Lipotatin 10mg Mebiphar medicine for total cholesterol treatment (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Atorvastatin

Ingredient

Composition information	Content
Atorvastatin	10mg

Uses

indications

Lipotatin 10 mg is indicated in the following cases:

Supports the diet in the treatment of total cholesterol hypertrophy, LDL-Cholesterol, Apolipoprotein B, triglycerides, mixed blood lipid disorders (ILA and ILB groups according to Fredrickson classifications), hyper triglyceride blood, Beta-lipoprotein disorders and HDL-Chinese HDL-Chinese HDL hypercasses Original blood cholesterol (heterozygous and non -family family). HMG-CAA Painting and selection, inhibiting the movement of 3-hydroxy-3-methylsutarianl-coenzyme A into Meovalonate, a precursor of sterol, including cholesterol. Atorvastatin reduces lipoprotein and plasma cholesterol by inhibiting HMG-CAA reducing enzymes, inhibiting the synthesis of cholesterol in the liver and increasing the number of LDL receptors in the liver on the cell surface to increase the removal and degrading LDL.

Atorvastatin reduces the production of LDL and LDL particles in patients with family cholesterol hypertension, significantly increases the activity of LDL receptors and benefits on the properties of circulating LDL particles.

Pharmacokinetics

absorption

The drug is absorbed quickly after oral, increasing in proportional to the dose of Atorvastatin. The maximum plasma drug concentration is achieved within 1–2 hours. Absolute bioavailability of Atorvastatin is about 14% and the system of systemic inhibitors inhibits HMG-CAA reducing enzymes about 30%.

Food reduces the speed and absorption level of about 25% when rated by CMAX, about 9% when assessed by AUC, but the reduction of LDL-C is constant when the drug is taken at the same time as the food. Plasma Atorvastatin concentration after morning medication is higher than the evening (about 30% for CMAX and AUC), but the effect is constant.

Distribution

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

Metabolism

Atorvastatin metabolizes mainly into hydroxylation derivatives in the Ortho, Para position and oxide products at the beta position. About 70% of the plasma inhibitors of HMG-COA reducing enzymes are due to active metabolites. Research shows the importance of Atorvastatin metabolized by Cytochrome P450 3A4 in the liver, suitable for the concentration of the drug in plasma increased in humans after use simultaneously with erythromycin.

Elimination

Atorvastatin and metabolites are except for bile mainly, but the drug does not pass through the gut liver cycle. The half-life of the drug in the average plasma in humans is about 14 hours, but half of the time of HMG-CoA reducing enzyme inhibitors is 10–20 hours. The amount of Atorvastatin is eliminated in urine about

Before taking Lipotatin 10mg Mebiphar medicine for total cholesterol treatment (3 blisters x 10 tablets)

How to use

oral medication.

This drug is only used by a doctor.

Before conducting treatment and during the treatment period, the patient needs to follow a reasonable diet.

Dosage

Hyper cholesterol (heterozygous and non -family family) and mixed blood lipid disorders (LLA and ILB groups according to Fredrickson classification):

Starting dose: Take 1-2 capsules 1 time/day.

Treatment dose: Take 1-8 capsules 1 time/day. Dosage needs to be adjusted specifically based on the characteristics of each patient.

Patients need to reduce LDL cholesterol (over 45%): Take 4 capsules/time/day.

Hypertly cholesterol hyperliper:

Take 1-8 capsules/day. At the same time coordinate with other lipid measures.

Coordinate treatment can be combined with resin to increase the effectiveness of treatment. Do not combine treatment between HMG-CAA reducing enzyme inhibitors and fibrate groups.

Note: When used in combination with amiodarone, do not use more than 2 tablets/day.

Recommendation: It is advisable to start treating 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 of each time spaced no less than 4 weeks and monitoring the harmful reactions of the drug, especially the harmful reactions to the muscle system.

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

When used with Darunavir + Ritonavir, Fosamprenavir, Fosamprenavir + Ritonavir, Saquinavir + Ritonavir, Atorvastatin dose not more than 20 mg/day.

When used with nelfinavir: not more than 40 mg atorvastatin/day.

When patients share Atorvastatin with other drugs, the dose is adjusted as the following recommendations: Used with cyclosporin, up to 10 mg/day; Used with clarithromycin, starting 10 mg/day, up to 20 mg/day; Used with Itraconazole, starting 10 mg/day, maximum 40 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 using overdose? Due to the drug associated with strong plasma proteins, when the hemorrhage is absorbing, the disposal of Atorvastatin is not significant.

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 10 mg lipotatin, you may experience unwanted effects (ADR).

In clinical trials, only less than 2% of patients have to stop the drug due to side effects.

About 1% of the most common adverse effects: constipation, flatulence, indigestion, abdominal pain, headache, nausea, muscle pain, fatigue, diarrhea, insomnia.

Side effects have been reported:

Vascular nerve edema, cramps, muscle inflammation, abnormalities, peripheral neuropathy, hepatitis, anorexia, vomiting.

Cognitive decline (memory loss, confusion, ...), hyperglycemia, HBA1C.

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

10 mg lipotatin drugs in the following cases:

Hypersensitivity to Atorvastatin or any ingredients of the drug.

The liver disease is progressing or there is an unexplained increase of serum transaminase exceeding 3 times on the normal level.

Pregnant and lactating women or suspicion of pregnancy.

Avoid using Atorvastatin while using Tipranavir + Ritonavir, Telaprevir.

Be cautious when used

It is necessary to consider when taking the statin group for patients with risk factors leading to muscle damage. The drug in the statin group is at risk of causing harmful reactions to the muscle system such as muscle atrophy, muscle inflammation, especially for patients with risk factors such as patients over 65 years old, patients with untreated thyroid diseases, patients with kidney disease. Need to closely monitor the harmful reactions during drug use.

Use carefully and if necessary, the lowest dose of Atorvastatin should be used when used with combination of Lopinavir + Ritonavir.

Effects on the liver: Atorvastatin can cause increased creatinine phosphokinase and transaminase. Atorvastatin should be reduced or stop using Atorvastatin when ALT or AST increases more than 3 times on a persistent normal level. Be cautious when used in patients drinking alcohol, with a history of liver disease.

Do not use Atorvastatin for liver disease that is progressing or increasing persistent transaminase. Do liver enzyme test before starting statin treatment and in case of clinical indications for testing later.

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 diseases, a history of muscle disease due to statin or fibrate before, a history of liver disease and/or drinking lots of alcohol, elderly patients (> 70 years old) have risk factors for muscle pattern, special possibility of drug interactions and some special patients. In these cases, risk benefits should be considered and monitor patients clinically when treated with statin. If CK test results> 5 times limited to normal levels should not start statin treatment.

During the treatment with Atorvastatin will cause muscle pain, muscle or element, accompanied by increased creatine phosphokinase (CPK)> 10 times the upper limit of normal levels, so it must be reported to the doctor immediately when there are these phenomena. Should stop treatment with Atorvastatin if CPK increases significantly or suspects muscle disease.

Patients with severe and acute scenes, at risk of muscle inflammation or factors that easily develop into secondary renal failure (such as severe acute infections, hypotension, surgery, trauma, severe metabolic disorders, electrolyte disorders, endocrine disorders, uncontrolled epilepsy). Should temporarily reduce the dose or stop treatment.

Children: When taking medication for 8 young patients with hypercholesteroline hypercholesterol, homosexuality is limited to the dose of up to 80 mg/ day, showing no clinical or biochemical results

The ability to drive and operate machinery

Caution when used for drivers and operating machinery.

Pregnancy

Do not use Atorvastatin for pregnant women, suspicion of pregnancy, or if possible pregnancy, should take effective contraceptive pills.

The period of breastfeeding

There is no document on whether or not the drug is excreted through breast milk or not, but due to the ability to cause adverse reactions to breastfeeding. So women who are taking drugs should not be breastfeeding.

Drug interaction

cyclosporin, Fibel acid derivatives, erythromycin, antifungal group Azole or Niacin: increase muscle disease when used simultaneously with Atorvastatin or Statin groups.

Antacid: Atorvastatin concentration in plasma will decrease by about 35% when used simultaneously with oral epidemic orally containing magnesium and aluminum hydroxide.

cholestyramine: Atorvastatin concentration in plasma decreased by about 25%, but the effectiveness of treatment on blood lipids is higher, when used simultaneously with cholestyramine.

Digoxin: Plasma digoxin concentrations are in a stable state will increase to nearly 20%. Need to monitor patients who are using digoxin.

erythromycin: Increased Atorvastatin levels in plasma (40%).

Oral contraceptive pills: Concomitance with oral contraceptive pills containing norethindrone and ethinyl estradiol will increase the AUC of Norethindrone and of Ethinyl estradiol nearly 20%.

The sharing of CYP3A4 enzyme inhibitors may increase the concentration of the drug in plasma, leading to an increased risk of muscle and muscle disease. When used in combination with amiodarone, do not use 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 simultaneously statin with the following drugs: gemfibrozil, other fibrate blood cholesterol medications, high -dose niacin (> 1 g/day), colchicine.

Concomplifying the use of statin lipid medications with HIV and hepatitis C (HCV) can increase the risk of muscle damage, the most serious muscle, kidney damage, leading to kidney failure and may be fatal.

Avoid using Atorvastatin with tipranavir + ritonavir, telaprevir. Use carefully and if necessary should use the lowest atorvastatin dose when used with Lopinavir + Ritonavir,

Use no more than 20 mg Atorvastatin when used with Darunavir + Ritonavir, Fosamprenavir, Fosamprenavir + Ritonavir, Saquinavir Ritonavir.

Use no more than 40 mg/day atorvastatin when using nelfinavir socks.

Storage

Store in a dry place, avoid light, temperature not exceeding 30 ° C.

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