokwera. Cmax m'magazi imatsimikiziridwa pambuyo pa maola 2. Kuchepa kwa cholesterol ya LDL sikudalira nthawi yomwe mumamwa mankhwalawa (m'mawa kapena madzulo). Pali ubale pakati pa mlingo ndi kuchuluka kwa mayamwidwe.

Bioavailability ndi otsika -12%, omwe amalumikizidwa ndi kagayidwe kachakudya kagayidwe m'mimba. Kuyankhulana ndi mapuloteni amwazi 98%. Zimapukusidwa mu chiwindi machitidwe a isoenzymes ndikupanga metabolites yogwira. Ntchito ya metabolites imatha maola 20-30. Amatulutsidwa m'matumbo. T1 / 2 - 14 maola. Mu mkodzo, 2% ya mlingo wotengedwa watsimikiza.

Contraindication

• matenda a chiwindi
• Hypersensitivity
• myopathy,
• Mimba ndi kuyamwa
• wazaka 18
• tsankho lactose.

Ndi mosamala amayika liti hyperthyroidism, ochepa hypotension, sepsiskukondera kwa electrolyte.

Zotsatira zoyipa

Zotsatira zoyipa:

• mutu astheniakufooka kusowa tulo, paresthesia,
• myalgiakupweteka kwapawiri ndi kumbuyo,
• zotupa pakhungu, kuyabwa, urticaria,
• zotumphukira edema.

Nthawi zambiri samakumana ndi mavuto:

• amnesia, zotumphukira neuropathy,
• chiwindi, jaundice, kukomoka, kapamba,
• kukokana myositis, rhabdomyolysis,
• tinnitus
• angioedema, polymorphic erythema,
• Hyper- kapena hypoglycemia, kuchuluka kwa CPK m'magazi,
• thrombocytopenia,
• alopecia,
• kunenepa kwambiri, kusintha kwa potency.

Tulip, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Mankhwala amaperekedwa pakamwa nthawi iliyonse masana.

Mlingo wa mankhwalawa umatengera mlingo wa cholesterol wa wodwala ndipo umachokera ku 10 mg mpaka 80 mg patsiku. Nthawi zambiri, 10 mg kapena 20 mg ndi mankhwala. Matenda akuluakulu a shuga ndi 80 mg.

Pakadutsa milungu itatu iliyonse, mulingo wa lipids umawongoleredwa ndipo mlingo wa mankhwalawo umasinthidwa. Odwala ndi mkhutu aimpso ntchito, mlingo sasintha. Ngati ntchito ya chiwindi sikokwanira, mlingo umachepetsa ndikuwunika pafupipafupi kwa ma transaminases (ACT ndi ALT).

Kuchita

Mukamagwiritsa ntchito mafupa, erythromycin, cyclosporine, chindwana, antifungal ndi mankhwala a immunosuppress, nicotinic acid chiopsezo cha myopathy chikuwonjezeka.

CYP3A4 Isoenzyme Inhibitors amachititsa kuwonjezeka kwa ndende ya atorvastatin.

Cyclosporin kumawonjezera bioavailability ndi ndende ya atorvastatin. Erythromycin, diltiazem ndi chindwana kuwonjezera kuchuluka kwa mankhwalawa. Itraconazole kumabweretsa kuwonjezeka kwa AUC ya atorvastatin ndi katatu.

Kugwiritsa ntchito kwambiri madzi a mphesa kumayambitsa kuchuluka kwa atorvastatin.

Kugwiritsa ntchito ndi efavirenz kapena rifampicin kumabweretsa kuchepa kwa kuchuluka kwa mankhwalawa.

Maantacid kuchepetsa ndende ya mankhwalawa ndi 35%.
Hypolipidemic zochita pamene amatengedwa colestipol okwera kwambiri kuposa mankhwala aliwonse payekhapayekha.

Mukamagwiritsa ntchito digoxin ndi atorvastatin muyezo waukulu, kuchuluka kwa digoxin kumawonjezeka. Atorvastatin amafupikitsa nthawi ya prothrombin ikagwiritsidwa ntchito limodzi warfarin. Amlodipine sizikhudza pharmacokinetics a mankhwalawa.

Zolemba za Tulip

Ator, Atoris, Atorvastatin, Atorvastatin-Teva, Thorvacard, Liptonorm, Novostat, Torvazin, Torvalip, Torvas.

Ndemanga za Tulip

Mankhwala othandiza kwambiri pochiza hyperlipidemia ndi ma statins, mphamvu yake yomwe yatsimikiziridwa mu maphunziro azachipatala. Pochita, mankhwala oyamba ndi ma genetic awo amagwiritsidwa ntchito kwambiri: atorvastatin (Tulip) simvastatin (Vasilip, Atherostat, Simlo), lovastatin (Holartar) Atorvastatin (Tulip) ndi mankhwala opangidwa omwe amakhala ndi moyo wautali kuposa ma statin ena. Imatha kuyendetsa ma triglycerides. Chifukwa chogwiritsa ntchito mankhwalawa, kuchepetsa kufala kwamwadzidzidzi kumatheka. myocardial infaration, kufunika kolowerera kosafunikira pazombo. Imachepetsa kupita patsogolo. atherosulinosis. Chithandizo chimayamba ndi mlingo wocheperako, pang'onopang'ono ukuwonjezereka kuti akwaniritse zomwe mukufuna.

Limodzi mwa zovuta zomwe zimachitika ndi chithandizo chamankhwala a statin ndizokwera mtengo kwawo, ndipo odwala amafotokozera. Vutoli limathetsedwa ndi zamagetsi, zomwe zimaphatikizapo Tulip. Mankhwalawa amalekeredwa bwino, koma amadziwika ndi zotsatira zoyipa za statins: kuchuluka kwa chiwindi ndi michere yama minofu (CPK). Pazowunika zawo, odwala amalabadira izi. Ngati kuchuluka kwa ma enzymes a chiwindi kudaposa nthawi 3, ndipo CPK ndi yokwera maulendo 5 kuposa momwe lilili labotale, mankhwalawo amathetsedwa. Ma enzyme akabwerera ku zinthu zofunika, chithandizo chimayambiranso, koma mankhwalawo amatengedwa pakadontho kochepa. Odwala ambiri amazindikira kupweteka kwam'mimba, kugona, kutsegula m'mimba kapena kudzimbidwa, komanso kugona. Myopathy ndiyosowa ndipo imawonetsedwa ndi zowawa ndi kufooka m'minyewa. Zochitika zonsezi ndizosakhalitsa ndipo zimazimiririka atasiya kumwa mankhwala.

Zizindikiro zogwiritsidwa ntchito

Kodi chimathandiza ndi chiyani? Lembani mankhwalawa mu milandu iyi:

• kutsika kwa kuchuluka kwa cholesterol yathunthu ndi cholesterol ndi LDL cholesterol (otsika kachulukidwe lipoprotein cholesterol) kwa odwala omwe ali ndi vuto la homozygous Famer hypercholesterolemia (osachita bwino kapena zakudya zosakwanira komanso njira zina zosagwiritsa ntchito mankhwala),
• kuchepa kwa mphamvu zapamwamba za apo-B (apolipoprotein B), TG (thyroglobulin), Chs ndi Chs-LDL ndikuwonjezereka kwa kuchuluka kwa Chs-HDL (high density lipoprotein cholesterol) mwa odwala osakanikirana a hyperlipidemia ndi heterozygous non-genalia genercho ndi njira zosachiritsika zochiritsira zam'magazi pakakhala kuti sizikwanira),
• kupewa kwakukulu kwa zovuta zamtima mu mtima mwa odwala osakhala ndi zizindikiro za matenda amkati (matenda a mtima), koma ndi zinthu zingapo zomwe zingayambitse kukula kwake (matenda oopsa a m'magazi, retinopathy, matenda osokoneza bongo, kudalira kwa chikonga, albuminuria, kutengera kwa majini, kutsika pang'ono kwa HDL-C mu plasma, zaka zopitilira 55)
• kupewa kwachiwiri kwa mtima mavuto a odwala matenda amitsempha yamagazi.

Malangizo ogwiritsira ntchito Tulip, mlingo

Musanayambe mankhwala (monga momwe amachitira panthawiyo), zakudya zoyenera za hypocholesterolemic ziyenera kutsatiridwa.

Mapiritsi amatengedwa pakamwa, ngakhale zakudya. Mlingowu umachokera pa 10 mg mpaka 80 mg patsiku ndipo zimatengera kuopsa kwa matendawa komanso machitidwe a thupi.

Pazipita tsiku lililonse 80 mg tsiku.

Mlingo wokhazikika malinga ndi malangizo ogwiritsira ntchito:

• Hypercholegous cholowa ndi polygenic) hypercholesterolemia (mtundu IIa) ndi Hyperlipidemia wosakanikirana (mtundu IIb): Tulip 10 mg kamodzi patsiku. Ngati ndi kotheka, kuwonjezeka kwapang'onopang'ono kwa mlingo mpaka 80 mg ndikotheka (mapiritsi 2 a 40 mg aliyense).
• Homozygous cholowa hypercholesterolemia: 80 mg (2 t. Tulip 40 mg) 1 nthawi patsiku.
• Kupewa kwa matenda a mtima: Tulip 10 mg 1 nthawi patsiku.
• Ngati kuchuluka kwa plasma LDL kwakukulu sikumafikiridwa, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa kukhala 80 mg patsiku, kutengera zomwe wodwalayo amachita pakadutsa masabata awiri mpaka anayi.

Kumayambiriro kwa mankhwalawa, pakatha milungu iwiri ya 2 (4) chithandizo ndikuwonjezeka kwa mlingo uliwonse, ndikofunikira kudziwa mulingo wa lipids mu plasma kuti munthawi yake musinthe.

Mlingo kusintha kwa matenda aimpso kukalamba sikufunika.

Ngati vuto la impso ndi okalamba odwala, kusintha kwa mankhwala sikofunikira. Ngati chiwindi ntchito, ntchito mosamala, kuwunika ntchito chiwindi michere.

Ngati kuwonjezeka kwa ntchito ya ACT kapena ALT kuchulukitsa katatu poyerekeza ndi VGN kumapitirira, tikulimbikitsidwa kuti muchepetse mankhwalawo kapena kusiya mankhwala.

Odwala ayenera kudziwitsidwa zakufunika kofunsa dokotala ngati kufooka kwamtundu wina kapena / kapena kufooka kwa minofu kumawonekera, makamaka ndi kuwonongeka konsekonse ndi kutentha thupi.

Kufotokozera za mankhwalawa

Tulip - Wothandizira Hypolipidemic.

Atorvastatin ndi mpikisano wosankha wa HMG-CoA reductase, enzyme yomwe imatembenuza 3-hydroxy-3-methylglutaryl coenzyme A kwa mevalonic acid, yomwe imatsogolera sterols, kuphatikiza cholesterol.

Triglycerides (TG) ndi cholesterol (Xc) zimaphatikizidwa pakupanga milingo yotsika kwambiri ya lipoproteins (VLDL) nthawi ya kapangidwe kake m'chiwindi, kulowa m'magazi am'magazi ndipo zimatengedwa kupita kuzinthu zopota. Low density lipoproteins (LDL) amapangidwa kuchokera ku VLDL panthawi yolumikizana ndi ma LDL receptors.

Kafukufuku wasonyeza kuti kuchuluka kwa cholesterol yathunthu, LDL ndi apolipoprotein B (apo-B) m'magazi kumathandizira kukulitsa kwa atherosclerosis ndipo ndi ena mwa omwe ali pachiwopsezo cha matenda amtima, pamene akuwonjezera kuchuluka kwa lipoproteins yapamwamba (HDL) kumachepetsa chiopsezo chitukuko cha matenda a mtima.

Atorvastatin amachepetsa kuchuluka kwa cholesterol ndi lipoproteins m'madzi am'magazi chifukwa cha kuletsa kwa HMG-CoA reductase, kaphatikizidwe ka cholesterol m'chiwindi komanso kuwonjezeka kwa "chiwindi" cholandilira cha LDL pamaselo a cell, zomwe zimapangitsa kuti pakhale kuchuluka ndi chidwi chachikulu cha LDL (malinga ndi maphunziro a preclinical).

Atorvastatin amachepetsa kaphatikizidwe ndi kusakazidwa kwa LDL-C, chonse Ch, apo-B wodwala yemwe ali ndi homozygous ndi heterozygous achibale hypercholesterolemia, hypercholesterolemia yoyamba ndi hyperlipidemia yosakanikirana.

Zimayambitsanso kuchepa kwa kuchuluka kwa cholesterol-VLDL ndi TG ndikuwonjezereka kwa kuchuluka kwa cholesterol-HDL ndi apolipoprotein A-1 (apo-A).

Odwala omwe ali ndi dysbetalipoproteinemia, kuchuluka kwa apakati-kachulukidwe lipoproteins Xc-LAPP kumachepa.

Atorvastatin mu Mlingo wa 10 mg ndi 20 mg amachepetsa kuchuluka kwa cholesterol ndi 29% ndi 33%, LDL - ndi 39% ndi 43%, apo-B - ndi 32% ndi 35% ndi TG - mwa 14% ndi 26%, zimayambitsa kuchuluka kwa HDL cholesterol ndi apo-A.

Atorvastatin mu Mlingo wa 40 mg amachepetsa kuchuluka kwa cholesterol ndi 37%, LDL - ndi 50%, apo-B - ndi 42% ndi TG - mwa 29%, amachititsa kuchuluka kwa cholesterol ndi HDL ndi apo-A.

Mlingo wothandizidwa pang'onopang'ono umachepetsa kuchuluka kwa LDL odwala omwe ali ndi homozygous Famer hypercholesterolemia, osagwirizana ndi mankhwala ena okhala ndi lipid-kuchepetsa.

Zilibe zotsatira za carcinogenic ndi mutagenic.

The achire zotsatira amapezeka 2 masabata pambuyo chiyambi cha mankhwala, ukufika kwambiri pambuyo 4 milungu ndipo kumatha nthawi yonse ya mankhwala.

Cheker Tulip Substitutes

Analogue ndiotsika mtengo kuchokera ku ma ruble 104.

Atorvastatin ndi analogue yaku Russia, motero imakhala yotsika mtengo kuposa mankhwala akunja, ngakhale siyimasiyana pakapangidwe. Contraindicated vuto la hypersensitivity, pa mimba ndi mkaka wa m`mawere.

Atorvastatin-Teva (mapiritsi) Kukala: 11 Pamwamba

Analogue ndiotsika mtengo kuchokera ku ma ruble 97.

Atorvastatin-Teva ndi mankhwala achi Israeli omwe samasiyana pakapangidwe, kotero mndandanda wazowonetsa, zotsutsana ndi zotsatirapo zake ndizofanana. Yogwira pophika: calcium ya atorvastatin mu mitundu yosiyanasiyana (kutengera mtundu wa kumasulidwa.)

Analogue ndiotsika mtengo kuchokera ku ma ruble 65.

Wopanga: Oxford (India)
Kutulutsa Mafomu:

• 20 mg mapiritsi, 30 ma PC.

Lipoford ali ndi mawonekedwe ofanana monga mankhwala "oyamba". Yogwira gawo la atorvastatin calcium trihydrate (yomwe imagwirizana ndi atorvastatin 10 mg). M'malo awa ali ndi mndandanda wawowonjezera wa nthawi, choncho, musanayambe chithandizo, muyenera kufunsa dokotala.

Analogs popanga ndi chisonyezo chogwiritsidwa ntchito

Mndandanda womwe uli pamwambapa wa analogies ya mankhwala, omwe akuwonetsa Tulip olowa m'malo, ndizabwino kwambiri chifukwa zimakhala ndi zinthu zomwe zimagwirizana ndipo zimagwirana molingana ndi chisonyezo chogwiritsidwa ntchito

Analogs mwa chisonyezo ndi njira yogwiritsira ntchito

Kuphatikizika kosiyanasiyana, kungagwirizane mukuwonetsa komanso momwe mungagwiritsire ntchito

Kodi mungapeze bwanji analogue yotsika mtengo ya mankhwala okwera mtengo?

Kuti mupeze chiwonetsero chotsika mtengo cha mankhwala, chofananira kapena chofanana, choyambirira timalimbikitsa kulabadira kapangidwe kake, zomwe ndi zinthu zomwezo zomwe zikugwira komanso zomwe zikugwiritsidwa ntchito. Zomwe zimagwiritsidwanso mosiyanasiyana ndi mankhwalawa zimawonetsa kuti mankhwalawo ndi ofanana ndi mankhwalawo, monga mankhwala ena kapena mitundu ina. Komabe, musaiwale za zovuta zomwe zimagwiritsidwa ntchito ndi mankhwala ofanana, omwe angakhudze chitetezo ndi kugwiranso ntchito. Musaiwale za malangizo a madotolo, kudzipereka nokha kungawononge thanzi lanu, chifukwa chake onani dokotala wanu musanagwiritse ntchito mankhwala.

Mlingo Wamitundu

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Mapiritsi okhala ndi mafilimu yoyera kapena pafupifupi yoyera, yozungulira, ya biconvex, yolembedwa "HLA 10" mbali imodzi, mawonekedwe owonongeka: mapiritsi oyera.

Othandizira: lactose monohydrate - 34,8 mg, croscarmellose sodium - 19.2 mg, hyprolose - 2 mg, polysorbate 80 - 2.6 mg, lolemera magnesium okusayidi - 26 mg, colloidal silicon dioxide - 1,2 mg, magnesium stearate - 1 mg, microcrystalline cellulose - mpaka 250 mg .

Ma Shell: hypromellose - 2.976 mg, hyprolose - 0,744 mg, titanium dioxide (E171) - 1.38 mg, macrogol 6000 - 0,6 mg, talc - 0,3 mg.

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

Mapiritsi okhala ndi mafilimu chikasu chopepuka, chozungulira, biconvex, cholembedwa "HLA 20" mbali imodzi, onani paziwonetsero: mapiritsi oyera.

Othandizira: lactose monohydrate - 34,8 mg, croscarmellose sodium - 19.2 mg, hyprolose - 2 mg, polysorbate 80 - 2.6 mg, lolemera magnesium okusayidi - 26 mg, colloidal silicon dioxide - 1,2 mg, magnesium stearate - 1 mg, microcrystalline cellulose - mpaka 250 mg .

Ma Shell: hypromellose - 2.976 mg, hyprolose - 0,744 mg, titanium dioxide (E171) - 1.368 mg, macrogol 6000 - 0.6 mg, talc - 0.3 mg, iron ironideide (E172) - 0,012 mg.

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

Mapiritsi okhala ndi mafilimu yoyera yokhala ndi chikasu cha chikaso cha chikasu, kuzungulira, biconvex, cholembedwa "HLA 40" - mbali imodzi, mawonekedwe owonekeratu: mapiritsi oyera.

Othandizira: microcrystalline cellulose - 284.97 mg, lactose monohydrate - 69.6 mg, croscarmellose sodium - 38.4 mg, hyprolose - 4 mg, polysorbate 80 - 5.2 mg, lolemera magnesium oxide - 52 mg, colloidal silicon dioxide - 2.4 mg, magnesium stearate - 2 mg.

Ma Shell: hypromellose - 5.952 mg, hyprolose - 1.488 mg, titanium dioxide - 2.736 mg, macrogol 6000 - 1.2 mg, talc - 0,6 mg, iron iron oxide (E172) - 0,024 mg.

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

Zotsatira za pharmacological

Atorvastatin ndi mpikisano wosankha wa HMG-CoA reductase, enzyme yomwe imatembenuza 3-hydroxy-3-methylglutaryl coenzyme A kwa mevalonic acid, yomwe imatsogolera sterols, kuphatikiza cholesterol.

Triglycerides (TG) ndi cholesterol (Xc) zimaphatikizidwa pakupanga milingo yotsika kwambiri ya lipoproteins (VLDL) nthawi ya kapangidwe kake m'chiwindi, kulowa m'magazi am'magazi ndipo zimatengedwa kupita kuzinthu zopota. Low density lipoproteins (LDL) amapangidwa kuchokera ku VLDL panthawi yolumikizana ndi ma LDL receptors.

Kafukufuku wasonyeza kuti kuchuluka kwa cholesterol yathunthu, LDL ndi apolipoprotein B (apo-B) m'magazi kumathandizira kukulitsa kwa atherosclerosis ndipo ndi ena mwa omwe ali pachiwopsezo cha matenda amtima, pamene akuwonjezera kuchuluka kwa lipoproteins yapamwamba (HDL) kumachepetsa chiopsezo chitukuko cha matenda a mtima.

Atorvastatin amachepetsa kuchuluka kwa cholesterol ndi lipoproteins m'madzi am'magazi chifukwa cha kuletsa kwa HMG-CoA reductase, kaphatikizidwe ka cholesterol m'chiwindi komanso kuwonjezeka kwa "chiwindi" cholandilira cha LDL pamaselo a cell, zomwe zimapangitsa kuti pakhale kuchuluka ndi chidwi chachikulu cha LDL (malinga ndi maphunziro a preclinical).

Atorvastatin amachepetsa kaphatikizidwe ndi kusakazidwa kwa LDL-C, chonse Ch, apo-B wodwala yemwe ali ndi homozygous ndi heterozygous achibale hypercholesterolemia, hypercholesterolemia yoyamba ndi hyperlipidemia yosakanikirana.

Zimayambitsanso kuchepa kwa kuchuluka kwa cholesterol-VLDL ndi TG ndikuwonjezereka kwa kuchuluka kwa cholesterol-HDL ndi apolipoprotein A-1 (apo-A).

Odwala omwe ali ndi dysbetalipoproteinemia, kuchuluka kwa apakati-kachulukidwe lipoproteins Xc-LAPP kumachepa.

Atorvastatin mu Mlingo wa 10 mg ndi 20 mg amachepetsa kuchuluka kwa cholesterol ndi 29% ndi 33%, LDL - ndi 39% ndi 43%, apo-B - ndi 32% ndi 35% ndi TG - mwa 14% ndi 26%, zimayambitsa kuchuluka kwa HDL cholesterol ndi apo-A.

Atorvastatin mu Mlingo wa 40 mg amachepetsa kuchuluka kwa cholesterol ndi 37%, LDL - ndi 50%, apo-B - ndi 42% ndi TG - mwa 29%, amachititsa kuchuluka kwa cholesterol ndi HDL ndi apo-A.

Mlingo wothandizidwa pang'onopang'ono umachepetsa kuchuluka kwa LDL odwala omwe ali ndi homozygous Famer hypercholesterolemia, osagwirizana ndi mankhwala ena okhala ndi lipid-kuchepetsa.

Zilibe zotsatira za carcinogenic ndi mutagenic.

The achire zotsatira amapezeka 2 masabata pambuyo chiyambi cha mankhwala, ukufika kwambiri pambuyo 4 milungu ndipo kumatha nthawi yonse ya mankhwala.

Mlingo

Asanayambe kugwiritsa ntchito mankhwalawa Tulip ®, wodwalayo ayenera kulimbikitsa kudya kwa hypocholesterolemic, komwe ayenera kupitiriza kutsatira nthawi yonse ya mankhwala.

Mankhwala amatengedwa pakamwa, ngakhale nthawi yakudya. Mlingo wa Tulip ® umasiyana kuchokera ku 10 mg mpaka 80 mg patsiku, ndipo umasankhidwa poganizira momwe magawo a LDL-C amathandizira, cholinga cha mankhwalawo komanso kuyankha kwakanthawi pazamankhwala.

Kwa odwala ambiri, mlingo woyambirira ndi 10 mg 1 nthawi / tsiku.

Kumayambiriro kwa mankhwalawa, pambuyo pa milungu iwiri kapena itatha chithandizo cha mankhwala a Tulip ®, ndikofunikira kuwongolera kuchuluka kwa lipids m'madzi am'magazi ndipo ngati kuli koyenera, sinthani mlingo wa mankhwalawa.

Mlingo wapamwamba tsiku lililonse ndi 80 mg / tsiku.

Hypercholegous cholowa ndi polygenic) hypercholesterolemia (mtundu IIa) ndi hyperlipidemia wosakanikirana (mtundu IIb)

Nthawi zambiri, ndikokwanira kugwiritsa ntchito mankhwalawa Tulip ® pa mlingo wa 10 mg 1 nthawi / tsiku (ndizotheka kugwiritsa ntchito atorvastatin pamapiritsi a 10 ndi 20 mg). Ngati ndi kotheka, kuwonjezeka kwapang'onopang'ono kwa mlingo mpaka 80 mg (mapiritsi 2 a 40 mg) ndikotheka, kutengera momwe wodwalayo amachitikira pakadutsa masabata 2-4, popeza momwe achire amawonera pambuyo pa masabata awiri, komanso chodabwitsa chachikulu chotsatira patatha milungu 4. Ndi chithandizo cha nthawi yayitali, izi zimapitirira.

Homozygous cholowa hypercholesterolemia

Mankhwala Tulip ® nthawi zambiri amagwiritsidwa ntchito muyezo wa 80 mg (mapiritsi 2 a 40 mg) 1 nthawi / tsiku.

Mtima Kupewa matenda

Tulip ® imagwiritsidwa ntchito mu mlingo wa 10 mg 1 nthawi / tsiku. Ngati kuchuluka kwa ndende ya LDL mu plasma sikukwaniritsidwa, ndikotheka kuwonjezera kuchuluka kwa mankhwalawa mpaka 80 mg / tsiku, kutengera momwe wodwalayo amayankhira pakadutsa masabata a 2-4.

Mlingo kusintha kwa Tulip ® odwala ndi mkhutu aimpso ntchito ndi okalamba osafunikira.

At Odwala omwe ali ndi vuto la chiwindi Kuchotsa kwa atorvastatin m'thupi kumachepa, motero tikulimbikitsidwa kuti mugwiritse ntchito mosamala ndikuwunika ntchito ya hepatic transaminases: ACT ndi ALT. Ngati kuwonjezeka kwa ntchito ya ACT kapena ALT kuchulukitsa katatu poyerekeza ndi VGN kumapitirira, tikulimbikitsidwa kuti muchepetse mankhwalawo kapena tileke mankhwala a Tulip ®.

Zotsatira zoyipa

Malinga ndi malangizo ogwiritsira ntchito, kuikidwa kwa Tulip kungakhale limodzi ndi zotsatirazi zoyipa:

• minofu: Mafupa a minyewa ya m'mimba: rhabdomyolysis, myalgia, neuropathy, myositis, bursitis, nyamakazi,
• Genitourinary: uterine kapena ukazi magazi, zotumphukira edema, kusabala, kusokonezeka kwa umuna, kuchepa kwa libido, kupangika kwamkodzo kwamkodzo, urolithiasis, matenda a urogenital,
• kupuma dongosolo: bronchial mphumu, pafupipafupi nosebleeds, chibayo, dyspnea, bronchitis, rhinitis,
• m'mimba thirakiti: kapamba, zilonda zam'mimba, kukanika kwa chiwindi, gastroenteritis, stomatitis, mkamwa wowuma, nseru, kutentha mtima, kuchepa kapena kuchuluka kwa chilimbikitso, kupindika, kusanza, kudzimbidwa kapena kutsegula m'mimba.
• chizungulire, kukhumudwa, kupweteka mutu, kugona, matupi ake, tinnitus, malaise, kupweteka pachifuwa, kuchuluka kwazovuta zamitsempha, arrhasmia ndikotheka.

Musanayambe mankhwala ndi mankhwalawa, miyezi 1.5 ndi miyezi itatu mutangoyamba chithandizo, komanso pakuwonjezeka kwa mlingo wa atorvastatin, ma indices a chiwindi ayenera kutsimikiza. Ntchito za ma enzymes a chiwindi ziyenera kuyang'aniridwa pamene zikuwoneka zilizonse za kuwonongeka kwa chiwindi.

Contraindication

Amatsutsana kuti apereke Tulip pazotsatirazi:

• Hypersensitivity to atorvastatin ndi zina zothandizira za mankhwala,
• matenda a chiwindi kapena kuchuluka kwa ntchito za "chiwindi" mu ma plasma osadziwika (kopitilira katatu poyerekeza ndi malire apamwamba)
• myopathy
• Mimba ndi kuyamwa
• zaka mpaka 18 - (kuchita bwino ndi chitetezo sizinakhazikitsidwe),
• kuchepa kwa lactase
• lactose tsankho,
• shuga-galactose malabsorption syndrome.

Mosamala: kumwa mowa kwambiri, mbiri yakale ya matenda a chiwindi, matenda am'matumbo (mbiri ya kugwiritsa ntchito kwa oimira ena a gulu la HMG-CoA reductase inhibitor), kusalinganika kwakukulu kwa electrolyte, endocrine (hyperthyroidism) ndi kusokonekera kwa metabolic, matenda oopsa owopsa. sepsis), khunyu yosalamulirika, opaleshoni yayikulu, zoopsa.

Bongo

Pankhani ya bongo, palibe mankhwalawa. Ndikofunika kuchitapo kanthu kuti muchepetse kuyamwa kwa mankhwala (chapamimba, kudya kwa adsorbents), kuchitira chithandizo chothandizira kuti thupi likhale lofunikira.

Analogs a Tulip, mtengo m'masitolo ogulitsa mankhwala

Ngati ndi kotheka, mutha kusintha tulip ndi analogue yogwira ntchito - awa ndi mankhwala:

Mukamasankha analogi, ndikofunikira kumvetsetsa kuti malangizo ogwiritsira ntchito Tulip, mtengo ndi kuwunika kwa mankhwala omwe ali ndi zotsatira zofananira sizikugwira ntchito. Ndikofunikira kupeza upangiri wa dokotala komanso kuti usasinthe popanda mankhwala.

Mtengo muma Russian pharmacies: mapiritsi a Tulip 10 mg 30 ma PC. - kuchokera 240 mpaka 270 rubles, 20 mg 30 mapiritsi. - kuyambira 363 mpaka 370 rubles.

Sungani ku kutentha kosaposa 25 ° C. Pewani kufikira ana. Moyo wa alumali ndi zaka zitatu. M'mafakisi, amagulitsidwa ndi mankhwala.

2 ndemanga za "Tulip"

Tulip adayamba kumwa atatenga kuyezetsa magazi komwe kuwonetsa kukweza mafuta m'thupi. Mankhwalawa adapangira kuti ateteze magazi kuundula magazi. Ndinkamwa mapiritsiwo kwa miyezi iwiri, koma kenako ndidamva bwino ndikuleka kumwa. Zinali zabwino kumwa iwo, chifukwa amayenera kumwa piritsi limodzi patsiku. Poyamba zonse zinali bwino. Kenako m'mimba mudayamba kupweteka, chizungulire champhamvu, dzanzi pang'ono mikono ndi miyendo idawonekera. Kukana kumwa mankhwalawa, patapita kanthawi ndidakhala bwino. Ngakhale ziyenera kudziwika kuti kuchuluka kwa cholesterol m'magazi kunachepa.

Osati mtundu wotchuka kwambiri wa Atorvastatin, kwa ine ndibwino kusankha atoris.

Zotsatira zoyipa

Malinga ndi WHO, zotsatira zosafunikira zimagawidwa malinga ndi kuchuluka kwa kakulidwe ka zinthu motere: Nthawi zambiri (> 1/100, 1/1000, 1/10 000, ® imatsutsana panthawi ya pakati. Popeza cholesterol ndi zinthu zopangidwa kuchokera ku cholesterol ndizofunikira chitukuko cha fetal, chiopsezo choletsa HMG-CoA reductase chimaposa phindu logwiritsa ntchito mankhwalawa panthawi yapakati.

Ngati amayi apezeka ndi pakati pa chithandizo ndi Tulip ®, kayendetsedwe kake ayenera kuyimitsidwa posachedwa, ndipo wodwalayo ayenera kuchenjezedwa za chiwopsezo chomwe chingakhalepo kwa mwana wosabadwayo.

Mankhwala Tulip ® angagwiritsidwe ntchito mwa akazi azaka zakubadwa pokhapokha ngati mwayi wokhala ndi pakati ndi wochepa kwambiri, ndipo wodwalayo akudziwitsidwa za ngozi yomwe ingachitike kwa mwana wosabadwayo panthawi ya chithandizo.

Akazi azaka zaubala munthawi ya chithandizo ndi Tulip ®, njira zodalirika zakulera ziyenera kugwiritsidwa ntchito.

Atorvastatin amachotseredwa mkaka wa m'mawere, chifukwa chake amadziwitsidwa kuti agwiritse ntchito poyamwitsa. Ngati kuli kofunikira kugwiritsa ntchito mankhwalawa Tulip ® munthawi ya mkaka wa m`mawere, kuyamwitsa kuyenera kuyimitsidwa.

Malangizo apadera

Zokhudza chiwindi

Monga momwe zilili ndi HMG-Co-reductase inhibitors (ma statins), omwe ali ndi chithandizo cha Tulip ®, chowongolera (nthawi zopitilira 3 poyerekeza ndi VGN) kuchuluka kwa ntchito za seramu ya hepatic transaminases: ACT ndi ALT ndizotheka.

Asanayambike mankhwala, masabata 6 ndi masabata 12 atatha kumwa mankhwalawa Tulip ® kapena atatha kuchuluka kwake, ndikofunikira kuyang'anira zizindikiro za chiwindi (ACT, ALT). Kuchita kwa chiwindi kuyeneranso kuyang'aniridwa pakakhala chizindikiro cha kuwonongeka kwa chiwindi. Pankhani yowonjezera ntchito ya ACT ndi ALT, ntchito zawo ziyenera kuyang'aniridwa mpaka zitasintha. Tulip ® iyenera kugwiritsidwa ntchito mosamala mu odwala omwe amamwa mowa kwambiri / komanso okhala ndi mbiri yodwala matenda a chiwindi.

Matenda a chiwindi pakanthawi yogwira kapena kuwonjezeka kwa ntchito ya hepatic transaminases ya plasma yamagazi osadziwika ndi kuphwanya kugwiritsa ntchito mankhwala a Tulip ®.

Kupewera kwa Stroko ndi Therapy ya Lipid-Kuchepetsa kwambiri (SPARCL)

Kuunikanso mwachidule kwa matenda osiyanasiyana am'magazi odwala omwe si a IHD omwe atha kudwala kumene sitiroko kapena matenda a ischemic (TIA) akuwonetsa kuti ali ndi chiwopsezo cha kugunda kwa hemorrhagic kwa odwala omwe amamwa atorvastatin pa mlingo wa 80 mg poyerekeza ndi placebo. Ngozi yayikulu kwambiri imawoneka kwa odwala omwe anali ndi vuto la hemorrhagic kapena infunction ya lacunar panthawi yomwe phunzirolo lidayamba. Kwa odwala omwe ali ndi vuto la hemorrhagic kapena infunction ya lacunar ndipo akutenga atorvastatin pa mlingo wa 80 mg, chiopsezo / phindu lake limakhala lodziwikiratu, ndipo chiopsezo chotenga hemorrhagic stroke chiyenera kuwunikidwa mosamala asanayambe chithandizo.

Mafupa a minofu

Mukamagwiritsa ntchito mankhwala Tulip ® amatha kukhala ndi myalgia. Kuzindikiritsa kwa myopathy (kupweteka kwa minofu ndi kufooka kophatikiza ndi kuwonjezeka kwa zochitika za CPK nthawi zopitilira 10 poyerekeza ndi VGN) kungaganizidwe mwa odwala omwe akutsutsana ndi myalgia, kufooka kwa minofu kapena kufooka komanso / kapena kuwonjezeka kwakukulu kwa ntchito za CPK. Mankhwala a Tulip ® ayenera kusiyidwa ngati pali kuwonjezeka kodziwika kwa ntchito za KFK kapena pamaso pa myopathy yotsimikizika.

Mukamagwiritsa ntchito mitundu ina ya HMG-Co-reductase inhibitors (ma statins), chiopsezo cha myopathy chitha kuchuluka mukamagwiritsa ntchito cyclosporine, fibrate, erythromycin, nicotinic acid mu lipid kutsitsa Mlingo (wopitilira 1 g / tsiku) kapena mankhwala antifungal a gulu la azole.Kugwiritsa ntchito Tulip ® kuphatikiza ndi ma fibrate, erythromycin, immunosuppressants, mankhwala antifungal a gulu la azole kapena nicotinic acid mu lipid yotsitsa Mlingo (wopitilira 1 g / tsiku), ndikofunikira kuyeza zabwino zomwe zikuyembekezeka ndikuwopsa kwa chithandizo ndi Tulip ®.

Osatinso kawirikawiri zomwe zimanenedwa ka necrotizing myopathy kapena atatha kulandira chithandizo ndi ma statins, kuphatikizapo atorvastatin. Immuno-mediated necrotizing myopathy imadziwika ndi kufooka kwa minofu kumtunda kwambiri komanso kuwonjezeka kwa magazi a m'magazi a CPK, omwe akupitilira ngakhale atasiya kulandira chithandizo cha statin.

Ngati ndi kotheka, kuphatikiza mankhwalawa kuyenera kuganiziranso za kugwiritsa ntchito mankhwalawa pang'onopang'ono ndikukonzanso Mlingo. Kuwunikira nthawi ndi nthawi za ntchito za CPK ndikulimbikitsidwa.

Kugwiritsa ntchito mankhwala a atorvastatin ndi fusidic acid osavomerezeka, chifukwa chake, kuleka kwa mankhwala a atorvastatin panthawi yogwiritsira ntchito fusidic acid kuyenera kuganiziridwanso.

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

Mukamagwiritsa ntchito mankhwalawa Tulip ®, komanso zoletsa zina za HMG-Co-reductase (ma statins), milandu yovuta ya rhabdomyolysis yolephera pachimake chifukwa cha myoglobinuria yalongosoledwa.

Ngati pali zizindikiro za myopathy zomwe zingachitike kapena chiopsezo chotukuka kwa matenda a impso chifukwa cha rhabdomyolysis (mwachitsanzo, matenda owopsa pachimake, hypotension yanyumba, kulowererapo kwakukulu kwa opaleshoni, kuvulala, kuperewera kwa metabolic, electrolyte ndi endocrine komanso kukomoka kosalamulirika), chithandizo cha Tulip ® chiyenera kuyimitsidwa kapena kwathunthu kuletsa.

Matenda am'mapapo

Milandu yachilendo kwambiri yomwe imayambika chifukwa cha matenda am'mapapo ochepa pomwe akuti amapezeka ndi ma statins ena, makamaka ndi chithandizo chanthawi yayitali. Mawonekedwe amankhwala amaphatikizapo kupuma movutikira, chifuwa chosabereka, komanso thanzi loperewera (kuchuluka kutopa, kuchepa thupi, komanso kutentha thupi). Ngati mukukayikira kuti mwayamba kukhala ndi matenda am'mapapo, chithandizo cha ma statins chiyenera kusiyidwa.

Kafukufuku wina akuonetsa kuti kugwiritsa ntchito ma statins, monga kalasi, kungapangitse kuchuluka kwa shuga m'magazi, ndipo mwa odwala ena omwe ali ndi chiopsezo chotenga matenda obwera ndi matenda am'tsogolo, amatha kuyambitsa matenda a hyperglycemia, omwe amafunikira chithandizo chokwanira cha antidiabetesic. Komabe, chiwopsezochi sichimawerengeka poyerekeza ndi kuchepa kwa chiwopsezo cham'mimba mutatenga ma statins, chifukwa chake, sichiyenera kukhala chifukwa choletsa chithandizo ndi ma statins. Odwala omwe ali pachiwopsezo (ndi chopanda kanthu m'mimba shuga wa glucose wa 5.6-6.9 mmol / L, BMI> 30 kg / m 2, triglycerides okwera, kuthamanga kwa magazi) amayenera kuwongoleredwa, onse kuchipatala komanso zamankhwala amitundumitundu, molingana ndi muyezo wapadziko lonse woperekera mankhwala thandizo.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Pochita ndi Tulip ®, muyenera kusamala mukamayendetsa magalimoto ndi kuchita zinthu zina zomwe zingakhale zoopsa zomwe zimafunikira chidwi chachikulu komanso kuthamanga kwa zochitika zama psychomotor.

Kuyanjana kwa mankhwala

Chiwopsezo cha myopathy pamankhwala othandizira ndi HMG-CoA reductase inhibitors imawonjezeka ndi kugwiritsa ntchito nthawi imodzi cyclosporine, erythromycin, clarithromycin, immunosuppress, antifungal mankhwala (azole otumphukira)chifukwa kuwonjezeka kwa ndende ya atorvastatin mu seramu yamagazi.

Ndi munthawi yomweyo kugwiritsa ntchito HIV protease zoletsa - indinavir, ritonavir - chiopsezo chokhala ndi myopathy chikuwonjezeka.

Kuyanjana kofananako ndikotheka ndikugwiritsa ntchito nthawi imodzi ya atorvastatin ndi michere ndi nicotinic acid mu lipid kutsitsa Mlingo (woposa 1 g / tsiku).

CYP3A4 Isoenzyme Inhibitors

Popeza atorvastatin imapangidwa pogwiritsa ntchito isoenzyme CYP3A4, kugwiritsa ntchito kwa mankhwalawa Tulip ® ndi zoletsa za isoenzyme izi kungapangitse kuchuluka kwa atorvastatin m'magazi a magazi. Kuchuluka kwa magwiridwe antchito ndi zomwe zimapangitsa kuti kuchuluka kwa atorvastatin kutsimikizidwe ndi kusiyanasiyana kwa zotsatira za CYP3A4 isoenzyme.

OATP1B1 zoyendetsa mapuloteni zotulutsa

Atorvastatin ndi ma metabolites ake ndi gawo lapansi la OATP1B1 protein protein. OATP1B1 inhibitors (mwachitsanzo, cyclosporine) angakulitse bioavailability wa atorvastatin. Chifukwa chake, kugwiritsa ntchito atorvastatin pa mlingo wa 10 mg ndi cyclosporine pa mlingo wa 5.2 mg / kg / tsiku kumawonjezera kuchuluka kwa atorvastatin mu plasma ya magazi ndi nthawi 7.7.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala a atorvastatin 10 mg ndi erythromycin (500 mg 4 nthawi / tsiku) kapena clarithromycin (500 mg 2 nthawi / tsiku), omwe amalepheretsa kuwonekera kwa cytochrome CYP3A4, kukuwonjezeka kwa kuchuluka kwa atorvastatin m'madzi a m'magazi (ndi 40% mukamagwiritsa ntchito ndi atorvastatin erythromycin ndi 56% - akagwiritsidwa ntchito ndi clearithromycin).

Kugwiritsa ntchito pamodzi kwa atorvastatin ndi proteinase inhibitors, omwe amadziwika kuti zoletsa za cytochrome CYP3A4 isoenzyme, kumayendera limodzi ndi kuwonjezeka kwa kuchuluka kwa atorvastatin m'madzi a m'magazi (pogwiritsa ntchito munthawi yomweyo ndi erythromycin - C_max atorvastatin imachuluka ndi 40%).

Kuphatikizidwa kwa atorvastatin pa 40 mg ndi diltiazem pa 240 mg kumabweretsa kuwonjezeka kwa ndende ya atorvastatin m'madzi a m'magazi.

Palibe kuyanjana kwakukulu kwa atorvastatin ndi cimetidine yemwe adapezeka.

Kugwiritsa ntchito munthawi yomweyo mankhwala a atorvastatin mu 20 mg mpaka 40 mg ndi itraconazole pa mlingo wa 200 mg kumabweretsa kuwonjezeka katatu kwa AUC ya atorvastatin.

Popeza madzi a mphesa amakhala ndi chimodzi kapena zingapo zomwe zimalepheretsa CYP3A4 isoenzyme, kugwiritsa ntchito mopitirira muyeso (zoposa 1.2 L patsiku kwa masiku 5) kungayambitse kuchuluka kwa plasma kwa atorvastatin.

CYP3A4 Isoenzyme Inductors

Kugwiritsa ntchito pamodzi kwa atorvastatin ndi ma inducers a SURZA4 isoenzyme (mwachitsanzo, efavirenz kapena rifampicin) kungayambitse kuchepa kwa kuchuluka kwa atorvastatin m'magazi am'magazi. Chifukwa cha magawo awiri ochita mogwirizana ndi rifampicin (wolimbikitsa wa CYP3A4 isoenzyme ndi OATP1B1 hepatocyte mayendedwe othandizira mapuloteni), kugwiritsa ntchito nthawi imodzi kwa atorvastatin ndi rifampicin sikulimbikitsidwa, chifukwa kuchepetsedwa kayendetsedwe ka atorvastatin pambuyo pa kuponderezedwa kwakukulu kwa placampatin.

Pogwiritsa ntchito munthawi yomweyo atorvastatin ndi kuyimitsidwa komwe kumakhala ndi ma magnesium ndi ma aluminium hydroxides mkati, kuchuluka kwa atorvastatin mu plasma kumatsika pafupifupi 35%, komabe, kuchepa kwa ndende ya LDL-C sikungasinthe.

Atorvastatin sichikhudza pharmacokinetics ya phenazone, chifukwa chake, kuyanjana ndi mankhwala ena omwe amapangidwa ndi isoenzymes yomweyo sayembekezeredwa.

Lipid-kutsitsa mphamvu ya kuphatikiza ndi colestipol imaposa izi kwa aliyense payekhapayekha, ngakhale kutsika 25% pa ndende ya atorvastatin pamene imagwiritsidwa ntchito limodzi ndi colestipol.

Kafukufuku wokhudzana ndi mgwirizano wa atorvastatin ndi fusidic acid sanachitike. Monga ma statins ena, kafukufuku wotsatsa wa kugwiritsidwa ntchito kwa atorvastatin ndi fusidic acid adanenanso za zotsatira za minofu, kuphatikizapo rhabdomyolysis. Makina olumikizirana sakudziwika. Odwala otere amafunika kuwunika mosamalitsa, ndipo mwina, kulekedwa kwakanthawi kwa atorvastatin.

Ngakhale maphunziro a kulumikizana kwa atorvastatin ndi colchicine sanachitike, milandu ya myopathy yanenedwa ndi mgwirizano wapakati ndi colchicine, ndipo kusamala kuyenera kuchitika pakupereka atorvastatin ndi colchicine.

Pogwiritsa ntchito mobwerezabwereza digoxin ndi atorvastatin pa 10 mg C_ss plasma digoxin sasintha. Komabe, pamene digoxin imagwiritsidwa ntchito limodzi ndi atorvastatin pa mlingo wa 80 mg / tsiku, kuchuluka kwa digoxin m'madzi am'magazi kumawonjezera pafupifupi 20%. Odwala omwe amatenga digoxin osakanikirana ndi atorvastatin amafunikira kuwunika kwa kuchuluka kwa digoxin m'madzi a m'magazi.

Ndi munthawi yomweyo kugwiritsa ntchito atorvastatin pa 10 mg 1 nthawi / tsiku ndi azithromycin pa mlingo wa 500 mg 1 nthawi / tsiku, kuchuluka kwa atorvastatin m'madzi a m'magazi sikusintha.

Pogwiritsa ntchito munthawi yomweyo atorvastatin komanso kulera kwapakamwa komwe kumakhala ndi norethisterone ndi ethinyl estradiol, pali chiwonjezeko chachikulu mu AUC ya norethisterone ndi ethinyl estradiol ndi 30% ndi 20%, motero, zomwe zimayenera kukumbukiridwa posankha njira yolerera pakamwa.

Atorvastatin wogwiritsidwa ntchito ndi terfenadine alibe zotsatira zambiri za pharmacokinetics za terfenadine.

Odwala omwe amatenga warfarin kwa nthawi yayitali, atorvastatin pa mlingo wa 80 mg / tsiku limafupikitsa nthawi ya prothrombin m'masiku oyamba olowa. Izi zimatha pambuyo masiku 15 ogwiritsa ntchito limodzi mankhwalawa. Ngakhale milandu yokhudza kusintha kwakukulu mu anticoagulant ikufotokozedwanso kawirikawiri, nthawi ya prothrombin iyenera kutsimikizika mwa odwala omwe akutenga coumarin anticoagulants kale komanso nthawi zambiri mokwanira kumayambiriro kwa chithandizo ndi atorvastatin kuonetsetsa kuti palibe kusintha kwakukulu kwa nthawi ya prothrombin. Nthawi yokhazikika ya prothrombin ikajambulidwa, imatha kufufuzidwa mosiyanasiyana kwa odwala omwe amatenga coumarin anticoagulants. Mukasintha mlingo kapena kusiya kumwa mankhwala, njira izi ziyenera kubwerezedwa. Panalibe kuyanjana pakati pa kugwiritsa ntchito atorvastatin ndi magazi kapena kusintha kwa nthawi ya prothrombin mwa odwala osatenga anticoagulants.

Ndi munthawi yomweyo kugwiritsa ntchito atorvastatin pa mlingo wa 80 mg ndi amlodipine pa 10 mg, ma pharmacokinetics a atorvastatin mu ofanana sasintha.

Mankhwala ena otsitsa lipid

Pogwiritsa ntchito munthawi yomweyo mankhwala a atorvastatin ndi mankhwala ena a hypolipidemic (mwachitsanzo, ezetimibe, gemfibrozil, zotumphukira za fibroic acid) pakuchepetsa Mlingo, chiopsezo chokhala ndi rhabdomyolysis chikuwonjezeka.

Mankhwala ena ophatikizika

Pogwiritsa ntchito atorvastatin ophatikizana ndi mankhwala a antihypertensive ndi estrogens (monga mankhwala othandizira), palibe kuyanjana kwakukulu kwachipatala komwe kunapezeka.