Mokhoa oa ho sebelisa lithethefatsi Liprimar?

Liprimar e hlahisoa ka mokhoa oa matlapa a koahetsoeng ka koae ea filimi: e tšoeu, e entsoe ka selikalikoe - e tšoeu motheo, e ngotsoe ka mahlakoreng a mabeli ho latela tekanyetso - "10" le "PD 155" / "20" le "PD 156" / " 40 ”le" PD 157 "/" 80 "le" PD 158 "(10 le 20 mg ka ngoe - likhomphutha tse 10.). Lithutsoana, lithutsoana tse 3 le 10 ka lebokoseng la karete ea karete, li-pcs tse 7. mokotla oa lebokose, 40 le 80 mg, e ngoe le e ngoe - li-pcs tse 10. ka marang-rang, lilakane tse 10 mokotleng oa karete, li-PC tse 7. Litlatsetsong, malepa a 2 kapa a 4 ka lebokoseng la karete.

Moetso oa Letlapa le le leng o kenyelletsa:

Motsoako o sebetsang: atorvastatin - 10, 20, 40 kapa 80 mg (ka tsela ea letsoai la calcium),
Lisebelisoa tse thusang: calcium carbonate - 33/66/132/264 mg, microcrystalline cellulose - 60/120/240/480 mg, lactose monohydrate - 32.8 / 65.61 / 131.22 / 262.44 mg, croscarmellose sodium - 9/18/36/72 mg, polysorbate 80 - 0.6 / 1.2 / 2.4 / 4.8 mg, hyprolose - 3/6/12/24 mg, magnesium stearate - 0.75 / 1.5 / 3/6 mg,
Kobo ea lifilimi: Opadry tšoeu YS-1-7040 (hypromellose - 66.12%, polyethylene glycol - 18.9%, titanium dioxide - 13.08%, talc - 1.9%) - 4.47 / 8.94 / 17 , 88 / 35.76 mg, emulsion ea simethicone (simethicone - 30%, stearic emulsifier - 0.075%, sorbic acid, metsi) - 0,03 / 0,06 / 0,12 / 0,24 mg, "candelilla wax" - 0, 08 / 0.16 / 0.32 / 0 mg.

Mofumahali

Atorvastatin ke inhibitor e khethiloeng ea HMG-CoA reductase, e leng enzyme ea mantlha e fetolang 3-hydroxy-3-methylglutaryl-CoA ho mevalonate, selelekela sa li-steroid, ho kenyelletsa le cholesterol. Liprimar e bua ka li-lipid tse fokotsang lihlahisoa tsa tlhaho tsa maiketsetso.

Ts'ebeliso ea atorvastatin ho bakuli ba nang le dyslipidemia e tsoakiloeng, mefuta eo e seng ea lelapa ea hypercholesterolemia, hammoho le heterozygous le homozygous Famal hypercholesterolemia e lebisa ho fokotseha hoa lipalo tsa plasma ea mali ea triglycerides (TG), haholo density lipoprotein cholesterol-ApLL-ApLL density lipoprotein cholesterol e tlaase (cholesterol-LDL) le cholesterol e felletseng. Hape, ha ho nka Liprimar, khatello ea cholesterol e phahameng ea methapo ea methapo (HDL-C) e eketseha.

Atorvastatin e thibela tlhahiso ea k'holeseterole ka har'a sebete, e thibela ho fokotsoa ha HMG-CoA, 'me e eketsa palo ea li-receptor tsa LDL tsa hepatic likhetlong tse ka ntle tsa lisele, tse lebisang ho nyoloheng le ho eketseha ha "LDL-C" hape ho tlatsetsa ho fokotseheng hoa cholesterol le LDL-C ka plasma.

Liprimar e fokotsa palo ea likaroloana tsa LDL 'me e thibela ho thehwa ha LDL-C, e lebisa keketseho e phehellang le e phehellang ts'ebetsong ea li-receptor tsa LDL, e kopantsoe le liphetoho tse ntle tsa likarolo tsa LDL, hape e fokotsa boemo ba cholesterol ea LDL ho bakuli ba nang le homozygous Famer hypercholesterolemia toredatiology. kalafo ka lithethefatsi tse ling tse fokotsang lipid.

Ha e nooa lethathamong la lethalinyana la 10-80 mg, atorvastatin e fokotsa khatello ea TG ka 14- 33%, apo-B ka 34-50%, cholesterol-LDL ka 41-61% le cholesterol ka 30-46%. Liphetho tsa kalafo li batla li tšoana le ho bakuli ba nang le mefuta eo e seng ea lelapa ea hypercholesterolemia, heterozygous Familia hypercholesterolemia le hyperlipidemia e kenyeletsang bakuli ba nang le lefu la tsoekere la mofuta oa 2.

Ho bakuli ba nang le hypertriglyceridemia e ka thoko, ntho e sebetsang Liprimara e theola boemo ba TG, apo-B, cholesterol-VLDL, cholesterol-LDL le cholesterol e felletseng mme e eketsa boemo ba cholesterol-HDL. Ho bakuli ba nang le dysbetalipoproteinemia, ha ba nka Liprimar, khatello ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo ea cholesterol (cholesterol-lowing steroids) ea fokotseha.

Ho bakuli ba nang le mofuta oa IIa le IIb hyperlipoproteinemia, ho latela sehlopha sa Fredrickson bakeng sa phekolo ea atorvastatin (lethal dose la 10-80 mg), khatello ea HDL-C e eketseha ka karolelano ka 5.1-8.7% ha e bapisoa le boleng ba pele, 'me phello ena ha e joalo ho nooa. Karolelano ea cholesterol-LDL / cholesterol-HDL le cholesterol-cholesterol-HDL e fokotsehile haholo (ho fokotseha ho tsebisoang ka tekanyetso ea Liprimar e nkuoe) ka 37-55% le 29-44%, ka ho latellana. Atorvastatin ka tekanyo ea 80 mg e fokotsa haholo menyetla ea ho ba le mathata a ischemic le ho fokotsa lefu ka 16% kamora ho qeta thupelo ea kalafo ea libeke tse 16, mme kotsi ea ho kenngoa sepetlele e amanang le angina pectoris, e tsamaeang le matšoao a ischemia ea myocardial, e fokotseha ka 26% ho latela lipatlisiso. , ho na le ho fokotseha ho teba ha matšoao a lefu la myocardial ischemia nakong ea kalafo e matla ea lipid-lowing (MIRACL). Ho bakuli ba nang le maemo a fapaneng a pele a LDL-C, bakuli ba nang le infina e sa tsitsang le myocardial ntle le Q wave, ho sa tsotelehe bong (monna le mosali) le lilemo (ba banyenyane le ba baholo ho lilemo tse 65), ho nka atorvastatin haholo ho fokotsa kotsi ea mathata a ischemic le lefu. Ho fokotseha ha mahlaseli a LDL-C ho plasma ho bontša khokahano e ntle le lethalinyana la Liprimar ho fapana le karolo ea karolo e sebetsang ea plasma ea mali. Tekanyetso e lokela ho khethoa ho latela phello ea kliniki.

Litlamorao tsa kalafo ea Liprimar li tlalehiloe libeke tse peli kamora ho qala kalafo, e fihla sehlohlolong kamora libeke tse 4 mme e phehella nakong eohle ea kalafo.

Ho bakuli ba nang le khatello ea mali ea methapo, le mabaka a mararo kapa ho feta, ho nka atorvastatin ka tekanyo ea 10 mg ho fokotsa kotsi ea ho tšoaroa ke lefu la pelo le sa bolaeang (le bolaeang) ha le bapisoa le placebo. Liphetho tsa thuto ea Anglo-Scandinavia mabapi le tlhahlobo ea sephetho sa lefu la pelo (ASCOT-LLA) lia tsebahala, ho latela hore tsamaiso ea Liprimar ka tekanyo ea 10 mg e fokotsa kotsi ea mathata a mang ka tsela e latelang:

setlaela (se senang / se bolaeang) - ka 26%,
mathata a coronary (infalction ea nama e sa cheheng le lefu la pelo le tsamaeang le lefu) - ka 36%,
mathata a pelo le pelo - ka 29%,
mathata a pelo le lits'ebetso tse ntlafatsang - ka 20%.

Ho latela liphetho tsa lipatlisiso tsa tsamaiso ea atorvastatin ea mofuta oa 2 lefu la tsoekere (CARDS), ts'ebeliso ea Liprimar ho bakuli ba nang le lefu lena e fokotsa kotsi ea mathata a pelo ho sa tsotellehe lilemo le bong kapa khatello ea mantlha ea LDL-C ka tsela e latelang:

stroke (se senang / se bolaeang) - ke 48%,
ischemia e seng bohloko ea myocardial ischemia, e se nang lefu (le e bolaeang) myocardial infarction - ka 42%,
mathata a mantlha a pelo (methapo ea kutlo, mekhoa ea ho hlasolla, ho se utloisehe ho bohloko ba pelo, lefu le sa bonahaleng, lefu le bolaeang ka lebaka la ho eketseha ha lefu la pelo, methapo ea methapo ea methapo ka ho fetesisa, 37).

Phuputso e mabapi le phello ea kalafo e matla ea "hypolipidemic" holima nts'etsopele ea coronary atherosulinosis (REVERSAL) e bontšitse hore bakuli ba nang le lefu la pelo ba natefeloa ke atorvastatin ka tekanyetso ea letsatsi le letsatsi ea 80 mg e baka ho fokotseha ha palo ea atheroma ka 0.4% kamora likhoeli tse 1,8 tsa kalafo.

Tsamaiso ea atorvastatin ka tekanyetso ea letsatsi le letsatsi ea 80 mg e ka fokotsa kotsi ea ho ba le lefu le sa bolaeang (le bolaeang) ho bakuli ba fetileng lefu la ischemic kapa stroke ka ho hloka nalane ea lefu la pelo le bapisoang le placebo ho latela liphetho tsa tlhahlobo ea thibelo ea stroke le phokotseho e matla ea cholesterol (SPARCL). Sena se fokotsa haholo menyetla ea ho ba le mathata a pelo le pelo le tlhoko ea lits'ebetso tsa revascularization. Ho fokotseha hoa menyetla ea ho senyeha ha methapo ea pelo nakong ea kalafo le atorvastatin ho bonoa lihlopheng tsohle tsa bakuli, ntle le moo ho neng ho kenyelletsa bakuli ba nang le lefu la hemorrhagic la mantlha kapa le sa khaotseng.

Ho bakuli ba nang le lefu la pelo ea coronary, ho nka Liprimar ka tekanyo ea 80 mg ha ho bapisoa le tekanyo ea 10 mg haholo ho fokotsa kotsi ea mathata ka tsela e latelang (ho latela liphetho tsa tlhahlobo ea kalafo ea TNT ho fihlela sepheo se secha sa lipid.

angina pectoris - 10,9%,
lefu la pelo le pelo (lefutso la pelo e sa bolaeang le lefu la pelo le tsamaeang le lefu) - ka 8.7%,
coronary artery bypass surge kapa lits'ebetso tse ling tse ntlafatsang - ka 13.4%,
infarction ea myocardial e senang mafura, e sa bakoang ke ts'ebetso - ka 4,9%,
ho beoa sepetlele se amanang le ho nyekeloa ke pelo - ka 2.4%,
lefu le sa bolaeang (le bolaeang) - ka 2.3%.

Lokolla liforomo le sebopeho

Setlhare sena se fumaneha litafoleng tse koahetsoeng ka ente. Setsi sa litekanyetso se na le calcium ea 10 mg ea calcium atorvastatin e le karolo e sebetsang. Bakeng sa lebelo la ho monya le ho eketseha ha bioavailability, letlapa le na le lintho tse ling:

phospholle cellulose,
magnesium stearate,
tsoekere ea lebese
Hyprolose
sodium hammart
calcium carbonate.

Ho hlophisoa ha matlapa ho kenyelletsa cellcose ea microcrystalline, tsoekere ea magnesium, tsoekere ea lebese, hyprolose, croscarmellose sodium, calcium carbonate.

Letsoalo la filimi le na le bokahare ba candelilla, hypromellose, polyethylene glycol, talc, emulsion simethicone, titanium dioxide. Ho matlapa a tšoeu a sebopeho sa elliptical, ho ngotsoe mongolo oa "PD 155" le lethal dose la ntho e sebetsang.

Ketso ea pharmacological

Liprimar ke sehlopheng sa lithethefatsi tse fokotsang lipid. Sesebelisoa se sebetsang sa atorvastatin ke sethala se khethiloeng sa HMG-CoA reductase, enzyme ea mantlha e hlokahalang bakeng sa phetoho ea 3enz hydroxy-3-methylglutaryl coenzyme e be mevalonate.

Ka boteng ba mofuta oa lefutso oa hypercholesterolemia (k'holeseterole e eketsehileng), dyslipidemia, ntho e sebetsang Liprimara e tla thusa ho fokotsa khatello ea plasma ea cholesterol e felletseng (Ch), apolipoprotein B, VLDL le LDL (lipenshene tse tlaase tsa methapo ea kutlo) le boholo ba triglycerides. Atorvastatin e baka keketseho ea tekanyo e phahameng ea letsoalo lipoprotein (HDL).

Mochine oa ts'ebetso o hlaha ka lebaka la khatello ea mosebetsi oa HMG-CoA reductase le thibelo ea sebopeho sa cholesterol ho hepatocytes.

Atorvastatin e khona ho eketsa palo ea li-receptor tse tlaase tsa methapo ea lipoprotein karolong e ka ntle ea membrane ea lisele tsa sebete, e lebisang ho ho nkeloeng le ho timeng ha LDL.

Setlhare se khona ho eketsa palo ea li-receptors tse tlase tsa methapo ea lipoprotein karolong e ka ntle ea membrane ea lisele tsa sebete.

K'hemik'hale e sebetsang e fokotsa motsoako oa cholesterol ea LDL le palo ea lipoprotein tse kotsi, ka lebaka leo ho nang le keketseho ea tšebetso ea li-receptor tsa LDL. Ho bakuli ba nang le homozygous hereditary hypercholesterolemia ba hananang le ketso ea lithethefatsi tse fokotsang lipid, likarolo tsa LDL lia fokotseha. Phello ea kalafo e bonoa nakong ea libeke tse peli kamora ho qala kalafo ea lithethefatsi. Phello e phahameng e tlalehiloe kamora khoeli ea kalafo le Liprimar.

Mofumahali

Kamora ho tsamaisoa ka molomo, matlapa ha a qhibilihe tlasa ts'ebetso ea hydrochloric acid ka mpeng, e oelang ho projimal ea jejunum. Karolong ena ea tšilo ea lijo, membrane ea filimi e kenella ka har'a hydrolysis.

Letlapa le roba, limatlafatsi le lithethefatsi li qala ho kenella ka microvilli e khethehileng.

Atorvastatin e kena maling ho tsoa leboteng la mala, moo e fihlelang lipalo tsa plasma tse phahameng ka nako ea lihora tse 1-2. Ho basali, khokahano ea ntho e sebetsang e phahame ka 20% ho feta ho banna.

Kamora ho tsamaisoa ka molomo, matlapa ha a qhibilihe tlasa ts'ebetso ea hydrochloric acid e ka mpeng.Liprimar 10 e kena maling a tsoang mokokotlong oa mala.
Ntho e sebetsang ea lithethefatsi e tlama ho albin ka 98%, ke ka lebaka leo hemodialysis e sa sebetseng.

Bioavailability e fihla 14-30%. Letšoao le tlase le bakoa ke parietal metabolism ea atorvastatin lera la mucous la lera la intestinal le phetoho liseleng tsa sebete ka isoenzyme ea cytochrome CYP3A4. Sesebelisoa se sebetsang se amana le albin ka 98%, ke ka lebaka leo hemodialysis e sa sebetseng. Ho felisoa ha halofo ea bophelo ho fihla lihora tse 14. Phello ea kalafo e nka lihora tse 20-30. Ka ts'ebetso ea moroto, atorvastatin e siea 'mele butle butle - ka moroto, kamora tekanyetso e le' ngoe, ke 2% feela ea lethalamo e fumanoang.

Matšoao a ho sebelisoa

Setlhare se sebelisoa ho tsa bongaka ho phekola:

hypercholesterolemia ea tlhaho ea lefutso le eo e seng lefutso,
eketseha maemo a triglycerides a hananang le kalafo ea ho ja,
hereditary homozygous hypercholesterolemia e nang le katleho e tlase ea lijo le mekhoa e meng eo e seng ea lithethefatsi ea kalafo,
mofuta o kopaneng oa hyperlipidemia.

Moriana o fanoa e le mokhoa oa ho thibela lefu la pelo ho bakuli ba se nang matšoao a lefu la pelo, empa ka mabaka a kotsi: botsofe, mekhoa e mebe, khatello e phahameng ea mali, lefu la tsoekere. Sehlopha sa kotsi se kenyeletsa batho ba nang le ts'oaetso ea hypercholesterolemia le boemo bo tlase ba HDL.

Lithethefatsi li fanoe e le mohato o ka thibeloang ho lefu la pelo.

Setlhare se sebelisoa e le tlatsetso ho kalafo ea ho ja bakeng sa nts'etsopele ea dysbetalipoproteinemia. Liprimar e sebelisoa e le mokhoa oa ho thibela nts'etsopele ea mathata a bakoang ke bakuli ba nang le myocardial ischemia ho fokotsa kotsi ea lefu, ho nyekeloa ke pelo, ho otloa le ho sepetlele bakeng sa angina pectoris.

Contraindication

Maloetse a sebete a sebetsang kapa keketseho ea tšebetso ea serum ea li-transaminase (makhetlo a fetang a 3 ha a bapisoa le moeli o kaholimo oa tloaelo) ea etiology e sa tsejoeng,
Ke lilemo tse fihlang ho lilemo tse 18 (ka lebaka la tlhaiso-leseling e sa lekaneng ea kliniki mabapi le polokeho le katleho ea Liprimar bakeng sa sehlopha sena sa bakuli),
Bokhachane le pelehi
Hypersensitivity ho lithethefatsi.

Setsoalle (Liprimar se lokela ho laeloa ka hloko):

Tšebeliso e mpe ea tahi
Matšoao a nalane ea lefu la sebete.

Nakong ea kalafo, basali ba lilemo tsa ho ba le bana ba hloka ho sebelisa mekhoa e loketseng ea ho thibela pelehi.

Litaelo tsa ho sebelisa Liprimar: mokhoa le litekanyetso

Pele u sebelisa Liprimar, ho hlokahala hore u leke ho fihlela taolo ea hypercholesterolemia ka thuso ea lijo, ho ikoetlisa 'meleng le ho theola boima ba' mele ho bakuli ba nang le botenya, hammoho le kalafo ea lefu lena le tlase.

Ha u fana ka litlhare, mokuli o lokela ho eletsoa hore a latele lijo tse tloaelehileng tsa hypocholesterolemic nakong eohle ea thupelo.

Liprimar e nkuoa ka molomo, nako e le 'ngoe ka letsatsi, ho sa natsoe lijo le nako ea letsatsi.

Ho latela se boletsoeng qalong ea LDL-C, sepheo sa kalafo le karabelo ea motho ka mong, tekanyo e ka fapana ho tloha ho 10 mg ho isa ho 80 mg (boholo).

Qalong ea kalafo le / kapa nakong ea keketseho ea tekanyetso libeke tse ling le tse ling le tse ling tse 2, ho hlokahala hore a laole litaba tsa lipid ka plasma mme, ho latela sena, a etse phetoho ea tekanyetso.

Bakeng sa bakuli ba bangata, tekanyetso ea letsatsi le letsatsi ea Liprimar e nang le hyperlipidemia e kopaneng (hyperlipidemia) le hypercholesterolemia ea mantlha ke 10 mg. Ha e le molao, phello ea kalafo e bonahatsoa ka matsatsi a 14, e fihla ka nako e fetang khoeli. Ka kalafo ea nako e telele, phello e phehella.

Ka homozygous ea lelapa hypercholesterolemia, Liprimar e laetsoe ka tekanyetso ea letsatsi le letsatsi ea 80 mg.

Bakeng sa bakuli ba nang le ho haella ha hepatic, tekanyo ea lithethefatsi e fokotseha ka tlase ho lekola mosebetsi oa aspartate aminotransferase le alanine aminotransferase.

Ho senyeha ha tšebetsong ha re sebetsa ha ho ame ho kenella ha atorvastatin ka plasma ea mali kapa tekanyo ea ho fokotseha ha litaba tsa LDL-C, ka hona, bakuli ba joalo ha ba hloke phetoho ea tekanyetso.

Ka tsamaiso e ts'oanang ka cyclosporine, tekanyo e phahameng ea Liprimar ke 10 mg.

Litlamorao

Joaloka molao, Liprimar e mamelleha hantle, mathata a hlahang a nka nako ebile a bonolo.

Nakong ea kalafo, litla-morao tse latelang li ka hlaha (≥1% - hangata, ≤1% - hangata):

Tsamaiso ea methapo e bohareng: khafetsa - hlooho ea hlooho, ho hloka boroko, asthenic syndrome, hangata - - peripheral neuropathy, kizunguzungu, malaise, paresthesia, amnesia, hypesthesia,
Sistimi ea tšilo ea lijo: khafetsa - ho ruruha, dyspepsia, ho nyekeloa, ho opeloa ke mpa, lets'ollo, lefutso, hangata - anorexia, ho hlatsa, pancreatitis, hepatitis, cholestatic jaundice,
Sistimi ea musculoskeletal: khafetsa - myalgia, hangata - myopathy, bohloko ba morao, mesifa ea mokokotlo, arthralgia, myositis, rhabdomyolysis,
Hematopoietic sistimi: khafetsa - thrombocytopenia,
Metabolism: hangata - hyperglycemia, hypoglycemia, maemo a eketsehang a serum creatine phosphokinase,
Litlamorao: khafetsa - chefo e nang le chefo e hlahisang chefo (Lyell's syndrome), lekhopho la letlalo, urticaria, pruritus, lefu la mothapo o bohloko, karabelo ea anaphylactic, erythema multiforme exudative (ho kenyeletsa le lefu la Stevens-Johnson),
Tse ling: khafetsa - ho tepella ho eketsehileng, edema e poteletseng, ho hloka matla, ho nona haholo, tinnitus, bohloko ba sefuba, ho se sebetse hantle ha renal, alopecia.

Bongata

Matšoao a overdose ea atorvastatin ke litla-morao tse eketsehang.

Haeba ho hlokahala, kalafo ea matšoao, ho lekola tšebetso ea creatine phosphokinase le liteko tse tloaelehileng tsa ts'ebetso ea sebete li khothalletsoa. Kaha ntho e sebetsang e kenella ka mafolofolo lits'ebetsong tsa ho tlama liprotheine tsa plasma, ts'ebeliso ea hemodialysis bakeng sa tlhahiso ea eona e nkoa e sa sebetse.

Motsoako o khethehileng oa atorvastatin ha o tsejoe.

Litaelo tse khethehileng

Kamora ho sebelisa Liprimar, keketseho e leka-lekaneng ea tšebetso ea serum ea alanine aminotransferase, andpartate aminotransferase, keketseho e phehellang ea litekanyetso tsa serum tsa hepatic transaminases (ntle le nts'etsopele ea jaundice kapa lipontšo tse ling tsa kliniki) li ka hlokomeloa. Ka ho fokotseha ha lethal dose, ho tlosoa hoa lithethefatsi (ka nakoana kapa ho felletse), ts'ebetso ea transaminase ea hepatic hangata e khutlela boemong ba pele. Maemong a mangata, bakuli ba ka tsoela pele kalafo ka tekanyo e fokotsitsoeng ntle le litlamorao tsa mokokotlo.

Matšoao a ts'ebetso ea sebete a tlameha ho beoa leihlo pele ho kalafo, libeke tse 6 le tse 12 kamora ho qala ha Liprimar kapa kamora ho eketseha ha tekanyetso, hammoho le nakong eohle ea kalafo.

Setlhare sena se hlakotsoe ka keketseho e tšoaeang mosebetsing oaineine phosphokinase, boteng ba belaelloang kapa bo netefalitsoeng ke myopathy. Ha ho fana ka Liprimar ka nako e le ngoe le li-immunosuppressants, fibrate, erythromycin, lithethefatsi tsa antifungal (li-azole derivatives) kapa nicotinic acid ho litekanyetso tsa hypolipidemic, ho lokela ho hopoloa hore sena se eketsa menyetla ea ho ba le myopathy. Ho lekola khafetsa boemo ba mokuli hoa hlokahala ho bona bofokoli ba mesifa kapa bohloko, haholo likhoeling tsa pele tsa kalafo le nakong ea litekanyetso tse ntseng li eketseha tsa lithethefatsi life kapa life. Haeba ho hlokahala ho etsa kalafo ea motswako, ho bohlokoa ho nahana ka monyetla oa ho sebelisa lithethefatsi tsena ka tekanyetso e tlase le ea tlhokomelo.

Ha u sebelisa Liprimar, ho kile ha hlalosoa maemo a sa tloaelehang a rhabdomyolysis le ho hloleha ho matla ka mpeng ka lebaka la myoglobinuria. Haeba ho na le matšoao a hore na myopathy e teng kapa ho ba teng hoa maemo a kotsi bakeng sa ho se sebetse hantle ha masapo ka lebaka la rhabdomyolysis (mohlala, ts'oaetso e matla ea methapo, khatello ea methapo, ho sithabela, metabolism, endocrine le mathata a electrolyte le ho ts'oaroa ho sa laoleheng, ts'ebetso e kholo ea ts'ebetso), ho khothalletsoa ho hlakola kalafo kapa ho e tlohela ka nakoana. .

Haeba o na le bofokoli bo sa hlalosoang kapa bohloko ba mesifa, haholo haeba bo tsamaisana le feberu kapa malaise, o lokela ho etela setsebi.

Tšusumetso ho bokhoni ba ho khanna makoloi le mekhoa e rarahaneng

Ha ho na tlhahisoleseling ka phello ea Liprimar mabapi le bokhoni ba ho khanna makoloi le ho etsa mesebetsi e kotsi e hlokang ts'ebetso e eketsehileng ea khatello le maikutlo a kapele a psychomotor. Leha ho le joalo, ka lebaka la monyetla oa ho ba le letsoalo, ho tlameha ho ba hlokolosi ha u ikoetlisa mesebetsing e kaholimo.

Bokhachane le pelehi

Nakong ea kalafo, basali ba lilemong tsa ho ba le bana ba nkang Liprimar ba lokela ho sebelisa lithibela-mafu tse tšepahalang. Morero oa lithethefatsi o patiloe ho bakuli ba sa sirelitsoeng ho ima. Ho na le tlhaiso-leseling mabapi le linyeoe tse sa tloaelehang tsa ho hloka toka ka tlhaho ka mor'a ho pepesetsoa ha HMG-CoA reductase inhibitors (li-statins) ka popelong. Boithuto ba liphoofolo bo tiisa phello e kotsi ho tsoalo.

Ha ho amohelehe ho fana ka Liprimar ho bo-'mè ba anyesang, kaha ha ho na tlhahisoleseling e tšepahalang mabapi le ho kenella ha atorvastatin ka lebese la matsoele. Haeba ho hlokahala ho sebelisa moriana nakong ea lebone, ho anyesa ho lokela ho hlakoloa, e le ho qoba keketseho ea menyetla e sa rateheng ho masea.

Sebelisa bongoaneng

Ts'ebetsong ea bana, Liprimar e tšoaelitsoe kalafo ea bana le bacha ba ka tlase ho lilemo tse 18, ka lebaka la khaello ea tlhaiso-leseling ea kliniki mabapi le katleho le polokeho ea kalafo sehlopheng sena sa lilemo. Mokhelo ke kalafo ea heterozygous Familia hypercholesterolemia, e bonts'ang ts'ebeliso ea atorvastatin ho bana ho tloha ho lilemo tse 10.

Ka ho se sebetse hantle ha sebete

Ho kopantsoe le ho sebelisa lithethefatsi bakeng sa bakuli ba nang le mafu a sebete sehlopheng se sebetsang, hammoho le keketseho ea ts'ebetso ea transpase ea hepatic ea tlhaho e sa tsejoeng plasma ea mali ka makhetlo a fetang a 3 ho bapisoa le moeli o kaholimo o tloaelehileng.

Ka tlhokomeliso, Liprimar e laeloa bakuli ba nang le nalane ea lefu la sebete le / kapa ba hlekefetsang joala.

Sebelisa botsofaling

Ha o sebelisa Liprimar ho bakuli ba tsofetseng, ha ho phapang pakeng tsa polokeho le ho sebetsa hantle ha ho bapisoa le sechaba ka kakaretso, ka hona, ha ho na tlhoko ea tokiso ea litekanyetso.

Kaha kotsi ea rhabdomyolysis e eketseha a le lilemo li fetang 70, Liprimar e lokela ho sebelisoa ka hloko.

Ho sebelisana le lithethefatsi

Ka tšebeliso e tšoanang ea Liprimar ka lithethefatsi tse ling, litlamorao li ka hlaha:

Cyclosporine, fibrate, erythromycin ,cacithromycin, lithethefatsi tsa antifungal (azole derivatives) le nicotinic acid ho litekanyetso tsa hypolipidemic: kotsi e eketsehileng ea myopathy,
CYP3A4 isoenzyme inhibitors: likhahla tse eketsehileng tsa plasma tsa atorvastatin,
Li-inhibitors tsa OATP1B1 (mohlala, cyclosporine): bioavailability ea atorvastatin,
Erythromycin ,cacithromycin, li-inhibitors tsa CYP3A4, diltiazem, lero la morara: plasma e ngata ea atorvastatin,
Itraconazole: Keketseho ea AUC (kakaretso ea plasma ea ntho) ea atorvastatin,
Inducters ea cytochrome CYP3A4 isoenzyme: ho fokotseha ha mahloriso ea atorvastatin ho plasma ea mali,
Colestipol: ho fokotseha ha bongata ba atorvastatin ho plasma, leha ho le joalo, phello e fokotsang ea ho kopana ha lithethefatsi e feta ea e mong le e mong oa bona,
Digoxin: keketseho ea khatello ea eona ha e nka Liprimar ka tekanyetso e phahameng (hoa hlokahala ho lekola boemo ba bakuli),
Lithibela-pelehi tsa molomo tse nang le norethisterone le ethinyl estradiol: AUC e eketsehileng ea lintho tsena.

Litšoantšiso tsa Liprimar ke: Atorvastatin, Atorvastatin-Teva, Atoris, Liptonorm, Torvakard, Atorvoks, Tribestan, Krestor.

Tlhahlobo mabapi le Liprimar

Hangata moriana o fuoa bakuli ba nang le mathata a fapaneng ts'ebetsong ea methapo ea pelo. Ho na le litlhahlobo tse fapaneng mabapi le Liprimar, haholo, bakuli ba bangata ba tlaleha katleho e kholo ea kalafo. Leha ho le joalo, bakuli ba bang ha ba utloisise ka nepo hore na ba ka e sebelisa joang ka lebaka la litlhaloso tse sa lekaneng tsa kalafo ea ngaka. Ka hona, ba leka ho ikemela kapa ho fetola litekanyetso tsa atorvastatin, e lebisang ponahalong ea litla-morao tse sa rateheng (ho hlaha ha ho khoptjoa le ho luma, ho tšeloa mali, jj.).

Litsebi li nka Liprimar e le e 'ngoe ea lithethefatsi tse sebetsang hantle haholo ha feela ho na le hore na litekanyetso li nka nako e kae le hore na nako e telele hakae ea bongaka. Ba boetse ba eletsa nakong ea kalafo ho etsa boikoetliso bo loketseng 'mele, ho latela lijo le ho etsa tlhahlobo ea mali khafetsa.

Mokhoa oa ho nka Liprimar 10

Matlapa a reretsoe ho tsamaisoa ka molomo, ho sa natsoe nako ea letsatsi kapa ea lijo. Phekolo ea lithethefatsi e etsoa feela ka ho se sebetse hantle ha mokhoa oa ho ja oa hypocholesterolemic, mehato ea ho fokotsa boima ba 'mele e khahlanong le semelo sa botenya bo feteletseng, boikoetliso. Haeba keketseho ea cholesterol e bakoa ke bokuli bo ka tlase, pele u sebelisa Liprimar, ho hlokahala hore u leke ho felisa ts'ebetso ea mantlha ea pathological. Nakong ea kalafo eohle ea lithethefatsi, o tlameha ho latela lijo tse khethehileng.

Phekolo ea lithethefatsi e nang le Liprimar 10 e etsoa feela ka ho se sebetse hantle ha lijo tsa hypocholesterolemic.

Motsoako oa letsatsi le letsatsi ke 10-80 mg bakeng sa tšebeliso e le 'ngoe mme o fetoha ho latela ts'ebetso ea LDL-C le phihlelong ea phello ea kalafo.

Sekhahla se phahameng se lumelletsoeng ke 80 mg.

Nakong ea kalafo le Liprimar, ho hlokahala hore ho be le leihlo la plasma ea lipids kamora libeke tse ling le tse ling tse 2, ka mor'a moo ho hlokahala hore u buisane le ngaka ea hau mabapi le liphetoho phetohong ea litekanyetso.

Ho felisa mofuta o kopaneng oa hyperlipidemia, ho hlokahala hore o nke 10 mg hang ka letsatsi, ha homozygous hereditary hypercholesterolemia e hloka tekanyetso e phahameng ea kalafo ea 80 mg. Maemong a morao-rao, litekanyetso tsa cholesterol li fokotsehile ka 20-45%.

Ho nka moriana oa lefu la tsoekere

Bakuli ba nang le lefu la tsoekere ba lokela ho ba hlokolosi ha ho hlaha hypercholesterolemia. Batho ba joalo ba kotsing ea ho ba le lefu la pelo. Liprimar e sebelisoa e le mokhoa oa ho thibela infarction ea myocardial. Litekanyetso li beoa ke ngaka e eang ho ea ka boemo ba cholesterol.

Bakuli ba nang le lefu la tsoekere ba lokela ho ba hlokolosi ha ho hlaha hypercholesterolemia.

Tsamaiso ea methapo e bohareng

Boitšoaro bo bobe bo nang le ts'ebetso ea ts'ebetso ea methapo bo bonahala e le:

ho hloka boroko
kakaretso malaise
asthenic syndrome
hlooho e bohloko le ho tsekela,
fokotseha le tahlehelo e felletseng ea kutloelo-bohloko,
peripheral nervous system neuropathy,
amnesia.

Ho tsoa ts'ebetsong ea phefumoloho

Dyspnea e ka hlaha.

Ka tšekamelo ea ho bonts'a ho fetoha ha anaphylactic, makhopho a letlalo, bofubelu, ho hlohlona, erythema e feteletseng, necrosis ea mokelikeli oa mafura a ka hlaha. Maemong a tebileng, edema ea Quincke le anaphylactic makala li hlaha.

Pele ho tšebeliso ea moriana o ka qholotsang ponahalo ea lekhopho letlalong.

Ho tsamaisana le joala

Moriana ha oa lokela ho kopanngoa le lino tse tahang. Tai ea ethyl e thibela ts'ebetso ea methapo e ka hare ea methapo, hepatobiliary le circular, ka hona phello ea hypocholesterolemic ea Liprimar e fokotsehile. Monyetla oa ho thehoa ha li-atherosselotic plaque marakong a methapo ea mali oa eketseha.

Moriana ha oa lokela ho kopanngoa le lino tse tahang.

Ho kopanya ha ho khothalelitsoe

Ka lebaka la kotsi ea methapo ea methapo ea methapo, tsamaiso e tšoanang ea Liprimar ha e khothalletsoe le:

lithibela-mafu tsa cyclosporin
nicotinic acid e tsoang ho
Erythromycin
lithethefatsi tsa antifungal
fibrate.

Tsamaiso e kopanetsoeng ea Liprimar le Erythromycin ha e khothalletsoe.

Motsoako o joalo oa lithethefatsi o ka lebisa ho myopathy.

Ka tlhokomelo

Ho khothalletsoa ho ba hlokolosi ha u ntse u sebelisa Liprimar ka litlhare tse ling:

Atorvastatin e khona ho eketsa AUC ea lithibela-pelehi tsa molomo ka 20-30%, ho latela lihormone tse fumanehang litokelong.
Atorvastatin e nang le litekanyetso tsa 40 mg, hammoho le 240 mg ea Diltiazem e lebisa keketseho ea plasma ea atorvastatin maling. Ha u nka 200 mg ea Itraconazole e nang le 20-40 mg ea Liprimar, keketseho ea AUC ea atorvastatin e ile ea bonoa.
Rifampicin e fokotsa maemo a plasma ea atorvastatin.
Colestipol e baka ho fokotseha hoa sethethefatsi se fokotsang cholesterol ea plasma.
Ka kalafo e kopaneng le digoxin, khatello ea lintho tse qetellang li eketseha ka 20%.

Jusi ea morara e hatella ketso ea cytochrome isoenzyme CYP3A4, ke ka hona ha u sebelisa lino tse fetang 1,2 tsa lero la lamunu ka letsatsi, mahlaseli a plasma a atorvastatin a eketseha. Phello e tšoanang e bonoa ha ho nkuoa li-inhibitors tsa CYP3A4 (Ritonavir, Ketoconazole).

Liprimar e thibetsoe ho sebelisa ho basali ba 10 baimana.

Sebelisa nakong ea bokhachane le pelehi

Ha hoa lumelloa ho sebelisa lithethefatsi bakeng sa basali baimana, joalo ka ho na le kotsi ea tlolo ea ho beoa ho nepahetseng ha lithane le litho nakong ea kholo ea "embryonic". Ha ho na data mabapi le bokhoni ba Liprimar ho kenella ka hematoplacental barriers.

Nakong ea phekolo ea lithethefatsi, ho anyesa ho lokela ho felisoa.

Mehloli ea litlhare e nang le litlamorao tse tšoanang e kenyelletsa:

Phetoho e etsoa kamora ho buisana le bongaka.

Video ea papatso "Liprimar" Liprimar commandAtoris thuto

Tekanyetso le tsamaiso

Pele o fana ka Liprimar, ho bohlokoa ho fihlela taolo ea hypercholesterolemia ka kalafo ea lefu lena le lefu le mekhoa e meng eo e seng ea bongaka (ho ja, ho ikoetlisa le ho theola boima ba 'mele ho bakuli ba nang le botenya).

Nakong ea kalafo ea lithethefatsi, mokuli o khothalletsoa ho latela lijo tse tloaelehileng tsa hypocholesterolemic.

Liprimar e etselitsoe tsamaiso ea molomo, ho sa tsotelehe nako ea letsatsi kapa ea lijo.

Tekanyetso e fapana ho tloha ho 10 ho isa ho 80 mg ka letsatsi. Khetho ea dose e etsoa ho tsotelloa litaba tsa cholesterol ea low-density lipoprotein cholesterol (LDL-C), litlamorao tsa motho ka mong le sepheo sa kalafo. Tekanyo e phahameng ea letsatsi le letsatsi ke 80 mg hang.

Qalong ea kalafo, hammoho le litekanyetso tse ntseng li eketseha, ho hlokahala ho tseba hore na li-lipid li ka bongata ka plasma ka mor'a libeke tse ling le tse ling tse 2, 'me ho nahanoa ka tlhaiso-leseling e fumanoeng, fetola tekanyetso.

Ka hyperlipidemia e tsoakaneng (e kopantsoeng) le hypocholesterolemia ea mantlha, tekanyetso ea Liprimar ho bakuli ba bangata ke 10 mg hang ka letsatsi. Phello ea kalafo e bonahala libeke tse peli tse qalang mme e fihla ho libeke tse 4 tsa kalafo. Ka kalafo ea nako e telele, phello e phehella.

Bakeng sa bakuli ba nang le homozygous Familyal hypercholesterolemia, Liprimar e beoa ka tekanyo ea 80 mg hang hang ka letsatsi (boemo ba LDL-C bo fokotsehile ka 18-45%).

Tabeng ea ho senyeha ha renal le ho batho ba tsofetseng, tokiso ea tekanyetso ha e hlokehe.

Ka ho hloleha ha sebete, lethal dose le fokotseha leihlo le sa khaotseng la ts'ebetso ea enzymes alanine aminotransferase le amartotransferase ea aspartate.

Ka tšebeliso e tšoanang ka cyclosporine, tekanyo ea Liprimar ha ea lokela ho feta 10 mg ka letsatsi.