Etu esi eji Atorvastatin 20?

Mbadamba ihe eji etinye fim, 20 mg.

Otu mbadamba ihe

• ihe na - arụ ọrụ - atorvastatin (n'ụdị nnu nnu atorvastatin) - 20 mg
• ndị na - ahụkarị - lactose monohydrate, microcrystalline cellulose, ssumum croscarmellose, hypromellose 2910, polysorbate 80, calcium stearate, calcium carbonate
• ihe nkpuchi shei - hypromellose 2910, polysorbate 80, titanium dioxide (E 171), talc

Akwa mbadamba ihe mkpuchi nke biconvex. N'oge ezumike ahụ, mbadamba ahụ na-acha ọcha ma ọ bụ ihe fọrọ nke nta ka ọ bụrụ ọcha.

Mlọ ọgwụ

Hypolipidem gị n'ụlọnga si ìgwè nke statins. Mainzọ kachasị mkpa nke atorvastatin bụ mgbochi nke ọrụ 3-hydroxy-3-methylglutarylcoenzyme A- (HMG-CoA) mbelata, enzyme nke na-egbochi ntụgharị nke HMG-CoA na mevalonic acid. Mgbanwe a bụ otu n'ime ụzọ izizi na cholesterol synthesis chain n'ime ahụ. Mmechi nke atorvastatin cholesterol synthesis na - eduga n'ịbawanye uru nke ndị na - anabata LDL (obere npoproteins dị ala) na imeju, yana na anụ ahụ extrahepatic. Ndị na-anabata ihe a na - ekekọta LDL ma wepụ ha na plasma ọbara, nke na - eduga n'ịbelata cholesterol LDL n'ime ọbara.

Mmetụta antisclerotic nke atorvastatin bụ nsonaazụ nsonaazụ nke ọgwụ na mgbidi nke arịa ọbara na akụkụ ọbara. Ọgwụ ahụ na-egbochi njikọ nke isoprenoids, nke bụ ihe na-eto eto nke mkpụrụ ndụ dị n’ime akwara ọbara. N'okpuru mmetụta nke atorvastatin, mmụba nke endothelium na-eme ka akwara ọbara dị mma. Atorvastatin na-ebelata cholesterol, obere lipoproteins dị ala, apolipoprotein B, triglycerides. Na-akpata mmụba nke HDL cholesterol (oke njupụta lipoproteins) yana apolipoprotein A.

Omume nke ọgwụ ahụ, dịka iwu, na-etolite mgbe izu abụọ nke nchịkwa gachara, a na-enweta nsonaazụ kachasị mgbe izu anọ gachara.

Mlọ ọgwụ

Idopu ihe n’ulo di elu. Oge iji rute ịta ahụhụ kachasị elekere bụ 1-2 elekere, ntinye uche kachasị na ụmụ nwanyị bụ 20% dị elu, AUC (mpaghara dị n'okpuru usoro) bụ 10% dị ala, ntinye uche kachasị na ndị ọrịa nwere nsogbu ịrụ mmanya bụ ugboro iri na isii, AUC ji okpukpu iri na otu karịa nke nkịtị. Nri jiri nwayọ belata ngwa-ngwa na oge iwere ọgwụ (site na 25% na 9%, otu), mana mbelata nke LDL cholesterol yiri nke ahụ na iji atorvastatin na-enweghị nri. Ntinye uche nke atorvastatin mgbe etinyere ya na mgbede dị ala karịa n'ụtụtụ (ihe dịka 30%). E gosipụtara mmekọrịta kwụụrụ n’etiti ogosi nke itinye uche na ogo nke ọgwụ ahụ.

Bioavailability - 14%, bioavailability usoro nke ọrụ mgbochi na-egbochi HMG-CoA reductase - 30%. Usoro bioavailability dị ala bụ n'ihi metabolism metabolism na akpụkpọ anụ mucous nke eriri afọ na n'oge "ụzọ mbụ" site na imeju.

Ogologo olu nke nkesa bụ 381 l, ihe jikọrọ ya na protein protein bụ 98%. Ọ metabolized kachasị na imeju n'okpuru ọrụ nke cytochrome P450 CYP3A4, CYP3A5 na CYP3A7 na nguzobe nke metabolites na-arụ ọrụ metabolites (ortho- na parahydroxylated n'ụkpụrụ, ngwaahịa beta-oxidation). Mmetụta ọgwụ mgbochi megide ọgwụ mgbochi HMG-CoA dị ihe dịka 70% kpebisiri ike site na ọrụ nke ịmegharị metabolites.

A na - akụ ya na bile mgbe akwara hepatic na / ma ọ bụ extrahepatic metabolism (anaghị ata ahụhụ enterohepatic siri ike).

Ọkara ọkara bụ awa 14. Ọrụ mgbochi ihe mgbochi megide HMG-CoA reductase na-adịgide ruo ihe dịka awa 20-30, n'ihi ọnụnọ nke metabolites na-arụ ọrụ. Ihe na-erughị 2% nke ọgwụ a na-ekpebi n’ime mmamịrị.

Achọghị ya ka ọ dịrị n'oge ịba ọcha n'anya.

Ihe ngosi maka ojiji

Ihe ngosi maka iji atorvastatin bu:

• hypercholesterolemia, dị ka mgbakwunye maka nri maka ọgwụgwọ nke ndị ọrịa nwere oke cholesterol, LDL cholesterol dị ala (lipoproteins dị ala), apolipoprotein B na triglycerides, yana ịbawanye HDL cholesterol (ịdị elu nke ịdị elu nke ukwuu) na ndị ọrịa nwere usoro ịgwọ ọrịa mbụ. hypercholesterolemia na-abụghị ketara eketa, jikọtara ọnụ (jikọtara) hyperlipidemia (Fredrickon ụdị IIa na IIb), ọkwa plasma triglyceride dị elu (Fredrickon ụdị III), n'ọnọdụ ebe nri anaghị enwe mmetụta zuru ezu.
• wedata cholesterol dị ala na LDL cholesterol na ndị ọrịa nwere ụdị hypercholesterolemia nke homozygous hereditary na ọnọdụ ebe enweghị mmeghachi omume zuru oke maka nri ma ọ bụ usoro ndị ọzọ na-abụghị ọgwụ.
• maka prophylaxis n'ime ndị ọrịa na-enweghị akara ọria ọria nke ọrịa obi, yana ma ọ bụ na-enweghị dyslipidemia, mana enwere ọtụtụ ihe ọghọm maka ọrịa obi obi dị ka ị smokingụ sịga, ọbara mgbali elu, ọrịa shuga mellitus, cholesterol HDL dị ala (HDL-C), ma ọ bụ na mmalite ọrịa obi na-arịa ọrịa obi na akụrụngwa ezinụlọ (iji belata ohere nke ịnwụ na ọrịa obi na akụrụngwa na-adịghị egbu egbu, belata ihe ọnya ọrịa strok).

Omume ọgwụ

Mmetụta ọgwụ ahụ bụ hypoliplera.

Ihe na-arụ ọrụ na-egbochi enzyme HMG-CoA reductase, nke a na-etinye na njikọta cholesterol na lipoproteins atherogenic na imeju, na-emekwa ka mmụba nke ihe ndị na-anabata hepatic cell na-enweta LDL. Theụ ọgwụ ahụ na ọgwụ nke 20 mg na-eduga ná mbelata cholesterol site na 30-46%, lipoproteins dị ala site na 41-61%, triglycerides site na 14-33%, na mmụba nke ụba antiatherogenic lipoproteins.

Debe ọgwụ ahụ na oke 80 mg na-ebelata ihe ize ndụ nke ndị na-adịghị mma na sistem obi, na-ebelata ọnwụ na ugboro ole a na-aga n'ụlọ ọgwụ n'ụlọ ọgwụ, gụnyere ndị ọrịa nwere nnukwu ihe egwu.

A na-emegharị dose nke ọgwụ ahụ dabere na ọkwa nke LDL.

A na-enweta arụmọrụ kachasị na ọnwa 1 mgbe ịmalite ọgwụgwọ.

Pharmacokinetics: weghaara site na eriri afọ, na - ebute oke plasma ịhapụ mgbe awa 1-2 gachara. Nri na oge nke ụbọchị anaghị emetụta arụmọrụ. A na-ebugharị ya na ọkwa plasma protein. Ọ na-eme ya na imeju ya na nguzobe nke metabolites na-arụ ọrụ metabolites. Apụrụ ya iche na nke ọzọ.

N'ime ndị ọrịa karịrị afọ 65, ma e jiri ya tụnyere ndị ọrịa na-eto eto, ịdị irè na nchekwa nke ọgwụ yiri nke ahụ.

Ọrụ mkpolata mkpokọ akụrụngwa emetụtaghị metabolism na mwepu nke ọgwụ ahụ ma ọ chọghị ịgbanwe mmezi ya.

Ọrịa imeju siri ike bụ ihe mgbochi maka iji atorvastatin.

Kedu ihe kpatara mbadamba mkpụrụ osisi Atorvastatin 20

Ihe ngosi maka ojiji:

• metabolism ọrịa nke lipoproteins na ọrịa lipidemia ndị ọzọ,
• ezigbo hypercholesterolemia,
• dị ọcha hypertriglyceridemia,
• gwakọtara na hyperlipidemia na-akọwaghị,
• mgbochi ihe omume obi na ndị ọrịa nwere nnukwu nsogbu,
• Obi akwara obi (angina pectoris, infarction myocardial),
• merụrụ aru.

Ngwongwo ogwu

Mlọ ọgwụ

Idopu ihe n’ulo di elu. Mwepu ọkara ndụ bụ 1-2 awa, Cmax n'ime ụmụ nwanyị ka 20% dị elu, AUC bụ 10% dị ala, Cmax n'ime ndị ọrịa nwere ọrịa imeju na-egbu egbu bụ ugboro iri na isii, AUC ji okpukpu iri na otu karịa na nkịtị. Nri jiri ntakịrị belata ọgwụ na ọgwụ a (site na 25 na 9%, otu), mana mbelata nke LDL cholesterol yiri nke ahụ na iji atorvastatin na-enweghị nri. Ntinye uche nke atorvastatin mgbe etinyere ya na mgbede dị ala karịa n'ụtụtụ (ihe dịka 30%). E gosipụtara mmekọrịta kwụụrụ n’etiti ogosi nke itinye uche na ogo nke ọgwụ ahụ. Bioavailability - 14%, bioavailability usoro nke ọrụ mgbochi na-egbochi HMG-CoA reductase - 30%. Usoro bioavailability dị ala bụ n'ihi metabolism metabolism n'ime eriri afọ na n'oge "ụzọ mbụ" site na imeju. Ogologo njupụta nke nkesa bụ 381 l, njikọta na protein plasma karịrị 98%. Ọ metabolized tumadi na imeju n'okpuru ọrụ nke cytochrome CYP3A4, CYP3A5 na CYP3A7 na nguzobe nke metabolites na-arụ ọrụ metabolites (ortho na parahydroxylated sitere, ngwaahịa nke oxidation beta). Na vitro, ortho- na para-hydroxylated metabolites nwere mmetụta inhibitory na mbelata HMG-CoA, yana nke atorvastatin. Mmetụta inhibitory ọgwụ a na-emegide HMG-CoA reductase bụ ihe dịka 70% kpebisiri ike site na ọrụ nke ịmegharị metabolites na-adịgide ruo ihe dị ka awa 20-30 n'ihi ọnụnọ ha. Iwepu ọkara ndụ bụ awa iri na anọ. A na - akụ ya na bile mgbe akwara hepatic na / ma ọ bụ extrahepatic metabolism (anaghị ata ahụhụ enterohepatic siri ike). Ihe na-erughị 2% nke ọgwụ a na-ekpebi n’ime mmamịrị. Achọghị ya ka ọ dịrị n'oge ịba ọcha n'anya n'ihi njikọkọ nke ukwuu na protin plasma. Site na nkwarụ imeju na ndị ọrịa nwere ị cirụ mmanya na-egbu egbu (-mụ-Pyug B), Cmax na AUC mụbara nke ukwuu (oge 16 na 11, n'otu n'otu). Cmax na AUC nke ọgwụ na ndị agadi (afọ 65) dị 40 na 30%, dị iche iche, dị elu karịa ndị ọrịa okenye okenye (enweghị ihe ọ bụla gbasara ọgwụgwọ). Cmax n'ime ụmụ nwanyị dị 20% dị elu, na AUC bụ 10% dị ala karịa nke ndị nwoke (ọ nweghị uru ụlọ ọgwụ). Ọkpụkpụ ntaramahụ ahụ anaghị emetụta nsị plasma nke ọgwụ.

Mlọ ọgwụ

Atorvastatin bụ ihe nnọchianya nke ahụ sitere na otu nke statins. Ọ bụ ihe na - egbochi asọmpi HMG-CoA reductase, enzyme nke na - atụgharị 3-hydroxy-3-methylglutaryl coenzyme A na mevalonic acid, nke bụ ihe na - ebute sterols, gụnyere cholesterol. A na-etinye Triglycerides na cholesterol n'ime imeju na nchịkọta nke lipoproteins dị obere (VLDL), na-abanye na plasma ma bufee ya na akwara anụ ahụ. A na-emepụta lipoproteins dị obere (LDL) site na VLDL n'oge mmekorita ndị na-anabata LDL. Mbelata plasma cholesterol na ọkwa lipoprotein n'ihi mgbochi nke HMG-CoA reductase, njikọ nke cholesterol na imeju na mmụba nke ọnụ ọgụgụ ndị na-anabata LDL na sel elu, nke na-eduga n'ịba ụba na catabolism nke LDL. Na-ebelata nguzobe nke LDL, na - eme ka mmụba na nkwụsi ike na ọrụ nke ndị na - anabata LDL. Mbelata LDL na ndị ọrịa nwere hypercholesterolemia homozygous familial, nke na-abụkarị nke na-agaghị emeli omume na ị withụ ọgwụ. Ọ na-ebelata ọkwa nke cholesterol ngụkọta site na 30-46%, LDL - site na 41-61%, apolipoprotein B - site na 34-50% na triglycerides - site na 14-33%, na-eme ka mmụba dị elu cholesterol-lipoproteins na apolipoprotein A. Dose-adabere na-ebelata ọkwa ahụ. LDL n'ime ndị ọrịa nwere hypercholesterolemia homozygous, na-eguzogide ọgwụgwọ na ọgwụ ndị ọzọ na-eme ka egbugbere ọnụ dị ala. N'ụzọ dị oke mkpa belata ihe egwu nke nsogbu nsogbu ischemic (gụnyere mmepe nke ọnwụ site na infarction myocardial) site na 16%, ihe ize ndụ nke ịmaliteghachi ụlọ ọgwụ maka angina pectoris, yana ihe ịrịba ama nke ischemia myocardial, na 26%. O nweghi uto carcinogenic na mutagenic. A na-enweta ọgwụ ọgwụgwọ ahụ izu abụọ mgbe ebidochara usoro ọgwụgwọ, rute karịa mgbe izu anọ gachara ma dịgide na oge ọgwụgwọ niile.

Usoro onunu ogwu na nhazi

N'ime, were n'oge ọ bụla n'ụbọchị, n'agbanyeghị nri ị na-eri. Tupu ịmalite ọgwụgwọ, ị ga-agbanye na nri nke na -ebelata mbelata nke egbugbere ọnụ ọbara, wee lelee ya n'oge oge ọgwụgwọ niile.

Na mgbochi nke akwara obi ọrịa Ọgwụ nke mbụ maka ndị okenye bụ 10 mg otu ugboro kwa ụbọchị. Ekwesịrị ịgbanwe ogwu ahụ site na obere elekere anya izu abụọ na abụọ n'okpuru njikwa palọm na plasma. Ogo kachasị kwa ụbọchị bụ 80 mg na 1 dose. Site na nchịkwa nke oge a na cyclosporine, ọnụọgụ atorvastatin kachasị kwa ụbọchị bụ 10 mg, yana clarithromycin - 20 mg, ya na itraconazole - 40 mg.

Nahypercholesterolemia bụ isi yana jikọtara hyperlipidemia (jikọtara) 10 mg otu ugboro kwa ụbọchị. Mmetụta ahụ gosipụtara onwe ya n'ime izu abụọ, a na-achọpụta mmetụta kachasị n'ime izu anọ.

NaHyzycholesterolemia homozygous familial dose mbụ bụ 10 mg otu ugboro kwa ụbọchị, mgbe ahụ mmụba na 80 mg otu ugboro kwa ụbọchị (mbelata na LDL site na 18-45%). Tupu ịmalite ọgwụgwọ, a ga-enyerịrị onye ọrịa hypocholesterolemic usoro, nke ọ ga-agbaso n'oge ọgwụgwọ. Site na imeju imeju, a ga-ebelata dose ahụ. Maka umuaka site na 10 rue 17 (naanị umu nwoke na ụmụ nwanyị na-ahụ nwoke) na heterozygous familial hypercholesterolemia, ọgwụ mbụ bụ 10 mg 1 oge kwa ụbọchị. O kwesịrị ka a bulie ọgwụ a tupu izu anọ ma ọ bụ karịa. Oke kachasị kwa ụbọchị bụ mg mg 20 (ịmụghị ọgwụ were ihe karịrị 20 mg amụbeghị).

Ndị okenye na ndị ọrịa nwere ọrịa akụrụ achoghi iri usoro ogwu usoro achoghi.

Ndị ọrịa nwere ọria imeju Ekwesịrị ilebara anya na iji kwụsịlata iwepu ọgwụ na ahụ ya. Ekwesịrị iji nlezianya nyochaa ụlọ ọgwụ na ụlọ nyocha nke ọrụ imeju,, na mgbanwe mgbanwe dị omimi, a ga-ebelata ma ọ bụ kagbuo dose ahụ.

Jiri na ngwakọta ọgwụ ndị ọzọ. Y’oburu n’iji atorvastatin na cyclosporine mee nkpa, uzo onorvastatin ekwesighi gafere 10 mg.

Nsonaazụ

Si ụjọ usoro: nsogbu ehighị ụra, isi ọwụwa, ọrịa asthenic, malaise, dizzness, neuropathy akụkụ, amnesia, paresthesia, hypesthesia, ịda mba.

Site na nri diges: ọgbụgbọ, afọ ọsịsa, mgbu nke afọ, dyspepsia, flatulence, afọ ntachi, vomiting, anorexia, hepatitis, pancreatitis, cholestatic jaundice.

Site na usoro akwara: myalgia, mgbu azụ, ogbu na nkwonkwo, ụdọ akwara, myositis, myopathy, rhabdomyolysis.

Mmeghachi omume nfụkasị ahụ: urticaria, pruritus, anụ ahụ ọkụ, ihe ọkụ ọkụ, anafilaisis, polymorphic exudative erythema (gụnyere ọrịa Stevens-Johnson syndrome), ọrịa Laille.

Site na akụkụ ahụ dị na hemopoietic: thrombocytopenia.

Site n'akụkụ nke metabolism: hypo- or hyperglycemia, ụba ọrụ nke CPK serum.

Usoro endocrine: ọrịa shuga mellitus - ugboro ole mmepe ga-adabere na ọnụnọ ma ọ bụ enweghị ihe ndị dị ize ndụ (glucose ≥ 5.6, index body body> 30 n'arọ / m2, triglycerides dị elu, akụkọ ihe mere eme nke ọbara mgbali).

Ndị ọzọ: tinnitus, ike ọgwụgwụ, mmekọahụ dysfunction, akụkụ akụkụ, oke ibu, obi mgbu, alopecia, ikpe nke mmepe nke ọrịa interstitial, ọkachasị na iji ogologo oge, ọbara ọgbụgba (mgbe iwere ya na nnukwu onunu ogwu na CYP3A4 inhibitors), Secondal renal ọdịda .

Ihe ngbanwe

hypersensitivity na akụkụ ọ bụla nke ọgwụ

ọrịa ọrịa imeju na-arụ ọrụ, ụba ọrụ nke transminases “imeju” (karịa ugboro atọ) nke amabeghị

ofmụ nwanyị dị afọ iri na ụma na-ejighị ụzọ zuru oke nke igbochi afọ ime

ụmụaka na-erubeghị afọ 18 (arụpụtaghị nrụpụta na nchekwa)

mmekorita ya na ndi na egbochi nje HIV (telaprevir, tipranavir + ritonavir)

enweghị nkwekọrịta nke galactose, ụkọ lactase ma ọ bụ nnabata glucose-galactose

Enwere ike ịgwa Atorvastatin nwanyi nke afọ omumu naanị ma ọ bụrụ na amata nke ọma na ọ dịrịghị ime ma gwa ya ihe egwu dị n ’ọgwụ ahụ nye nwa ebu n’afọ.

akụkọ banyere ọrịa imeju

ezigbo elektrọnikodu

endocrine na ọrịa metabolic

nnukwu ọrịa na-efe efe (sepsis)

nnukwu ịwa ahụ

Mkparịta ụka ọgwụ ọjọọ

Site na nchịkwa nke oge cyclosporine, fibrates, erythromycin, clarithromycin, immunosuppressive, ọgwụ antifungal (nke metụtara azoles) na nicotinamide, nsonaazụ nke atorvastatin na plasma na ihe ize ndụ nke myopathy na rhabdomyolysis na akwara ọdịda na-abawanye.

Antacids na-ebelata ịta ahụ site na 35% (nsonaazụ nke cholesterol LDL adịghị agbanwe).

Ojiji nke atorvastatin nwere warfarin nwere ike iwelite nsonaazụ nke warfarin na ụtụ coagulation na ụbọchị mbụ (mbelata oge prothrombin). Mmetụta a na-apụ n'anya mgbe ụbọchị iri na abụọ nke nchịkwa ọgwụ ndị a.

Ojiji nke atorvastatin nwere ihe mgbochi nchebe nke a maara dị ka ndị na - egbochi CYP3A4 bụ mmụba na mkpokọta plasma nke atorvastatin (ya na iji ya na erythromycin, Cmax nke atorvastatin na-abawanye 40%). Ndị na-egbochi nje HIV bụ ndị na-egbochi CYP3A4. Ihe jikọtara ọnụ na mgbochi nje HIV na statins na-abawanye ọkwa nke statins n'ọbara ọbara, nke n'ọnọdụ ndị dị obere na-eduga na mmepe nke myalgia, na n'ọnọdụ ndị pụrụ iche na rhabdomyolysis, nnukwu ọrịa na ndakpọ nke akwara ndị ahụ, na-eduga na myoglobulinuria na nnukwu akụrụ nke ọdịda. Nsogbu ikpeazu n’ime otu ụzọ n’ụzọ atọ nke ikpe gwụsịrị na ọnwụ.

Jiri atorvastatin jiri nlezianya na obere opekempe nke nje HIV na-egbochi: lopinavir + ritonavir. Ọgwụ nke atorvastatin ekwesịghị gafere 20 mg kwa ụbọchị mgbe ejikọtara ya na ndị na-egbochi nje HIV: fosamprenavir, darunavir + ritonavir, fosamprenavir + ritonavir, saquinavir + ritonavir. Ọgwụ nke atorvastatin ekwesịghị gafere 40 mg kwa ụbọchị mgbe ejikọtara ya na nje na-egbochi nje na-egbochi nelfinavir.

Mgbe ị na-eji digoxin na mkpokọta atorvastatin na dose nke 80 mg / ụbọchị, ịta nri digoxin na-abawanye ihe dịka 20%.

Na-eme ka ịta ahụ dịkwuo mma (mgbe ejiri ọgwụ atorvastatin dekọọ ya na ọgwụ nke 80 mg / ụbọchị) nke ọgwụ mgbochi nwere norethisterone site na 30% na ethinyl estradiol site na 20%.

Mmetụta dị ala nke ijikọ ọnụ na colestipol dị elu karịa nke ahụ maka ọgwụ ọ bụla iche, n'agbanyeghị mbelata 25% na ntinye nke atorvastatin mgbe ejiri colestipol jiri ya mee ihe.

Ojiji nke oge a na-eji ọgwụ ndị na-ebelata mkpokọta homonụ steroid endogenous (gụnyere ketoconazole, spironolactone) na-eme ka ohere nke belata homonụ steroid endogenous (ịkpachara anya kwesịrị igosipụta).

Iji mmiri mkpụrụ osisi grape n'oge ọgwụgwọ nwere ike ibute mmụba nke plasma nke atorvastatin. Ya mere, n'oge ọgwụgwọ, ekwesịrị izere ihe ọ juiceụpeụ mkpụrụ osisi grape.

Ntụziaka pụrụ iche

Atorvastatin nwere ike ibute mmụba na CPK serum, nke ekwesiri iburu n'uche na nchọpụta ọdịiche nke mgbu obi. Okwesiri iburu n’uche na mmụba na KFK ugboro 10 ma e jiri ya tụnyere usoro, yana myalgia na adịghị ike nwere ike jikọta ya na myopathy, a ga-akwụsị ịgwọ ya.

Site na iji atorvastatin na-eme n'otu oge na cytochrome CYP3A4 protease inhibitors (cyclosporine, clarithromycin, itraconazole), ekwesịrị ịmalite mkpụrụ mbụ na 10 mg, na obere usoro ọgwụgwọ ọgwụ, a ga-akwụsị atorvastatin.

Ọ dị mkpa iji oge niile na-eleba anya n'ihe ndị na-egosi ọrụ imeju tupu ọgwụgwọ, 6 na izu iri na abụọ mgbe mmalite nke ọgwụ ma ọ bụ mgbe ịbawanye ọgwụ, na oge kwa oge (ọ bụla 6 ọnwa) n'oge oge niile eji eme ihe (ruo mgbe nhazi nke ọnọdụ ndị ọrịa nke ọkwa transaminase ya gafere. ) A na-ahụ mmụba nke transmeta “hepatic” tumadi na ọnwa atọ mbụ nke nchịkwa ọgwụ. Ọ na-atụ aro ịkagbu ọgwụ ma ọ bụ belata dose ahụ na mmụba na AST na ALT karịa ugboro atọ. Ojiji nke atorvastatin kwesịrị ịkwụsị ruo nwa oge na mmepe nke mgbaàmà nke ọrịa na-atụ aro ọnụnọ nke nnukwu myopathy, ma ọ bụ ọnụnọ nke ihe na-ekwu maka mmepe nke nnukwu akwara ọdịda n'ihi rhabdomyolysis (ọrịa siri ike, mbelata ọbara mgbali, nnukwu ịwa ahụ, trauma, metabolic, endocrine ma ọ bụ nsogbu elektrọnte). . E kwesịrị ịdọ ndị ọrịa ọdụ na ha kwesịrị ịgakwuru dọkịta ozugbo ma ọ bụrụ na mgbu na-enweghị nkọwa ma ọ bụ adịghị ike nwere ahụ, ọ bụrụ na ọnya ma ọ bụ ahụ ọkụ na-eso ya.

Enwere akụkọ banyere mmepe nke atciic fasciitis na iji atorvastatin, agbanyeghị, njikọ na nchịkwa nke ọgwụ ga-ekwe omume, mana egosighi na etiology ahụ amabeghị.

Mmetụta n’ọkpụkpụ akwara. Mgbe ị na-eji atorvastatin, dị ka ọgwụ ọgwụ ndị ọzọ nke klas a, a na-akọwapụta ikpe nke rhabdomyolysis na nnukwu ọrịa gbasara akụrụ nke myoglobinuria kpatara. Akụkọ ihe mere eme nke akụrụngwa akwara nwere ike ịbụ ihe ọghọm maka rhabdomyolysis. Ekwesịrị iji nlezianya nyochaa ọnọdụ nke ndị ọrịa dị otú a maka mmepe nke ngosipụta nke akwara ọkpụkpụ.

Atorvastatin, yana statins ndị ọzọ, n'ọnọdụ ndị a na-adịghị ahụkebe nwere ike ibute mmepe nke myopathy, nke ihe mgbu na-egosipụta ma ọ bụ adịghị ike nke anụ ahụ gosipụtara na mmụba na ọkwa nke creatine phosphokinase (CPK) ihe karịrị ugboro iri site na uru ọnụ ụzọ dị elu. Combinedjikọtara ọnụ ọgụgụ atorvastatin dị elu na ọgwụ ọjọọ dịka cyclosporine na ndị na-egbochi CYP3A4 isoenzyme (dịka ọmụmaatụ, clarithromycin, itraconazole na ndị na-egbochi nje HIV) na-amụba ohere nke myopathy / rhabdomyolysis. Mgbe ị na-eji statins, ndị mmadụ na-ekwu na myopathy necrotizing myopathy na-egbochi nsogbu (IONM), autoimmune myopathy. IONM mara adịghị ike na otu akwara proximal yana mmụba nke serine creatine kinase, nke na-adịgide n'agbanyeghị nkwụsị nke ịnata statins, a na-achọpụta nrịba myopathy n'oge usoro ahụ ike, nke na-adịghị eso mgbakasị ahụ, mmezi na-apụta mgbe a na-ewere immunosuppressants.

Mmepe nke myopathy kwesịrị ịbụ onye a na-enyo enyo na ndị ọrịa nwere nsogbu myalgia, mmerụ ahụ ike ma ọ bụ adịghị ike na / ma ọ bụ mmụba dị ịrịba ama na ọkwa nke CPK. E kwesiri ịdọ ndị ọrịa ọdụ na ha kwesịrị ịgwa dọkịta ha ozugbo banyere ọdịdị mgbu, ọnya ma ọ bụ adịghị ike na akwara, karịsịa ma ọ bụrụ na ha na-arịa ọnya ma ọ bụ ahụ ọkụ, yana ọ bụrụ na mgbaàmà akwara na-adịgide mgbe ha kwụsịrị atorvastatin. Site na mmụba dị ịrịba ama na ọkwa nke CPK, myopathy chọpụtara ma ọ bụ myopathy na-enyo enyo, a ga-akwụsị ịgwọ atorvastatin.

Ihe ize ndụ nke ịmalite ọrịa myopathy n'oge ọgwụgwọ nke ọgwụ nke klas a na-abawanye site na ojiji nke cyclosporin, usoro nke fibric acid, erythromycin, clarithromycin, onye na-egbochi hepatitis C na-egbochi, telaprevir, jikọtara ojiji nke ndị na-egbochi nje HIV (gụnyere saquinavir + ritonavirvorvor + ritona ritona, + ritona ritonavona + ritona, + darunavir + ritonavir, fosamprenavir na fosamprenavir + ritonavir), nicotinic acid ma ọ bụ ndị ọrụ antifungal sitere na otu azole. Na-atụle ajụjụ nke na-ejide a Nchikota ọgwụ na atorvastatin na fibric acid nkwekọrịta, erythromycin, clarithromycin, saquinavir na Nchikota na ritonavir, lopinavir na Nchikota na ritonavir, darunavir na Nchikota na ritonavir, fosamprenavir, ma ọ bụ fosamprenavir na Nchikota na ritonavir, antifungal mmadụ si na ìgwè nke azoles ma ọ bụ nicotinic acid n a usoro onodu ogwugwo, ndi dibia kwesiri ilebara ele anya na uru di iche iche anya ma nwekwaa nleba anya ọnọdụ ndị ọrịa ịchọpụta ihe ịrịba ama ọ bụla na ihe mgbaàmà nke mgbu akwara, ọnya ma ọ bụ adịghị ike, karịsịa n'oge ọnwa mbụ nke ọgwụgwọ, yana n'oge mmụba na dose nke ọgwụ ọ bụla. Ọ bụrụ na ịchọrọ iji atorvastatin na ọgwụ ndị a dị n'elu, ị ga-atụle ohere nke iji atorvastatin na mbido mbụ na usoro mmezi.

N'ọnọdụ ndị dị otú a, ọ dị mkpa iji chọpụta ọrụ nke creatine phosphokinase (CPK) oge ụfọdụ, n'agbanyeghị, njikwa dị otú ahụ anaghị ekwe nkwa igbochi myopathy siri ike.

N'ime ndị ọrịa nwere akụkọ banyere ọrịa strok ma ọ bụ infarction na lacunar, ojiji nke Atorvastatin ga - ekwe omume naanị mgbe ọ bụla kpebisiri ike n'ihe ize ndụ / uru, ekwesịrị ịtụle ihe ize ndụ nke ọrịa strok ugboro ugboro.

Mụ nwanyị nke afọ omumu kwesịrị iji ụzọ ịtụkwasị obi na-egbochi afọ ime. Ebe obu na cholesterol na ihe ndi choputara n’ime cholesterol di nkpa maka mmepe nwa ebu n’afọ, ihe ọghọm nke igbochi HMG-CoA mbelata ga-erite uru nke iji ọgwụ n’oge afọ ime. Mgbe nne jiri lovastatin (ihe HMG-CoA reductase inhibitor) na dextroamphetamine na usoro ọnwa atọ nke ịtụrụ ime, amụrụ ụmụ nwere ajọ ọkpụkpụ, tracheo-esophageal fistula, na anus atresia. N'ihe dị ime n'oge ọgwụgwọ, ekwesịrị ịkwụsị ọgwụ a ozugbo, a ga-adọ ndị ọrịa aka na ntị banyere ihe nwere ike ibute nwa ebu n’afọ.

Evidencefọdụ ihe akaebe na-egosi na akpụ dị ka klaasị na-amụba glucose ọbara, na ndị ọrịa nọ n'ihe egwu dị elu nke ibute ọrịa shuga, ha nwere ike ibute mmụba shuga, nke chọrọ ọgwụgwọ kwesịrị ekwesị. Agbanyeghị, uru dị na statins n'ibelata ihe ize ndụ nke ọrịa obi karịrị ntakịrị ntakịrị ihe ọghọm nke ibute ọrịa shuga, yabụ agaghị akwụsị akwụsị statins. Enwere ihe kpatara nlebara anya glycemia n'oge ọrịa na ndị ọrịa nọ n'ihe ize ndụ (glucose na-ebu ọnụ nke 5.6 - 6.9 mmol / l, body body index> 30 n'arọ / m2, ụba triglycerides, ọbara mgbali elu), dịka ndụmọdụ ndị a dị ugbu a.

Akụkụ nke mmetụta ọgwụ nwere ike ịkwọ ụgbọala ma ọ bụ usoro ndị nwere ike ịdị ize ndụ: N'iburu nsogbu ndị ọghọm dị na ọgwụ ahụ kwesịrị ịkpachara anya mgbe ị na-anya ụgbọ ala ma ọ bụ usoro ndị ọzọ nwere ike ibute nsogbu.

Dodoụbiga ya ókè

Ọrịa Edebebeghị akara nke ị signsụbiga mmanya ókè. Mgbaàmà nwere ike ịgụnye mgbu na imeju, nnukwu akụrụ akwara, iji myopathy na rhabdomyolysis ruo ogologo oge.

Ọgwụgwọ: enweghị ọgwụ mgbochi akọwapụtara, ọgwụgwọ ọrịa na usoro iji gbochie mmụcha ọzọ (ọnya na-egbu egbu ma na - eme ka unyi arụ ọrụ). Atorvastatin nwere ihe jikọrọ protein ndị dị na plasma; n'ihi ya, ịba ọcha n'anya adịghị arụ ọrụ. Site na mmepe nke myopathy, nke rhabdomyolysis na nnukwu akwara ọdịda (ọdịda adịkarịsịrị) - ịkwụsị ị drugụ ọgwụ ahụ ozugbo na iwebata usoro ọgwụgwọ diuretic na sodium bicarbonate. Rhabdomyolysis nwere ike iduga mmepe nke hyperkalemia, nke chọrọ nchịkwa intravenous nke calcium chloride ma ọ bụ glucose glucose, infusion nke glucose na insulin, iji ndị na-eme mgbanwe na ion potassium ma ọ bụ, n'ọnọdụ ndị siri ike, hemodialysis.

Emeputa

RUE Belmedpreparaty, Republic nke Belarus

Adreesị Iwu na Nkwupụta Kwuru Okwu:

220007, Minsk, Fabricius, 30,

t./f.: (+375 17) 220 37 16,

Aha na obodo nke akwụkwọ ikike ndebanye aha

RUE Belmedpreparaty, Republic nke Belarus

Adreesị nke nzukọ ahụ nke na-anabata mkpesa nke ndị na-azụ ahịa banyere ogo ngwaahịa dị na ókèala Republic of Kazakhstan:

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Almaty, abụrụ. Beysebaeva 151

+ 7 (727) 378-52-74, + 7 (727) 225-59-98

Adreesị email: [email protected]

I.O. Onye na-esote onye isi Director maka ogo

Usoro onunu ogwu na nhazi

Tupu ịmalite Atorvastatin, a ga-ebugharị onye ọrịa ahụ na nri nke na -ebelata mbelata ọbara, nke a ga-ahụrịrị n'oge ọgwụgwọ ya.

N'ime, were oge ọ bụla n'ụbọchị (mana n'otu oge ahụ), n'agbanyeghị nri ị ga-eri.

Usoro akwadoro ịmalite bụ 10 mg otu ugboro n'ụbọchị. Na-esote, a na-ahọrọ dose ahụ n’otu dabere na ọdịnaya cholesterol - LDL. Ekwesịrị ịgbanwe ogwu ahụ ka ọ dịkarịa ala izu anọ. Ogo kachasị kwa ụbọchị bụ 80 mg na 1 dose.

Homozygous hereditary hypercholesterolemia

Usoro ọgwụgwọ bụ otu ihe ahụ na ụdị hyperlipidemia ndị ọzọ. A na-ahọrọ oge izizi iche iche dabere ogo ọrịa ahụ. N'ime ọtụtụ ndị ọrịa nwere hypercholesterolemia homozygous, a na-ahụ mmetụta kachasị mma mgbe ị na-eji ọgwụ ahụ kwa ụbọchị nke 80 mg (otu oge).

Ọrụ imeju na-arụ ọrụ

N'ime ndị ọrịa nwere ọrụ imeju na-adịghị mma, a ga-eji nlezianya mee ihe mgbe ọ na-akwụsịlata iwepụ ọgwụ na ahụ. Ekwesịrị iji nlezianya nyochaa ụlọ ọgwụ na ụlọ nyocha, ọ bụrụ na achọpụtara mgbanwe mgbanwe ọrịa, ịbelata ọgwụ ahụ ma ọ bụ kwụsịlata ọgwụgwọ.

Mmekọrịta na ọgwụ ndị ọzọ

Site na nhazi nke cyclosporine, fibrates, erythromycin, clarithromycin, immunosuppressive, ọgwụ antifungal (metụtara azoles) na nicotinamide, itinye uche nke atorvastatin na plasma (yana ihe ize ndụ nke myopathy) na-abawanye.

Antacids na-ebelata ịta ahụ site na 35% (nsonaazụ nke cholesterol LDL adịghị agbanwe).

Ihe eji emeju atorvastatin nwere ihe mgbochi nchebe nke a maara dika CYP3A4 cytochrome P450 inhibitors tinyere mmụba nke mkpokọta plasma nke atorvastatin.

Mgbe ị na-eji digoxin na mkpokọta atorvastatin na dose nke 80 mg / ụbọchị, ịta nri digoxin na-abawanye ihe dịka 20%.

Na-eme ka ndọta ahụ dị pasent 20 (mgbe e nyere ya ọgwụ atorvastatin na dose 80 mg / ụbọchị) nke ọgwụ mgbochi nwere noareindrone na ethinyl estradiol. Mmetụta ịdị ala nke njikọta na colestipol karịrị nke ahụ maka ọgwụ ọ bụla n'otu n'otu.

Site na nchịkwa nke oge a na warfarin, oge prothrombin na-ebelata na ụbọchị mbụ, agbanyeghị, mgbe ụbọchị iri na ise gasịrị, ihe ngosi a na-ahụkarị. N'akụkụ a, ndị ọrịa na-ewere atorvastatin nwere warfarin kwesịrị yikarịrị ka oge prothrombin ga-achịkwa.

Iji ihe ọpeụpeụ mkpụrụ osisi grape n'oge ọgwụgwọ na atorvastatin nwere ike ibute mmụba nke ọgwụ na plasma ọbara. N'akụkụ a, ndị ọrịa na-a theụ ọgwụ ahụ kwesịrị izere ị drinkingụ ihe ọ juiceụ thisụ a.

Doụbiga ihe mgbaàmà ókè

Edebebeghị ihe ịrịba ama nke ịdoụbiga mmanya ókè. Mgbaàmà nwere ike ịgụnye mgbu na imeju, nnukwu akụrụ akwara, iji myopathy na rhabdomyolysis ruo ogologo oge.

Enweghị ọgwụ mgbochi akọwapụtara, ọgwụgwọ ọrịa akara na usoro iji gbochie mmụba ndị ọzọ (ọnya na-egbu egbu na ikpo ọkụ unyi).Atorvastatin nwere ihe jikọrọ protein ndị dị na plasma; n'ihi ya, ịba ọcha n'anya adịghị arụ ọrụ. Site na mmepe nke myopathy, nke rhabdomyolysis na nnukwu akwara ọdịda (ọdịda adịkarịsịrị) - ịkwụsị ị drugụ ọgwụ ahụ ozugbo na iwebata usoro ọgwụgwọ diuretic na sodium bicarbonate. Rhabdomyolysis nwere ike iduga mmepe nke hyperkalemia, nke chọrọ nchịkwa intravenous nke calcium chloride ma ọ bụ glucose glucose, infusion nke glucose na insulin, iji ndị na-eme mgbanwe na ion potassium ma ọ bụ, n'ọnọdụ ndị siri ike, hemodialysis.