Atorhasan medicine 20mg reduces cholesterol and triglycerides in the blood (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Atorvastatin
Ingredient High blood cholesterol

Ingredient

Composition information	Content
Atorvastatin	20mg

Uses

Indications

Atorhasan 20 drugs are indicated in the following cases:

Treatment of lipid disorders

Supplementing food therapy in adults and children> 10 -year -old hyperplasine cholesterol and cholesterol and mixed blood lipid disorders, hypercholesterolemia of heterozygous family and hyperglyceride.

Atorvastatin is also indicated to reduce total cholesterol and LDL - cholesterol in adults adults hyperchemical hematoma from homozygous family, supplementing other treatments for hypog and lipids.

Provisions of cardiovascular events

In adults, there is no clinical manifestation of coronary heart disease, there are many risk factors for coronary heart disease (such as age, smoking, hypertension, low HDLCHOLesterol, a family with a history of coronary heart disease), Atorvastatin combined with eating therapy to reduce the risk of myocardial infarction, stroke, and a trick to regenerate coronary artery and lumbarity.

In patients with type 2 diabetes, there is no clinical manifestation of coronary heart disease but there are many risk factors for coronary heart disease (such as retinopathy, albuminuria, smoking, hypertension), Atorvastatin combined with eating therapy to reduce the risk of myocardial infarction and stroke.

In patients with clinical manifestations of coronary heart disease, Atorvastatin combined with eating therapy to cut down the risk of non -death myocardial infarction, stroke from death or non -death stroke, must conduct coronary regeneration procedure, angina and reduce the risk of hospitalization due to congestive heart failure.

Pharmacokological

Atorvastatin belongs to a group of blood lipid regulating drugs. Atorvastatin is also known as HMG - Coa Reductase inhibitors, because of the competitive inhibitor with HMG - CoA Reductase, is the HMG - COA enzyme into Mevalonic Acid, an early precursor of cholesterol.

HMG inhibitor - CoA Reductase reduces cholesterol synthesis in the liver and reduces cholesterol levels in cells. This stimulates increased LDLolesterol receptors on the liver cell membrane, thus increasing LDL clearance from circulation. Atorvastatin reduces the whole cholesterol level, LDL - cholesterol and VLDLCHOLesterol in plasma. The drug also tends to reduce triglycerides and increase HDL - cholesterol in plasma ...

Most have shown that statin slows down the process of progress and or retreats with coronary artery or ornamental arteries, reduces blood pressure in people with hypertension and increases the first cholesterol, can increase bone density.

Statin also has anti -inflammatory effects, in hypercholesteroline hyperactive people, with or without coronary artery disease, the statin may have anti -inflammatory activity, statin therapy in these patients reducing CRP (C - Reactive Protein) concentration. CRP concentration also decreases in patients with normal cholesterol with high CRP levels before treatment. Recent studies show that reducing the level of CRP may reduce the risk of relapse or death from coronary artery causes.

pharmacokinetic

absorption

After drinking, Atorvastatin quickly absorbed through the gastrointestinal tract. Absolute bioavailability of about 14%. The peak concentration of the drug in plasma is about 1-2 hours after drinking. Food reduces the speed and or absorption level, but due to low reduction, it does not change the important change in clinical effects on the effect of regulating blood lipids.

oral Atorvastatin in the evening makes the peak concentration of the drug in plasma and the area under the curve (AUC) decreased by 30-60%, but the effect of regulating blood lipids does not change and slightly higher than drinking in the morning.

distribution

Atorvastatin is allocated mainly in the liver and can be distributed in external tissues such as spleen, kidney, adrenal glands. Link about 98% with plasma proteins, mainly albumin. The distribution of Atorvastatin is about 381 liters.

transformation

Atorvastatin metabolizes the first time in the liver. The drug is metabolized mainly by the microsom cytochrom P450 enzyme system, mainly by isenzyme 3A4 (CYP3A4) into an active form.

Elimination

Atorvastatin is eliminated mostly through feces, less than 2% of the dose is eliminated through urine. Selling time for plasma is about 14 hours.

Pharmacokinetics on special clinical subjects

Elderly

Atorvastatin plasma concentrations and active metabolites in healthy elderly people are higher in young people, but the effect on blood lipid is similar to young people.

Children

Research in children 6 - 17 years old increases heterozygous family blood cholesterol and has LDL - cholesterol ≥ 4mmol/l concentration that is treated with Atorvastatin 5 - 20mg/day. The mass of the body is meaningful to the pharmacokinetics of Atorvastatin. Atorvastatin's apparent clearance in children is similar in adults with the corresponding weight. The level of total cholesterol, LDL - cholesterol consistent according to Atorvastatin concentration into hydroxyatorvastatin.

Gender

There is a difference between Atorvastatin and the metabolites are active in women and men (women with C value is 20% higher and 10% lower AUC value than men). However, this difference does not lead to a significant change in the effectiveness of clinical drugs.

kidney failure

Renal failure does not affect plasma concentrations or effectiveness on Atorvastatin's blood lipids and metabolites ...

Hepatic failure

Atorvastatin plasma concentrations and significant metabolites increase (AUC value increased by 16 times and C increased 11 times) in people with chronic alcoholic liver disease (Child Pugh B).

polemib1 polymorphism

The receiving in the liver of HMG - CoA Reductase inhibitors including Atorvastatin is related to Oatib. In a patient with a Slocib1 -shaped form, there is an increased risk of atorvastatin level and can lead to muscle pattern.

polymorphism in CATPIB1 encryption gene (SLCO1B1C.521cc) increases 2.4 times the AUC value of Atorvastatin compared to a group of patients without changing genes (C.521TT). The reduction of the receiver of Atorvastatin in the liver can also occur in these patients. The effects on the effectiveness of treatment have not been determined.

Before taking Atorhasan medicine 20mg reduces cholesterol and triglycerides in the blood (10 blisters x 10 tablets)

How to use

Take medicine with water, can use the drug at any time of the day, during meals or outside meals. However, you should fix the daily medication time. Atorhasan 20 pills are not designed to double, so do not double the tablet to take 10 mg/time/day.

In case you are using other drugs that reduce cholesterol containing cholestyramin or colestipol, should take Atorhasan 20 after 2 hours when taking the above drugs.

Dosage

The starting dose is usually 10mg/time/day in adults and children 10 years of age and older. Your doctor may increase the dose for you to achieve the best treatment effect, the dose adjustment time is usually at least every 4 weeks.Maximum dose is 80mg/time/day in adults and 20mg/time/day for children.

Do not use Atorhasan 20 if you are using drugs containing cyclosporin, tipranavir + ritonavir and telaprevir.

Atorhasan 20 dose should not exceed 20mg/day (1 tablet) when combining drugs containing clarithromycin, iTraconazole, Darunavir + ritonavir, fosamprenavir, fosamprenavir + ritonavir, saquinavir + ritonavir.

Atorhasan 20 dose must not exceed 40mg/day (2 tablets/day) when combining drugs containing Nelfinavir, BoCeprevir.

Notify your doctor if you have liver, kidney or medication diseases that contain a combination of Lopinavir + Ritonavir because your doctor may need to adjust the dose in these cases.

Atorhasan 20 is not used in people with progressive liver disease.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? Bring the remaining packaging of the drug so that the doctor can know for sure which drug you have used.

What to do when forgetting a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Atorhasan 20mg, you may experience unwanted effects (ADR).

Rare (can affect 1 - 10 people in 100,000 people):

Serious allergic reactions include swelling of the face, tongue, throat and causing shortness of breath.

Serious skin reactions such as swelling, peeling, blistering, mouth, eyes, genitalia accompanied by fever. The rash on the palm or the blistering feet.

muscle weakness, muscle pain. If the above symptoms are accompanied by high fever, weakness, it may be a sign of muscle necrosis, often prolonged despite being stopped or may be life -threatening and causing kidney damage.

bleeding or abnormal bruises, may be a sign of liver disease.

Other unwanted effects

Common (can affect 1- 10 people in 100 people)

rhinitis, sore throat, nosebleeds, allergic reactions, increased blood sugar, increased creatin kinase, headache, nausea, constipation, flatulence, indigestion, diarrhea, muscle pain, joint pain, back pain, abnormal liver function test results.

Anorexia, weight gain, hypoglycemia, nightmares, insomnia, dizziness, numbness in your fingers and toes, reducing sensation, changing taste, memory impairment, blur, tinnitus, vomiting, belching, upper abdominal pain and lower abdominal pain, pancreatitis, hepatitis, skin rash, itching, urticaria, hair loss, muscle pain, fatigue, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever, fever Calculate.

Visual, bleeding or abnormal bruises, biliary obstruction (jaundice or yellow eye), tendon lesions.

Allergic reactions include symptoms such as chest pain or sudden shortness of breath, swelling of the eyelids, face, lips, mouth, tongue, throat, fainting, hearing loss, large breasts in men.

weak muscle.

Some unwanted effects in children's studies

Headache, abdominal pain, liver functional testing, increased phosphorus creatinkase (common).

Sexual disorders, depression, interstitial lung disease (shortness of breath, persistent cough, fever), diabetes, cognitive impairment (memory loss, confusion, ...), increase HBA1C.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Atorhasan 20 drugs are contraindicated in the following cases:

allergies to Atorvastatin or any ingredients of the drug.

You are suffering from liver disease.

You have abnormal and unexplained liver function test parameters.

You are using drugs containing cyclosporin, telaprevir, tipranavir + ritonavir.

Women of reproductive age do not use appropriate contraception.

Pregnant or pregnant women.

Lactating women.

Caution when using

Notice to the doctor before treatment if you impaired kidney function, hypothyroidism, a history of yourself or a family history of genetic muscle disease, a history of muscle disease due to the use of statin or fibrat before, the history of liver disease or drinking lots of alcohol, old age (> 70 years old), using drugs in the "drug interaction". Doctors need to conduct blood tests to consider whether you should use the drug or not, avoid unwanted events seriously on the basis.

During the use of the drug, you need to notify the doctor when there are muscle manifestations such as muscle pain, muscle, muscle weakness ...

The doctor needs to take a liver function test before you start using the drug and then if necessary (such as the signs of suggesting liver damage). Notify the doctor if you drink a lot of alcohol or have a history of liver disease.

There have been rare reports on interstitial lung disease in patients using statins, especially for prolonged treatment. The possible symptoms include shortness of breath, they do not sputum, body weakness (fatigue, weight loss, fever). Notify your doctor if you experience the above symptoms when taking the drug.

There is evidence that statin groups increase blood sugar in some patients, increasing risk of diabetes. However, this risk does not lead to stopping treatment for statin for outstanding heart benefits. If you have risk factors for diabetes (hunger, obesity, hyperceride, hypertension should notify the doctor for monitoring.

Atorhasan 20 preparations contain lactose, notify your doctor if you have diseases that do not tolerate some types of sugar (glucose, galactose, ...).

Need to consult a pharmacist in the case:

You have had a stroke of cerebral hemorrhage or cerebral infarction.

Hypothyroidism.

You have experienced repetitive muscle pain or family history suffering from muscle diseases.

You have experienced muscle diseases throughout the treatment process with lipid lowering drugs (Statin or Fibrat drugs).

drink a lot of alcohol.

You have a history of liver disease.

People over 70 years old.

You have severe respiratory failure.

Severe infections.

Hypotension.

undergoing surgery or major injury.

There are abnormalities in metabolism, endocrine, electrolytes.

uncontrolled convulsions.

Having diseases of some sugar intolerance.

Pregnant women, plans to get pregnant, nursing women.

The ability to drive and operate machinery

The drug usually does not affect the ability to work. However, if you experience unwanted effects that affect your ability to work, do not drive, operate machinery, work on high or other cases.

Pregnancy

must not use Atorhasan 20 in pregnant women or possibly pregnancy. Inhibiting cholesterol synthesis can harm the normal development of the fetus. There have been a few reports, although rarely about birth defects after the uterus with similar drugs.

Women of reproductive age should take appropriate contraception during treatment. If you find pregnancy during the use of the drug, it is necessary to stop the medication immediately and notify your doctor. Consult your doctor in case you are pregnant, plan to get pregnant or think you are pregnant.

Breastfeeding period

Not yet determined whether the drug may be secreted into breast milk or not. Because of the risk of unwanted effects in babies, do not use Atorhasan 20 if you are breastfeeding.

Medicinal interaction

drugs to treat diseases of the immune system (cyclosporin).

Antibiotics and antifungal drugs (erythromycin, clarithromycin, telithromycin, ketoconazole, otraconazole, voriconazole, fluconazole, posaconazol, rifampin, rifampicin, fusidic acid).

Other lipid hypertrophic medications (gemfibrozil, Fibrat, Colestipol groups).

Calcium channel blockers treat angina or hypertension (amlodipine, diltiazem, verapamil), pills to treat arrhythmia (amiodaron, digoxin).

HIV treatment (Ritonavir, Lopinavir, Atazanavir, Indinavir, Darunavir, combination of Tipranavir + Ritonavir, ...).

Treatment of hepatitis C (Telaprevir).

Ezetimib (drugs that reduce cholesterol), warfarin (anticoagulant drugs), oral contraceptives, Stiripentol (anti -epileptic drugs), cimetidine (drugs to treat gastrointestinal diseases), phenazon (pain relievers), colchicin (gout treatment drugs), antibiotic (aluminum and magenes), boceprevir (treating drugs. liver like hepatitis c).

Out -of -the -art grapefruit juice can change the effectiveness of Atorhasan 20.

The process of drug interaction can increase the severity of unwanted effects, including muscle and muscle disease.

Storage

Where dry, less than 30 ° C. Avoid light.

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