Atorvastatin medicine 20mg TV.Pharm treat hypercholesterol blood, prevent coronary artery events (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Atorvastatin
Ingredient High blood fat, high blood cholesterol

Ingredient

Composition information	Content
Atorvastatin	20mg

Uses

indications

Atorvastatin 20 drugs are indicated in the following cases:

Hyper cholesterol hypertrophy treatment: Atorvastatin is appointed to complementary food therapy to reduce total cholesterol levels and LDL cholesterol in patients with primary hyperchemical hypercholesterol (TuyP IIA and IIB), triglyceride less low.

Primary prophylaxis (level 1) Coronary events: In people with hypercholesterol blood without clinical manifestations of coronary artery, indication of Atorvastatin to:

Reduce the risk of myocardial infarction.

Reduce the risk of tips for regenerating coronary artery.

Reduce the risk of cardiovascular death.

Atherosclerosis: In patients with hypercholesterolemia, clinical manifestations of coronary artery disease, including previous myocardial infarction, indicated atorvastatin to:

Slow the progression of coronary atherosclerosis.

Reduce the risk of acute coronary events.

TIVE2 - Atorvastatin is also indicated to reduce total cholesterol and LDL cholesterol in patients with hypertonic hypertension, supplementing other lipid treatments.

Pharmacology

Atorvastatin is a selective inhibitor and competition for HMG-CoA reducing enzymes, inhibiting the movement of the 3-hydroxy-3-methyl-glutaryl-coenzyme A into Mevalonate, a precursor of sterols, including cholesterol. Cholesterol and triglycerides circulate in blood in the form of lipoprotein molecules. These molecules are divided into high molecular weight lipoprotein (HDL), medium molecular weight lipoprotein (IDL), low molecular weight lipoprotein (LDL) and Lipoprotein very low molecular weight (VLDL). Triglycerides and cholesterol combined into VLDL in the liver. From the liver they are released into plasma to go to peripheral tissues, LDL is formed from VLDL and degenerated mainly through LDL receptors. Clinical and pathological studies have shown that increased cholesterol levels, LDL cholesterol and apolipoprotein B (APO B) in the blood increases the process of atherosclerosis and increases the risk factors for cardiovascular disease, while increasing HDL cholesterol reduces cardiovascular disease.

Atorvastatin reduces total cholesterol, LDL cholesterol and apoprotein B in patients with hypercholesterol blood cholesterol and heterozygous, hyperplasia and mixed blood lipids. It also reduces VLDL cholesterol and triglycerides and increases HDL cholesterol, Apolipoprotein A-1. Atorvastatin reduces total cholesterol, LDL cholesterol, VLDL cholesterol, apolipoprotein B, triglycerides, and non -HDL cholesterol and HDL cholesterol hyperplasia in patients with hyperlly triglycerides are simple. It reduces the average density cholesterol (IDL cholesterol) in patients with blood lipoprotein metabolism disorders. The effectiveness of Atorvastatin on the death rate and cardiovascular events have not been set up.

Pharmacokinetics

absorption

Atorvastatin absorbs rapidly after drinking, the maximum concentration in plasma is achieved after 1-2 hours. Atorvastatin absorption level increases corresponding to the dose. Atorvastatin's bioavailability is about 14% and the whole body of the body inhibits HMG-CAA reducing enzymes is about 30%.

Distribution

The distribution of Atorvastatin is about 381 liters. More than 98% Atorvastatin is attached to plasma proteins. The ratio of plasma blood is about 0.25 indicates that the drug is soaked into red blood cells. Based on mice observations, Atorvastatin may eliminate milk.

Metabolism

Atorvastatin metabolizes mainly into hydroxylation derivatives at Ortho and Para positions and even oxidized products at beta.

Elimination

Atorvastatin and its metabolites are excreted mainly into bile after the metabolism through the liver and/or outside the liver. However, the drug does not go through the intestinal cycle. Atorvastatin's sale time is about 14 hours, but the sale time of HMG -CAA reducing enzymes inhibits about 20-30 hours due to the main metabolites of Atorvastatin. Under 2% Atorvastatin oral and found in urine.

Before taking Atorvastatin medicine 20mg TV.Pharm treat hypercholesterol blood, prevent coronary artery events (3 blisters x 10 tablets)

How to use

Atorvastatin 20mg oral medicine.

Dosage

recommendation to start treatment with the lowest dose that the drug works, then if necessary, can adjust the dose according to the needs and response of each person by increasing the dose each spaces for no less than 4 weeks and must monitor the harmful reactions of the drug, especially the harmful reactions to the muscle system. Atorvastatin when used in combination with Amiodaron: Do not use more than 20 mg/day.

Initial dose: 10 mg/day. The dose can be adjusted (if necessary) after 4 weeks of treatment.

Maintenance dose: 10 - 40 mg/day. The dose may be increased but not more than 80 mg/day.

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 do

do when overdose? In case of overdose, patients need to be treated with symptoms, and use other necessary supportive measures to maintain living functions. Because most of the drug is associated with plasma proteins, the hemorrhage is almost not increasing the elimination of Atorvastatin from the body.

What to do when you forget 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 Atorvastatin 20mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Digestive: diarrhea, constipation, flatulence, abdominal pain and nausea.

Central nerve: headache, dizziness, blurred vision, insomnia, weakness.

Neuros - muscle and bone: muscle pain, joint pain.

Liver: Hyper enzyme.

Uncommon, 1/1000

Neurological - muscle and bone: muscle disease (combining muscle weakness and increased content of plasma creatinine phosphokinase - CPK).

DA: Ban Da.

Respiratory: rhinitis, sinusitis, sore throat, cough.

Rare, ADR

Neuros - muscles and bones: muscle inflammation, muscle pilot, leading to secondary acute renal failure due to myoglobinuria.

Metabolism: hyperglycemia, HBA1C.

Neurological: Cognitive decline (such as memory loss, confusion).

Instructions on how to handle ADR

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

Atorvastatin medicine 20mg contraindicated in the following cases:

Sensitive to any ingredients of the drug.

Progressive liver and liver disease has an increase in prolonged serum transaminase concentration.

Pregnant women, nursing women.

Itraconazole antifungal drugs, ketoconazol, fibrat drug groups, gemfibrozil, high -dose niacin (> 1 g/day), colchicin.

Caution when using

It is necessary to consider when using Atorvastatin for patients with risk factors leading to muscle damage. Atorvastatin is at risk of harmful reactions to muscle systems such as muscle atrophy, muscleitis, especially for patients with risk factors such as patients over 65 years old, patients with unproven thyroid diseases, patients with kidney disease. Need to closely monitor the harmful reactions during drug use.

Before treatment with Atorvastatin must eliminate the causes of blood cholesterol due to: underdogy -controlled diabetes, blood protein disorders, biliary liver disease, due to some other drugs, alcoholism.

Must conduct quantitative cholesterol, LDL cholesterol, HDL cholesterol and triglyceride.

Must conduct periodic lipid quantification, with a distance of less than 4 weeks, and adjust the dosage according to the patient's response to the drug.

It is necessary to conduct liver enzyme tests before starting atorvastatin treatment and in case of clinical indications for testing 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 Atorvastatin or previous fibrat, a history of liver disease and/or drinking alcohol, elderly patients (> 70 years old) with risk factors for medication and some patients. In these cases, the benefits/risks should be considered and monitor patients clinically when treated with Atorvastatin. If CK test results> 5 times the upper limit of normal levels, do not start treatment with atorvastatin.

During Atorvastatin treatment, patients need to notify when there are muscle manifestations such as muscle pain, stiff muscle, muscle weakness, ... When these manifestations, patients need to test CK to take appropriate interventions.

Patients with Transaminase Alat or ASAT increases should be monitored until the resolving abnormalities, if the concentration increases to 3 times the limit above the normal level is required to stop treatment.

Be cautious when taking medicine for patients to drink a lot of alcohol or a history of liver disease.

Need to stop or terminate Atorvastatin treatment when the patient has severe acute symptoms of muscle disease or risk factors leading to the development of secondary renal failure into globulin ureter (severe infections, hypotension, surgery, damage, hormonal disorders, endocrine and severe metabolism, uncontrolled epilepsy).

The ability to drive and operate machinery

Because the drug is likely to cause dizziness, it is necessary to use carefully for the driver and operate machinery.

pregnancy

is not used.

The period of breastfeeding

is not used.

Drug interaction

use Atorvastatin along with enzyme inhibitors CYP3A4 can increase the concentration of Atorvastatin in plasma, leading to increased risk of muscle and muscle disease. Atorvastatin when used in combination with amiodaron, should not be used more than 20 mg/day because it increases the risk of muscle pattern. For patients who have to take a dose of over 20 mg/day to be effective for treatment, the doctor may choose another statin (such as pravastatin).

Increased risk of muscle damage when using Atorvastatin simultaneously with the following drugs: Gemfibrozil; other fibrat blood cholesterol medications; High doses (> 1 g/day); Colchicin.

Avoid simultaneous use of Atorvastatin with oral epidemics used orally containing magnesi, aluminum hydroxyd and cholestyramin due to reducing the level of Atorvastatin in plasma.

The concentration of Atorvastatin in plasma will increase when used simultaneously with digoxin, erythromycin or clarithromicin.

Be cautious when using Atorvastatin with birth control pills containing norethindron, Ethinyl estradiol will increase the effects of norethindron, ethinyl estradiol.

Simultaneous use of Atorvastatin with HIV and hepatitis C (HCV) can increase the risk of muscle damage, the most seriousness is muscle pattern, kidney damage leading to kidney failure and can be fatal.

Storage

Store in a dry place, not more than 30 ° C, avoid light.

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