Yaya ake amfani da Atorvastatin-Teva?

Siffar sashi - allunan da aka shirya fim: kusan fari ko fari, farar fata mai siffa, akan sanya su a bangarorin biyu: a gefe daya - “93”, a daya - “7310”, “7311”, “7312” ko “7313” (10 inji mai kwakwalwa a cikin boge, a cikin kwali na kwali na 3 ko 9 na blister).

Kwamfutar hannu 1 ya ƙunshi:

abu mai aiki: alli na atorvastatin - 10.36 mg, 20.72 mg, 41.44 mg ko 82.88 mg, wanda yayi daidai da 10 mg, 20 mg, 40 mg ko 80 mg na atorvastatin, bi da bi,
karin abubuwan taimako: eudragit (E100) (copolymer na dimethylaminoethyl methacrylate, butyl methacrylate, methyl methacrylate), lactose monohydrate, alpha-tocopherol macrogol succinate, povidone, croscarmellose sodium, sodium stearyl fumara
Abun rufe fim: opadry YS-1R-7003 (polysorbate 80, hypromellose 2910 3cP (E464), titanium dioxide, hypromellose 2910 5cP (E464), macrogol 400).

Alamu don amfani

heterozygous familial da rashin dangi na hypercholesterolemia, hypercholesterolemia na farko da haɗe (hade) hyperlipidemia (nau'ikan IIa da IIb bisa ga rarrabuwa na Fredrickson) a haɗe tare da rage yawan abinci mai narkewa da nufin rage yawan matakan cholesterol, low-low lipoprotein liLpro, liL, L-li li, li-li lipro lirol liL, L-lipid, lipoprotein lilestrol liL, LL, LL-lipid babban lipoprotein cholesterol (HDL),
dysbetalipoproteinemia (nau'in III gwargwadon rarrabuwa na Fredrickson), haɓakar ƙwayar jini mai mahimmanci (nau'in IV bisa ga tsarin Fredrickson) - tare da maganin rashin abinci,
Hyzygolestus familial hypercholesterolemia - don runtse LDL cholesterol da jimlar cholesterol tare da isasshen ingancin maganin wariyar abinci da sauran hanyoyin da ba magani ba.

Contraindications

gazawar hanta (azuzuwan Yara-Pugh A da B),
pathologies na hanta mai aiki, haɓaka aikin enzymes na hepatic (fiye da sau 3 sama da babba na al'ada) asalin asali,
lokacin ciki da shayarwa,
shekaru zuwa shekaru 18
rashin hankali ga abubuwan da ke cikin miyagun ƙwayoyi.

Tare da taka tsantsan, ana ba da shawarar cewa Atorvastatin-Teva an tsara shi tare da tarihin cututtukan hanta, marasa lafiya da hypotension art, dogarawar giya, rashin daidaituwa na electrolyte, matsanancin ƙwayar cuta (sepsis), cututtukan tsokoki na kasusuwa, cututtukan da ba a sarrafa su ba, da kuma manyan hanyoyin aikin tiyata. raunin da ya faru.

Sashi da gudanarwa

Allunan ana shan su a baki sau 1 a rana, ba tare da la'akari da yawan abinci ba a kowane lokaci na rana.

Likita ya tsara kashi ɗaya daban-daban, la'akari da matakin farko na LDL cholesterol, makasudin magani da amsar mai haƙuri ga maganin.

Gudanar da Atorvastatin-Teva ya kamata ya kasance tare da kullun (1 lokaci kowane makonni 2-4) saka idanu akan matakin lipids a cikin jini, bisa ga bayanan da aka samu, daidaita sashi.

Ya kamata a yi gyaran fuska ba fiye da 1 lokaci a cikin makonni 4.

Matsakaicin adadin yau da kullun shine 80 MG.

Nagari maganin yau da kullun:

heterozygous familial hypercholesterolemia: kashi na farko shine 10 MG, yin gyare-gyare na kowane sati 4, yakamata a kawo shi 40 MG. Lokacin da aka magance shi da kashi 40 MG, ana shan magani a hade tare da jerin abubuwan bile acid, tare da monotherapy, an ƙara yawan kashi zuwa 80 MG,
hypercholesterolemia na farko da kuma gauraye (haɗe) hyperlipidemia: 10 MG, a matsayin mai mulkin, kashi yana ba da mahimmancin sarrafa matakan lasa. Mahimmin tasiri na asibiti yawanci yakan faru ne bayan makonni 4 sannan ya ci gaba da tsawaita amfani da miyagun ƙwayoyi,
Iyalin hypercholesterolemia na homozygous: 80 MG.

Don cututtukan zuciya da babban haɗari na rikicewar zuciya, ana bada shawarar kulawa tare da makasudin da ke gaba don gyaran lipid: jimlar cholesterol ƙasa da 5 mmol / l (ko ƙasa da 190 mg / dl) da LDL cholesterol ƙasa da 3 mmol / l (ko ƙasa da 115 mg) / dl).

Game da gazawar hanta, mai haƙuri na iya buƙatar gabatar da ƙananan allurai ko dakatar da magani.

Tare da gazawar koda, ba a buƙatar daidaita sashi ba, tunda magani ba ya canza taro a cikin jini.

Side effects

daga tsarin mai juyayi: sau da yawa - ciwon kai, marassa galibi - cin zarafin dandano, jin nauyi, rashin bacci, bacci, tashin hankali, rashin bacci, ciwon mara, da wuya - neuropathy na waje, mita da ba a sani ba - rashin kwanciyar hankali, asarar ƙwaƙwalwar ajiya ko asara, damuwa ta bacci,
daga tsarin rigakafi: sau da yawa - halayen rashin lafiyan, da wuya ainun - anaphylactic shock, angioedema,
daga jijiyar ciki: sau da yawa - tashin zuciya, dyspepsia, zawo, flatulence, maƙarƙashiya, infrequently - ciki na ciki, belching, pancreatitis, amai,
daga tsarin musculoskeletal da tsoka mai haɗuwa: sau da yawa - jin zafi a cikin ƙwallon kafa, kumburi a cikin gidajen abinci, myalgia, ciwon baya, arthralgia, spasm na tsoka, mara wuya - rauni na tsoka, ciwon wuya, da wuya - rhabdomyolysis, myopathy, myositis, tendonopathy tare da jijiyoyin jiki, ba a san tazarar ba - immuno-mediated necrotizing myopathy,
daga tsarin hepatobiliary: na lokaci daya - hepatitis, da wuya - cholestasis, da wuya - gazawar hanta,
daga tsarin lymphatic da tsarin jini: da wuya - thrombocytopenia,
daga tsarin numfashi, kirji da gabobin jiki: sau da yawa - hanci, jin zafi a cikin yankin pharyngeal-laryngeal, nasopharyngitis, yawan da ba a sani ba - cututtukan huhun ciki,
alamomin dakin gwaje-gwaje: sau da yawa - karuwa a cikin ƙwayoyin motsi na ƙwayoyin cuta, hyperglycemia, a lokaci-lokaci - hypoglycemia, leukocyturia, ƙara yawan aikin hanta enzymes, hanjin ba a sani ba - ƙara yawan matakan glycosylated haemoglobin maida hankali,
a wani bangare na bangaren ji, rarrabuwar labyrinth: akai-akai - tinnitus, da wuya - rushewar ji,
a sashen bangaren hangen nesa: akai-akai - raguwar bayyanawar hangen nesa, da wuya - rushewar gani,
halayen cututtukan fata: akai-akai - ƙoshin fata, fitsari, alopecia, urticaria, da wuya - erythema multiforme, bullous dermatitis, da wuya - mai guba da keɓaɓɓen ƙwayar cuta, rashin lafiyar Stevens-Johnson,
daga tsarin haihuwa: da wuya - gynecomastia, mita da ba a sani ba - lalatawar jima'i,
rikice-rikice na gaba ɗaya: na lokaci-lokaci - rauni, asthenia, zazzabi, ciwon kirji, yanki na ciki, ƙima mai nauyi, ƙarancin iska, anorexia.

Umarni na musamman

A baya, hypercholesterolemia yakamata a yi ƙoƙarin sarrafa maganin rage cin abinci, ƙara yawan aiki na jiki, kuma a cikin marasa lafiya tare da kiba, asarar nauyi da kuma lura da wasu yanayi.

Amfani da Atorvastatin-Teva yana ba da damar kiyaye daidaitaccen tsarin abinci na hypocholesterol, wanda likita ya umarta lokaci guda tare da miyagun ƙwayoyi.

HMG-CoA reductase inhibitors na iya shafar canjin yanayin ƙirar ƙwayoyin cuta na aikin hanta a duk lokacin da ake yin magani. Sabili da haka, ya kamata magani ya kasance tare da saka idanu akan aikin hanta tare da mitar da ke gaba: kafin farawa daga jiyya, bayan kowane ƙaruwa ya karu, sannan bayan 6 da 12 makonni bayan fara magani, to kowane watanni shida. Ya kamata likita ya kula da marassa lafiyar da ke da tsauraran matakan enzymes har sai matakin ya koma na al'ada. Idan ƙirar aspartate aminotransferase (AST) da alanine aminotransferase (ALT) sun fi sau 3 girman ƙimar ƙa'idodin, yakamata a rage ko a soke.

Haɓakawa na myopathy na iya zama tasiri mara amfani na shan atorvastatin, alamunsa sun haɗa da karuwa a cikin creatine phosphokinase (CPK) na 10 sau ko fiye idan aka kwatanta da babba iyakar ƙa'idar a hade tare da jin zafi da rauni a cikin tsokoki. Yakamata a sanar da marassa lafiya game da bukatar tuntuɓi likita kai tsaye idan akwai rashin jin daɗi da rauni a cikin tsokoki, tare da zazzabi da zazzaɓi. Ya kamata a daina amfani da hanyoyin warkarwa yayin da yake ci gaba da faɗakarwa a cikin ayyukan KFK ko kasancewar waɗanda ake zargi ko tabbatar da rashin lafiyar.

A kan tushen yin amfani da atorvastatin, haɓaka rhabdomyolysis tare da mummunan lalacewa na renal saboda myoglobinuria yana yiwuwa. Idan akwai wani mummunan ciwo mai saurin kamuwa da cuta, jijiyoyin jini, yawan tiyata, rauni, matsanancin metabolism, endocrine da rikicewar lantarki, rikicewar rashin tsari ko bayyanar sauran abubuwan haɗari don lalacewa na renal yayin rhabdomyolysis, ana ba da shawarar dakatar da maganin Atorvastatin-Teva.

Shan miyagun ƙwayoyi ba ya shafar ikon mai haƙuri na tuki motoci da injin.

Hulɗa da ƙwayoyi

Haɗin HMG-CoA reductase inhibitors tare da fibrates, cyclosporine, maganin ƙwaƙwalwar macrolide (gami da erythromycin), nicotinic acid, wakilin antifungal azole yana ƙara haɗarin myopathy ko kuma zai iya haifar da rhabdomyolysis, tare da lalacewa na lalacewa na aikin myoglobinuria. Sabili da haka, an ba da shawarar cewa a cikin daidaitaccen yanayi, kwatanta amfanin da haɗarin far, yin yanke shawara game da nadin atorvastatin lokaci guda tare da waɗannan kwayoyi.

Tare da tsananin taka tsantsan, ana bada shawara don yin magani a hade tare da cyclosporine, masu hana HIV kariya, maganin rigakafin macrolide (ciki har da erythromycin, clarithromycin), magungunan azole antifungal, nefazodone da sauran masu hana CYP3A4 isoenzyme, tunda yana yiwuwa a ƙara maida hankali kan ƙwayoyin cutar atorvastatin da jini .

Ta amfani da Atorvastatin-Teva na lokaci daya:

cimetidine, ketoconazole, spironolactone da sauran magunguna waɗanda ke rage taro na kwayoyin steroid na endogenous, suna ƙara haɗarin rage haɓaka matakin hormones na steroid endogenous,
maganin hana haihuwa wanda ke dauke da sinadarin ethineyl estradiol da norethisterone suna kara maida hankali kan abubuwan da ke aiki a cikin jini,
abubuwan dakatarwa da ke dauke da sinadarin hydroxide na aluminum da magnesium sun rage (a kusan 35%) yawan atorvastatin a cikin plasma, ba tare da canza matsayin raguwa a cikin LDL ba,
digoxin na iya kara yawan plasma,
warfarin yana haifar da raguwa a cikin lokacin prothrombin a farkon farawa, a cikin kwanaki 15 na gaba, mai nuna alamar an dawo da shi al'ada,
cyclosporin da sauran masu hana P-glycoprotein na iya haɓaka bioavailability na atorvastatin,
terfenadine baya canzawa cikin plasma jini.

Haɗin magani tare da colestipol yana da tasiri sosai akan lipids fiye da ɗaukar kowane magunguna dabam, kodayake matakin atorvastatin a cikin jini yana raguwa da kusan 25%.

Yawan amfani da ruwan 'ya'yan innabi a lokacin jiyya ya kamata a iyakance, tunda ruwan' ya'yan itace mai yawa yana haifar da yawan atorvastatin a cikin plasma.

Magungunan ba zai tasiri kan magungunan phenazone da sauran magunguna masu metabolized guda ɗaya na isotozymes ba.

Ba a tabbatar da tasirin rifampicin, phenazone, da sauran CYP3A4 don gabatar da shirye-shiryen isoenzyme akan Atorvastatin-Teva ba.

Zai yiwu a yi ma'amala da ma'amala ta musamman da amfani da magungunan antiarrhythmic na III (ciki har da amiodarone).

Nazarin bai bayyana hulɗar atorvastatin tare da cimetidine, amlodipine, magungunan antihypertensive.

Maganin magunguna na atorvastatin teva

Magungunan yana cikin zaɓaɓɓun masu hana gwagwarmaya na enzyme HMG-CoA reductase, wanda ke ɗaukar ma'adinin mevalonic acid, mai fara aiki na cholesterol da sauran sterols.

Triacylglycerides (fats) da cholesterol a cikin hanta suna ɗaure zuwa lipoproteins mai yawa mai yawa, daga inda jini ke motsa su zuwa tsokoki da tsoput nama. Daga cikin waɗannan, yayin samar da lipolysis, an ƙirƙiri ƙarancin lipoproteins (LDL), wanda ke rarraba ta hanyar hulɗa tare da masu karɓa na LDL.

Ayyukan miyagun ƙwayoyi an yi niyya don rage yawan kitsen mai da cholesterol a cikin jini ta hana ayyukan Hzy-CoA reductase enzyme, cholesterol biosynthesis a cikin hanta da haɓaka yawan masu karɓar LDL waɗanda ke haɓaka haɓakawa da catabolism na ƙananan ƙarancin lipoproteins.

Tasirin miyagun ƙwayoyi ya dogara da matakin da aka ɗauka kuma ya ƙunshi a cikin rage girman lipoproteins mai yawa a cikin marasa lafiya tare da keta haddin ƙwayar cholesterol metabolism (hypercholesterolemia), wanda ba za'a iya daidaita shi tare da wasu magunguna don rage yawan lipids na jini.

Shan miyagun ƙwayoyi yana haifar da raguwa a matakin:

jimlar cholesterol (30-46%),
cholesterol a cikin LDL (41-61%),
apolipoprotein B (34-50%),
triacylglycerides (14-33%).

A lokaci guda, matakin cholesterol a cikin haɓakar babban lipoproteins mai yawa (HDL) da apolipoprotein A. Ana lura da wannan tasirin a cikin marasa lafiya da keɓaɓɓiyar gado da kuma hanyoyin da aka samu na hypercholesterolemia, cakuda nau'in dyslipidemia, gami da nau'in ciwon sukari na 2 na mellitus. Tasirin magungunan ƙwayar magunguna yana rage yiwuwar cututtukan zuciya da barazanar mutuwa dangane da su.

Dangane da binciken asibiti, sakamakon yin amfani da miyagun ƙwayoyi a cikin marasa lafiya da ke da shekaru bai bambanta cikin aminci da inganci ba a cikin mummunan shugabanci daga sakamakon lura da marasa lafiya na wasu tsararraki.

Abubuwan da ke cikin miyagun ƙwayoyi suna shan saurin hanzari bayan maganin baka. Mafi girman hankali a cikin jini an rubuta shi bayan sa'o'i 1-2. Cin dan kadan yana rage jinkirin shan kayan aiki, amma ba ya tasiri tasirin aikinsa. Yin amfani da ƙwayar cuta shine 12%. A bioavailability na inhibitory aiki dangi da enzyme HMG-CoA reductase shine 30%, wanda ke haifar da ta hanyar metabolism na farko a cikin narkewa da hanta. Ya danganta da garkuwar jini da kashi 98%.

Abubuwan da ke aiki sun kasu kashi biyu na metabolites (ortho- da para-hydroxylated ceri, samfuran beta-hada abubuwa) don mafi yawan hanta a cikin hanta. An sake yin shi a ƙarƙashin aikin da keɓaɓɓen CYP3A4, CYP3A5 da CYP3A7 na cytochrome P450. Ayyukan inhibitory na wakilin magunguna wanda ke da alaƙa da enzyme HMG-CoA reductase shine 70% ya dogara da aikin abubuwan metabolites na sakamakon.

Fitowar metabolites na ƙarshe yana faruwa ne ta hanyar bile, kawai wani ɓangaren ne mai mahimmanci (Manuniya don amfanin atorvastatin teva

Yin rigakafin cututtuka na tsarin zuciya da jijiyoyin jini (cututtukan zuciya da jijiyoyin jini, bugun jini, raunin zuciya), da rikitarwarsu:

a cikin manya a rukuni ɗaya ko sama da haɗari: tsofaffi, hauhawar jini, masu shan sigari, mutanen da ke da raguwar HDL ko cutarwar da ta fi ƙaruwa don cututtukan zuciya da jijiyoyin bugun jini,
a cikin marasa lafiya da nau'in ciwon sukari na 2 na mellitus tare da proteinuria, retinopathy, hauhawar jini,
a cikin marasa lafiya da cututtukan zuciya na zuciya (don guje wa ci gaban rikitarwa).

Jiyya na cututtukan zuciya:

tare da hypercholesterolemia na farko (wanda aka samo da kuma gado, ciki har da nau'ikan homo-heterozygous na familial hypercholesterolemia) - ana amfani da miyagun ƙwayoyi azaman kayan aiki mai zaman kanta kuma a matsayin wani ɓangare na jiyya mai fa'ida tare da sauran hanyoyin rage kiɗa (LDL apheresis),
tare da gaurayewar dyslipidemia,
a cikin marasa lafiya tare da hauhawar triglycerides a cikin jini (nau'in IV a cewar Fredrickson),
a cikin marasa lafiya da na farko dysbetalipoproteinemia (Fredrickon nau'in III) tare da gazawar maganin rashin cin abinci.

Yadda ake ɗauka

Sashi na yau da kullun ya dogara da matakin farko na cholesterol kuma yana cikin kewayon 10-80 mg. Da farko, ana yin allurai 10 a rana sau ɗaya a kowane lokaci na rana, ba tare da ambaton abincin ba. Daidaitawar kashi ya dogara da alamun mutum na cholesterol, wanda dole ne a sanya ido da farko a kowane 2, sannan kowane mako 4.

Daidaitattun abubuwan yau da kullun na manya:

tare da hypercholesterolemia na farko da cakuda hyperlipidemia: 10 MG sau ɗaya a rana (ana yin rikodin sakamako na warkewa bayan kwanaki 28 daga farkon magani, tare da tsawan magani wanda wannan sakamakon ya tabbata)
tare da heterozygous hereditary hypercholesterolemia: 10 MG sau ɗaya a rana (kashi na farko tare da ƙarin gyara da kawo shi zuwa 40 MG kowace rana),
tare da homozygous hereditary hypercholesterolemia: 80 MG 1 lokaci ɗaya kowace rana.

Cututtukan fitsari ba sa tasiri ga haɗuwa da abu mai aiki a cikin jini ko tasirin Atorvastatin-Teva. Babu buƙatar daidaita sashi saboda cutar koda. Game da aikin hanta mai rauni, daidaita sashi yana da mahimmanci tare da aikin sashin jiki. A lokuta masu tsauri, an soke aikin magani.