Atorvastatin 10mg khapharco drugs for total cholesterol treatment, LDL - cholesterol (10 blisters x 10 tablets)

Atorvastatin reduces the strongest LDL cholesterol (25 - 61 %) compared to any drug used alone, and proved prospects for patients who need to reduce cholesterol, which is now only achieved when combined with drugs. Atorvastatin increases HDL cholesterol levels (high density lipoprotein) from 5-15 % and thus damaging LDL/HDL ratios and total/HDL cholesterol. 10-30 % by increasing the clearance of VLDL (Lipoprotein very low density) residual by LDL receptor.

In clinical studies, evidence suggests that statins significantly reduce coronary artery events, all cardiovascular events have existed and reduce the total number of deaths in people with coronary artery disease.

pharmacokinetic

absorption

Atorvastatin is quickly absorbed after oral, the maximum plasma drug concentration is achieved within 1-2 hours. The level of absorption and concentration of Atorvastatin increases proportional to the dosage of Atorvastatin. Atorvastatin should have a biological capacity of 95 - 99% compared to the solution. Atorvastatin's absolute biological comfort is about 14% and the system of systemicity of HMG - COA is about 30%.

Low -body comfort is due to purification in the gastrointestinal mucosa or first metabolism in the liver. Although the food reduces the speed and level of about 25% when it is rated by CMAX and about 9% when assessed by AUC, the reduction of LDL - C is unchanged when Atorvastatin is taken at the same time as food or not. A plasma Atorvastatin concentration after taking the evening in the evening is lower in the morning when used in the morning (about 30% for CMAX and AUC).

distribution

The average distribution of Atorvastatin is about 381 liters. Over 98% of Atorvastatin is connected to plasma proteins. The ratio of plasma red blood cells is approximately 0.25%, showing the permeability into low red blood cells.

transformation

Atorvastatin is converted mainly into hydroxy derivatives at Ortho and Para positions and oxidant products at Beta. About 70% of plasma inhibitors of HMG - COA enzymes are due to active metabolites.

Elimination

Atorvastatin and its metabolites are excreted mainly over the back of the metabolism in the liver or outside the liver. However, the drug does not go through the gut liver cycle. Atorvastatin's average plasma cancellation time in humans is about 14 hours, but half of the time of HMG - CoA reducing enzyme inhibits is 10-20 hours due to the contribution of active metabolites. Under 2% of the oral atorvastatin is found in the urine.

Notify the physician the unwanted effects when using the drug.

Precautions when used

Before the first reincarnation with statin, it is necessary to determine the cause of blood cholesterol and quantify lipid indicators to determine the treatment dose. Periodic lipid quantification must be conducted, with a distance of less than 4 weeks and adjust the dosage according to the patient's response to the drug.

Need to use caution in patients with alcohol and/or a history of liver disease. The liver enzyme test should be conducted before starting statin treatment and in case of clinical indications require torn tiring later.

Consider monitoring Creatin Kinase (CK) in the case:

Before treatment, CK tests should be conducted in the following cases: impaired renal function, hypothyroidism, self -history or family history of genetic muscle disease, a history of muscle disease due to the use of statin or fibrat before, a history of liver disease or drinking a lot of alcohol, elderly patients (> 70 years old) with risk factors for muscle patterns, drugs and some special patients.

In these cases, the benefits/risks should be considered and monitor patients clinically when treated with statin. If CK test results> 8 times the upper limit of normal levels, do not start statin treatment.

During statin treatment, patients need to notify when there are muscle manifestations such as muscle pain, muscle stiffness, muscle weakness ... When there are these manifestations, the patient needs to consider CK to take appropriate interventions.

Statin therapy is likely to cause muscle and muscle pattern, so it is necessary to reduce the dose or stop treatment in patients with a condition that suggests muscleitis (muscle aches, muscle weakness, increased cretine phosphokinase to more than 10 times compared to the upper limit of normal level) or there are risk factors leading to the development of secondary kidney failure into Myoglobulin.

Use drugs for women during pregnancy and lactation

Pregnancy

States reduce cholesterol synthesis and maybe many other substances with biological activity derived from cholesterol so the drug can be harmful to the fetus. Contraindicated use of statin during pregnancy.

Breastfeeding period

Statin is distributed into breast milk. Due to the serious unwanted potential for breastfeeding children should be contraindicated to use statin in breastfeeding women.

The effect of the drug on driving and operating machinery

Atorvastatin does not affect or negligible on the ability to drive and operate machinery, should be used for drivers and operating machinery.

Drug interaction

Atorvastatin combination treatment with cyclosporin, erythromycin, ketoconazole, increases the risk of muscle and muscle pattern.

Atorvastatin increases the risk of anticoagulants Warfarin.

Antacids, cholestyramine reduces the level of Atorvastatin in plasma.

Increased risk of muscle damage when using statin simultaneously with the following drugs: Gemfibrozil, other fibrat blood cholesterol medications, high -dose niacin (> 1 g/day), Colchicin.

Concomitance the use of clinical lipid medications with HIV and hepatitis C (HCV) can increase the risk of muscle damage, the most serious muscle, kidney damage leads to kidney failure and may cause death.

Avoid using Atorvastatin with: Tipranavir + Ritonavir, Telaprevir.

Use carefully and if necessary, the lowest dose of Atorvastatin should be used with: lopinavir + ritonavir.

Do not use more than 20 mg atorvastatin/day with: Darunavir + Ritonavir, Fosamprenavir, Fosamprenir + Ritonavir, Saquinavir + Ritonavir.

Do not use more than 40 mg atorvastatin/day with: nelfinavir.