atorvastatin tablets is covered.ob. 10 mg 90 pcs. (Atorvastatin)
Special Price
$26.35
Regular Price
$31.00
In stock
SKU
newyork499089
Release form
Film-coated tablets Buy atorvastatin tablets is covered.ob. 10 mg 90 pcs. (Atorvastatin) in newyork free shipping. Fast international shipping USA, AU, EU, UK and others.
Film-coated tablets Buy atorvastatin tablets is covered.ob. 10 mg 90 pcs. (Atorvastatin) in newyork free shipping. Fast international shipping USA, AU, EU, UK and others.
Release form
Film-coated tablets
Packing
Per pack 90 pcs.
Indications
Primary hypercholesterolemia (heterozygous familial and non-familial hypercholesterolemia, according to Fredrickson type IIa), combined (mixed) hyperlipidemia (according to Fredrickson types IIb and III), dysbetalipoproteinemia (according to Fredrickson type III) (as a supplement to the diet), familial endogenous hypertriglyceridemia (according to Fredrickson type IV), resistant to dietary methods of treatment.
Homozygous hereditary hypercholesterolemia (as an adjunct to lipid-lowering therapy, including autohemotransfusion of LDL-purified blood).
Diseases of the cardiovascular system (including in patients without the clinical manifestations of IHD, but with increased risk factors for its occurrence - over 55 years old, nicotine addiction, arterial hypertension, genetic predisposition), incl. against the background of dyslipidemia - secondary prevention in order to reduce the total risk of death, myocardial infarction, stroke, re-hospitalization for angina pectoris and the need for revascularization.
Contraindications
hypersensitivity, liver disease in the active stage (including active chronic hepatitis, chronic alcoholic hepatitis), increased activity of hepatic transaminases (more than 3 times compared with the upper limit of normal) of unclear origin, liver failure, cirrhosis of any etiology, pregnancy and lactation period.
Use during pregnancy and lactation
Atorvastatin passes through the placenta and reaches the fetal liver level equivalent to that in the mother's plasma. Atorvastatin did not show teratogenicity in rats when used in doses up to 300 mg / kg / day and in rabbits at doses up to 100 mg / kg / day. These doses created an exposure 30 (rats) and 20 (rabbits) times the exposure in humans (in terms of body surface area, in mg / m2).
In studies in rats receiving atorvastatin at doses of 20, 100 and 225 mg / kg / day from the 7th day of pregnancy to the 21st day of lactation, there was a decrease in the survival of cubs at birth, newborns, and the maturation of cubs of females who received 225 mg doses of atorvastatin / kg / day A decrease in body weight on days 4 and 21 was recorded in young females, those who received atorvastatin at a dose of 100 mg / kg / day decreased body weight at birth, on days 4, 21 and 91 - at a dose of 225 mg / kg / day. Delayed development was observed at a dose of 100 mg / kg / day (rotor activity) and 225 mg / kg / day (fear with sounds, disturbance of the formation of the auricle, opening time of the eyes). These doses correspond to AUC values of 6 (100 mg / kg) and 22 times (225 mg / kg) higher than AUC in humans at a dose of 80 mg / day. Rare cases of congenital abnormalities have been observed after intrauterine exposure to HMG-CoA reductase inhibitors.
Cholesterol and other substances synthesized from cholesterol are important for fetal development (including the synthesis of steroids and cell membranes). Since HMG-CoA reductase inhibitors reduce cholesterol synthesis and, possibly, the synthesis of other biologically active substances - cholesterol derivatives, these drugs can have a harmful embryonic effect when taken by pregnant women. In this regard, HMG-CoA reductase inhibitors are contraindicated during pregnancy and breastfeeding.
There is one report of severe congenital bone deformity, tracheo-esophageal fistula and anal atresia (VATER association) in a child born to a mother who took lovastatin with dextroamphetamine sulfate in the first trimester of pregnancy.
The safety of atorvastatin in pregnant women has not been established.
FDA category of action for the fetus is X.
Women of childbearing age can take atorvastatin only if they use reliable contraceptive measures. If the patient is planning a pregnancy, she should stop taking the drug at least 1 month before the planned pregnancy. In case of pregnancy during treatment, atorvastatin should be discontinued immediately. The patient should be informed of a possible risk to the fetus.
Animal experiments have shown that atorvastatin passes into rat milk. The levels of drugs in the plasma and liver of young nursing animals are from those in human milk 50 and 40%, respectively.
It is not known whether atorvastatin is secreted into human milk. Since a serious negative effect on the baby is possible, when taking atorvastatin, it is necessary to stop breastfeeding.
Special instructions
Before starting therapy with atorvastatin, the patient must be prescribed a standard hypocholesterol diet, which he must observe during the entire period of treatment.
The use of HMG-CoA reductase inhibitors to lower blood lipids can lead to a change in biochemical parameters that reflect liver function. Liver function should be monitored before starting therapy, 6 weeks, 12 weeks after starting atorvastatin and after each dose increase, and periodically, for example, every 6 months. An increase in the activity of “liver” enzymes in the blood serum can be observed during therapy with Atorvastatin. Patients with an increase in enzyme levels should be monitored until the enzyme levels return to normal. In the event that the values ​​of alanine aminotransferase (ALT) or aspartic aminotransferase (AST) are more than 3 times higher than the upper acceptable limit, it is recommended to reduce the dose of atorvastatin or discontinue treatment.
Atorvastatin should be used with caution in patients who abuse alcohol and / or have liver disease. Active liver disease or a persistent increase in the activity of aminotransferases of unknown origin serve as contraindications to the appointment of Atorvastatin.
Treatment with atorvastatin may cause myopathy. The diagnosis of myopathy (muscle pain and weakness in combination with an increase in the activity of creatine phosphokinase (CPK) by more than 10 times compared with the upper limit of the norm) should be discussed in patients with common myalgia, pain or muscle weakness and / or a marked increase in CPK activity. Patients should be warned that they should immediately inform the doctor about the appearance of unexplained pain or weakness in the muscles, if they are accompanied by malaise or fever. Atorvastatin therapy should be discontinued if there is a marked increase in CPK activity or in the presence of confirmed or suspected myopathy. The risk of myopathy in the treatment of other drugs of this class increased with the simultaneous use of cyclosporine, fibrates, erythromycin, nicotinic acid or azole antifungal agents. Many of these drugs inhibit the metabolism mediated by cytochrome P450 3A4 and / or drug transport. Atorvastatin is biotransformed under the influence of CYP 3A4. Prescribing atorvastatin in combination with fibrates, erythromycin, immunosuppressive agents, azole antifungal agents or nicotinic acid in hypolipidemic doses, the expected benefit and risk of treatment should be carefully weighed and patients should be regularly observed to detect muscle pain or weakness, especially during the first months of treatment and during periods of increasing doses of any drug. In such situations, periodic determination of CPK activity can be recommended, although such control does not prevent the development of severe myopathy.
When using Atorvastatin, as well as other drugs of this class, cases of rhabdomyolysis with acute renal failure due to myoglobinuria are described. Atorvastatin therapy should be temporarily discontinued or completely discontinued if there are signs of a possible myopathy or a risk factor for the development of renal failure due to rhabdomyolysis (e.g., severe acute infection, arterial hypotension, serious surgery, trauma, severe metabolism, endocrine and electrolyte disturbances and uncontrolled convulsions).
Before starting Atorvastatin therapy, it is necessary to try to achieve control of hypercholesterolemia by adequate diet therapy, increased physical activity, weight loss in patients with obesity and treatment of other conditions.
Patients should be warned that they should immediately consult a doctor if unexplained muscle pain or weakness occurs, especially if they are accompanied by malaise or fever.
Composition of
One tablet contains:
active substance:
atorvastatin calcium trihydrate (in terms of atorvastatin) - 10.00 mg
excipients: microcrystalline
microcrystalline cellulose - 49.68 mg,
lac calcium carbonate - 33.00 mg,
crospovidone - 7.50 mg,
carboxymethyl starch sodium (sodium starch glycolate) - 4.50 mg,
hyprolose (hydroxypropyl cellulose) - 3.00 mg,
magnesium stearate - 1.50 mg
film coat:
[hypromellose - 2.250 mg, talc - 0.882 mg, hyprolose (hydroxypropylcell lulose) - 0.873 mg, titanium dioxide - 0.495 mg] or [dry mix for film coating containing hypromellose (50.0%), talc (19.6%), hyprolysis (hydroxypropyl cellulose) (19.4%), titanium dioxide (11.0%)] - 4,500 mg.
Dosage and Administration
Inside.
Before prescribing Atorvastatin, the patient should be advised of a standard lipid-lowering diet, which he must continue to follow throughout the duration of therapy.
The initial dose is an average of 10 mg / day. The dose varies from 10 to 80 mg / day.
The drug can be taken at any time of the day with food or regardless of the meal time. The dose is selected taking into account the initial levels of cholesterol / LDL, the purpose of therapy and individual effect. At the beginning of treatment and / or during an increase in the dose of Atorvastatin, it is necessary to monitor plasma lipid levels every 2–4 weeks and adjust the dose accordingly.
To ensure the dosage regimen for the drug given below, it is possible to use the drug Atorvastatin in another dosage form: film-coated tablets, 10 mg and 20 mg. The maximum daily dose of the drug is 80 mg.
With simultaneous use with cyclosporine, the daily dose of atorvastatin should not exceed 10 mg.
Primary hypercholesterolemia and mixed hyperlipidemia. In most cases, a dose of 10 mg of Atorvastatin once a day is sufficient. A significant therapeutic effect is observed after 2 weeks, and the maximum therapeutic effect is usually observed after 4 weeks. With prolonged treatment, this effect persists.
Special patient groups
Impaired renal function. The use of the drug in patients with renal failure and kidney disease does not affect the level of atorvastatin in the blood plasma or the degree of decrease in cholesterol / LDL when it is used, therefore, changing the dose of the drug is not required.
Impaired liver function. With liver failure, the dose must be reduced.
Elderly patients. When using the drug in elderly patients, differences in safety, the effectiveness or achievement of the goals of lipid-lowering therapy in comparison with the general population was not observed.
Side effects of
In controlled clinical trials (n = 2502), less than 2% of patients discontinued treatment due to side effects caused by atorvastatin. The most common adverse effects associated with taking atorvastatin were constipation, flatulence, dyspepsia, and abdominal pain.
From the nervous system and sensory organs:? 2% - headache, asthenic syndrome, insomnia, dizziness
From the cardiovascular system:? 2% - chest pain, blood pressure, phlebitis, arrhythmia, angina pectoris, anemia, lymphadenopathy, thrombocytopenia.
From the respiratory system:? 2% - sinusitis, pharyngitis, bronchitis, rhinitis
From the digestive tract:? 2% - abdominal pain, constipation or diarrhea, dyspepsia, flatulence, nausea
From the musculoskeletal system:? 2 % - arthralgia, myalgia, arthritis
From the genitourinary system:? 2% - urogenital infections, peripheral edema
From the skin:
Allergic reactions:? 2% - skin rash
Other:? 2% - infection, accidental injury, flu-like syndrome, back pain of alkaline phosphatase, increased ALT or AST, exacerbation of gout.
Side effects noted in post-marketing studies with atorvastatin therapy: anaphylaxis, angioedema, bullous rash (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), rhabdomyolysis, tendon rupture.
Drug interactions
The risk of developing myopathy with statins is increased when used in combination with cyclosporine, fibrates, erythromycin, nicotinic acid in lipid lowering doses, strong CYP3A4 inhibitors (including clarithromycin, HIV protease inhibitors).
When using atorvastatin in combination with inhibitors of the CYP3A4 isoenzyme (for example, cyclosporine, macrolide antibiotics - erythromycin and clarithromycin, itraconazole, HIV protease inhibitors), plasma concentrations of atorvastatin may increase (atorvastatin metabolism should be used with caution if you take CYP3 by the above means (see "Special Instructions").
With the combined use of atorvastatin at a dose of 40 mg and itraconazole at a dose of 200 mg once a day, an increase in AUC of atorvastatin by 3 times was revealed compared with AUC with monotherapy.
Concomitant use of atorvastatin with protease inhibitors (lopinavir / ritonavir, ritonavir / saquinavir) was accompanied by an increase in plasma concentrations of atorvastatin. With the simultaneous use of atorvastatin at a dose of 40 mg and the combination of lopinavir + ritonavir (at a dose of 400/100 mg 2 times a day), an increase in AUC of atorvastatin by 5.9 times was revealed compared with AUC with monotherapy. When using atorvastatin at a dose of 40 mg with a combination of ritonavir + saquinavir (at a dose of 400/400 mg 2 times a day), its AUC increased 3.9 times.
Antacids reduce the concentration of atorvastatin by 35% (the effect on LDL cholesterol does not change).
With repeated use of digoxin and atorvastatin, Css digoxin increases by about 20% (patients should be monitored).
When combined with atorvastatin and oral contraceptives, the AUC of norethindrone and ethinyl estradiol increases by about 30 and 20% (this effect should be taken into account when choosing an oral contraceptive for a woman receiving atorvastatin).
When taken with erythromycin (a CYP3A4 inhibitor), the plasma concentration of atorvastatin increases by approximately 40%. The hypolipidemic effect of the combination of atorvastatin with colestipol is superior to that for each drug individually. Simultaneous use with drugs that reduce the concentration or activity of endogenous steroid hormones (including ketoconazole, spironolactone, cimetidine), increases the risk of reducing the production of endogenous steroid hormones (caution should be exercised).
With oral administration of atorvastatin and a suspension containing magnesium and aluminum hydroxide, plasma concentrations of atorvastatin decreased by approximately 35%, but the degree of decrease in cholesterol / LDL levels did not change.
Overdose
Treatment: No specific antidote, symptomatic therapy is performed.
Hemodialysis is ineffective.
Storage conditions
Store in a dry, dark place, out of the reach of children, at a temperature of 15 ° C to 30 ° C.
Shelf life
2 years.
Deystvuyushtee substance
Atorvastatin
Terms and conditions otpuska IZ pharmacy prescription
Appointment
Appointment
For adults prescribed by a doctor
atorvastatin tablets is covered.ob. 10 mg 90 pcs. (Atorvastatin) florida in pharmacy online. Cheap price, instruction, side effects, dosage. atorvastatin tablets is covered.ob. 10 mg 90 pcs. - Sale. PayPal accept. Free shipping florida. Fast international shipping.
Film-coated tablets
Packing
Per pack 90 pcs.
Indications
Primary hypercholesterolemia (heterozygous familial and non-familial hypercholesterolemia, according to Fredrickson type IIa), combined (mixed) hyperlipidemia (according to Fredrickson types IIb and III), dysbetalipoproteinemia (according to Fredrickson type III) (as a supplement to the diet), familial endogenous hypertriglyceridemia (according to Fredrickson type IV), resistant to dietary methods of treatment.
Homozygous hereditary hypercholesterolemia (as an adjunct to lipid-lowering therapy, including autohemotransfusion of LDL-purified blood).
Diseases of the cardiovascular system (including in patients without the clinical manifestations of IHD, but with increased risk factors for its occurrence - over 55 years old, nicotine addiction, arterial hypertension, genetic predisposition), incl. against the background of dyslipidemia - secondary prevention in order to reduce the total risk of death, myocardial infarction, stroke, re-hospitalization for angina pectoris and the need for revascularization.
Contraindications
hypersensitivity, liver disease in the active stage (including active chronic hepatitis, chronic alcoholic hepatitis), increased activity of hepatic transaminases (more than 3 times compared with the upper limit of normal) of unclear origin, liver failure, cirrhosis of any etiology, pregnancy and lactation period.
Use during pregnancy and lactation
Atorvastatin passes through the placenta and reaches the fetal liver level equivalent to that in the mother's plasma. Atorvastatin did not show teratogenicity in rats when used in doses up to 300 mg / kg / day and in rabbits at doses up to 100 mg / kg / day. These doses created an exposure 30 (rats) and 20 (rabbits) times the exposure in humans (in terms of body surface area, in mg / m2).
In studies in rats receiving atorvastatin at doses of 20, 100 and 225 mg / kg / day from the 7th day of pregnancy to the 21st day of lactation, there was a decrease in the survival of cubs at birth, newborns, and the maturation of cubs of females who received 225 mg doses of atorvastatin / kg / day A decrease in body weight on days 4 and 21 was recorded in young females, those who received atorvastatin at a dose of 100 mg / kg / day decreased body weight at birth, on days 4, 21 and 91 - at a dose of 225 mg / kg / day. Delayed development was observed at a dose of 100 mg / kg / day (rotor activity) and 225 mg / kg / day (fear with sounds, disturbance of the formation of the auricle, opening time of the eyes). These doses correspond to AUC values of 6 (100 mg / kg) and 22 times (225 mg / kg) higher than AUC in humans at a dose of 80 mg / day. Rare cases of congenital abnormalities have been observed after intrauterine exposure to HMG-CoA reductase inhibitors.
Cholesterol and other substances synthesized from cholesterol are important for fetal development (including the synthesis of steroids and cell membranes). Since HMG-CoA reductase inhibitors reduce cholesterol synthesis and, possibly, the synthesis of other biologically active substances - cholesterol derivatives, these drugs can have a harmful embryonic effect when taken by pregnant women. In this regard, HMG-CoA reductase inhibitors are contraindicated during pregnancy and breastfeeding.
There is one report of severe congenital bone deformity, tracheo-esophageal fistula and anal atresia (VATER association) in a child born to a mother who took lovastatin with dextroamphetamine sulfate in the first trimester of pregnancy.
The safety of atorvastatin in pregnant women has not been established.
FDA category of action for the fetus is X.
Women of childbearing age can take atorvastatin only if they use reliable contraceptive measures. If the patient is planning a pregnancy, she should stop taking the drug at least 1 month before the planned pregnancy. In case of pregnancy during treatment, atorvastatin should be discontinued immediately. The patient should be informed of a possible risk to the fetus.
Animal experiments have shown that atorvastatin passes into rat milk. The levels of drugs in the plasma and liver of young nursing animals are from those in human milk 50 and 40%, respectively.
It is not known whether atorvastatin is secreted into human milk. Since a serious negative effect on the baby is possible, when taking atorvastatin, it is necessary to stop breastfeeding.
Special instructions
Before starting therapy with atorvastatin, the patient must be prescribed a standard hypocholesterol diet, which he must observe during the entire period of treatment.
The use of HMG-CoA reductase inhibitors to lower blood lipids can lead to a change in biochemical parameters that reflect liver function. Liver function should be monitored before starting therapy, 6 weeks, 12 weeks after starting atorvastatin and after each dose increase, and periodically, for example, every 6 months. An increase in the activity of “liver” enzymes in the blood serum can be observed during therapy with Atorvastatin. Patients with an increase in enzyme levels should be monitored until the enzyme levels return to normal. In the event that the values ​​of alanine aminotransferase (ALT) or aspartic aminotransferase (AST) are more than 3 times higher than the upper acceptable limit, it is recommended to reduce the dose of atorvastatin or discontinue treatment.
Atorvastatin should be used with caution in patients who abuse alcohol and / or have liver disease. Active liver disease or a persistent increase in the activity of aminotransferases of unknown origin serve as contraindications to the appointment of Atorvastatin.
Treatment with atorvastatin may cause myopathy. The diagnosis of myopathy (muscle pain and weakness in combination with an increase in the activity of creatine phosphokinase (CPK) by more than 10 times compared with the upper limit of the norm) should be discussed in patients with common myalgia, pain or muscle weakness and / or a marked increase in CPK activity. Patients should be warned that they should immediately inform the doctor about the appearance of unexplained pain or weakness in the muscles, if they are accompanied by malaise or fever. Atorvastatin therapy should be discontinued if there is a marked increase in CPK activity or in the presence of confirmed or suspected myopathy. The risk of myopathy in the treatment of other drugs of this class increased with the simultaneous use of cyclosporine, fibrates, erythromycin, nicotinic acid or azole antifungal agents. Many of these drugs inhibit the metabolism mediated by cytochrome P450 3A4 and / or drug transport. Atorvastatin is biotransformed under the influence of CYP 3A4. Prescribing atorvastatin in combination with fibrates, erythromycin, immunosuppressive agents, azole antifungal agents or nicotinic acid in hypolipidemic doses, the expected benefit and risk of treatment should be carefully weighed and patients should be regularly observed to detect muscle pain or weakness, especially during the first months of treatment and during periods of increasing doses of any drug. In such situations, periodic determination of CPK activity can be recommended, although such control does not prevent the development of severe myopathy.
When using Atorvastatin, as well as other drugs of this class, cases of rhabdomyolysis with acute renal failure due to myoglobinuria are described. Atorvastatin therapy should be temporarily discontinued or completely discontinued if there are signs of a possible myopathy or a risk factor for the development of renal failure due to rhabdomyolysis (e.g., severe acute infection, arterial hypotension, serious surgery, trauma, severe metabolism, endocrine and electrolyte disturbances and uncontrolled convulsions).
Before starting Atorvastatin therapy, it is necessary to try to achieve control of hypercholesterolemia by adequate diet therapy, increased physical activity, weight loss in patients with obesity and treatment of other conditions.
Patients should be warned that they should immediately consult a doctor if unexplained muscle pain or weakness occurs, especially if they are accompanied by malaise or fever.
Composition of
One tablet contains:
active substance:
atorvastatin calcium trihydrate (in terms of atorvastatin) - 10.00 mg
excipients: microcrystalline
microcrystalline cellulose - 49.68 mg,
lac calcium carbonate - 33.00 mg,
crospovidone - 7.50 mg,
carboxymethyl starch sodium (sodium starch glycolate) - 4.50 mg,
hyprolose (hydroxypropyl cellulose) - 3.00 mg,
magnesium stearate - 1.50 mg
film coat:
[hypromellose - 2.250 mg, talc - 0.882 mg, hyprolose (hydroxypropylcell lulose) - 0.873 mg, titanium dioxide - 0.495 mg] or [dry mix for film coating containing hypromellose (50.0%), talc (19.6%), hyprolysis (hydroxypropyl cellulose) (19.4%), titanium dioxide (11.0%)] - 4,500 mg.
Dosage and Administration
Inside.
Before prescribing Atorvastatin, the patient should be advised of a standard lipid-lowering diet, which he must continue to follow throughout the duration of therapy.
The initial dose is an average of 10 mg / day. The dose varies from 10 to 80 mg / day.
The drug can be taken at any time of the day with food or regardless of the meal time. The dose is selected taking into account the initial levels of cholesterol / LDL, the purpose of therapy and individual effect. At the beginning of treatment and / or during an increase in the dose of Atorvastatin, it is necessary to monitor plasma lipid levels every 2–4 weeks and adjust the dose accordingly.
To ensure the dosage regimen for the drug given below, it is possible to use the drug Atorvastatin in another dosage form: film-coated tablets, 10 mg and 20 mg. The maximum daily dose of the drug is 80 mg.
With simultaneous use with cyclosporine, the daily dose of atorvastatin should not exceed 10 mg.
Primary hypercholesterolemia and mixed hyperlipidemia. In most cases, a dose of 10 mg of Atorvastatin once a day is sufficient. A significant therapeutic effect is observed after 2 weeks, and the maximum therapeutic effect is usually observed after 4 weeks. With prolonged treatment, this effect persists.
Special patient groups
Impaired renal function. The use of the drug in patients with renal failure and kidney disease does not affect the level of atorvastatin in the blood plasma or the degree of decrease in cholesterol / LDL when it is used, therefore, changing the dose of the drug is not required.
Impaired liver function. With liver failure, the dose must be reduced.
Elderly patients. When using the drug in elderly patients, differences in safety, the effectiveness or achievement of the goals of lipid-lowering therapy in comparison with the general population was not observed.
Side effects of
In controlled clinical trials (n = 2502), less than 2% of patients discontinued treatment due to side effects caused by atorvastatin. The most common adverse effects associated with taking atorvastatin were constipation, flatulence, dyspepsia, and abdominal pain.
From the nervous system and sensory organs:? 2% - headache, asthenic syndrome, insomnia, dizziness
From the cardiovascular system:? 2% - chest pain, blood pressure, phlebitis, arrhythmia, angina pectoris, anemia, lymphadenopathy, thrombocytopenia.
From the respiratory system:? 2% - sinusitis, pharyngitis, bronchitis, rhinitis
From the digestive tract:? 2% - abdominal pain, constipation or diarrhea, dyspepsia, flatulence, nausea
From the musculoskeletal system:? 2 % - arthralgia, myalgia, arthritis
From the genitourinary system:? 2% - urogenital infections, peripheral edema
From the skin:
Allergic reactions:? 2% - skin rash
Other:? 2% - infection, accidental injury, flu-like syndrome, back pain of alkaline phosphatase, increased ALT or AST, exacerbation of gout.
Side effects noted in post-marketing studies with atorvastatin therapy: anaphylaxis, angioedema, bullous rash (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), rhabdomyolysis, tendon rupture.
Drug interactions
The risk of developing myopathy with statins is increased when used in combination with cyclosporine, fibrates, erythromycin, nicotinic acid in lipid lowering doses, strong CYP3A4 inhibitors (including clarithromycin, HIV protease inhibitors).
When using atorvastatin in combination with inhibitors of the CYP3A4 isoenzyme (for example, cyclosporine, macrolide antibiotics - erythromycin and clarithromycin, itraconazole, HIV protease inhibitors), plasma concentrations of atorvastatin may increase (atorvastatin metabolism should be used with caution if you take CYP3 by the above means (see "Special Instructions").
With the combined use of atorvastatin at a dose of 40 mg and itraconazole at a dose of 200 mg once a day, an increase in AUC of atorvastatin by 3 times was revealed compared with AUC with monotherapy.
Concomitant use of atorvastatin with protease inhibitors (lopinavir / ritonavir, ritonavir / saquinavir) was accompanied by an increase in plasma concentrations of atorvastatin. With the simultaneous use of atorvastatin at a dose of 40 mg and the combination of lopinavir + ritonavir (at a dose of 400/100 mg 2 times a day), an increase in AUC of atorvastatin by 5.9 times was revealed compared with AUC with monotherapy. When using atorvastatin at a dose of 40 mg with a combination of ritonavir + saquinavir (at a dose of 400/400 mg 2 times a day), its AUC increased 3.9 times.
Antacids reduce the concentration of atorvastatin by 35% (the effect on LDL cholesterol does not change).
With repeated use of digoxin and atorvastatin, Css digoxin increases by about 20% (patients should be monitored).
When combined with atorvastatin and oral contraceptives, the AUC of norethindrone and ethinyl estradiol increases by about 30 and 20% (this effect should be taken into account when choosing an oral contraceptive for a woman receiving atorvastatin).
When taken with erythromycin (a CYP3A4 inhibitor), the plasma concentration of atorvastatin increases by approximately 40%. The hypolipidemic effect of the combination of atorvastatin with colestipol is superior to that for each drug individually. Simultaneous use with drugs that reduce the concentration or activity of endogenous steroid hormones (including ketoconazole, spironolactone, cimetidine), increases the risk of reducing the production of endogenous steroid hormones (caution should be exercised).
With oral administration of atorvastatin and a suspension containing magnesium and aluminum hydroxide, plasma concentrations of atorvastatin decreased by approximately 35%, but the degree of decrease in cholesterol / LDL levels did not change.
Overdose
Treatment: No specific antidote, symptomatic therapy is performed.
Hemodialysis is ineffective.
Storage conditions
Store in a dry, dark place, out of the reach of children, at a temperature of 15 ° C to 30 ° C.
Shelf life
2 years.
Deystvuyushtee substance
Atorvastatin
Terms and conditions otpuska IZ pharmacy prescription
Appointment
Appointment
For adults prescribed by a doctor
atorvastatin tablets is covered.ob. 10 mg 90 pcs. (Atorvastatin) florida in pharmacy online. Cheap price, instruction, side effects, dosage. atorvastatin tablets is covered.ob. 10 mg 90 pcs. - Sale. PayPal accept. Free shipping florida. Fast international shipping.
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