Lipistad 10 STADA treatment for cholesterol and IIPID mixed blood (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Atorvastatin

Ingredient

Composition information	Content
Atorvastatin	10mg

Uses

Indications

Lipistad 10mg Stada 3x10 is indicated in the following cases:

Reduce LDL - Cholesterol, Apolipoprotein B and Triglyceride, HDL - Cholesterol Increasing HDL in the treatment of hyperuremia, including cholesterol hypercacting and IIPID hypermath of mixed blood (hyperlote ty blood lipoprotein IIA or IIB), hypermens of blood triglyceride (type IV) and betalipoprotein disorders.

Support treatment for patients with hyperchemical hyperchemical hypertension, the function of some LDL receptors still remains. 3-Hydroxy-3-Methylglutaryl-Coenzyme A into Mevalonate, precursor of cholesterol. Atorvastatin as well as some of its metabolites have pharmacological activity in humans. The liver is the first place to act and is the main place to synthesize cholesterol and LDL clearance. The decrease in LDL-C is more correlated with the dose of the drug rather than the drug concentration in the body. Dosage in each individual should be based on therapeutic response.

pharmacokinetic

absorption

Atorvastatin is quickly absorbed through the gastrointestinal tract, the peak concentration in plasma is in 1-2 hours. The drug has absolute bioavailability of about 12% due to initial clearance in the gastrointestinal mucosa and/or first metabolism in the liver.

Distribution

98% linked drugs with plasma proteins.

Metabolism

Atorvastatin is metabolized through Cytochrom P450 ISOENZYM CYP3A4 into some active metabolites. The average selling time in Atorvastatin's plasma is about 14 hours but the sale time of HMG -CoA Reductase inhibitors is about 20-30 hours due to the contribution of active metabolites.

Elimination

Atorvastatin is mainly excreted in the bile in the form of metabolites.

Before taking Lipistad 10 STADA treatment for cholesterol and IIPID mixed blood (3 blisters x 10 tablets)

How to use

Lipistad 10 is taken once a day, regardless of the meal.

Patients should have a standard diet to reduce cholesterol before taking Atorvastatin and should maintain this regime during treatment with the drug.

Dosage

Atorvastatin's common starting dose in adults to control primary hypercholesterol hypercectomy (with or without heterozygous family) and mixed lipid disorders of 10mg or 20mg x 1 time/day. Patients need to reduce LDL - cholesterol more than 45% to achieve the goal should start at a dose of 40mg daily. The usual maintenance dose of Atorvastatin in adults from 10 - 80mg x 1 time/day.

Atorvastatin starting dose recommends that the treatment of hypercholesteroline blood cholesterol is heterosexual in girls after puberty and boys from 10 years and older is 10mg x 1 time/day; The maximum recommendation is 20mg per day.

The usual dose of Atorvastatin to control hypercholesterolemia has a homozygous family of 10 - 80mg x 1 time/day. The drug is also used to support other lipid therapies (such as plasma LDL filtration) or when these therapy cannot be applied.

Atorvastatin's dose should be calibrated by no less than 4 weeks apart, until the desired lipoprotein concentration is reached. Atorvastatin dose reduction in patients with serum cholesterol levels decreased below the required limit.

Should reduce the dose of Atorvastatin for patients who are taking drugs interacting with Atorvastatin as follows:

Amiodaron: Do not use more than 20mg atorvastatin/day.

ciclosporin: Maximum dose 10mg x 1 time/day.

Clarithromycin: The starting dose of 10mg x 1 time/day, a maximum dose of 20mg x 1 time/day.

iTraconazole: starting dose 10mg x 1 time/day, maximum dose 40mg x 1 time/day.

tipranavir + ritonavir, telaprevir: Avoid using atorvastatin.

Lopinavir + Ritonavir: Use caution and use the lowest atorvastatin dose necessary.

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

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

Renal failure: Because Atorvastatin is insignificant through the kidney, there is no need to adjust the dose in patients with renal impairment.

Hepatic failure: Because Atorvastatin is metabolized mainly through the liver and is able to accumulate in plasma in patients with liver failure, caution should be used for patients who drink plenty of alcohol and/or have a history of liver disease, closely monitor these patients while treating with Atorvastatin.

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 using overdose? In case of overdose, symptomatic treatment and necessary support measures. Because the drug is strongly connected to plasma proteins, the hemorrhage does not significantly increase the clearance of Atorvastatin.

What to do when forgetting 1 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 Lipistad 10mg Stada 3X10, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Digestive: constipation, flatulence, indigestion and abdominal pain.

Instructions on how to handle ADR

The ability to have unwanted effects is generally not serious and can recover such as memory loss, confusion, hyperglycemia, HBA1C increase. When encountering 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

Lipistad 10mg Stada 3X10 contraindicated in the following cases:

Patients with hypersensitivity to any ingredients of the drug.

Be cautious when using

before using Atorvastatin should try to control hyperchemical hypertension with appropriate diet, exercise and lose weight for obese patients and treat other diseases.

Should conduct liver enzyme test before starting treatment with statin and in case of clinical indications for testing later.

Consider monitoring Creatin Kinase (CK):

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 statin or fibrat before, a history of liver disease and/or drinking lots of alcohol, elderly patients (> 70 years old) have risk factors for medication, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drugs, such as drug concentrations Special patient. In these cases, the benefits/risks should be considered and monitor patients clinically when treated with statin. If CK test results> 5 times the upper limit of normal levels, do not start treatment with statin.

The risk of muscle pattern increases when using atorvastatin simultaneously with drugs that increase the level of Atorvastatin in plasma such as strong CYP3A4 inhibitors or protein inhibitors.

Atorvastatin treatment should temporarily stop or stop treatment in any patient with acute and severe illness, which suggested that muscle disease or patients with risk factors for progressive to secondary renal failure due to muscle panasia (such as severe acute infection, hypotension, surgery, trauma, hormonal disorders, endocrine and heavy electrolytes, uncontrolled epilepsy).

Safety and effectiveness of Atorvastatin in children who have not puberty or under 10 years old have not been evaluated.

The ability to drive and operate machinery

The drug affects negligible on the ability to drive and operate machinery.

Pregnancy

contraindicated atorvastatin for pregnant women. Atorvastatin should only be used for women who are giving birth age when they are definitely not pregnant. If the patient is pregnant while taking the medication, he should stop taking the drug and give the patient about the danger that can occur for the fetus.

Breastfeeding period

It is unclear whether Atorvastatin is distributed into breast milk or not. Because Atorvastatin's ability can cause serious unwanted effects on breastfeeding children are contraindicated for women who are breastfeeding.

Drug interaction

Increased risk of muscle lesions when using statin simultaneously with gemfibrozil, other fibrat blood cholesterol medications, high doses (> 1g/day) and colchicin.

CYP3A4 inhibitors

If possible, avoid simultaneous use with strong CYP3A4 inhibitors (such as ciclosporin, clarithromycin, iTraconazole and HIV's protease inhibitors including ritonavir, lopinavir, darkavir ...).

In case of simultaneous use with the above drugs, it is advisable to reduce the starting dose and maximum dose of Atorvastatin and recommend the monitoring of patients clinically. Medium CYP3A4 inhibitors (such as erythromycin, diltiazem, verapamil and fluconazole) may increase plasma Atorvastatin levels.

It is necessary to consider reducing the maximum dose of Atorvastatin and recommendation to monitor patients clinically when used simultaneously with medium CYP3A4 inhibitors.

Should follow the appropriate clinical monitoring after starting or adjusting the dose of the inhibitor. The simultaneous use of statin medications with protease inhibitors of HIV or hepatitis C (HCV) may increase the risk of muscle damage. The most serious is the pattern, kidney damage leads to renal failure and can be fatal.

Protein inhibitors carrying

Ciclosporin protein inhibitors (like ciclosporin) may increase the concentration of Atorvastatin. If must be used simultaneously, the dose should be reduced and clinically effectively monitored.

Colestipol

When used simultaneously Colestipol with Atorvastatin reduces about 25% of Atorvastatin concentration in plasma. However, when combining Atorvastatin and Colestipol, LDL-C decreases higher when taking these two drugs individually.

digoxin

When using multi -dose atorvastatin simultaneously with digoxin, the stable plasma concentration of Digoxin increases nearly 20% appropriate monitoring in patients using digoxin.

Oral contraceptives

Simultaneous use of Atorvastatin with oral contraceptives increases the AUC of Norethindron and ethinylelestradiol. This increase should be considered when choosing oral contraceptives for women who are taking Atorvastatin.

warfarin

Atorvastatin does not have a significant clinical effect on prothrombin when used on patients treated with long -term warfarin.

Grapefruit

It is not recommended to simultaneously drink grapefruit and Atorvastatin juice because this combination may increase the risk of unwanted effects.

Storage

In closed packaging. The temperature does not exceed 30 ° C.

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