Dorotor 20mg Domesco medicine for increased cholesterol (2 blisters x 10 tablets)

Dosage form Box of 2 blisters x 10 tablets
Specifications Atorvastatin
Ingredient High blood fat, high blood cholesterol

Ingredient

Composition information	Content
Atorvastatin	20mg

Uses

Indications

Dorotor 20mg drug is indicated in the following cases:

Treatment of lipid disorders

Atorvastatin is appointed to complementary food therapy to reduce total cholesterol levels and LDL cholesterol, apolipoprotein B (APO B) and triglycerides and to increase HDL-C in plasma hyperplasia patients with primary blood cholesterol and hypertension lipid disorders, hyperlipidemia, blood and hyperlipid family.

Prophylaxis (level I) Cardiovascular complications

In people with hypercholesterolemia, there is no clear clinical manifestation of coronary artery disease, indicating dorotor 20mg combined with eating therapy to reduce the risk of the first severe artery accident (myocardial infarction, unstable angina, coronary regeneration procedure, coronary death or stroke).

Secondary provision (Level II) Cardiovascular complications

In patients with hypercholesterolemia that has clinical manifestations of coronary artery disease, including myocardial infarction and previous angina, dorotor indications for complementary dorotor and eating therapy to reduce the risk of total death, reducing the recurrence of myocardial infarction, stroke or transient ischemic attacks, hospitalized due to blood failure and reducing the risk of coronary artery tricks.

Cardiovascular complications in people with diabetes

Atorvastatin is used to supplement dining therapy to reduce total cholesterol levels and high ldl-cholesterol in serum and reduce the risk of coronary artery accident for the first time or recurring (primary or secondary prophylaxis) in patients with diabetes with or without clinical evidence with coronary artery disease and hyperchemical cholesterol.

Reducing coronary atherosclerosis progression

Atorvastatin is used to complement the diet in hypercholesteroline hypercholesterol with clinical manifestations of coronary artery disease, including previous myocardial infarction, to slow down the process of coronary atherosclerosis.

Pharmacokological

Atorvastatin (found in dorotor 20mg) belongs to a group of blood lipid regulators. Atorvastatin is a competitive inhibitor with hydroxymethylglutaryl coenzyme (HMG - CoA) Reductase, is the HMG -coa -converted catalyst enzyme into Mevalonic Acid, the precursor of cholesterol.

Atorvastatin inhibits HMG-COA Reductase that reduces cholesterol synthesis in the liver and reduces the concentration of cholesterol in the cell. This stimulates increased LDL-cholesterol receptors on the liver cell membrane, thus increasing the clearance of LDL from circulation. Atorvastatin reduces all cholesterol levels, LDL-C and VLDL-C in plasma. The drug also tends to reduce triglycerides and increase HDL-C in plasma.

In addition, Atorvastatin also has anti -atherosclerotic effects. Most have proved to slow down the process of progress and/or retreat atherosclerosis and/or carotid arteries. The current mechanism of action is not fully known, but this effect can be independent of the effect of regulating blood lipids.

Vascular effect: Atorvastatin lower blood pressure in people with hypertension and hyperglycemia. The effect of reducing blood pressure may be associated with the recovery of the endothelial dysfunction caused by Atorvastatin, activating the endothelial oxidation oxidation and reducing plasma Aldosteron concentration.

Anti -inflammatory effects: In people with hypercholesterolemia, with or without coronary artery disease, Atorvastatin may have anti -inflammatory activity. Statin therapy in these patients reduces the CRP plasma (C-Reactive protein) plasma concentrations. CRP levels also decrease in patients with normal cholesterol with high CRP levels before treatment. Effects for CRP levels are not correlated with changing LDL-C levels. Recent studies show that reducing the level of CRP may reduce the risk of relapse or death from coronary artery causes.

Effect for bone: Atorvastatin may increase bone density.

The effect of regulating blood lipids is more corresponding to the dosage than with plasma concentrations.

pharmacokinetic pharmacokinetics

absorption

After drinking, Atorvastatin quickly absorbs and strongly transformed in the liver. Absolute bioavailability of atorvastatin 14%. Time to reach the peak concentration 1 - 2 hours.

Food changes the bioavailability of Atorvastatin after drinking. Food reduces the speed and/or the level of absorption, but due to low reduction, it does not change the clinical change in the effect of regulating blood lipids. The concentration of plasma drugs may be related to day and night, taking Atorvastatin in the evening, causing the peak concentration in plasma and the area under the concentration - time curve (AUC) decreased by 30-60%. Despite reduced bioavailability, Atorvastatin's blood lipid regulation effects in the evening do not change and slightly higher than drinking in the morning.

For the elderly, aged 65 and older, the plasma concentration of Atorvastatin may be higher than the young but does not change the effect of regulating blood lipid.

For mild renal failure (Creatinin 61 - 90 ml/minute clearance): Atorvastatin pharmacokinetics do not change much.

In people with liver failure, Atorvastatin can accumulate in plasma.

Distribution

Atorvastatin is distributed mainly into the liver, partly into tissues (spleen, kidney, adrenal glands). Atorvastatin binds 88 - 99% with plasma proteins, mainly albumin. Atorvastatin can pass the placenta and distribute to breast milk.

Elimination

Atorvastatin is strongly metabolized in the liver due to the microsom cytochrom P450 (CYP) enzyme system, mainly due to isenzyme 3A4 (CYP 3A4). Selling Atorvastatin 14 hours. However, there is no correlation between pharmacokinetic parameters and treatment time (at least 24 hours). Selling waste time in long plasma, Atorvastatin can accumulate in plasma. Atorvastatin is eliminated through urine (2 - 20% of the dose) and fertilizer (60 - 90% of the dose).

Before taking Dorotor 20mg Domesco medicine for increased cholesterol (2 blisters x 10 tablets)

How to use

Dorotor 20mg drugs are indicated by oral. Can take 1 single dose at any time of the day, at meals or hungry.

drugs for adults.

Dosage

start dose 10mg, once a day. Adjust the dose every 4 weeks, if necessary and if tolerated.

maintenance dose 10mg - 40mg/day. If necessary, the dose can be increased, but not more than 80mg/day.

Note: Patients when taking Atorvastatin combined with the following drugs:

When used in combination with Amiodarone, do not use more than 20mg/day. 10mg, 1 time/day and up to 40mg, 1 time/day. fosamprenavir; (fosamprenavir + ritonavir); (Saquinavir + ritonavir). Especially the reactions are harmful to the muscle system.

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? Due to the strong drug associated with plasma proteins, the hemorrhage does not expect to significantly increase the clearance of Atorvastatin.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when forgetting a dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Dorotor 20mg, you may experience unwanted effects (ADR). Here are unwanted effects when using dorotor 20mg:

Common

diarrhea, constipation, flatulence, abdominal pain, nausea.

muscle disease (combining muscle weakness and increased content of plasma creatin phosphokinase).

skin rash.

Myalgitis, muscle pilot, leading to secondary secondary renal failure due to myoglobinuria.

Other side effects:

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

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

Dorotor medicine 20mg contraindicated in the following cases:

Hypersensitivity to HMG-COA RUDEETASE or any ingredients of the drug.

Liver disease or serum transaminase prolonged without explaining.

Women during pregnancy or lactation.

Caution when using

recommendations to do liver enzyme test before starting statin treatment and in case of clinical indications for testing later. Caution should be used in patients who drink a lot of alcohol and/or have a history of liver disease.

Consider monitoring Creatine 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 and/or drinking lots of alcohol, elderly patients (> 70 years old) with risk factors for muscle patterns, drugs that occur with special patients.

In these cases, the benefits/risks should be considered and clinically monitoring clinically when treated with statin. If the results of CK test> 5 times the upper limit of normal levels, do not start treatment with statin.

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

Only use Atorvastatin for women of reproductive age when they are certainly not pregnant and only in the case of hypercholesteroline blood cholesterol very high without responding to other drugs.

The ability to drive and operate machinery

Be careful when driving and operating machinery due to the side effects of Dorotor 20mg that causes headaches, dizziness, blurred vision, insomnia, weakness. If there are the above symptoms, you should not drive and operate machines.

Pregnancy

Because Atorvastatin reduces cholesterol synthesis and maybe many other substances with biological activity derived from cholesterol, the drug can be harmful to the fetus if used for pregnant women. So contraindicated use of Atorvastatin during pregnancy.

Breastfeeding period

Atorvastatin is distributed into milk. Because the potential has a serious unwanted effect for breastfeeding children, it is contraindicated to use 20mg dorotor in nursing mothers.

Drug interaction

Atorvastatin may increase the effect of warfarin. Prothrombin must be determined before starting to use Atorvastatin and regularly monitoring in the early stages of treatment to ensure no change in prothrombin time.

Bile acid -mounted resins can significantly reduce Atorvastatin's biological capacity when taken. So the time to use these 2 drugs must be apart.

diltiazem: Increases the concentration of Atorvastatin in plasma, at risk of muscle fiber, kidney failure.

Rifampicin reduces Atorvastatin levels when combined.

Increased risk of muscle and muscle disease in patients with combination treatment of Atorvastatin with cyclosporin, erythromycin, otraconazole, ketoconazole (due to inhibition of cytochrom CYP3 A4). When used in combination with amiodarone, do not use more than 20mg/day because it increases the risk of muscle pattern. For patients who have to take a dose of over 20mg/day to be effective for treatment, the doctor can choose another statin.

Increased risk of muscle lesions when using statin simultaneously with gemfibrozil drugs, blood cholesterol fibrat cholesterol, high -dose niacin (> 1g/day), Colchicin.

Avoid simultaneous use and limit of Atorvastatin dosage when used simultaneously with HIV and hepatitis C (HCV) because it can increase the risk of muscle damage, the most serious is muscle pattern, kidney damage leading to kidney failure and may cause death:

Avoid simultaneous use of Atorvastatin with Telaprevir and the form of coordination (tipranavir + ritonavir). simultaneously applied with (darkavir + ritonavir); fosamprenavir; (fosamprenavir + ritonavir); (Saquinavir + ritonavir).

Storage

Leave a cool place, avoid light, temperatures below 30⁰C.

To be out of reach of children.

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