Roxeracene, nemo, siyan

Sunan kasuwanci na miyagun ƙwayoyi: Roxera

Sunan kasa da kasa mai zaman kanta: Rosuvastatin (Rosuvastatinum)

Form sashi: allunan da aka saka wa fim

Aiki mai aiki: rosuvastatin

Rukunin Magunguna: magungunan rage kiba.

Hypocholesterolemic da magungunan hypotriglycerlera. HMG CoA reductase inhibitors.

Propertiesungiyoyin magunguna:

Ayyukan aikin roxer an yi niyya ne don hana ayyukan microsomal enzyme hydroxymethylglutaryl-CoA reductase, wanda yake aiki a matsayin mai taimaka wajan iyakance farkon matakin kwazon cholesterol.

Normalization na alamomin bayanin martaba na lipid (tasirin rage yawan lipid) saboda raguwar yawan kwastomomi na jini, triglycerides, low lipoproteins yawa, kazalika da karuwa a yawan yawaitar yawan abubuwan lipoprotein. Magungunan yana cikin rukunin magungunan "Statins".

Alamu don amfani:

Primary hypercholesterolemia (nau'in IIa a cewar Fredrickson) ko cakuda dyslipidemia (nau'in IIb a cewar Fredrickson) azaman kari ne ga abinci tare da rashin ingancin abinci da sauran magungunan marasa magani (misali aiki na jiki, asarar nauyi), haɗin gwiwa na dangi na hyzycholesterolemia a matsayin ƙari ga abincin da sauran su maganin rage kiba (alal misali, LDL-apheresis) ko kuma irin wannan maganin ba shi da tasiri, toshewar jini (nau'in Fredrickson na IV) a matsayin kari ga abincin, don rage jinkirin ciwan atherosclerosis a matsayin ƙari biyu ga abinci a cikin marasa lafiya waɗanda aka nuna magani don rage yawan ƙwayar plasma na Chs da Chs-LDL, rigakafin rigakafin manyan rikice-rikice na zuciya da jijiyoyin jini (bugun jini, myocardial infarction, farfadowa na jijiya) a cikin tsofaffi marasa lafiya ba tare da alamun asibiti na cututtukan hanji ba, amma tare da ƙara haɗarin ci gabanta (shekaru sama da 50 ga maza kuma sama da 60 na mata, haɓakar plasma mai girma na furotin C-reactive (≥2 g / l) a gaban aƙalla ɗaya daga cikin ƙarin abubuwan haɗarin, kamar hauhawar jini. Zia, da low jini taro na HDL-Xc, shan taba, farkon jijiyoyin zuciya jijiya cuta a cikin iyali tarihi).

Ciki da kuma lactation - Roxer yana contraindicated a ciki da lactation. Ya kamata matan da suka isa haihuwa suyi amfani da hanyoyin da suka dace na hana haihuwa.

Tunda cholesterol da abubuwa da aka hada daga cholesterol suna da mahimmanci don haɓakar tayin, yuwuwar haɗarin hana haɓakar HMG-CoA don tayin ya wuce fa'idodin amfani da miyagun ƙwayoyi yayin daukar ciki.

Game da ciki yayin yin magani, ya kamata a dakatar da amfani da miyagun ƙwayoyi nan da nan.

Babu bayanai game da kewayen rosuvastatin tare da madara (an san cewa sauran masu hana HMG-CoA reductase za a iya cire su a cikin madara), don haka ya kamata a dakatar da amfani da miyagun ƙwayoyi yayin shayarwa.

Yarjejeniyar:

Tare da maganin yau da kullun har zuwa 30 MG

Cutar cututtukan hanta a cikin aiki mai aiki (ciki har da ci gaba mai yawa a cikin aikin hepatic transaminases da haɓaka cikin ayyukan hepatic transaminases a cikin jini jini fiye da sau 3 idan aka kwatanta da VGN), gazawar renal mai ƙarfi (CC ƙasa da 30 ml / min), myopathy, amfani da cyclosporine, marasa lafiya An yi niyya ga ci gaban rikice-rikice na ciki, ciki, lokacin shayarwa, amfani da mata masu haihuwa waɗanda ba sa amfani da hanyoyin isasshen rigakafin, rashin haƙuri, ƙarancin lactose PS, glucose-galactose malabsorption ciwo, shekaru 18 da shekaru, hypersensitivity zuwa rosuvastatin ko zuwa wani bangaren na miyagun ƙwayoyi.

Tare da maganin yau da kullun na 30 MG ko fiye:

matsakaici zuwa ga mummunan lalacewa na koda (CC kasa da 60 ml / min), hypothyroidism,

cututtukan tsoka a cikin tarihin (ciki har da tarihin dangi), myotoxicity tare da sauran HMG-CoA reductase inhibitors ko fibates a cikin tarihi, yawan shan barasa, yanayin da zai iya haifar da karuwa cikin ƙwayar plasma na rosuvastatin, yin amfani da fibrates lokaci guda, marasa lafiya na tseren Mongoloid.

Tare da taka tsantsan tare da maganin yau da kullun zuwa 30 MG:

shekaru sama da 65, yawan jijiya, yawan tiyata, rauni, matsanancin aiki, endocrine ko rikicewar lantarki ko rikicewar rikice-rikice, amfani da lokaci guda tare da ezetimibe.

Sashi da gudanarwa:

Ana ɗaukar magani a baka. Kada ku tauna ko nika kwamfutar hannu, hadiye duka, a wanke da ruwa, ana iya ɗauka a kowane lokaci na rana, ba tare da la'akari da cin abinci ba.

Kafin farawa da jiyya tare da magani na roxer, mai haƙuri ya kamata ya fara bin madaidaicin tsarin abincin hypocholesterolemic kuma ci gaba da bin sa yayin jiyya. Ya kamata a zaɓi kashi na miyagun ƙwayoyi daban-daban dangane da maƙasudin kwantar da hankali da amsawar warkewa don magani, yin la’akari da shawarwarin ƙasa akan maƙasudin ƙwayar cutar plasma mai ƙwaƙwalwa.

Thewarin da aka ba da shawarar farawa ga marasa lafiya da ke fara shan maganin, ko don marasa lafiya da aka canjawa wuri daga ɗaukar sauran masu hana haɓaka HMG-CoA, ya kamata su zama 5 ko 10 mg sau ɗaya a rana.

Tare da yin amfani da magani a lokaci guda tare da gemfibrozil, fibrates, acid nicotinic a cikin kashi fiye da 1 g kowace rana, ana ba da shawarar marasa lafiya don farawa na 5 MG. Lokacin zaɓin kashi na farko, mutum yakamata ya jagorance shi ta hanyar ƙwayar ƙwaƙwalwar ƙwayar ƙwaƙwalwar ƙwaƙwalwa cikin mutum yayi la'akari da haɗarin yiwuwar haɓaka rikitar cututtukan zuciya, kuma yuwuwar haɗarin sakamako masu illa ya kamata a la'akari. Idan ya cancanta, ana iya ƙara yawan kashi bayan makonni 4.

Sakamakon ci gaban yiwuwar sakamako masu illa yayin amfani da kashi 40 MG kowace rana, idan aka kwatanta da ƙananan allurai na miyagun ƙwayoyi, kara kashi zuwa 40 MG kowace rana bayan ƙarin kashi ya fi yadda aka bada shawarar farko don makonni 4 na maganin za a iya aiwatarwa kawai a cikin marasa lafiya tare da babban matsayi na hypercholesterolemia da babban haɗarin haɓaka rikicewar cututtukan zuciya (musamman a cikin marasa lafiya tare da familial hypercholesterolemia) waɗanda ba su cimma sakamakon da ake buƙata ba na maganin tare da kashi 20 MG kowace rana, kuma rs wanda zai zama a karkashin kulawa na likita. Musamman saka idanu akan marasa lafiya da suke karɓar ƙwayar a kashi 40 MG kowace rana ana bada shawara.

Yin amfani da kashi 40 na MG kowace rana a cikin marasa lafiya waɗanda ba su yi shawara da likita ba a ba da shawarar su ba. Bayan makonni 2-4 na ilmin likita da / ko tare da karuwa a cikin kashi na shirye-shiryen roxer, saka idanu na metabolism na lipid ya zama dole (gyara kashi ya zama dole idan ya cancanta).

A cikin marassa lafiya da gazawar sassaucin matsakaici ko matsakaici, ba a buƙatar daidaita sashi. A cikin marasa lafiya da gazawar na koda (CC kasa da 30 ml / min), yin amfani da roxer yana contraindicated. Yin amfani da miyagun ƙwayoyi a cikin kashi fiye da 30 MG kowace rana yana contraindicated a cikin marasa lafiya tare da matsakaici da matsanancin ƙarancin renal (CC kasa da 60 ml / min). Ga marasa lafiya tare da gazawar matsakaici na matsakaici, shawarar farko na maganin shine 5 MG kowace rana.

Roxer yana cikin contraindicated a cikin marasa lafiya da aiki hanta da cutar. Babu wani gogewa game da amfani da miyagun ƙwayoyi a cikin marasa lafiya da gazawar hanta sama da maki 9 (aji C) akan ma'aunin Yara-Pugh.

An ba da shawarar marasa lafiya masu shekaru 65 da haihuwa don fara amfani da miyagun ƙwayoyi tare da kashi 5 MG kowace rana.

Lokacin da aka yi nazarin sigogin roshovastatin na magunguna na rosavastatin a cikin marasa lafiya na kabilu daban-daban, an lura da haɓaka tsarin rosuvastatin tsakanin Jafananci da Sinanci. Ya kamata a la'akari da wannan gaskiyar yayin amfani da maganin Roxer a cikin waɗannan rukunin masu haƙuri. Lokacin amfani da allurai na 10 da 20 a kowace rana, shawarar da aka fara bayarwa ga marasa lafiya na tseren Mongoloid shine 5 MG kowace rana. Marasa lafiya na tseren Mongoloid, amfani da miyagun ƙwayoyi a cikin kashi 40 MG yana haɓaka.

Yin amfani da miyagun ƙwayoyi a cikin kashi 40 MG yana cikin contraindicated a cikin marasa lafiya wanda aka ƙaddara ga haɓakar rikice-rikice na myotoxic. Idan ya zama dole a yi amfani da allurai na 10 da 20 a kowace rana, shawarar farko da aka bayar don wannan rukunin marasa lafiya shine 5 MG.

Lokacin amfani da gemfibrazil, kashi na aikin roxer bai kamata ya wuce 10 MG kowace rana ba.

Yin hulɗa tare da wasu kwayoyi:

Cyclosporine - tare da amfani da rosuvastatin da cyclosporine lokaci guda, kungiyar ta AUC na rosuvastatin tana matsakaicin 7 sau sama da yadda aka lura cikin masu sa kai. Yawan plasma na rosuvastatin yakan tashi sau goma sha daya.

Amfani da lokaci guda tare da rosuvastatin baya tasiri akan cyclosporine a cikin jini.

Rashin daidaituwa na anticoagulants - kamar yadda yake tare da sauran masu hanawa na rage girman HMG-CoA, fara rosuvastatin farjin ko kara yawan sa a cikin marasa lafiya suna shan maganin rashin daidaituwa a lokaci guda (alal misali, warfarin) na iya haifar da karuwa a MHO. Daukewar rosuvastatin ko rage yawan adadin sa na iya haifar da raguwa a cikin MHO. A irin waɗannan halayen, ana ba da shawarar saka idanu akan MHO.

Ezetimibe - yin amfani da rosuvastatin da ezetimibe na lokaci guda ba tare da canji a cikin AUC ko Cmax na magunguna biyu ba. Koyaya, hulɗar magunguna tsakanin rosuvastatin da ezetimibe, wanda aka nuna ta ƙara haɗarin haɓaka halayen tsoffin mara amfani, ba za'a iya yanke hukunci ba.

Gemfibrozil da sauran magunguna masu rage girman lipid - amfani da rosuvastatin da gemfibrozil suna kaiwa zuwa sau biyu a Cmax da AUC na rosuvastatin. Gemfibrozil, fenofibrate, sauran fibrates, da kuma rage rage kiba na nicotinic acid (allurai babba ko daidai da 1 g a kowace rana) sun kara haɗarin myopathy lokacin amfani da su tare da masu hana haɓaka HMG-CoA (mai yiwuwa saboda gaskiyar cewa suma suna iya haifar da myopathy yayin amfani dashi monotherapy). Yin amfani da fibrates da rosuvastatin a lokaci-lokaci na 30 MG yana haɓaka. A cikin irin waɗannan marasa lafiya, yakamata a fara amfani da magani na 5 MG kowace rana.

Inhibitors na kariya daga kwayar cutar HIV - amfani da lokaci guda na masu hana kwayar cutar kwayar cutar kwayar cutar HIV na iya kara daukar hankalin rosuvastatin. Amfani guda 20 na rosuvastatin guda biyu tare da haɗuwa da masu hana garkuwa da kwayar cutar HIV guda biyu (400 MG na lopinavir / 100 MG na ritonavir) yana haɗuwa tare da haɓakawa a cikin daidaito na AUC (0-24 h) da Cmax na rosuvastatin ta 2 da sau 5, bi da bi.

Antacids - amfani da rosuvastatin da lokaci guda tare da maganin antioxids wanda ke dauke da aluminum da magnesium hydroxide, yana haifar da raguwa a cikin ƙwayar plasma na rosuvastatin da kusan 50%. Ba a faɗi wannan tasirin idan an yi amfani da antacids awanni 2 bayan shan rosuvastatin.

Erythromycin - yawan amfani da rosuvastatin da erythromycin yana haifar da raguwa a cikin AUC (0-t) na rosuvastatin da 20% kuma Cmax ta 30%. Irin wannan hulɗar na iya faruwa sakamakon karuwar motsin hanji wanda ya haifar ta hanyar amfani da erythromycin.

Harkokin hana haihuwa / maye gurbin maganin motsa jiki (HRT) - yin amfani da rosuvastatin da na hana haihuwa sau daya yana kara AUC na ethinyl estradiol da norgestrel da 26% da 34%, bi da bi. Irin wannan karuwa a cikin ƙwayar plasma ya kamata a la'akari yayin zaɓin sashi na hana haihuwa. Babu bayanai na magunguna akan amfani da rosuvastatin da maganin sauyawa na hormone, sabili da haka, irin wannan tasirin bazai iya cire shi ba lokacin amfani da wannan haɗin. Koyaya, wannan haɗin an yi amfani dashi sosai yayin gwaji na asibiti kuma haƙuri yana da haƙuri sosai.

Digoxin - Babu muhimmiyar ma'amala ta rosuvastatin tare da digoxin da ake tsammanin.

Isoenzymes na cytochrome P450 - rosuvastatin ba mai hanawa bane kuma mai samar da cytochrome P450. Bugu da ƙari, rosuvastatin mai rauni ne na wannan tsarin na isoenzyme. Babu wata muhimmiyar hulɗa a asibiti tsakanin rosuvastatin da fluconazole (mai hana isoenzymes CYP2C9 da CYP3A4) da ketoconazole (mai hana inginenymym CYP2A6 da CYP3A4). Amfani da rosuvastatin da itraconazole lokaci guda (inhibition na isoenzyme CYP3A4) yana ƙara AUC na rosuvastatin da kashi 28%, wanda ba shi da mahimmanci a asibiti. Don haka, ba a tsammanin hulɗa da aka danganta da cytochrome P450.

Yawan abin sama da ya kamata:

Ba'a bayyana hoton asibiti na yawan abin sama da ya kamata ba.

Tare da kashi ɗaya na allurai na yau da kullun na miyagun ƙwayoyi, sigogi na pharmacokinetic na rosuvastatin ba su canzawa.

Jiyya: bayyanar cututtuka, sa ido kan aikin hanta da aikin CPK ya zama dole, babu takamaiman maganin rigakafi, hemodialysis ba shi da tasiri.

Side effects:

Tsarin abin da ya haifar da tasirin sakamako: sau da yawa (> 1/10), sau da yawa (> 1/100, amma 1/1000, amma 1/10 000, amma

Alamu don amfani

Me ke taimaka wa Roxer? Adana magungunan a cikin halaye masu zuwa:

cakuda dyslipidemia ko hypercholesterolemia na farko (azaman ƙari ga abincin tare da ƙarancin hanyoyin magunguna marasa magani na jiyya - asarar nauyi, aikin jiki, da sauransu),
familial homozygous hypercholesterolemia (ban da hanyar magani ta baya),
nau'in hypertriglyceridemia na IV (a ƙari ga abincin),
haɓakar atherosclerosis a cikin marasa lafiya waɗanda aka wajabta su don rage yawan haɗarin Xc da Xs-LDL a cikin ƙwayar plasma,
rigakafin farko na cututtukan zuciya (farfadowa daga jijiya, rauni, rauni), a cikin marassa lafiya da ke fama da cutar sankara, da kuma tsofaffi,

Umarnin don amfani da Roxer, sashi

An tsara allurai na daban, a karkashin kulawar cholesterol a cikin jini. Suna shan maganin ba tare da la'akari da abinci ba, an wanke shi da ruwa. Dangane da umarnin, kashi na farko bai wuce kwamfutar hannu 1 na Roxer 5 mg / 10 mg sau ɗaya a rana.

Matsakaicin sashi shine 40 MG kowace rana.

Bayar da mafi girman kashi 40 MG a kowace rana zai yiwu ne kawai ga marasa lafiya da mummunan hypercholesterolemia kuma a cikin haɗarin haɗari daga tsarin zuciya (musamman a cikin yanayin hypercholesterolemia na iyali), wanda ba a cimma sakamakon da ake so tare da 20 MG kowace rana. Gudanar da aikin likita yakamata a gudanar da shi kawai a karkashin kulawa ta likita.

Shan maganin a kashi 40 MG a kowace rana a cikin marasa lafiyar da ba su yi shawara da likita ba a ba da shawarar su ba. Bayan makonni 2-4 na amfani ko a kowane karuwa a cikin ƙwayar ƙwayar cuta, ya zama dole don saka idanu kan alamomin metabolism na lipid (idan ya cancanta, ana iya buƙatar daidaita sashi).

Matsakaicin 20 MG / rana ya kasance mafi girman ga masu ɗauka da ƙwayoyin cot21 c.521CC ko s.421AA. Ana iya yin amfani da mafi girman kashi (40 MG) kawai ga marasa lafiya tare da mummunan matakin karuwar cholesterol da babban haɗarin bugun zuciya.

Shan magungunan anticoagulants (warfarin, da sauransu) a lokaci guda kamar yadda statin zai iya haifar da zub da jini, da kuma glycosides na zuciya (alal misali, digoxin) - ƙara maida hankali kan ƙarshen.

Tasirin warkewa yana ɗauka a cikin kwanaki 5-8, kuma mafi girman tasirin - har zuwa makonni 3-4 na jiyya.

Side effects

Dangane da umarnin yin amfani da shi, alƙawarin Roxer zai iya haɗawa da waɗannan sakamako masu biyowa:

A wani ɓangare na tsarin rigakafi: angioedema da sauran halayen da suka danganci rashin ƙarfi.
Daga tsarin juyayi: bushewar zuciya, ciwon kai, asarar ƙwaƙwalwar ajiya, polyneuropathy.
Daga jijiyoyin mahaifa: jin zafi a ciki, tashin zuciya, maƙarƙashiya, huhun ciki, hepatitis, jaundice, zawo, haɓaka ayyukan ƙwayoyin hepatic.
Daga fata: itching, kurji, ciwo na Stevens-Jones.
Daga kasusuwa da tsarin tsoka: myalgia, myopathy, rhabdomyolysis.
Daga tsarin urinary: proteinuria, hematuria.
Janar: asthenia.

Contraindications

An ba da izini don ƙirƙirar Roxer a cikin waɗannan lambobin:

hypersensitivity to rosuvastatin ko kowane ɓangare na maganin,
cutar hanta a cikin aiki aiki (ciki har da ci gaba da karuwa a cikin aikin hepatic transaminases da kuma karuwa a cikin aikin hepatic transaminases a cikin jini fiye da sau 3 idan aka kwatanta da VGN),
matsakaici zuwa ga rashin cin nasara na koda (creatinine Cl kasa da 60 ml / min),
ciwon kai
amfani da maganin cyclosporine,
marasa lafiya sun yi jinkiri ga cigaban rikitarwa,
ciki, shayarwa,
amfani cikin mata masu haihuwa, waɗanda ba sa amfani da hanyoyin isasshen rigakafin haihuwa,
hawan jini
tarihin cututtukan tsoka (gami da tarihin dangi),
myotoxicity lokacin amfani da sauran tarihin HMG-CoA reductase inhibitors ko fibrates,
yawan shan barasa
yanayi wanda zai iya haifar da karuwa a cikin rozuvastatin a cikin jini,
amfani da fibrates lokaci daya,
rashin maganin lactose, karancin lactase, cututtukan cututtukan glucose-galactose malabsorption,
Mongoloid marasa lafiya
shekaru zuwa shekaru 18.

Yawan abin sama da ya kamata

Babu wani bayani game da hoton asibiti na yawan zubar da jini. Ba a lura da canji a cikin sigogin magunguna na kayan aiki lokacin shan manyan allurai ba.

Rosuvastatin ba shi da takamaiman maganin rigakafi; hemodialysis ba shi da tasiri. A cikin yanayin yawan abin sama da ya kamata, ana aiwatar da maganin tiyata a ƙarƙashin ikon aikin hanta da aikin aikin phosphokinase.

Analogs na Roxer, farashin a cikin kantin magunguna

Idan ya cancanta, zaku iya maye gurbin Roxer tare da analog don abu mai aiki - waɗannan magunguna ne:

Rosulip,
Kanta
Rosart,
Reddistatin,
Lipoprime,
Rosuvastatin,
Suvardio
Anna Faris,
Rosufast,
Rosucard.

Lokacin zabar analogues, yana da mahimmanci a fahimci cewa umarnin don amfani da Roxer, farashin da sake dubawa na kwayoyi tare da tasirin irin wannan ba su amfani. Yana da mahimmanci don samun shawarar likita kuma kada kuyi canjin magani mai yanci.

Farashi a cikin magunguna na Rasha: Allunan Roxer 5 MG 30 inji mai kwakwalwa. - daga 384 zuwa 479 rubles, 10 mg 30 inji mai kwakwalwa. - daga 489 zuwa 503 rubles, 15 mg 30pcs. - daga 560 rubles.

Adana a yanayin zafi har zuwa 25 ° C. Ayi nesa da isar yara. Rayuwar shelf shine shekaru 3. A cikin kantin magunguna, wajan takardar izinin likita.

A cewar likitocin, Roxer ya rage rage tasirin cholesterol. An lura cewa miyagun ƙwayoyi sun fara samun sakamako na warkewa da sauri fiye da sauran kwayoyi tare da irin wannan sakamako. Tare da haƙuri mai kyau, jinya mai tsawo yana yiwuwa. Daga cikin gazawar na nuna babban tsadar gaske da ci gaban sakamako.

3 sake dubawa don “Roxer”

Tare da waɗannan kwayoyin, ta saukar da cholesterol na jini a cikin watanni biyu daga 9 zuwa 5.8, ana iya jure shi sau ɗaya (ban da wuya ciwon kai na maraice a maraice), suna yin sauƙaƙe, ba tare da halayen rashin lafiyan ba. Likita an umurce shi da ɗauka koyaushe, farashin maganin yana da takaici, yana da ɗan tsada a gareni.

da zaran an fara kama, dakatar da shan miyagun ƙwayoyi, yana taimakawa mutum da gaske, amma ba duka ba.

Na gwada shi. Haɓakawa ya zo a ƙarshen makon farko, amma a gefe guda ni kan abinci ne. Ta dauki miyagun ƙwayoyi na dogon lokaci, kimanin shekaru 1.5 tare da hutu na watanni 2. Cholesterol lowers.

Fom ɗin saki

Roxer yana samuwa a cikin nau'i na allunan mai rufi tare da farin fim membrane, wanda ya bambanta da bayyanar dangane da maida hankali kan abubuwan da ke aiki a cikinsu:

Allunan tare da abun ciki rosuvastatin a kashi 5, 10 ko 15 MG, suna da siffar zagaye, biconvex, tare da bevel. A gefe ɗaya ana sanya alamar ta yi daidai da adadin kayan aiki: “5”, “10” da “15”, bi da bi.
Allunan tare da abun ciki rosuvastatin a kashi 20 na MG, zagaye, biconvex, tare da bevel.
Allunan tare da abun ciki rosuvastatin a kashi na 30 MG, biconvex, suna da kamannin capsule da haɗari a garesu.
Allunan tare da abun ciki rosuvastatin a kashi 40 MG, biconvex, suna da siffar capsular.

Yankunan biyu suna bayyane a fili akan yanke kwamfutar hannu, ɗayan ciki yana da fari.

Aikin magunguna

Tasirin magungunan Roxer na miyagun ƙwayoyi an yi nufin shi ne:

Hibarfin aikin ƙwayar enzyme microsomal hydroxymethylglutaryl-CoA reductasewanda yake aiki a matsayin mai karfafawa don iyakance matakin farkon aikin cholesterol.
Normalization na lipid profile (sakamakon rage kiba) ta ragewa jini taro na duka cholesterol, triglycerides, lipoproteins ƙarancin yawa har ma da ƙara maida hankali lipoproteins babban yawa.

Magungunan yana cikin rukunin magungunan "Statins”.

Magunguna da magunguna

Sau daya a jiki rosuvastatin tsokani da sakamakon masu zuwa:

Taimaka wajen rage yawan tashin hankali low yawa lipoprotein cholesterol,
Taimaka wajen rage yawan tattarawar hankali cholesterol,
Taimaka wajen rage yawan ƙwayoyin triglyceride,
Yana Inganta Ingantaccen Ra'ayoyi babban yawan lipoprotein cholesterol,
Yana taimaka rage taro lowpo lipoprotein apolipoprotein (apoliprotein B),
Yana taimaka rage taro low yawa lipoprotein cholesterol,
Yana taimaka rage taro low low yawa lipoprotein cholesterol,
Yana taimaka rage taro ragu mai yawa lipoprotein triglycerides,
Yana inganta Taro jini plasma apoliprotein A1,
Lowers cholesterol rabo low yawa na lipoproteinszuwa babban yawan lipoprotein cholesterol,
Yana rage adadin kuzari baki daya cholesterol zuwa babban yawan lipoprotein cholesterol,
Yana rage rashi low yawa lipoprotein cholesterol zuwa babban yawan lipoprotein cholesterol,
Yana rage rashi lowpo lipoprotein apolipoprotein (apoliprotein B) zuwa kumburin A1.

Tasirin asibiti game da amfani da Roxers yana haɓaka mako guda bayan fara karatun tare da miyagun ƙwayoyi. Kimanin 90% na iyakar tasirin magani an lura dashi bayan sati biyu.

Yawancin lokaci yana ɗaukar makonni huɗu don cimma sakamako mafi girma, bayan wannan ana kiyaye shi a duk tsawon lokacin magani.

Mafi girman maida hankali ne akan plasma rosuvastatin an lura da shi awanni biyar bayan ɗaukar kwayar, tabbataccen samfurin nuna bioavailability shine 20%.

Rosuvastatin yaduwar kayan tarihi zuwa hantakasancewar cibiyar farko cholesterol da metabolizing low yawa lipoprotein cholesterol.

Rarraba kayan shine kusan lita 134. Kusan 90% rosuvastatin ya daure wa ƙwayoyin plasma (yafi albumin).

Rosuvastatin metabolized zuwa iyaka (kimanin 10%). A cikin vitro ta amfani da mutum hepatocytes bincike metabolism abubuwa sun nuna cewa yana da batun kawai kaɗan metabolism dangane da Tsarin enzyme cytochrome P450. Haka kuma, wannan metabolism ba za'a iya ɗaukarsa da mahimmanci a asibiti ba.

Babban baiyanashiga cikin metabolism rosuvastatinshine CYP 2C9. Zuwa mafi ƙarancin kaɗan, sun shiga cikin aiwatarwa. warewa 2C19, 3A4 da 2D6.

A kan aiwatar da metabolization, manyan biyu metabolite:

N-desmethyl halin da kusan rabin aiki ba idan aka kwatanta da rosuvastatin. Game da batun lactone, sannan ana daukar shi wani nau'i ne na rashin aikin asibiti.

Rosuvastatin yana da fiye da 90% aikin hana aiki da hydroxymethylglutaryl-CoA reductase (HMG-CoA reductase), wanda yake zagayawa cikin jikin mutum a cikin tsarin jini gaba daya.

Mafi yawan ingesed rosuvastatin (kusan 90%) an nuna shi ba a canzawa tare da abinda ke ciki hanjin ciki. A wannan yanayin, duka abu mai narkewa da kayan aikin da ba a cika aiki an keɓe su ba.

Ragowarrosuvastatin ke banbanta da kodan tare da fitsari (kamar 5% - canzawa).

Rabin rayuwar kayan shine kusan awanni 20 kuma baya dogaro da karuwar kashi na maganin. Matsakaicin yarda daga jini jini kusan lita 50 ne a awa daya. Matsakaicin ma'aunin bambanci dangane da matsakaicin darajar (mai kawo canji) shine 21.7%.

Kamar yadda yake ga sauran magungunan da ke hana aiki hydroxymethylglutaryl-CoA reductasekama da hantarosuvastatin yana haɓaka shigarwar jigilar ƙwayar membrane OATP-S, wanda ke taka muhimmiyar rawa a kan aiwatar da cire abubuwa daga hanta.

Rosuvastatin halin da kwayar cutar ta dogara da shi, wanda yake kara girma daidai da hauhawar kashi.

Yin maimaita yau da kullun amfani da miyagun ƙwayoyi ba ya haifar da wani canje-canje a cikin halayen magunguna na kayan aikinsa.

Shekarun mai haƙuri da jinsi ba su da tasiri kan magunguna. A lokaci guda, bincike ya nuna cewa a cikin marasa lafiya na tseren Mongoloid, ƙungiyar AUC da mafi yawan abubuwan plasma rosuvastatin kwatankwacin ninki biyu a matsayin na masu haƙuri na tseren Caucasian.

Indiyawannan suna da alamu masu kama da waɗanda suke mafi girma ga Caucasians kusan sau 1.3. Babu bambance-bambance masu mahimmanci na asibiti a cikin alamomi na wakilan tseren Negroid da Caucasians.

A cikin marasa lafiya tare da na gazawar a cikin ladabi mai sauƙi ko matsakaici, alamomi na babban taro na rosuvastatin da N-desmethyl a cikin jini yana da kusan canzawa.

A cikin siffofin mai tsananina gazawar alamace ta girma plasma rosuvastatin yana ƙaruwa kusan sau uku, kuma alama ce mafi girma yawan ƙwayar cuta N-desmethyl- kusan sau tara idan aka kwatanta da alamu waɗanda aka lura cikin masu sa kai na lafiya.

Plasma maida hankali ne rosuvastatin a cikin marasa lafiya da suka kasance a kan maganin hemodialysiskusan sau biyu ya wuce waɗanda ke cikin masu taimako na lafiya.

A gazawar hantasaboda cututtukan hanta na koda, ƙwaƙwalwar ƙwayar plasma rosuvastatin an daidaita shi da kyau.

A cikin marassa lafiya wanda cutar sa ta shiga aji A yaro pew sikelin, mai nuna fifiko mafi girma rosuvastatin a jini jini kuma AUC ya karu da 60 da 5%, bi da bi, idan aka kwatanta da marasa lafiya, hanta wanda yake lafiya.

Idan cutar hanta Ya kasance nau'in B ta yaro pew sikelin, Manuniya bi da bi ta hanyar 100 da 21%. Ga marasa lafiya wanda cutar ta ke cikin nau'in C, ba a samun bayanai, wanda ke da alaƙa da rashin ƙwarewa tare da rosuvastatin a gare su.

Contraindications

Contraindications zuwa alƙawarin allunan Roxer waɗanda ke ɗauke da rosuvastatin a allurai daidai yake da 5, 10 da 15 MG sune:

hypersensitivity zuwa daya ko fiye da aka gyara na miyagun ƙwayoyi,
siffofin aiki cututtukan hanta (haɗe har da cututtukan yanayin da ba a san asalinsa ba), kazalika da halayen da aka samu ci gaba ta ciki hepatic transaminases, da yanayi a cikin kowane ɗayan hepatic transaminases yana ƙaruwa da ba ƙasa da sau uku ba,
ilimin cutar kodaa wane izini creatinine ba ya ƙimar adadin 30 ml / min,
na wucin gadi mai gado cutar neuromuscularsanadin lalacewar tsoka (myopathies),
amfani da wani maganin rashin lafiya Sankarini,
bincikar lafiya tare da ƙara haɗarin ci gaba rikicewar damuwa,
rashin haƙuri lactose,
karancin lactase,
glucose galactose malabsorption,
ciki (Hakanan, ba a sanya magani ga mata masu haihuwa ba idan ba'a yi amfani dasu ba hanawa),
nono
shekaru zuwa shekaru 18.

Allunan magani rosuvastatin 30 da 40 MG suna contraindicated:

marasa lafiya da hypersensitivity zuwa daya ko fiye da aka gyara na miyagun ƙwayoyi,
marasa lafiya da siffofin aiki cututtukan hanta (haɗe da cututtukan yanayi da ba a san asalinsu ba), kazalika da halayen da ake nunawa ta karuwa a matakin hepatic transaminases, da yanayi a cikin kowane ɗayan hepatic transaminases yana ƙaruwa da ba ƙasa da sau uku ba,
ilimin cutar kodaa wane izini creatinine ba ya ƙimar adadin 60 ml / min,
na wucin gadi mai gado cutar neuromuscularsanadin lalacewar tsoka (myopathies),
hawan jini,
amfani da wani maganin rashin lafiya Sankarini,
bincikar lafiya tare da ƙara haɗarin ci gaba rikicewar damuwa (lokacin da tarihin haƙuri yana da bayanin kula game da guba na tsoka wanda tsokanar wani inhibitor ya haifar hydroxymethylglutaryl-CoA reductase ko tsari na asali fibroic acid),
barasa giya
nauyi siffofin gazawar hanta,
Tsere na Mongoloid
liyafa a lokaci guda zazzabi,
rashin haƙuri lactose,
karancin lactase,
glucose galactose malabsorption,
ciki (Ba a kuma sanya mata ba ga mata masu haihuwa har sai sun yi amfani da rigakafi),
nono
shekaru har zuwa 18 kuma sunfi shekaru 70.

Side effects

Sakamakon sakamako masu zuwa na iya faruwa yayin jiyya tare da Roxeroy:

dysfunctions tsarin rigakafigami da halayen saboda rashin hankalin rosuvastatin ko wasu abubuwan da ke cikin magani, gami da haɓakawa angioedema,
dysfunctions tsarin narkewaaka bayyana a cikin nau'i na maƙarƙashiya na lokaci-lokaci, jin zafi a cikin yankin na epigastric, tashin zuciya, a lokuta mafi wuya na iya haɓaka maganin ciwon huhu,
rikice-rikice wanda ke faruwa a ɓangaren fata da ƙananan kasusuwa kuma ana bayyana su ta hanyar rashes akan fata, ƙoshin fata,cututtukan mahaifa,
kasusuwa tsoka, wanda bayyana kamar myalgia (sau da yawa) kuma wani lokacin myopathies da rhabdomyolysis,
gaba daya cuta, mafi yawan wanda yake asthenia,
dysfunctions koda da urinary fili, wanda yawanci suna tare da haɓakar ƙwayar furotin a cikin fitsari.

Roxer na iya shafar canji a ma'aunin dakin gwaje-gwaje. Don haka, bayan shan miyagun ƙwayoyi, aiki na iya ƙaruwa creatine kinasealamun nuna hankali glucose, bilirubinhanta enzyme gamma glutamyl transpeptidases, alkaline phosphatase, kamar yadda kuma alamomin plasma taro na hormones ya canza glandar thyroid.

Mitar da tsananin tasirin sakamako masu dogaro ne da kashi-kashi.

Allunan Roxer: umarni don amfani, hanyar gudanarwa da kuma tsarin jigila

Kafin rubuta magani, ana bada shawarar mai haƙuri don canzawa zuwa tsarin abinci na yau da kullun, maƙasudin wanda shine rage matakin cholesterol. Biye da wannan abincin ya zama dole kuma a duk lokacin kulawa.

An zaɓi kashi ɗaya akayi daban-daban ta likitan halartar dangane da dalilin maganin da tasirin sa. An ba shi izinin shan maganin a kowane lokaci na rana, ba a ɗaure shi da lokacin cin abinci ba.

An ƙone kwamfutar hannu duka, ba tare da murƙushewa ba, ba tare da taunawa ba kuma shan ruwa mai yawa.

Marasa lafiya tare da hypercholesterolemia ya kamata ku fara shan miyagun ƙwayoyi tare da allurai daidai da 5 ko 10 MG rosuvastatin. Ana ɗaukar allunan a baki sau ɗaya a rana. Haka kuma, wannan yanayin ya ci gaba ga marasa lafiyar da ba a bi da su ba gumaka, da kuma ga marasa lafiyar da aka riga aka yi magani da magungunan da ke hana aiki hydroxymethylglutaryl-CoA reductase.

Lokacin da aka ƙayyade lokacin farko na Roxers, likita ya ba da hankali ga alamun nuna hankali cholesterol, kuma yana kimanta haɗarin ci gaba rikitarwa na zuciya da sakamako masu illa.

A cikin yanayin inda ya cancanta, ana iya daidaita sashi zuwa matakin na gaba, duk da haka, ana aiwatar da irin wannan daidaitawar ba a cikin makwanni 4 bayan alƙawarin farko.

Ganin cewa halayen marasa illa suna da dogaro ga kashi, yayin ɗaukar 40 MG na rosuvastatin faruwa sau da yawa fiye da lokacin ɗaukar shi a cikin ƙananan ƙananan yawa, ƙaruwa na yau da kullun zuwa 30 ko 40 MG ya kamata a aiwatar tare da kulawa mai girma don:

mai raunin marasa lafiya hypercholesterolemia,
marasa lafiya waɗanda galibi suna haɓaka rikitarwa daga aikin zukata da tsarin jijiyoyin jiki (musamman, idan an gano mai haƙuri familial hypercholesterolemia).

Idan shan kananan allurai rosuvastatin a cikin wadannan nau'ikan marasa lafiya ba su bayar da sakamakon da ake tsammanin ba, bayan nada Roxers a cikin kashi 30 ko 40 MG kowace rana, dole ne marasa lafiya koyaushe su kasance karkashin kulawar likitan su.

Hakanan, ana nuna kulawa ta yau da kullun a cikin lokuta inda magani ya fara kai tsaye tare da kashi 30 ko 40 MG.

A daidai da umarnin don amfani, an nuna Roxer 20 MG a matsayin kashi na farko don rigakafin cututtuka zukata da tasoshin ga marasa lafiyawaɗanda ke da ha ari don haɓaka irin wannan cutar.

Mutanen da ke da rauni matsakaici na aiki koda Ba a buƙatar daidaitawa ga kashi ba, koyaya, an tsara magunguna tare da taka tsantsan ga wannan rukunin marasa lafiya.

Idan akwai aiki mai rauni koda matsakaici lokacin yarda creatinine yana tsakanin 60 ml / min, magani yana farawa tare da kashi 5 MG. Babban allurai na miyagun ƙwayoyi (30 da 40 mg) an sabunta su.

Marasa lafiya tare da tsananin dysfunctions kodaharamta yin amfani da miyagun ƙwayoyi a kowane sashi ya haramta.

Lokacin rubuta roxers ga marasa lafiya tare da cututtukan hanta, alamomin wanene yaro pew sikelin kada ku wuce 7, babu karuwa a cikin tsarin bayyanar rosuvastatin.

Idan masu nuni da ingancin aiki hantadaidai yake da maki 8 ko 9 a ciki yaro pew sikelin, shigarwar tsarin yana ƙaruwa. Sabili da haka, kafin sanya magunguna ga irin wannan marasa lafiya, ana buƙatar ƙarin nazarin aikin. koda.

Experiencewarewa a cikin kula da marasa lafiya waɗanda alamomin su suka wuce maki 9 a ciki yaro pew sikelinya ɓace

Yawan abin sama da ya kamata

Bayyanannin asibiti wadanda zasu iya faruwa idan shawarar da aka bayar ta wuce ta hanyar maganin ba a bayyana shi. Bayan kashi ɗaya na Roxer a cikin kashi sau da yawa mafi girma fiye da kafa kullun, manyan canje-canje na asibiti a cikin magunguna rosuvastatin ba a lura.

Game yawan abin sama da ya faru da kuma abin da ya faru bayyanar cututtuka na maye jiki yana nuna alamun magani kuma, idan ya cancanta, nadin wani saiti na matakan tallafawa.

Hakanan ana bada shawarar saka idanu akan aiki. creatine kinase da kuma gudanar da gwaji don kimanta aiki hanta.

Dacewar alƙawari maganin hemodialysis dauke ba tsammani.

Haɗa kai

A lokacin nada Roxers a hade tare da Sankarini ya karu sosai AUC rosuvastatin (kusan sau bakwai), yayin maida hankali cyclosporine ya kasance canzawa.

Tare da gudanarwa na lokaci daya tare da magungunan antagonist bitamin K ko kwayoyi waɗanda ke hana aiki hydroxymethylglutaryl-CoA reductase, a farkon hanya na jiyya, kazalika da haɓakawa na yau da kullun ta hanyar titration, za'a iya lura da karuwa a cikin INR (ƙaddarar ƙayyadaddun ƙasashen duniya).

A matsayinka na mai mulki, a kan banbancin ragi na kashi-kashi ta hanyar cirewa ko cikakken cire magani, wannan alamar tana raguwa.

Amfani da haɗin kai tare da ƙwayar lipid-rage rage ƙwayoyi Ezetimibe ba ya haifar da sauye-sauye a cikin AUC da adadin mafi yawan ƙwayoyin plasma na magungunan biyu ba, duk da haka, ba za a cire yiwuwar hulɗa magunguna ba.

A hade tare da Gemfibrozil da sauran magunguna waɗanda ke taimakawa rage matakan lipidsyana haifar da ƙaruwa biyu a cikin AUC da mafi yawan fifiko plasma rosuvastatin.

Nazarin na musamman sun nuna alƙawarin tare da Fenofibrate wataƙila ba sanannu ga canji a ma'aunin magunguna ba, duk da haka, yiwuwar hulɗa da magunguna ba a cire shi ba.

Rubuta kwayoyi Hemfibrozil da Fenofibratekazalika da kwayoyi nicotinic acid, yayin ganawarsu da masu hana su hydroxymethylglutaryl-CoA reductase kara saurin ci gaba myopathies (wanda, mafi kusantarwa, yana faruwa ne saboda ikon da sukeyi na haifar da irin wannan sakamako idan aka tsara su azaman wakilin monotherapeutic).

Tare da amfani da lokaci daya na Roxers tare da fibrates, rosuvastatin a allurai daidai yake da 30 da 40 ba ayi wa allurai. Farkon maganin yau da kullun rosuvastatin don marasa lafiya suna shan fibratesshine 5 MG.

Amfani da magunguna tare da masu hana su amfani da maganin serinekariya tsokani canji ga bayyanar rosuvastatin. A saboda wannan dalili, ba a ba da umarnin Roxer. HIV- marasa lafiya masu kamuwa da cuta suna shan magani tare da magungunan inhibitor kariya ta serine.

Duk da yake shan tare da maganin antacid plasma maida hankali ne shirin rosuvastatinrage by game da rabi. Don rage zafin wannan tasirinantacids An bada shawara don ɗaukar awa biyu bayan ɗaukar allunan Roxer.

A bango daga alƙawarin lokaci guda rosuvastatin tare da Amaryaw Kudin AUC rosuvastatin ya ragu da kashi 20%, kuma ƙwaƙƙwaran aikinsa shine kusan na uku. Wannan na iya zama saboda karuwar motsi. hanjin cikiwanda liyafar ta tsokani Amaryaw.

Tare da nadin Roxers a hade tare da rigakafin hormonal don gudanar da baka, mai nuna alama ta AUC ethinyl estradiol yana ƙaruwa da kashi 26%, kuma guda alama ce Norgestrel - da kashi 34%.

Wannan karuwa a cikin matakan AUC dole ne a yi la’akari da zaɓin mafi kyau duka. maganin hana haifuwana baka.

Babu wata hanyar samar da magunguna game da amfani da jituwa tare da magunguna don maganin maye gurbin maganin, amma, ba a cire damar hulɗa da karuwar AUC ba.

Nazarin haɗuwa da rosuvastatin tare da na'urar bugun zuciya Digoxin bai nuna ma'amala da cudanya da juna ba.

Rosuvastatin Ba ta da tasiri ko ƙarfafawa warewa tsarin cytochrome P450. Bugu da kari, metabolization rosuvastatin a ƙarƙashin rinjayar su ƙanƙanene kuma ba ƙimar asibiti ba.

Duk wata ma'amala mai ma'ana tsakanin rosuvastatin da kuma jami'ai na antifungal Fluconazole da Ketoconazolewannan yana hana ayyukan cytochrome isoenzymes ba'a lura dasu ba.

Haɗuwa tare da maganin antifungal Intraconazole, wanda ke hana aiki kauda kai CYP 3A4, yana haifar da karuwa a cikin AUC na rosuvastatin da kashi 28%. Koyaya, wannan karuwa ba'a ɗauka da mahimmanci a asibiti ba.

Pharmacokinetics

Lokaci don isa mafi yawan maida hankali na plasma (Cmax) na rosuvastatin a cikin jini bayan gudanarwar baka shine kimanin awa 5. Cikakken bioavailability na abu

20% Tsarin metabolism yana faruwa ne musamman a cikin hanta. Ofimar rarraba shine kusan lita 134. Yawancin abu (kusan 90%) suna ɗaure zuwa sunadaran plasma, galibi tare da albumin.

Rosuvastatin yana fuskantar karancin metabolism (

10%). Abinda ke cikin abubuwan da ba takamammen keɓaɓɓun na cytochrome P450. Babban isoenzyme da ke tattare da aikin shi shine isoenzyme CYP2C9. Haɗuwa cikin metabolism na isoenzymes CYP2C19, CYP3A4, CYP2D6 yana faruwa zuwa ƙarancin ƙima. Babban sanannen metabolites shine N-desmethylrosuvastatin (aiki yana kusan sau 2 ƙasa da rosuvastatin) da kuma lactone metabolites (basu da aikin aikin magani). Ayyukan magunguna don hanawa na plasma HMG-CoA reductase an bayar dashi musamman saboda rosuvastatin (fiye da 90%).

Kimanin kashi 90% na kayan suna toshewa ta cikin hanjin da bai canza ba (gami da rosuvastatin da ba a kulawa da shi), sauran - ta hanta. Rabin rayuwar wani abu daga plasma na jini shine kimanin awanni 19 (kara yawan kashi baya tasiri wannan alamar). Geometric ma'anar bayanan plasma shine 50 l / h (tare da ma'anar bambancin - 21,7%).

Tare da cin abincin yau da kullun, ba a lura da canje-canje a cikin sigogin kantin magani ba. Bayyanar tsari na karuwa a gwargwadon kashi.

Dangane da bincike na kantin magani, a cikin marasa lafiya na tseren Mongoloid (Jafananci, Filipinos, Sinanci, Koreans da Vietnamese), AUC na tsakiya da mafi girman yawan rosuvastatin yana ƙaruwa sau biyu idan aka kwatanta da tseren Caucasoid, don Indiyawan suna da yawan adadin karuwa a cikin AUC da Cmax na mediya wanda ke 1.3.

A cikin marasa lafiya tare da keɓantaccen keɓancewar creatinine (CC) ƙasa da 30 ml / min, yawan plasma na rosuvastatin da N-desmethylrosuvastatin a cikin jini yana ƙaruwa sosai.

A cikin cututtukan hanta na ƙwayar cuta, yawan ƙwayar rosuvastatin yana tashi zuwa kullun. Lokacin yin kwatancen: marasa lafiya waɗanda ke da aikin hanta na al'ada / marasa lafiya tare da gazawar hanta (bisa ga ƙimar Yara-Pugh: 7 ko ƙananan maki / maki 8) AUC da Cmax na rosuvastatin suna ƙaruwa da 5 da 60% / 21 da 100%, bi da bi. Kwarewa tare da rosuvastatin a cikin marasa lafiya da gazawar hanta sama da maki 9 ba ya nan.

Abun ciki da nau'i na saki

Roxer na miyagun ƙwayoyi yana samuwa a cikin nau'in kwamfutar hannu don gudanarwa na baka (sarrafa baka). Allunan an rufe su da farin fim fim. Zagaye, biconvex tare da bevel, a gefe guda alamar "10", zamewa. Babban sinadaran aiki na miyagun ƙwayoyi shine rosuvastatin. Abunda ke cikin kwamfutar hannu guda 10 ne. Hakanan an haɗa da magabata, waɗanda suka haɗa:

Macrogol 6000.
Methyl methacrylate copolymer.
Microcrystalline cellulose.
Colloidal silicon dioxide.
Titanium dioxide
Sanatari
Lactose Monohydrate.
Magnesium stearate.

Allunan Roxer suna kunshe a cikin fakitin bakin gilashi 10. Akwatin kwali ya ƙunshi blister 3 ko 9 da umarnin amfani da miyagun ƙwayoyi.

Kayan magunguna

Babban abu mai aiki na allunan Roxer, rosuvastatin yana toshe ayyukan enzyme HMG-CoA reductase, wanda ke da alhakin ƙirar ƙwayar mevalonate mai ƙwayar cuta. Yana da aiki a cikin ƙwayoyin hanta, waɗanda ke da alhakin haɗarin cholesterol (nasu), saboda wanda matakin sa cikin jini ya ragu. Hakanan, a kan tushen yin amfani da miyagun ƙwayoyi, ƙarancin lipoproteins mai ƙarancin raguwa da raguwa sosai (ba da gudummawa ga saka tasirin cholesterol a cikin ganuwar arteries) da kuma haɗuwa da yawan ƙwayar lipoproteins mai yawa (rage yawan aiwatar da ajiyar cholesterol a cikin ganuwar arteries).

Bayan shan allunan Roxer a ciki, sinadarin da ke aiki yana da sauri sosai, amma ba a cika shi cikin jini. Tare da gudanawar jini, yana shiga cikin ƙwayoyin hanta (hepatocytes), inda yake da tasirin warkewa. Rosuvastatin ba shi da metabolized kuma an cire shi sau ɗaya tare da feces.

Sashi da gudanarwa

A ciki, kwamfutar hannu bai kamata a tauna ko murƙushe ba, a haɗiye ta gaba ɗaya, a wanke da ruwa, ana iya ɗauka a kowane lokaci na rana, ba tare da la'akari da lokacin cin abinci ba. Kafin farawa da jiyya tare da Roxer, mai haƙuri ya kamata ya fara bin daidaitaccen tsarin abincin da ke ciwan jiki da ci gaba da bin sa yayin jiyya. Ya kamata a zaɓi kashi na miyagun ƙwayoyi daban-daban dangane da maƙasudin kwantar da hankali da amsawar warkewa don magani, yin la’akari da shawarwarin ƙasa akan maƙasudin ƙwayar cutar plasma mai ƙwaƙwalwa. Initialwarin da aka ba da shawarar farko ga marasa lafiya da ke fara shan maganin, ko don marasa lafiya da aka canjawa wuri daga ɗaukar wasu masu hana Htr-CoA reductase inhibitors, ya kamata ya zama 5 ko 10 MG na miyagun ƙwayoyi Roxer 1 lokaci a rana.

Tare da yin amfani da magunguna tare da lokaci guda tare da gemfibrozil, fibrates, acid nicotinic a cikin rage ƙwayar lipid (fiye da 1 g / rana), ana ba da shawarar marasa lafiya farkon kashi na miyagun ƙwayoyi 5 MG / rana. Lokacin zaɓin kashi na farko, mutum yakamata ya jagorance shi ta hanyar ƙwayar ƙwaƙwalwar ƙwayar ƙwaƙwalwar ƙwaƙwalwa cikin mutum yayi la'akari da haɗarin yiwuwar haɓaka rikitar cututtukan zuciya, kuma yuwuwar haɗarin sakamako masu illa ya kamata a la'akari. Idan ya cancanta, ana iya ƙara yawan kashi bayan makonni 4.

Sakamakon yiwuwar haɓakar tasirin sakamako lokacin amfani da kashi 40 MG / rana, idan aka kwatanta da ƙananan allurai na ƙwayoyi, ƙara yawan zuwa mafi girman 40 MG / rana ya kamata a la'akari da shi kawai a cikin marasa lafiya da mummunan hypercholesterolemia da babban haɗarin haɓaka rikicewar cututtukan zuciya ( musamman a cikin marasa lafiya da familial hypercholesterolemia) waɗanda ba su cimma sakamakon da ake buƙata ba na jiyya tare da kashi 20 MG / rana, kuma wanene zai kasance a ƙarƙashin kulawar likita. Musamman saka idanu akan marasa lafiya da suke karɓar ƙwayar a kashi 40 MG / rana.

Yin amfani da kashi 40 MG / rana a cikin marasa lafiya waɗanda ba su yi shawara da likita ba a ba da shawarar su ba. Bayan makonni 2-4 na ilmin likita da / ko tare da karuwa a cikin adadin magungunan Roxer, saka idanu akan metabolism na lipid ya zama dole (gyara kashi ya zama dole idan ya cancanta).

Marasa lafiya tare da gazawar koda

A cikin marasa lafiya tare da gazawar sassauci na matsakaici ko matsakaici, ba a buƙatar daidaita sashi. A cikin marasa lafiya da mummunan gazawar koda (CC kasa da 30 ml / min), amfani da Roxer yana contraindicated. Yin amfani da Roxer a kashi na fiye da 30 MG / rana an contraindicated a cikin marasa lafiya da matsakaici zuwa matsanancin ƙarancin renal (CC kasa da 60 ml / min). Ga marasa lafiya da matsakaiciyar kasawar koda, shawarar farko na Roxer shine 5 MG / day.

Yi amfani yayin ciki da shayarwa

Magungunan Roxer yana contraindicated a cikin ciki da lactation.

Ya kamata matan da suka isa haihuwa suyi amfani da hanyoyin da suka dace na hana haihuwa.

Game da ciki yayin yin magani, ya kamata a dakatar da amfani da miyagun ƙwayoyi nan da nan.

Babu bayanai game da tsallakewar rosuvastatin tare da madara (an san cewa sauran masu hana HMG-CoA reductase za a iya cire su a cikin madara), don haka ya kamata a daina amfani da miyagun ƙwayoyi yayin shayarwa.

Paarancin aiki na haya

A cikin marasa lafiya da ke karɓar ƙwayoyi masu yawa na rosuvastatin (musamman 40 mg / rana), an lura da tubular proteinuria, wanda aka gano ta amfani da tsararrun gwaji kuma, a mafi yawan lokuta, na lokaci ne ko na gajere. Irin wannan proteinuria baya nuna ciwo ko ci gaban cututtukan koda. Matsakaicin mummunan lalacewa na yara wanda aka lura a cikin binciken bayan-tallace na rosuvastatin ya fi girma tare da kashi 40 MG / rana. A cikin marasa lafiya da ke shan Roxer magani a kashi 30 ko 40 MG / rana, ana bada shawara don saka idanu akan alamun alamun aiki a lokacin jiyya (aƙalla lokaci 1 a cikin watanni 3).

Tasiri akan tsarin musculoskeletal

Lokacin amfani da rosuvastatin a cikin dukkan allurai, amma musamman a allurai da suka wuce 20 MG / rana, an ba da rahoton abubuwan da suka biyo baya a kan tsarin musculoskeletal: myalgia, myopathy, a lokuta mafi wuya, rhabdomyolysis. Yawancin lokuta marasa wuya na rhabdomyolysis an lura dasu tare da amfani da lokaci ɗaya na HMG-CoA reductase da ezetimibe inhibitors. Yakamata ayi amfani da irin wannan haɗuwa tare da taka tsantsan, tunda baza'a iya ma'amala da siyayyar magunguna ba. Kamar yadda yake game da sauran masu hana Hgor-CoA reductase inhibitors, yawan rhabdomyolysis a cikin tallace-tallace bayan amfani da miyagun ƙwayoyi na Roxer ya fi girma lokacin da kashi 40 na MG / rana.

Eterayyade aikin CPK

Ba za a iya tantance aikin CPK ba bayan matsanancin ƙoƙari na jiki kuma a gaban wasu dalilai masu yiwuwar karuwa a cikin aikinsa, wannan na iya haifar da fassarar da ba ta dace ba game da sakamakon. Idan farkon aikin CPK ya wuce mahimmanci (sau 5 sama da iyakar ƙimar ƙa'idar aiki), ya kamata a sake yin bincike bayan kwanaki 5-7. Ba za ku iya fara amfani da magani ba idan sakamakon reanalysis ya tabbatar da farkon ayyukan KFK na farko (fiye da sau biyar-biyar da ya wuce iyakar ƙimar ƙa'idodi).

Kafin farawan magani

Ya danganta da maganin yau da kullun, ya kamata a tsara magungunan Roxer tare da taka tsantsan ga marasa lafiya tare da abubuwan haɗari da ke faruwa don myopathy / rhabdomyolysis, ko kuma amfani da miyagun ƙwayoyi ya kasance contraindicated (duba sassan "Contraindications" da "Gargadi").

Wadannan abubuwan sun hada da:

mai aiki mai ɗaukar hoto,
hawan jini
tarihin cututtukan tsoka (gami da tarihin dangi),
myotoxic illa lokacin ɗaukar sauran HMG-CoA reductase inhibitors ko fibrates a cikin tarihi,
yawan shan ruwa sosai
sama da shekaru 65 da haihuwa
yanayi wanda yaduwar rosuvastatin a cikin jini na iya karuwa,
lokaci daya na amfani da fibrates.

A cikin irin waɗannan marasa lafiya, wajibi ne don tantance haɗarin da kuma yiwuwar amfani da ilmin likita. Hakanan ana bada shawarar saka idanu akan asibiti. Idan aikin farko na CPK ya fi sau 5 girma fiye da babba na al'ada, ba za a fara farawa tare da Roxer ba.

A lokacin cutar magani

Yakamata a sanar da mara lafiya game da bukatar neman kulawar likita na gaggawa idan kwatsam fara jin zafi, rauni na tsoka ko maɗauri, musamman a hade tare da zazzabi da zazzabi. A cikin irin waɗannan marasa lafiya, yakamata a ƙayyade aikin CPK. Dole ne a dakatar da aikin idan aikin CPK ya haɓaka sosai (fiye da sau 5 idan aka kwatanta da babba na al'ada) ko kuma idan alamun bayyanar tsokoki suna haifar da haifar da rashin jin daɗi yau da kullun (koda kuwa aikin CPK bai wuce 5 sau mafi girman iyaka al'ada). Idan bayyanar cututtuka ta ɓace kuma ayyukan CPK sun koma al'ada, ya kamata a ba da shawara don sake dawo da amfani da Roxer ko wasu masu hana haɓaka rage Hase-CoA a cikin ƙananan allurai tare da kulawa da kulawa na likita. Kulawa da aikin CPK da rashin bayyanar cututtuka ba shi da amfani. Yawancin lokuta masu wuya na rigakafin rikice-rikice necrotizing myopathy tare da bayyanar asibiti a cikin nau'i na rauni mai tsoka mai ƙarfi da haɓaka aikin CPK a yayin aikin jiyya ko lokacin dakatar da amfani da inhibitors na HMG-CoA, ciki har da rosuvastatin. Ana iya buƙatar ƙarin nazarin ƙwayar tsoka da ƙwayar jijiya, nazarin serological, kazalika da maganin hana daukar ciki.

Babu alamun alamun kara yawan jijiyoyin jiki yayin daukar rosuvastatin da maganin kwantar da hankali. Koyaya, an sami karuwa game da cutar myositis da myopathy a cikin marasa lafiya suna ɗaukar wasu hanyoyin hanawa na HMG-CoA reductase a hade tare da fibroic acid abubuwan da aka samo (misali gemfibrozil), cyclosporine, nicotinic acid a cikin rage ƙananan ƙwayoyi (fiye da 1 g / rana), magungunan antifungal azole, masu hana kwayar cutar kwayar cutar kwayar cutar kwayoyi da kuma maganin macrolide.

Lokacin da aka yi amfani da shi tare da wasu masu hana haɓakar HMG-CoA reductase, gemfibrozil yana ƙara haɗarin myopathy. Saboda haka, ba ayi shawarar amfani da magani na lokaci daya Roxer da gemfibrozil ba. Abubuwan da ake amfani da su yayin canza ƙwayar plasma na lipids tare da haɗuwa da Roxer tare da fibrates ko nicotinic acid a cikin rage ƙwayoyin lipid a cikin hankali yana la'akari da yiwuwar haɗarin. Magungunan Roxer a cikin kashi 30 na MG / rana yana contraindicated don haɗuwa da magani tare da fibrates. Saboda yawan haɗarin rhabdomyolysis, Roxer bai kamata a yi amfani da shi ba a cikin marasa lafiya tare da matsanancin yanayi wanda zai iya haifar da myopathy ko yanayin da ke haifar da ci gaban lalacewar renal (alal misali, sepsis, hypotension, tiyata mai zurfi, rauni, rauni metabolism, endocrine da electrolyte hargitsi ko kuma raunin da ba a sarrafa shi ba).

Tasiri a hanta

Dangane da maganin yau da kullun, Roxer ya kamata a yi amfani dashi tare da taka tsantsan a cikin marasa lafiya da yawan shan barasa da / ko tarihin cutar hanta ko an hana amfani da shi (duba sassan "Contraindications" da "Tsanani").

An bada shawara don ƙayyadadden gwaje-gwaje na aikin hanta kafin lokacin farawa da watanni 3 bayan farawa. Yin amfani da miyagun ƙwayoyi Roxer ya kamata a dakatar dashi ko yakamata a rage yawan maganin idan aikin "hanta" transaminases a cikin jijiyoyin jini ya ninka har sau 3 sama da iyakar al'ada.

A cikin marasa lafiya tare da hypercholesterolemia saboda hypothyroidism ko ciwo nephrotic, ya kamata a gudanar da ilimin cututtukan cututtukan cututtukan cututtuka kafin a yi magani tare da Roxer.

Form sashi

Allunan da aka sanya fim 5 MG, MG 10, 20 MG da 40 MG

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abu mai aiki - alli na rosuvastatin alli 5.21 mg, 10.42 mg, 20.83 mg, ko 41.66 mg (daidai da 5 mg rosuvastatin, 10 mg, 20 mg da 40 mg, bi da bi),

amagabata: celclosese na microcrystalline, lactose anhydrous, crospovidone, silicon dioxide, colloidal anhydrous, magnesium stearate,

fim kwance: babban copolymer na kwalba methacrylate, macrogol 6000, titanium dioxide E171, lactose monohydrate.

Allunan suna zagaye cikin tsari, tare da wani dan ƙaramin yanayin biconvex, wanda aka lullube da farin fim ɗin fim, wanda aka yiwa alama "5" a gefe ɗaya kuma tare da bevel (don sashi na 5 MG).

Allunan suna zagaye cikin tsari, tare da wani ƙaramin biconvex, mai rufi da farin fim ɗin fim, wanda aka yiwa alama "10" a gefe ɗaya kuma an yanke shi (don sashi na 10 mg).

Allunan zagaye-zagaye, mai rufi tare da farin fim mai rufi, tare da bevel (don sashi na 20 MG).

Allunan masu launin capsule tare da saman biconvex, an shafe su tare da farin fim ɗin rigakafin (don sashi na 40 mg).

Sashi da gudanarwa

Kafin fara amfani da magani, mai haƙuri ya kamata ya kasance a kan daidaitaccen abinci tare da ƙarancin cholesterol kuma ya ci gaba da bin wannan abincin yayin magani. An saita kashi na miyagun ƙwayoyi daban-daban, gwargwadon burin maganin, maganin mai haƙuri ga magani. Shafin farko da aka bada shawarar shi ne daga 5 MG zuwa 10 MG kuma ana shan shi sau daya a rana. Kashi guda iri ɗaya ne ga marasa lafiya waɗanda ke ɗaukar statins a karon farko, ko kuma suna juyawa daga jiyya tare da wani inhibitor na HMG, CoA reductase. Lokacin zabar maganin farawa, yana da mahimmanci don la'akari da matakin farko na cholesterol da haɗarin cututtukan zuciya, da kuma haɗarin haɗarin halayen masu illa.

Idan ya cancanta, ana iya ƙara yawan kashi bayan makonni 4. Ganin yawan karuwar rahotannin halayen masu illa yayin ɗaukar kashi 40 MG idan aka kwatanta da ƙananan allurai, haɓakawa na yau da kullun zuwa 30 MG ko 40 MG yakamata a yi la'akari kawai ga marasa lafiya da mummunar cutar hauka da haɗarin bugun zuciya (musamman, tare da familial hypercholesterolemia) , wanda ba shi yiwuwa a cimma matakan rage ƙwayar lipid a lokacin ɗaukar ƙananan allurai, wanda kuma za'a kula dashi. Musamman hankali ga marasa lafiya wajibi ne lokacin da suka fara shan allurai na 40 MG ko 30 MG.

Theara yawan zuwa 40 mg yana yiwuwa ne kawai a ƙarƙashin kulawar likita. Ba a bada shawarar sashi na 40 MG don marasa lafiya waɗanda ba su sha maganin ba. Bayan makonni 2 na jiyya da / ko tare da karuwa a cikin kashi na Roxer, saka idanu na metabolism na lipid ya zama dole (idan ya cancanta, daidaita kashi).

Roxera® ana iya ɗauka a kowane lokaci na rana, ba da abinci ba.

Yi amfani da tsofaffi

An ba da shawarar marasa lafiya waɗanda shekarunsu suka haura 70 don fara shan maganin tare da kashi 5 MG

Sashi a cikin marasa lafiya da na koda

A cikin marasa lafiya tare da gazawar sassauci na matsakaici ko matsakaici, ba a buƙatar daidaita sashi, maganin farko na maganin shine 5 MG. A cikin marasa lafiya da matsakaici mai rauni illa aiki (keɓaɓɓen bayyana kasa da 60 ml / min) - amfani da miyagun ƙwayoyi a cikin sashi na 40 MG ne contraindicated. A cikin marasa lafiya da mummunan gazawar koda (keɓantar da keɓaɓɓen ƙasa da 30 ml / min), an hana yin amfani da Roxer®.

Sashi a cikin marasa lafiya da lalacewar hanta

A cikin marasa lafiya waɗanda ke da guda 7 ko scoasa da ƙarancin Yara-Pugh, ba a buƙatar daidaita sashi ba. Babu wani gogewa game da amfani da miyagun ƙwayoyi a cikin marasa lafiya tare da maki sama da 9 akan sikelin Yara-Pugh.

Roxer® yana cikin contraindicated a cikin marasa lafiya da aiki hanta da cutar.

An lura da karuwar tsarin rosuvastatin tsakanin Jafananci da Sinanci. Shawarar farawa don marasa lafiya Asiya shine 5 MG. Yin amfani da miyagun ƙwayoyi a kashi 30 na MG ko 40 MG ya haɗu a cikin marasa lafiya na tseren Asiya.

Dosing a cikin marasa lafiya da predisposition zuwa myopathy

Thewarin da aka ba da shawarar farawa ga marasa lafiya tare da abubuwan da ke haifar da ci gaban myopathy shine 5 MG. Allurai na 40 MG da MG 30 sune ke cikin irin wannan mara lafiyar.