Inexpensive and effective analogues of Atorvastatin: TOP 5 drug substitutes

Atorvastatin is a lipid-lowering drug, a statin. Instructions for use indicate how to properly take 10 mg, 20 mg, 40 mg and 80 mg tablets of Teva and Lexwm to lower blood cholesterol levels in adults, children and pregnancy. What Atorvastatin helps with, information on prices, analogues and patient reviews will also be presented in the article.

Combination forms of Atorvastatin

The price of the drug Atorvastatin (patient reviews confirm this) remains affordable for a wide range of patients.
It is a relatively safe medication that can be combined with other classes of drugs. Most often, Atorvastatin and other statins are released in isolation, that is, there is only one active ingredient in one tablet. However, there are also combined forms. Examples are the following drugs: “Caduet”, “Duplekor”, “Statinam”. Here, Atorvastatin is combined with amlodipine, a calcium channel blocker, which is also often used in the treatment of cardiac pathologies. The dosage of this drug is selected by the doctor.

Interaction

In addition to drugs containing only atorvastatin, combined forms are also used in the treatment of patients with concomitant pathology.

Examples of such combinations are:

• “Liprimar” (of the products containing atorvastatin, this was the first to go on sale, passed all the necessary clinical trials and is original).
• "Caduet";
• "Duplekor";
• "Statins."

These medications combine atorvastatin with amlodipine, a substance belonging to the class of calcium channel blockers. Such drugs are widely used in the treatment of patients suffering from arterial hypertension.

Consequently, such combination drugs are convenient to use in cases where high blood cholesterol and vascular atherosclerosis are combined in one patient with arterial hypertension syndrome.

The dosage of drugs is selected individually in each specific case, depending on the initial level of blood pressure and cholesterol concentration in the blood. Based on the results of further monitoring of blood parameters and blood pressure, the initial dosage may be changed depending on the dynamics.

The duration of the therapeutic course is also determined individually.

Interaction of Atorvastatin with other medications

Atorvastatin may not work with all medications, and sometimes taking two medications together can cause severe side effects.

A negative reaction of the body can occur when taking Atorvastatin and Niacin, as well as when taking statins and antifungal medications simultaneously.

If you take Digoxin and Atorvastatin at the same time, then the concentration of Digoxin increases, and the concentration of Atorvastatin increases to the level of the maximum dosage of the drug.

A change in pharmacokinetics is observed when Atorvastatin is taken simultaneously with the drug Ethinyl estradiol, as well as with the drug Norethindrone.

It is also not recommended to take Atorvastatin and grapefruit juice. The juice reduces the medicinal effect of the statin, but increases its negative impact on organs and systems in the body.

It is not recommended to take Atorvastatin and grapefruit juice

Drug interactions

When treating with Atorvastatin, various reactions are possible with the simultaneous use of other groups of drugs:

• Metabolic transformation of atorvastatin occurs with the participation of the cytochrome P450 3A4 system. When it is combined with its inhibitors, the plasma content of statin increases, which manifests itself in a more powerful effect. The intensity of the processes depends on the power of the inhibitors. Co-administration with Cyclosporine, Clarithromycin, Ketocconazole and other drugs should not be allowed. If it is impossible to cancel the combination dose, you should carefully consider the dosage and monitor the patient’s condition.
• Pomegranate juice exhibits inhibitor properties and can increase the concentration of atorvastatin.
• Combination with gemfibrozil should be avoided, since a synchronous course increases the risk of myopathy and/or rhabdomyolysis.
• The dosage of Atorvastitan should be reduced when combined with niacin to avoid skeletal muscle disorders.
• The content of Atorvastatin increases when combined with diltiazem, drugs with antacids. Dosage adjustment is needed.

Caution is required when combined with transport protein inhibitors, as the exposure of Atorvastatin may increase. If concomitant use cannot be avoided, careful titration of dosages should be carried out.

The threat of side effects of muscle tissue, the development of rhabdomyolysis, increases when combined with ezetimibe.

Since the specific pharmacological interaction with fusidic acid has not been studied, the patient’s condition must be carefully monitored. It is possible that if undesirable conditions develop, it will be necessary to stop taking Atorvastatin.

When combined with oral contraceptives, the concentration of hormones may increase, so the choice of contraceptives must be done with particular care.

Combination with Warfarin may lead to the development of myopathy and/or rhabdomyliosis.

Atorvastatin indications for use

Before starting treatment, it is necessary to determine the indications for use of the drug. They stem from the main mechanism of its action and are associated with a hypocholesterolemic effect. Range of indications:

• hereditary (familial) heterozygous hypercholesterolemia;
• polygenic (primary) hypercholesterolemia class IIa according to Fredrickson;
• combined (IIb) dyslipidemia;
• homozygous familial hypercholesterolemia;
• hypertriglyceridemia (statin treatment in combination with diet and exercise);
• conditions associated with atherosclerotic damage to the vascular wall of the heart, brain, kidneys, and limbs;
• arterial hypertension with high cardiovascular risk;
• prevention of acute coronary events against the background of existing atherosclerotic lesions of the coronary arteries;
• prevention of recurrent myocardial infarction or cerebral stroke.

These indications determine the cases when the prescription of the drug Atorvastatin is required. Reviews from doctors about its use clearly confirm this need. It is a proven fact that statins, including Atorvastatin with its numerous generics, are much safer than the cardio forms of acetylsalicylic acid, although they also help to significantly reduce the likelihood of developing a first myocardial infarction and a second case.

conclusions

The article tells you everything patients need to know about using atorvastatin. This includes detailed descriptions of side effects, a question that worries everyone. Doctors will also find a lot of useful information for themselves. Atorvastatin lowers “bad” cholesterol in the blood more than the previous generation of statins - lovastatin and simvastatin. It not only slows down the development of atherosclerosis, but also reduces the thickness of atherosclerotic plaques. Older drugs do not affect cholesterol deposits that have already appeared on the walls of the arteries.

Rosuvastatin is an even newer drug than atorvastatin. Currently, the main competition among statins in the pharmaceutical market is between these drugs. Atorvastatin is not thought to increase the risk of diabetes mellitus as much as rosuvastatin. Atorvastatin may be preferable for patients with heart failure. Although the manufacturers of rosuvastatin are unlikely to agree with this :). Atorvastatin appears to protect the kidneys better than rosuvastatin in patients with type 1 and type 2 diabetes. The choice of a specific drug should be made by the attending physician. Do not self-medicate.

General information about the drug and instructions for use

Atorvastatin belongs to the third generation of lipid-lowering drugs of the statin group. Compared to the drugs of the first two generations, it copes better with the task, with fewer side effects and contraindications.

About 70-75% of cholesterol is produced by the liver and only about 25% comes from food. Statins help reduce the production of a substance by the liver, the main source of cholesterol.

The medication inhibits the process of cholesterol formation in hepatocytes (80% of this substance is formed in the body itself from dietary fats, and only 20% comes from outside through the digestive system). The drug acts on the enzyme that catalyzes the reaction of cholesterol formation, thus inhibiting it.

On the other hand, the drug helps remove excess low-density lipoproteins from the bloodstream. This is one of the fractions of cholesterol that settles on the walls of blood vessels and forms atherosclerotic plaques. With the correct dosage, the effect of the drug reaches its peak within a month and reduces cholesterol levels in the blood to physiological norms.

If within a month the effectiveness of the medicine has not manifested itself properly, the doctor will adjust the dose.

Atorvastatin is available in various dosages (10, 20, 30, 40 and 80 mg). Begin the course of treatment with the smallest dosage. If advanced atherosclerosis occurs, the doctor will individually prescribe a higher dose as the initial dose. Doing this on your own is strictly prohibited. The drug has contraindications and side effects.

Which manufacturer is better?

The drug "Atorvastatin" is produced by various domestic pharmaceutical companies, "Canonpharma", "Teva", "Vertex". Each manufacturer differs in production technology, degree of purification and quality of auxiliary ingredients in the dosage form.

We recommend paying attention to Israeli-made Atorvastatin (). The manufacturer has established itself as a conscientious and reliable company; the active substance is highly purified, which eliminates the side effects stated in the instructions

Use of atorvastatin

Atorvastatin is a statin medicine that improves blood cholesterol levels. It lowers levels of “bad” LDL cholesterol as well as triglycerides, and increases “good” HDL cholesterol. Atorvastatin, like other statins, has proven effectiveness in the prevention of first and recurrent heart attacks and ischemic strokes. Prescribing this drug reduces the likelihood that you will have to undergo stenting, coronary bypass surgery, surgically remove atherosclerotic plaques from the carotid artery, or restore blood flow in the legs.

It is officially believed that atorvastatin inhibits the development of atherosclerosis because it lowers “bad” LDL cholesterol. Anecdotal evidence is that statins are beneficial because they reduce chronic, low-grade inflammation. This can be seen as blood test results for C-reactive protein and other inflammatory markers improve. Free radicals stop oxidizing LDL cholesterol, and therefore it is not deposited on the walls of the arteries, no matter how much of it circulates in the blood. This point of view is gaining increasing popularity among specialists.

Atorvastatin is one of the newer statins. It lowers LDL cholesterol more than the previous generation of drugs - lovastatin and simvastatin. It may be less effective than rosuvastatin. More than 40,000 patients took part in foreign clinical trials of this drug, of which 40% were over 65 years of age, 7% were over 75 years of age. This medicine has been well studied and has proven effectiveness in middle-aged and elderly people, as well as for adolescents suffering from hereditary familial hypercholesterolemia. The original drug of atorvastatin is called Lipitor. Until 2012, until its patent expired, this drug was sold for an astronomical amount - more than $125 billion.

Reducing “bad” cholesterol

Atorvastatin is one of the most popular statins around the world and in Russian-speaking countries. Doctors prescribe it to lower “bad” LDL cholesterol in their patients. Experts are also paying more and more attention to the additional effects of statins that are not related to cholesterol. These effects are called pleiotropic. The main one is the reduction of chronic low-grade inflammation in the blood vessels. It is possible that the reduction in the incidence of heart attack, stroke and other cardiovascular “events” in patients is due precisely to the pleiotropic effects of atorvastatin, and not to the normalization of cholesterol.

Atorvastatin is prescribed in dosages from 10 to 80 mg per day. The expected reduction in “bad” cholesterol is 36-53%. The higher the dose the patient takes, the more his LDL cholesterol will decrease. At the same time, as the dose increases, the frequency of side effects increases. Atorvastatin not only lowers LDL, but also increases the level of “good” HDL cholesterol. This effect is not linearly related to drug dosage. Increasing the daily dose will not necessarily cause an additional increase in the concentration of HDL cholesterol in the blood. In any case, the atherogenicity coefficient will become closer to normal.

To keep cholesterol, triglycerides and atherogenicity levels normal, switch to a low-carbohydrate diet. This will allow you to reduce the dosage of atorvastatin or even completely abandon statin treatment.

Atherosclerosis

Atorvastatin inhibits the development of atherosclerosis. Thanks to this, the risk of a first and repeated heart attack, ischemic stroke, leg problems, and the need to surgically restore blood flow through the arteries is reduced. Officially, statins are believed to help against atherosclerosis because they reduce LDL cholesterol. The lower the cholesterol level, the less of it is deposited on the walls of the arteries in the form of plaques.

An alternative point of view is that the anti-inflammatory effect of statins is the main one. If chronic inflammation is suppressed, cholesterol will not be oxidized by free radicals. LDL cholesterol, which is in a normal state, not oxidized, is not deposited on the walls of blood vessels, no matter how much it circulates in the blood. The level of chronic inflammation is determined by blood tests for C-reactive protein. High doses of atorvastatin, up to 80 mg per day, may be required to reduce “bad” LDL cholesterol to normal levels. However, to improve C-reactive protein blood test results, taking lower doses is usually sufficient. Monitor your C-reactive protein levels, not just your “good” and “bad” cholesterol.

Atorvastatin was the first statin to be proven to reduce the size of atherosclerotic plaques. Later, the same property was discovered in rosuvastatin. Before the study results were published, it was believed that statins could only slow down the development of atherosclerosis, but had no effect on existing plaques. In order for the volume of atherosclerotic plaques to begin to decrease, LDL cholesterol must be reduced by 40% or more. Articles in medical journals in English and Russian generally recommend that doctors be bolder in prescribing high-dose statins to their patients, rather than limiting themselves to low and medium doses.

Unfortunately, not everything is clear with the use of atorvastatin and other statins for the treatment of atherosclerosis. These drugs reduce cholesterol deposits on artery walls. At the same time, they stimulate the deposition of calcium in blood vessels. Arteries coated with calcium deposits become stiff and not as flexible as normal. This is considered an advanced stage of atherosclerosis. First, soft cholesterol plaques appear, and then hard calcium is added to them. Read the article “Statins and atherosclerosis” for more details. Find out how to prevent calcium from coating your artery walls and slow down aging.

Cardiac ischemia

People diagnosed with coronary artery disease are those at high cardiovascular risk. They need to take atorvastatin or other statins as part of a combination of medications. The benefits of statins will be much greater than the possible risk of side effects. As is known, the cause of coronary heart disease is atherosclerosis of the coronary vessels. Atorvastatin inhibits the development of atherosclerosis or even reduces the volume of atherosclerotic plaques. Thanks to this, patients reduce the risk of heart attack and stroke, as well as manifestations of atherosclerosis of the vessels through which blood flows to the brain and lower extremities.

In 2013, the journal “Atherosclerosis and Dyslipidemia” published information on the results of treatment with atorvastatin in 25 patients diagnosed with coronary heart disease.

All patients took the drug 80 mg per day. We did not use the original drug Liprimar, but the generic atorvastatin-Teva.

Studies have proven that atorvastatin is an effective and very safe treatment for older people and diabetics suffering from coronary heart disease. Moreover, for middle-aged patients who have a lower risk of side effects. If you have stable coronary heart disease, you can not rush to undergo stenting or coronary bypass surgery, but first try to be treated with medications, including high doses of cholesterol drugs. Also read the article “Preventing Heart Attack and Stroke” and follow the steps it describes.

Foreign studies compared the effectiveness of drug and surgical treatment of coronary heart disease. It turned out that in stable patients, surgery does not reduce mortality or the risk of cardiovascular disaster. But surgical treatment is expensive, and the patient has a considerable risk of dying on the operating table. The AVERT (Atorvastatin VErsus Revascularization Treatment) trial showed that taking atorvastatin 80 mg daily along with other medications for 18 months was as effective as surgery in stable patients with coronary artery disease at low risk of heart attack. Surgical treatment is necessary if medications do not help much, as well as in acute cases.

After a heart attack

Atorvastatin or other statins should be started as soon as possible after the patient has a heart attack. This will reduce the risk of a recurrent heart attack and improve rehabilitation results. In 2005, the results of the IDEAL - Incremental Decrease in End-points through Aggressive Lipid-lowering study were published. It turned out that in the long term, atorvastatin at a high dosage of 80 mg per day does not help people who have had a heart attack any better than simvastatin 20 mg per day. 8888 patients took part and were followed for almost 5 years. In this study, patients were not prescribed statins immediately, but only 21-23 months after the heart attack. In the first hours and days after a heart attack, medium and high doses of statins are likely to improve the prognosis better than low doses.

Statins are prescribed to patients who are indicated for surgical treatment of cardiovascular diseases. In 2004, the results of the ARMYDA study - Atorvastatin for Reduction of MYocardial Damage during Angioplasty - were published. People who took atorvastatin 40 mg per day before coronary angioplasty had more favorable outcomes from surgery than patients who did not receive statins. Another study, called STATIN STEMI, showed that atorvastatin could be given at 10 or 40 mg per day before stent surgery for 7 days with no difference.

Ischemic stroke

Long-term treatment with statins reduces the risk of stroke in patients with hypertension, coronary heart disease and diabetes. In 2004, an analysis of several studies on the effectiveness of statins in preventing stroke was published in English. It said atorvastatin reduced the risk of stroke by 41% and simvastatin by 34%. Statins for stroke prevention should be taken even by people who have normal cholesterol, but have other risk factors, especially elevated C-reactive protein.

To find out how effective atorvastatin is in preventing recurrent stroke, the SPARCL study - Stroke Prevention by Aggressive Reduction in Cholesterol Level - was conducted with the participation of 4371 patients. Patients who had suffered an ischemic stroke within the previous 6 months were prescribed atorvastatin 80 mg per day, in addition to standard treatment. There was also a control group of patients who took a placebo instead of the real medicine. All patients were followed for about 5 years.

Read detailed articles:

• Ischemic stroke
• Hemorrhagic stroke
• Stroke treatment
• Rehabilitation after stroke

Among patients treated with atorvastatin, the incidence of recurrent stroke decreased by only 16% compared with the placebo group. It would seem that the result is modest. But it turned out that the problem was the low commitment of the study participants. Many patients did not take the real cholesterol drug prescribed to them. On the other hand, in the placebo group, many patients took statins that were prescribed to them by doctors at other medical institutions. By changes in blood cholesterol levels, you can determine whether the patient is taking statins or not. Among patients who were actually treated with statins, the rate of recurrent stroke decreased by 31%.”

Compound

The instructions for use, reviews and clinical recommendations attached to the drug "Atorvastatin" do not contain information about the differences in dosage forms. In practice, such differences exist, and they regulate the dynamics of the therapeutic action.

What is important is how quickly the therapeutic effect of the dose taken occurs. That is why the dosage form of the original drug “Liprimar” is the reference

The dosage form consists of atorvastatin calcium and a tablet shell. The latter, in turn, consists of calcium carbonate, microcrystalline cellulose, lactose monohydrate, polysorbate 80, croscarmellose sodium, magnesium stearate, hydroxypropylcellulose, talc, titanium dioxide, polyethylene glycol, hydroxypropylcellulose, simethicone emulsion, benzoic and sorbic acid.

The instructions for use attached to the original drug "Atorvastatin" (reviews also indicate this) do not contain information about the mass of each component. This is a trade secret of the American company PFIZER HCP CORPORATION. It is this composition of the Liprimar dosage form that makes it possible to achieve a constant concentration of atorvastatin in the blood.

High cholesterol in children

Atorvastatin is prescribed to adolescents who have been diagnosed with a rare hereditary disease - heterozygous familial hypercholesterolemia. You can be treated with this drug, like other statins, starting from the age of 10 years. Girls can only take statins one year after their first menstruation occurs.

Atorvastatin is no more likely to cause side effects than placebo in the treatment of familial hypercholesterolemia. There is no data on the effectiveness of this medicine in children under 10 years of age. During clinical studies, the original drug Liprimar was prescribed to children and adolescents in dosages not exceeding 20 mg per day. Therefore, there is no information about how higher doses might work.

Atorvastatin important information about the drug

Do not miss an appointment with your doctor or laboratory tests. During your treatment, your doctor may order additional laboratory tests, especially if you have symptoms of liver damage.

Before you have any laboratory tests/tests (for example, for other medical conditions), tell your other healthcare providers or laboratory personnel that you are taking Atorvastatin.

Be careful to ensure that no one else in your family accidentally takes this drug. The best option is to store absolutely all medications in places that are difficult for children (and pets) to reach.

It is important to keep a written list of all prescription and over-the-counter drugs you take (as well as vitamins, minerals or other dietary/biological supplements). You should bring this list with you every time you visit a doctor or if you are admitted to a hospital.

Also, this will be no less (!) important information in case of emergency situations.

Adverse reactions

Probably, every person has had a situation when the medicine does not help, but, on the contrary, worsens their well-being. This means that an adverse reaction has occurred and the medication must be stopped immediately.

You should stop taking the medicine and consult a doctor if you have the following symptoms:

• an increase or decrease in blood glucose for no apparent reason (typical for diabetics, almost never occurs in healthy people);
• exacerbation of gouty processes;
• increased sweating;
• unmotivated weight gain (no changes in diet);
• various skin rashes;
• alopecia (develops very rarely);
• swelling (the most dangerous is swelling of the face, which can develop into Quincke's edema);
• urinary disturbances (oliguria, anuria);
• myospasms of any localization;
• the appearance of symptoms of arthritis;
• cramps (usually localized in the area of ​​the feet and calf muscles);
• decreased potency and suppressed sexual desire;
• uterine bleeding (in women);
• nosebleeds;
• bleeding of mucous membranes (in the mouth, rectum or vagina);
• stomatitis;
• dyspeptic disorders;
• biliary or intestinal colic;
• obstructive jaundice;
• exacerbation of bronchopulmonary pathologies;
• the appearance of signs of arrhythmia and angina pectoris;
• hearing and vision impairment;
• migraine;
• asthenic syndrome;
• sleep disorders;
• a change in the blood count (anemia, thrombocytopenia), which is sometimes detected with long-term use of the medicine.

The list looks scary and impressive, but in fact there is no big reason for concern - Atorvastatin is well tolerated by patients, and the risk of developing negative reactions is very small.

Atorvastatin analogs and substitutes

The original drug is not the only one of its kind. Based on the main active ingredient, a lot of generics have been created with similar (for example, Atoris, Atokor, Atormak or Atorvox), and sometimes completely different (Torvacard, Tulip, Vasator), trade names, differing in the composition of additional components. Some of them are cheaper, and some are downright more expensive. They can be replaced one with another, but only with the knowledge of the attending physician.

Which statin based on atorvastatin is better?

On pharmacy packaging, next to the original name there is often an abbreviation or another word, for example, Atorvastatin SZ or Atorvastatin MS. These particles represent different manufacturers. In these cases we are talking about Russian pharmaceuticals and Medisorb. On other packages you can see additional words “Pranafarm”, “Ozone”, “LEKSVM”, “Vertex”, “Canonpharma”, “Akrikhin”, “Actavis”, “Biocom”, “ALSI Pharma”.

Among the imported analogues you can find Atorvastatin Alkaloid (Macedonia), Atorvastatin Teva (Israel), Ananta (India), Pfizer (USA), Bluefish (Sweden), Ratiopharm (Germany), “ Avexima (international company)… It is impossible to reliably say which company’s drugs are better. In fact, these are synonyms, direct analogues. Statins called Atorvastatin contain the same active substance. They differ only in their auxiliary components: tablets can be replaced using those with fewer side effects in an individual treatment regimen. However, like drugs based on atorvastatin with other trade names.

This is evidenced by reviews from specialists and patients: well-tolerated drugs based on atorvastatin were selected for patients, and the replacement did not affect the results of the lipid profile. But no one has yet succeeded in fully replacing pharmacological products with folk remedies.

The difference between Atorvastatin and Rosuvastatin, Simvastatin and Lovastatin

The drug under discussion is a third-generation synthetic statin. Below it in rank and older in terms of time of release into therapeutic practice are synthetic Fluvastatin, semi-synthetic Simvastatin and Pravastatin and natural Lovastatin. More modern lipid-lowering drugs include the latest generation synthetic drugs Pitavastatin and Rosuvastatin. What is the difference between them?

Lovastatin is made from waste products of Aspergillus fungi. Its production is troublesome, time consuming and not worth the money spent. The same raw materials are used in the manufacturing process of Simvastatin and Fluvastatin. These statins are prodrugs: their metabolites act on lipid metabolism, not themselves. Therefore, a certain time must pass before the desired effect is achieved. In contrast, Atorvastatin, Pitavastatin or Rosuvastatin are already ready to fight “bad” cholesterol immediately after entering the blood.

The situation is similar with the degree and speed of influence on the body: drugs of the 3rd and 4th generations are much more effective (Simvastatin - 2 times, Pravastatin and Lovastatin - 4 times, Fluvastatin - 8 times). However, both doctors and patients are interested in which statin is safer. And here it all depends on the chemical formula of the drug. Fat-soluble Lovastatin, Simvastatin and Atorvastatin penetrate brain cells more easily. And side effects from the central nervous system become more likely compared to water-soluble Rosuvastatin, Fluvastatin and Pravastatin. But the latter have a stronger effect on liver cells, which can be manifested by an increase in the level of liver enzymes in the blood.

Comparison of statins in terms of their effect on HDL and LDL cholesterol levels

If we compare drugs of the latest generations, the main thing that distinguishes Atorvastatin from Rosuvastatin and Pitavastatin is that it is less effective (2 times) and, accordingly, has a smaller list of adverse reactions. In addition, the concentration of the most modern drugs in the blood is not affected by food intake, while the content of other statins depends on the time of eating.

Lovastatin, Simvastatin or Atorvastatin, Rosuvastatin: which of them is better to tell the doctor. But from the standpoint of evidence-based medicine, the choice fell on statins with synthetic active ingredients atorvastatin or rosuvastatin. The latter include Rosart, Rosucard, Mertenil, Crestor, Suvardio, Cardiolip and many others. But if patients intend to take medications only based on medicinal herbs, then clover extract (Atheroclephyte Evalar) can replace synthetics.

Analogues of the drug Atorvastatin

Analogues are determined by structure:

1. Vasator.
2. Lipona.
3. Liptonorm.
4. TG tor.
5. Tulip.
6. Atoris.
7. Torvacard.
8. Atorvox.
9. Liprimar.
10. Atorvastatin Teva.
11. Lipoford.
12. Anvist.
13. Atomax.
14. Torvazin.
15. Atorvastatin LEKSVM.
16. Atocord.

Application

Indications for use: what is the drug prescribed for? What does Atorvastatin help with?

Hypercholesterolemia

The use of Atorvastatin is justified as a dietary supplement when an increase in cholesterol is detected, as well as:

• increased LDL (low-density lipoprotein), apolipoprotein B and triglycerides;
• to increase the level of HDL cholesterol (high-density lipoprotein) in patients with primary hypercholesterolemia (hereditary heterozygous and non-hereditary hypercholesterolemia), combined (mixed) hyperlipidemia (Fredrickson type IIb and III), elevated plasma triglyceride levels (Fredrickson type III);
• when diet does not have sufficient effect.

Atorvastatin is recommended for use in order to lower total cholesterol and LDL cholesterol in people with homozygous hereditary hypercholesterolemia, if there is no sufficient response to diet or other non-drug measures.

Prevention of complications from the heart and blood vessels

Atorvastatin is prescribed to patients who do not have clinical signs of heart and vascular disease, with identified/absent dyslipidemia, but who have multiple risk factors for the formation of coronary artery disease (coronary heart disease) - smoking, high blood pressure, diabetes mellitus, low HDL.

The drug is used for the following purposes:

• reducing the risk of fatal coronary artery disease and non-fatal myocardial infarction;
• minimizing the likelihood of stroke, angina pectoris, hospitalization for the development of CHF (chronic heart failure).

Use in childhood (patients 10–17 years old)

The administration of Atorvastatin in childhood is recommended as an addition to the diet used to reduce cholesterol and apolipoprotein B levels if there is a history of heterozygous hereditary hypercholesterolemia.

The medicine is approved for use in girls only after the onset of the first menstruation

The drug is used if, despite dietary nutrition, the child maintains the following indicators:

• LDL exceeds 190 mg/dl;
• LDL exceeds 160 mg/dL, but if the patient has a predisposition to developing heart and vascular diseases at the genetic level or there are two or more factors that increase this risk.

Pharmacological group

Atorvastatin is a lipid-lowering drug that belongs to the selective inhibitors of HMG-CoA reductase. This is an enzyme that takes part in the formation of cholesterol deposits. Taking pills reduces the production of “bad” cholesterol and stimulates the formation of “good” cholesterol. According to the instructions for use, systematic use of the drug allows you to reduce the amount of total cholesterol by 40–60% and suppresses its synthesis by liver cells. Clinical trials have shown that after a course of taking the drug, the risk of developing myocardial infarction and coronary heart disease is significantly reduced. In addition, taking the drug improves the functioning of the myocardium, blood vessels, and provides the heart muscle and brain structures with the necessary amount of oxygen. Quite often, the drug is prescribed as a prophylactic for people who are at risk of developing heart pathologies.

The drug is adsorbed in the gastrointestinal tract. After taking the drug, its maximum concentration in the blood plasma is observed after 2 hours. Atorvostatin is excreted by the kidneys within 20 hours after administration.

Pharmacokinetics

The drug has a high degree of absorption. The maximum concentration in the blood is reached two hours after taking the tablet. Eating food reduces the absorption of the drug, while a decrease in the concentration of LDL cholesterol is achieved when using Atorvastatin on an empty stomach. The concentration of the drug in the evening is reduced by 30% compared to morning administration. When conducting research, experts found that the degree of absorption directly depends on the dosage. Metabolism is carried out primarily by the liver. The drug is excreted from the body with bile without passing through enterohepatic recirculation. A urine test detects no more than 2% of the medication taken. It is not excreted during hemodialysis. It should be said that in women, the absorption of the active substance is 20% higher, and in alcohol addicts suffering from liver cirrhosis, it is 16 times higher.

Atorvastatin tablets

The drug Atorvastatin is available in the form of pale yellow or milky white tablets, enteric-coated. The drug reduces the concentration of lipids in the blood and the amount of total cholesterol. Triglyceride levels are reduced due to the drug's inhibition of the isoenzyme responsible for fat synthesis.

Compound

The drug Atorvastatin is a lipid-lowering drug from the statin group. The medicine contains a selective competitive enzyme inhibitor that inhibits the synthesis of cholesterol in the body. Thanks to this action, the concentration of low-density lipoproteins is reduced and the formation of cholesterol plaques is prevented.

When taken orally, Atorvastatin cholesterol tablets are quickly absorbed through the wall of the small intestine and enter the bloodstream. The bioavailability of the main active ingredient is 60% of its maximum concentration. Plasma protein binding reaches 95%. The components of the drug are partially metabolized under the influence of liver enzymes, after which they are excreted from the body in urine, feces, and sweat.

With prolonged use, the medication can accumulate in the body, for example, if kidney function is reduced, and have some toxic effect on internal organs. In this case, there is a rapidly passing fever (at night), headache, and general weakness. In combination with decreased liver function, the accumulation of the drug can cause general poisoning of the body.

The drug Atorvastatin is used to lower cholesterol levels in atherosclerotic lesions of the cardiovascular system, the presence of plaques of small and large capillaries. The lipid-lowering effect is achieved by combining adequate diet therapy and the use of drugs that inhibit the synthesis of cholesterol in the blood plasma and muscles. Main indications for use:

• heart attack;
• stroke;
• skeletal muscle myopathy;
• severe smooth muscle myopathy;
• Lyell's syndrome;
• angina pectoris;
• hereditary or familial hypercholesterolemia.

Features of application

Before prescribing Atorvastatin, doctors try to restore lipid balance through diet, physical activity, and weight loss. In essence, this tactic continues throughout the entire period of statin treatment. Immediately before the first dose of the drug, liver function is monitored. Then it becomes permanent: 1.5 weeks after the start of therapy, after 3 months, and then every six months and after each dosage change.

In addition, treatment regimens for concomitant diseases are reviewed before starting therapy. For high blood pressure, hypothyroidism, obesity, liver pathology, select compatible medications or change the dosage of those used, according to the annotation. Patients are also warned about the possibility of myopathy, and therefore they are required to report any muscle pain to their doctor.

The minimum course of treatment is not designed for a couple of days, but will last as long as the specialist says. Usually the minimum is several months. After all, lipid imbalance has developed over years or even decades. And it will also take a long time to fix it. Therefore, there should be no question about whether you can take a break on your own: you must take the pills constantly. Atorvastatin can be taken for years without a break, but a lipid profile will tell you how long this will have to be done in each specific case.

For liver dysfunction

Atorvastatin is approved only in the absence of liver pathology or mild liver failure. However, the need for its use and the possibility of replacing it with other agents that do not affect the liver are assessed. Monitoring the functional activity of hepatocytes in the case of liver failure is of particular importance. Tests must be done on time and after proper preparation.

For impaired renal function

Only 2% of Atorvastatin metabolites are excreted in the urine. Therefore, the condition of the kidneys does not affect its content in the blood. Patients with renal pathology do not require treatment adjustment: the dosage of a statin depends only on the level of “bad” cholesterol.

What is Atorvastatin?

Atorvastatin belongs to the lipid-lowering drugs of the statin group. The pharmacological effect of the drug is reduced to a decrease in the level of low-density lipoproteins and an increase in the level of high-density lipoproteins. In other words, the product cleanses the blood of “bad” cholesterol and maintains the level of “good” cholesterol. Tablets are available in the following dosages: 10, 20, 40 and 80 mg.

The first results of treatment are observed 2 weeks after the start of treatment, the maximum effect occurs after a month.

The pharmacological group of the drug is biconvex tablets, coated with a white coating. The healing substance is calcium trihydrate, and the additional components in the tablet are:

• magnesium stearate;
• Aerosil;
• starch and lactose;
• microcrystalline cellulose;
• calcium carbonate;
• opadray.

The use of the drug reduces the risk of heart disease.

After completing the course of taking Atorvastatin, positive results are observed, thanks to which the drug received good reviews:

• reducing the likelihood of developing a heart attack, coronary heart disease;
• there is an improvement in heart function and vascular patency;
• prevention of stroke and cardiovascular diseases is carried out.

Return to contents

Contraindications

The drug is metabolized by liver cells, and if their function is severely impaired, Atorvastatin is contraindicated. This applies not only to obvious liver pathology with acute or chronic failure, but also to hidden processes in which the content of liver enzymes in the blood is increased (3 times or more). Such changes can occur after past liver diseases, electrolyte imbalance, endocrine pathology, metabolic disorders, sepsis.

An absolute contraindication to the use of Atorvastatin is intolerance to any of its components.

As for compatibility with alcohol, it is not advisable to drink alcohol while taking any medication. And since the toxic effect of “high degree” drinks especially affects the liver, they are contraindicated in treatment with statins.

During pregnancy and breastfeeding

There have been no studies in this direction, and no one knows how Atorvastatin affects the fetus and whether it passes into breast milk. Therefore, it is not prescribed to pregnant women, and if there is an absolute need to take it during lactation, the child is transferred to artificial feeding. In this regard, women of reproductive age while taking a statin are recommended to use adequate methods of contraception in order to reduce the likelihood of pregnancy to zero.

For children

Atorvastatin is prescribed only to adults, and it is intended both for the treatment of lipid metabolism disorders and for the prevention of cardiovascular complications against the background of already developed vascular atherosclerosis. The effect of a statin on children and adolescents has not been studied enough, so doctors do not risk using it in patients under 18 years of age.

Side effects

Taking the drug causes a number of side effects, including:

• dizziness, insomnia, migraine, general weakness;
• respiratory tract diseases;
• arrhythmia, angina pectoris, orthostatic hypotension, chest pain, increased blood pressure;
• disruption of the gastrointestinal tract;
• seborrhea, eczema, profuse sweating, dermatitis;
• myalgia, convulsions;
• swelling, weight gain.

The drug should be taken with caution by people suffering from hypertension - Atorvastatin can increase blood pressure.

Blood pressure problems as a side effect

It is worth noting that the instructions for use note among the side effects of the drug an increase in blood pressure, which is why hypertensive patients should monitor the tonometer readings during therapy. In addition, there have been cases where the drug enhanced the effect of hypertensive medications. Let us remind you that Atorvastatin is contraindicated in the presence of arterial hypotension (low blood pressure).

The drug Atorvastatin is a lipid-lowering drug from the group of statins. The drug selectively and effectively inhibits HMG-CoA reductase, an enzyme that regulates the conversion of HMG-CoA to mevalonate, which is a precursor of sterols, including cholesterol.

Reduces the formation of LDL and total cholesterol by 30-46%, LDL - by 41-61%, apolipoprotein B - by 34-50% and TG - by 14-33% increases the level of high-density lipoproteins and apolipoprotein in the blood. The concentration of the active substance in the blood plasma is proportional to the dose taken.

Atorvastatin is used for hypercholesterolemia as an addition to the diet if the diet does not provide the desired effect. Reduces the risk of ischemia and mortality in patients of all ages with non-Q wave myocardial infarction and unstable angina.

Atorvastatin can be prescribed to patients without symptoms of cardiovascular disease (with or without dyslipidemia), however, there are several risk factors for the development of cardiovascular disease (including hypertension, diabetes mellitus, smoking, low levels of high-density lipoprotein cholesterol or the presence of a genetic predisposition to diseases of the cardiovascular system at a young age).

Atorvastatin tablets photo

Composition - 1 film-coated tablet contains the active substance atorvastatin calcium trihydrate - 10.85 mg and 21.70 mg, which corresponds to 10 mg and 20 mg of the active substance.

The maximum concentration of AB in the blood plasma is achieved after 1-2 hours; it should be noted that the maximum concentration in the blood of women is 20% higher. The concentration of Atorvastatin depends on the time of taking the tablet, so when taken in the evening, the level of AB is lower than in the morning (by approximately 30%).

The half-life from the body is 14 hours.

Side effects

During treatment with Atorvastatin, its negative manifestations may be observed in the body:

• There is an exacerbation of gouty inflammations,
• The pathology of mastodynia is worsening,
• Quite rarely, but the body accumulates extra pounds,
• Albuminuria appears
• Decreased blood glucose (hypoglycemia),
• Quite rarely, blood sugar increases, hyperglycemia,
• Petechiae and ecchymoses appear.
• Seborrhea occurs
• Eczema appears on the skin,
• The pathology of xeroderma manifests itself,
• Pathology alopecia,
• There is an increased secretion of sweat by the body,
• Swelling of angioedema nature,
• Anaphylactic shock,
• Stevens-Johnson syndrome, as well as Lyell's syndrome,
• Erythema exudative.
• Skin rashes that cause severe itching
• Contact type dermatitis
• Hives,
• Swelling of angioedema nature.

Quite rarely, increased blood sugar (hyperglycemia)

For the genitourinary and muscular systems

The negative impact of the presence of statin drugs in the body is felt by the urinary and urinary systems, and muscle tissue cells of the musculoskeletal organs:

• There is a decrease in libido in women,
• There is severe impotence,
• Epididymitis develops
• Pathology metrorrhagia,
• The disease nephrourolithiasis,
• Vaginal and uterine bleeding,
• Pathology hematuria,
• nephritis disease,
• Disorders such as dysuria,
• Disorders in joint contractures,
• Muscle tone is impaired
• Pathology of torticollis,
• Rhabdomyolysis disease,
• Inflammation arthralgia,
• Myalgia disease,
• Pathology tenosynovitis and bursitis,
• Inflammatory processes in the joints, arthritis,
• Cramps in the muscles of the lower extremities.

Cramps in the muscles of the lower extremities

Side effects on the respiratory and digestive systems

Taking the medication Atorvastatin also negatively affects all internal organs of the digestive tract, affects the respiratory system, and damage to the mucous membranes is felt:

• Stomatitis in the oral cavity,
• Dry mouth
• Severe bleeding from the gums,
• Frequent constipation
• Severe intestinal upset, diarrhea,
• Constant urge of the body to empty the intestines,
• Bloating in the stomach, flatulence,
• Pain in the abdominal region,
• Colic of the liver organ,
• Jaundice,
• Inflammatory processes in pancreatic cells, pancreatitis,
• Inflammation in the duodenum,
• Painful stomach cramps pathology gastralgia,
• Gastric pathology gastroenteritis,
• Inflammation on the tongue, glossitis,
• Anorexia,
• Severe nausea, causing strong vomiting from the body,
• Fatty and black feces are melena,
• Bronchitis,
• Asthma of bronchial etiology,
• Apnea,
• Blood from the sinuses
• Inflammation in the lungs, pneumonia.

Blood from the sinuses

Side effects on the hematopoietic and blood flow systems

The negative effect of the drug Atorvastatin is felt by the hematopoiesis and hemostasis system, as well as the blood flow system and organs that acutely sense deviations in the blood supply:

• Anemia develops
• Thrombocytopenia appears
• Pathology of the lymphatic system, lymphadenopathy,
• Unstable cardiac angina,
• There is no rhythm in the heart organ - arrhythmia,
• Pathology phlebitis,
• Increased blood pressure index,
• Chest pain
• Rapid heartbeat, tachycardia,
• Complete or partial loss of taste,
• Glaucoma of the visual organ,
• Hearing impairment, deafness,
• Hemorrhage of the optic organ,
• Dry eyes
• Ringing and noise in the ears.

Side effects on brain cells

From disturbances in the blood flow system, the brain reacts most clearly:

• The patient loses consciousness
• Pathology hypoesthesia,
• Depressive state
• Migraine pains,
• Pathology of hyperkinesis,
• Nerve palsy in the facial area,
• Partial or complete amnesia
• Neuropathy of the peripheral parts of the human body,
• Pathology paresthesia,
• Nightmares,
• Drowsiness during the day and insomnia at night,
• General malaise in the body,
• Pathology asthenia,
• Head pain that varies in intensity
• There is dizziness in the head, sometimes quite strong.

Spinning in my head

How to use Atorvastatin 20 correctly?

Atorvastatin 20 is a drug whose action is aimed at lowering cholesterol levels in the blood. The drug has a large number of side effects, so it should be used only as prescribed by a doctor.

pharmachologic effect

The drug has the following properties:

1. Suppresses the activity of the enzyme that regulates the rate of conversion of fats to mevalonate. This substance belongs to sterols, among which cholesterol, which is dangerous for the human body, is detected.
2. Reduces cholesterol and LDL (low density lipoprotein) levels. The amount of high-density protein-fat compounds increases while taking the drug. This becomes possible due to the suppression of the action of the reductase enzyme and a decrease in the sensitivity of liver receptors.
3. Prevents the development of ischemic heart damage, angina pectoris and heart attack in patients of any age.
4. Reduces the risk of deadly cardiovascular diseases. Prevents disruption of cerebral blood supply leading to stroke.

Pharmacodynamics and pharmacokinetics

1. After administration, part of the active substance is absorbed by the intestinal walls and penetrates the blood. The maximum concentration of the drug depends on the dose taken.
2. The human body absorbs approximately 15% of the active component. This is explained by the breakdown of the substance in the digestive tract and binding to blood plasma proteins.
3. The drug is excreted from the body in urine and feces in the form of inactive metabolic products.

Release form, composition and packaging

The drug is available in the form of white and round tablets. Each contains:

• atorvastatin calcium trihydrate (20 mg);
• corn starch;
• calcium carbonate;
• talc;
• titanium dioxide;
• iron oxide;
• silica.

Tablets are packaged in contour cells of 10 pcs. They are delivered to pharmacies in cardboard boxes, including 3 blisters and instructions for use.

Our readers successfully use ReCardio to treat hypertension. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

What does Atorvastatin 20 help with?

The drug is prescribed for the following conditions:

• a primary increase in cholesterol levels due to the ineffectiveness of a lipid-lowering diet;
• mixed hypertriglyceridemia and hypercholesterolemia;
• hereditary high cholesterol levels that cannot be corrected through diet.

How to take Atorvastatin 20

When taking the medicine, you should consider the rules of use.

How much to take

The dosage is selected depending on the initial level of cholesterol and low-density protein-fat compounds. Treatment begins with 10 mg of Atorvastatin per day. Subsequently, the dose is gradually increased to 80 mg per day.

In the first weeks of therapy and when changing the dosage, control tests for blood lipids are carried out.

Before or after meals

Tablets are taken regardless of meals.

In the morning or evening

The drug can be used at any time of the day.

At what pressure

If you have high blood pressure, it is not advisable to take the medicine.

How long does it take to work?

Atorvastatin begins to act within 20 minutes after entering the digestive system.

Side effects

The following side effects may occur while taking medications:

1. Neurological disorders. Patients complain of dizziness, sleep problems, general weakness, nightmares and migraines.
2. Decreased visual and hearing acuity. The drug causes retinal hemorrhages, glaucoma, and inflammation of the conjunctiva.
3. Impaired functions of the circulatory system (decreased levels of hemoglobin, platelets and lymphocytes).
4. Breathing problems. The drug can cause inflammation of the bronchi and lungs, short-term respiratory arrest, and attacks of bronchial asthma.
5. Digestive disorders. When taking Atorvastatin, pain and a feeling of heaviness in the stomach, flatulence, diarrhea, and belching occur. Ulceration of the intestinal mucosa is less common.
6. Myopathy, convulsive syndrome, inflammation of the joint membranes.
7. Dysfunction of the excretory system. During treatment, cystitis, swelling of the lower extremities, and genitourinary infections often occur.
8. Skin manifestations (baldness, increased sensitivity to sunlight, increased sweating, erythematous rashes).

From the cardiovascular system

Side effects in this category include:

• chest pain;
• tachycardia;
• signs of vasodilation;
• drop in blood pressure;
• inflammation of the venous walls;
• angina pectoris.

Special instructions when using Atorvastatin 20

The dosage and regimen depend on the age and condition of the person.

Use of the drug during pregnancy and lactation

Atorvastatin should not be taken during pregnancy and breastfeeding.

The drug passes into breast milk, causing a negative effect on the baby's body. If treatment is necessary, breastfeeding is abandoned.

Young women should use effective contraception during therapy.

Use in children

The use of the medicine by patients under 18 years of age is not allowed.

Use in old age

The effect of the drug on the body of a patient over 55 years of age is the same as on the body of a younger person.

Use for renal impairment

The presence of diseases of the excretory system does not affect the absorption and excretion of the active substance, therefore, if renal failure is detected, the dosage is left the same.

Use for liver dysfunction

For liver diseases, Atorvastatin is taken in smaller doses.

Alcohol compatibility

When using the drug against the background of alcohol consumption, the effect of Atorvastatin may be weakened or side effects may increase. Therefore, during treatment they refuse to consume alcoholic beverages.

Impact on the ability to drive vehicles and complex mechanisms

During treatment, it is recommended to refrain from driving a car or other vehicles.

Contraindications

• for severe liver pathologies;
• in case of intolerance to the components of the drug;
• with decompensated diabetes mellitus;
• with increased transaminase activity.

Overdose

In case of overdose, increased side effects are observed. Treatment consists of symptomatic and supportive measures.

Drug interactions

The risk of undesirable consequences increases when the drug is used together with antibiotics and antifungals.

The use of Atorvastatin in combination with cardiac glycosides requires monitoring of vital signs. When taking the drug and hormonal contraceptive pills simultaneously, the effectiveness of the latter decreases. Atorvastatin is compatible with antihypertensive drugs.

Analogs

Analogs of Atorvastatin 20 include:

• Torvacard (capsules);
• Atoris (tablets);
• Liprimar (injections and tablets).

Conditions of release and storage

The drug is stored in a dry place, protected from light.

Can I buy it without a prescription?

Tablets are dispensed with a doctor's prescription.

The average price of 30 tablets is 120 rubles.

Best before date

Shelf life: 24 months from the date of manufacture.

Manufacturer

Drugs based on atorvastatin are produced by the following companies:

• "Teva", Israel;
• "Kanonpharma", Russia;
• "Northern Star", Russia;
• "Vertex", Russia;
• "Izvarino Pharma", Russia.

Reviews

Andrey, 49 years old, Yakutsk: “Atorvastatin helped quickly, cholesterol returned to normal, the unpleasant manifestations of hypercholesterolemia disappeared. However, the diet must be followed even after completion of treatment. The drug has an affordable price, is highly effective, and is well tolerated by the body. I don’t plan to take it often; I maintain normal cholesterol levels with diet.”

Svetlana, 55 years old, Yuzhnouralsk: “During a general blood test, a high level of cholesterol was detected. I was prepared for long-term, expensive treatment, but the doctor prescribed Atorvastatin, which has an affordable price. I completed the full course of treatment, but the amount of cholesterol remained the same. I consider the drug ineffective, so I decided to take better products.”

Atorvastatin analogues in alphabetical order

Astin, Atokor, Atorvakor, Atoris, Atormak, Vabadin, Vazilip, Crestor, Livostor, Limistin, Lipostat, Liprimar, Pravastatin, ROSUVASTATIN, Simvakor, Simvastat, Simvastatin, Storvas, Tolevas, Torvacard, Tulip, Emstat, Etset

Other drugs are analogues of Atorvastatin, which are not sold (or are rare):

Abitor, Aztor, Aktastatin, Allesta, Atorem, Atrox, Atrolip, Zosta, Lescol, Liperoz, Lipidex, Lipicor, Lipimax, Lipitin, Lipristat, Liprox, Lovahexal, Lovacor, Lovastatin, Lovasterol, Mevacor, Redistatin, Rofast, Simvacol, Simvalimit, Simvasandoz, Torvadak, Escolan.

Classification of statins

1. The first is called natural, and was obtained from penicillin fungi. The drugs often cause side effects and have little effect on cholesterol molecules.
2. Secondly, they have a gentle effect on the body, their effect turns out to be more effective than natural ones.
3. Third, in addition to the main effect, they stimulate the formation of high-density cholesterol and help reduce the level of triglycerides, which provoke the development of atherosclerosis.
4. Fourth - they are recognized as the most effective and safe, easily accumulate in the body and significantly reduce cholesterol levels.

You should not take these drugs without a doctor's prescription: the drugs have a number of side effects. A specialist should explain how to take statins correctly and at what time of day after laboratory tests and anamnesis of the disease. When taking statins, you should be aware of interactions with other drugs. When broken down, they can be blocked by other substances and not have a therapeutic effect. When taking statins for cholesterol, the patient should carefully monitor his health and, if his condition worsens, seek medical help.

Indications for use

The conditions for which statins are prescribed are called dyslipidemias. Translated into simple language, this is a disorder of fat metabolism. It does not manifest itself in anything for a very long time, and only with intensive deposition of “bad” cholesterol in the vascular walls do typical atherosclerotic symptoms begin. In the initial stage, lipid imbalance is detected exclusively in the laboratory. The analysis is called a lipidogram, it includes the main indicators of fat metabolism - triglycerides, cholesterol, both total and included in fat-protein complexes, cholesterol transport proteins, as well as the atherogenicity coefficient.

Without determining the lipid profile (the second name for a lipid profile), it is impossible to determine the dosage and type of statin that the patient will take for a long time (and, possibly, throughout his life). In addition, a lipid profile is necessary to monitor treatment that has already begun. Venous blood is given for analysis after some simple preparation: without it, the results may be distorted.

The advantage of Atorvastatin is its effectiveness in the treatment of all types of hypercholesterolemia (hereditary and acquired). It reduces the level of “bad” cholesterol and transport proteins that can be deposited in the walls of the arteries. At the same time, it increases lipoprotein levels and increases the number of receptors that capture cholesterol for intracellular consumption or utilization. In addition, Atorvastatin reduces triglycerides in the blood, but this does not mean that it can be taken for weight loss.

The mechanism of action of the active substance is based on the suppression of the main enzyme that catalyzes the formation of cholesterol by liver cells. The enzyme is called hydroxymethylglutaryl-coenzyme A reductase, and Atorvastatin, accordingly, is an inhibitor of HMG-CoA reductase. It is this quality of the drug that allows not only to stop the growth of existing atherosclerotic plaques, but also to prevent their appearance in people with an increased risk of developing atherosclerosis. Therefore, it can be prescribed for those with a genetic predisposition to hypercholesterolemia at a young age or for heavy smokers and hypertensive patients after 55 years.

Statin does not treat blood vessels, but in case of coronary heart disease or cerebral atherosclerosis, it prevents complications such as heart attack or stroke. Indications for its use include acute forms of ischemic heart disease, conditions after them, and acute cerebrovascular accidents. Atorvastatin is also prescribed in the postoperative period in vascular medicine and cardiology. And the best results are achieved when the drug is taken in combination with other lipid-lowering drugs and in combination with other methods of correcting fat metabolism (diet, moderate physical activity, giving up bad habits).

Pharmacological characteristics

Atorvastatin is a drug from the statin group. The statin molecule binds to part of the coenzyme A receptor through competitive antagonism.

The drug has a positive effect on the condition of atheroma, the vascular wall with endothelial dysfunction, improves the rheological properties of blood, and has antiproliferative and antioxidant effects.

Atorvastatin reduces cholesterol levels in patients with familial homozygous hypercholesterolemia unresponsive to lipid-lowering drugs.

Analogues of the drug

All Atorvastatin tablets, reviews of which can be read below, are produced by various pharmacological companies. Most often, the names of drugs are modified, which allows them to be patented. The trade names of analogues, that is, drugs that contain atorvastatin as an active ingredient, are as follows: “Anvistat” and “Atocord”, “Atomas” and “Ator”, “Atorvox” and “Atoris”, “Vazotor” and “Lipoford”, "Liprimar" and "Liptonorm", "Novostat" and "Torvazin", "Torvacard" and "Tulip".

Also, some manufacturers produce their medicine “Atorvastatin” (reviews can be read below) under a similar trade name. Actavis, Vertex, Izvarino Pharma, ALSI Pharma, Canon Pharma, Obolentsensky Pharmaceutical Enterprise, Protek-SVM, Severnaya Zvezda, TABUK Pharmaceuticals, TEVA Pharmaceutical Industries and others produce the drug, name which consists of an INN (“Atorvastatin”) and a traditional prefix. An example is Atorvastatin Teva, reviews of which confirm its clinical effectiveness.

Analogs

1. Anvistat;
2. Atocord;
3. Atomax;
4. Atorvastatin LEKSVM;
5. Atorvastatin Teva;
6. Atorvox;
7. Atoris;
8. Vasator;
9. Lipona;
10. Lipoford;
11. Liprimar;
12. Liptonorm;
13. TG torus;
14. Torvazin;
15. Torvacard;
16. Tulip.

When choosing analogues, it is important to understand that the instructions for use of Atorvastatin, the price and reviews of drugs with similar effects do not apply. It is important to consult a doctor and not change the drug yourself.

Simvastatin and Atorvastatin - which is better?

Simvastatin is a natural statin, and Atorvastatin is a more modern statin of synthetic origin. Although they have different metabolic pathways and chemical structures, they have similar pharmacological effects.

Also, the drugs have the same side effects, but Simvastatin is much cheaper than Atorvastatin, so in terms of price factor, Simvastatin is a better choice.

Directions for use and dosage

The instructions for use indicate that treatment with Atorvastatin should be preceded by a special diet that helps lower blood cholesterol levels. It will need to be adhered to throughout the entire period of use of the product.

The initial dosage (recommended by the manufacturer) is 10 mg. If necessary, it can be increased to a maximum of 80 mg. Atorvastatin should be taken strictly at the same time of day, regardless of meals.

How long to take the product? The duration of the course is selected individually and depends on the diagnosis.

The development of the therapeutic effect should be expected after 14 days from the start of treatment. Its maximum is observed after 4 weeks of regular use, and for this reason it is advisable to review and change the initial dosage after a month from the start of therapy. The drug must be taken without interruption throughout the entire course prescribed by the doctor.

Dosages depending on the diagnosis:

• Hereditary/non-hereditary hyperlipidemia, combined dyslipidemia. The initial dosage (according to the annotation) is 10 mg daily. It can be increased to 80 mg.
• Homozygous familial hypercholesterolemia. The active substance range is 10–80 mg. The drug is prescribed as an additional drug to complement the prescribed treatment, or if therapy with other drugs is not possible.
• Heterozygous hereditary hypercholesterolemia in childhood (children 10–17 years old). The starting dosage is 10 mg per day. The maximum recommended is 20 mg per day. The rate is calculated individually and depends on the final goal. The dosage needs to be changed at intervals of 4 weeks, sometimes more.
• Prevention of the development of cardiovascular complications. In order to prevent possible complications, a dosage of 10 mg is used. If necessary, it can be increased.

Special patient groups:

• With kidney failure. Kidney pathologies do not affect the concentration of atorvastatin or reduce the level of LDL in the blood plasma. In this regard, no adjustment of the initial dosage is required.
• With liver dysfunction. The dosage is calculated individually, due to the slow rate of elimination of the active substance from the body.
• Elderly patients. Patients over 70 years of age do not need dosage adjustment.

Concomitant use of lipid-lowering drugs

Atorvastatin can be used with bile acid sequestrants

Concomitant use of HMG-CoA reductase inhibitors with drugs from the fibrate group should be done with caution.

Other combinations

Dosage in patients taking Itraconazole, Cyclosporine, Clarithromycin and protease inhibitors is discussed here. The recommendations will be as follows:

Concomitant use of Cyclosporine and HIV protease inhibitors or hepatitis C virus inhibitors with Atorvastatin is prohibited. In patients with HIV infection undergoing treatment with the combination of Lopinavir + Ritonavir, Atorvastatin is prescribed with caution. The dosage should be minimal. Patients taking Itraconazole, Clarithromycin, as well as HIV-infected patients (if they are receiving the following drug regimens: Saquinavir + Ritonavir, Darunavir + Ritonavir, Fosamprenavir, Fosamprenovir + Ritonavir) should receive a dose not exceeding 20 mg

When undergoing treatment with HIV protease inhibitors Nelfanavir or Boceprivir (hepatitis C virus protease inhibitor), the dosage of Atorvastatin is limited to 40 mg.

Description and composition

Atorvastatin is a drug from the statin group, the action of which is aimed at reducing the density and formation of lipoproteins in the lumen of blood vessels, increasing the density of “good” cholesterol in the blood plasma. The effect of taking the drug will be noticeable after 1 – 2 weeks of systematic use. To achieve the maximum therapeutic effect, you need to take the drug for at least 1 month. Reviews about the drug are quite good. Many doctors often use the drug in practice; they consider it one of the effective in the treatment of heart pathologies that manifest themselves against the background of high cholesterol levels in the blood.

The active component of the drug is calcium salt, which has the ability to suppress cholesterol synthesis in hepatocytes. The drug also contains auxiliary components that complement the effect of the drug.

Where to buy analogues of Atorvastatin

You can order medications online cheaper. The most trusted and largest online pharmacy chains are:

1. "Apteka.ru" - (https://apteka.ru). For comparison, let's imagine the prices of some tablets. “Atorvastatin-SZ” 10 mg 30 tablets – 147 rubles, “Tulip” 10 mg 30 tablets – 283 rubles.
2. (https://wer.ru) - “Atorvastatin-SZ” - 138 rubles, “Tulip” - 261 rubles.

In Moscow

Pharmacies in Moscow where you can always buy lipid-lowering drugs at a low price:

1. "Rigla", metro Paveletskaya, emb. Derbenevskaya, building 22. Phone: 8-800-777-03-03.
2. "EAPteka", metro Avtozavodskaya, st. Masterkova, 3. Phone: 8-800-775-03-33.

In St. Petersburg

1. "Rigla", metro station Kupchino, st. Balkanskaya, 17. Phone: 8-800-777-03-03.
2. "Ozerki", metro station Begovaya, st. Turistskaya, 10. Phone: 8-812-603-00-00.

Atorvastatin price

Pharmacological effect

Conventionally, we can distinguish 3 main directions in which Atorvastatin acts on the body:

1. Atorvastatin and its analogues act on the part of cholesterol metabolism that concerns its biosynthesis. This substance, as a result of a complex of biochemical reactions, inhibits cholesterol synthesis. After such exposure, the concentration of the atherogenic fraction of lipids decreases, and subsequently the intracellular cholesterol content, and the proportion of healthy fats increases. The consequence of the use of this substance is a significant slowdown in the growth of atherosclerotic plaques.
2. Atorvastatin also has an antioxidant effect, thanks to which it protects the inner surface of blood vessels from the negative effects of free radicals.
3. In addition, this substance can have a positive effect on the rheological parameters of blood, reducing its viscosity, which contributes to a significant improvement in hemodynamics and microcirculation in tissues.

General information

This drug is usually classified as a third generation of substances from the pharmacological class of statins.

Reducing the degree of progression of atherosclerotic plaques on the vascular endothelium as a result of a complex of biochemical reactions, Atorvastatin, however, does not cause involution of foci of cholesterol deposition. The diameter of vessels affected by atherosclerosis remains the same during the course of treatment.

The clinical effect of Atorvastatin is expressed in a significant slowdown in the development of coronary heart disease, cerebrovascular disease and arterial insufficiency of the lower extremities (due to slowing down the formation of plaques).

The degree of absorption of the drug is quite high. Food slightly reduces this indicator, but the decrease in the concentration of low-density lipoproteins in plasma does not change significantly.

Side effects of the drug

Atorvastatin may cause side effects. Tell your doctor if any of these symptoms are severe or mild (but don't go away):

• diarrhea;
• heartburn;
• flatulence;
• increased fatigue;
• joint pain;
• memory loss (difficulty concentrating).

Some side effects may be serious. The following symptoms are rare, but if you have any of them, contact your doctor immediately and get emergency medical help:

• muscle pain or weakness;
• heat;
• unexplained chest pain;
• nausea, vomiting;
• excessive sleepiness;
• unusual bleeding or bruising;
• loss of appetite;
• pain in the upper right side of the stomach;
• flu symptoms;
• dark colored urine;
• yellowing of the skin or eyes;
• rash/hives/itching;
• difficulty breathing/swallowing;
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or feet;
• hoarseness appears/voice disappears.

Atorvastatin may cause other side effects. Tell your doctor right away if you experience any unusual problems while taking this medicine.

Overdose

Symptoms of a drug overdose are not so common, but the following signs and conditions may still indicate their development:

• convulsions;
• nausea, urge to vomit;
• heart rhythm disturbance;
• headache.

The appearance of such symptoms is a reason to immediately consult a doctor. In a hospital setting, the patient will receive the necessary medical care.

Reviews

Yana When I was diagnosed with high cholesterol in my blood, I immediately decided to start treatment so as not to wait for complications. I went on a diet recommended by the doctor, gave up smoking, and started playing sports. The medication I was prescribed was Lovastatin, I took 20 mg for three months. Now the indicators are normal, but I continue to lead a healthy lifestyle.

Valery I was diagnosed with atherosclerosis by accident. During a hospital visit for another reason, the doctor ordered a blood test for biochemistry. It turned out that there was one more problem added to all of them. A complex treatment was prescribed, based on Lovastatin. I took it 40 mg in the evenings, then, when my readings were almost back to normal, the doctor reduced the dosage to 20 mg. The most difficult thing was to give up bad habits and poor nutrition, but the doctor explained that without this, treatment would be ineffective. I'm glad I listened to the doctor.

Irina was very surprised when she found out that I had high cholesterol in my blood. The doctor explained that in my case a hereditary factor played an important role. I was upset, but I had to get treatment. I immediately excluded fatty and other prohibited foods from my diet and started taking medications. I took Lovastatin 1 tablet (20 mg) per day, a month later I took a blood test again, and the doctor increased the dose to 2 tablets per day. I hope your cholesterol levels will return to normal soon.

Drug interactions Atorvastatin

To achieve an additive effect, atorvastatin can be prescribed in combination with ion exchange resins (cholestyramine). The combined use of atorvastatin with other HMG-CoA reductase inhibitors and fibrates should be avoided. The risk of developing myopathy during treatment with statins increases with simultaneous use of cyclosporine, fibrates, erythromycin, nicotinic acid preparations or azole antifungals. With long-term simultaneous use of atorvastatin and digoxin, the equilibrium concentration of the latter in the blood plasma increases by approximately 20%, which requires appropriate monitoring. In healthy individuals, the plasma concentration of atorvastatin increases by approximately 40% when used simultaneously with erythromycin (an inhibitor of cytochrome P450 3A4). With the combined use of atorvastatin with oral contraceptives, an increase in plasma concentrations of norethindrone and ethinyl estradiol was noted.

Price comparison table

The table shows the average price of medicines in Russia.

Lipid-lowering drugs of the statin group are available by prescription. They can be purchased at retail pharmacies or online.

Method of use of the drug "Atoris"

Recommendations on how to take Atoris come down to clarifying some aspects. In particular, the medicine is taken in the prescribed dose once a day after dinner before bedtime. A single dose can be 10, 20 and 40 mg. Since the drug is a prescription drug, a doctor's consultation is required to purchase it. It is he who, after analyzing lipid profile fractions and assessing the level of total blood cholesterol, is able to recommend the correct dosage of atorvastatin, its class analogues or generics.

For initial cholesterol levels of 7.5 and above, it is recommended to take 80 mg/day. A similar dosage is prescribed to patients who have suffered a myocardial infarction or are in the acute period of its course. At concentrations between 6.5 and 7.5, the recommended dose is 40 mg. 20 mg is taken when the cholesterol level is 5.5 – 6.5 mmol/liter. 10 mg of the drug is recommended for children aged 10 to 17 years with heterozygous hypercholesterolemia, as well as adults with primary hypercholesterolemia.

Contraindications and side effects

Statins are a group of drugs that have a large number of side effects, which is why their independent use is unacceptable. Patients often complain about the following negative effects of Livazo:

• headache;
• nausea, urge to vomit, disturbances in stool stability (alternating constipation and diarrhea);
• pain in muscles and joints, myalgia;
• drowsiness or, conversely, insomnia;
• slight loss of taste;
• general malaise.

With long-term therapy with statins, some patients experience ringing in the ears, swelling on the body, and allergic-type rashes on the skin. The level of hemoglobin in the blood may decrease and the volume of transaminases may increase.

The rarest side effects of Livazo include impaired liver function, the development of acute pancreatitis, significant deterioration in memory and visual function, and a tendency to depression and psychosis. In isolated cases, patients taking statins have experienced nightmares, decreased libido, and loss of sexual function.

You should not take statin drugs, including Livazo, if you have the following health problems:

Doctor Myasnikov’s opinion on the benefits and harms of statins

• liver diseases occurring in acute form or their chronic forms in the acute stage;
• special sensitivity to the drug group statins and their active ingredients;
• galactose intolerance (including those having a hereditary etiology);
• malabsorption syndrome;
• simultaneous use of drugs from the cephalosporin group;
• myopathy.

Statins are not prescribed to patients under 18 years of age, as well as to women who are pregnant or breastfeeding a newborn child. If Livazo is recommended for use by a woman of childbearing age, she must take oral contraceptives so that an unexpected pregnancy does not occur during statin therapy.

What pressure does it help with and how to take Lisinopril correctly

Problems with blood pressure are one of the most common pathologies diagnosed in people of all ages. Chronic or sudden changes in indicators require correction with appropriate medications. One such drug is Lisinopril, from the instructions for use of which we learn at what pressure it should be used. We will also consider what contraindications should be taken into account before starting treatment.

• Instructions for use
• How to take the drug
• Contraindications and side effects
• Differences from other drugs
• Lisinopril or Enalapril – which is better?
• Diroton or Lisinopril - which is better?
• Lisinopril or Lozap – which is better?

• Use of drugs to increase blood pressure

• At what blood pressure is Indapamide taken?

• What does Diltiazem help with: instructions for use

At what blood pressure should Lisinopril be taken? The drug belongs to the group of ACE inhibitors. After taking the drug, vasodilation occurs, so it is indicated for hypertension. With regular use, the work of the heart muscle and blood circulation improves, and excess sodium salts are removed from the body. The drug effectively reduces diastolic and systolic parameters without affecting heart rate.

The drug is available in the form of tablets with different dosages. The color of the tablets depends on the amount of active substance. Deep orange – 2.5 mg, pale orange – 5 mg, pink – 10 mg, white – 20 mg. The price of Lisinopril is 70–200 rubles. depending on the dosage and number of tablets in the package.

The drug contains lisinopril dihydrate; depending on the manufacturer, the tablets may contain various additional substances that do not have a therapeutic effect.

Atorvastatin is a drug that lowers the level of lipoproteins in the blood.

Thus, the name of the active component of this medicine coincides with its name Atorvastatin - the basis of the drugs Vasilip, Liprimar, Atoris. Treatment with this medicine reduces the concentrations of lipoproteins in the human body. In other words, this drug can lower cholesterol.

Composition and release form

The active ingredient of the drug is lovastatin, which belongs to the group of statins. The product is available in different dosages: 20 mg or 40 mg of active substance. The composition includes auxiliary components: corn starch, cellulose, lactose, magnesium stearate, aerosil, bugylhydroxyanisole.

The release form of Lovastatin is white tablets with a yellowish tint. They have a convex shape, with a dividing strip in the middle. The tablets are placed in a blister; the cardboard packaging contains blisters and instructions for use of the drug.

The recipe in Latin looks like this: Lovastatini 0.1. D. td N 50 in tab. S, where Lovastatini is the name of the product, 0.1. D. td – dosage, N 50 in tab. S – release form.

Instructions

The manufacturer's instructions for the use of Lovastatin suggest the prescription of different doses and dosage regimens, depending on the nature of the pathology. It is prohibited to start taking the drug on your own; the prescription is made by the attending physician after a comprehensive diagnosis. When determining the dosage and other features of the use of the medicine, the doctor takes into account:

Another article:

Instructions for the drug Atoris

• how much cholesterol levels in the blood exceed the norm;
• what condition are the vessels in?
• what is the general condition of the patient;
• what other drugs will be prescribed and how they will be tolerated by the patient’s body.

Usually the initial dose of the drug is 20 mg per day. A month later, the patient is sent for a repeat blood test to determine the result - how effective Lovastatin was. If cholesterol levels have decreased, but only slightly, and the patient tolerates therapy normally, the daily dose may increase to 40 mg per day.

The patient must have a blood test monthly so that the attending physician can assess how rapidly cholesterol levels are being reduced.

The maximum permissible daily dose is 80 mg, but it is prescribed in rare cases, and the patient is under constant medical supervision. It is recommended to take the tablets in the evening with a small amount of water. The 80 mg dose can be divided into several doses.

Sometimes Lovastatin can be prescribed for prophylactic purposes, for example, to prevent diseases of the cardiovascular system. In this case, the daily dosage of the drug usually does not exceed 10–20 mg.

Known and safe analogues of Atorvastatin

Drug substitutes are drugs with the same active ingredients and dosage, but with different trade names, which are registered by pharmaceutical manufacturing companies.

Also, analogues may differ in the content of auxiliary components: preservatives, shell composition, which do not affect the pharmacological effect.

Atorvastatin and its analogues are produced by Russian and foreign companies. A proven reputation and good quality of medicines distinguish the pharmaceutical companies Pfizer, KRKA, Zentiva, Teva, Lek, North Star, Vertex.

Atoris

One of the best substitutes for Atorvastatin. Manufacturer: KRKA (Slovenia).

III generation lipid-lowering drug statins. Total cholesterol levels are reduced by decreasing LDL concentrations. The effect is dose dependent. The higher the dosage, the more the sterol level decreases. Only a doctor can calculate the exact dose, taking into account a biochemical blood test, the expected result, and existing chronic diseases.

Atoris is recommended for lowering cholesterol in patients with homozygous hyperlipidemia, which is resistant to conventional lipid-lowering drugs. Also prescribed for mixed hypercholesterolemia, dysbetalipoproteinemia.

The drug is effective as a prophylactic agent that prevents the development of vascular and heart diseases. It can be prescribed as secondary prevention to persons suffering from coronary artery disease, in order to reduce the risk of mortality, heart attack, and stroke.

Take 1 tablet/day, in the evening. If necessary, the dosage is increased every 4 weeks. Biochemical blood parameters must be monitored.

Atoris is well tolerated by the body. In very rare cases, adverse reactions from the nervous system are possible: headaches, insomnia, dizziness. Symptoms go away on their own and do not require specific therapy. But you need to inform your doctor about them; perhaps these are errors in the treatment regimen. They can be corrected by changing the medication or adjusting the dose.

Main contraindications: acute liver diseases. Prescribe with caution to children and adolescents under 18 years of age. There is insufficient clinical trial data on the effectiveness and safety of the drug for this age category.

Liprimar

An original drug produced by PFIZER (Germany). It was this company that received the license to produce Atorvastatin. The most expensive of all analogue drugs, price from 600 rubles.

It is highly effective in treatment. Available in packages from 14 to 100 tablets. This is convenient for patients who are just starting to take statins. At the beginning of treatment, you can buy a small package to evaluate the action and reaction of the body.

Take 1 piece/time per day, morning, afternoon or evening, regardless of food. Prescribed to adults, adolescents, and children over 10 years of age. The use of the drug in elderly people does not require dose adjustment.

Liprimar is well tolerated. Adverse reactions are rare and pass quickly. Discontinuation of the drug or adjustment of the daily amount is not required.

Liptonorm

Manufacturer: BIOPHARM Pvt. Ltd. (India). The main indications are primary, mixed hypercholesterolemia, homozygous hyperlipidemia, as an addition to diet and exercise.

Prescribe with caution to patients with mild or moderate functional liver disorders. Since the withdrawal of atorvastatin is slow, it is necessary to monitor blood biochemical parameters.

Do not take the drug if you have chronic active or alcoholic hepatitis. Contraindicated for pregnant and lactating women, children, and adolescents under 18 years of age. Taking the pills should be stopped 1-2 months before the planned pregnancy.

Torvacard

Manufacturer: ZENTIVA (Czech Republic).

Prescribed to reduce high levels of total cholesterol, for diseases of the cardiovascular system (increased risk of coronary artery disease, heart attack, stroke), severe stage of atherosclerosis (damage to the peripheral, carotid arteries, accompanied by severe clinical symptoms).

The drug can be used in complex therapy with fibrates and bile acid sequestrants. Dosage – 1 tablet/day, at any time of the day. The therapeutic effect is noticeable after 2 weeks. With long-term therapy, the achieved result is maintained.

During treatment with the drug, there were complaints of muscle pain. The presence of such symptoms requires consultation with a doctor. The medication may need to be changed.

Tulip

Analogue of Atorvastatin from the pharmaceutical company SANDOZ (Slovenia).

Prescribed to correct total cholesterol levels in patients with various forms of hypercholesterolemia. For the primary prevention of cardiovascular complications without signs of coronary artery disease, with high risk factors for its development (age over 50 years, chronic diabetes mellitus, stage II-III hypertension, low HDL concentration).

Standard dosage: 1 tablet/day, regardless of food.

Rarely, dizziness and coordination problems may occur in the nervous system. During treatment, it is advisable to avoid work that requires increased concentration and driving vehicles.

Atorvastatin-Teva

Manufacturer: TEVA (Israel). An inexpensive substitute for Atorvastatin, costing from 200 rubles.

Prescribed as the main remedy for the treatment of hypercholesterolemia, advanced atherosclerosis, prevention of cardiovascular complications after surgery or a heart attack.

Atorvastatin- OBL

Manufactured by FP Obolenskoe (Russia).

A lipid-lowering drug belonging to the third generation statins. Prescribed for the treatment of primary and secondary hypercholesterolemia, with increased serum levels of thyroglobulin.

A dosage of 80 mg is prescribed with caution to children and adolescents under 18 years of age, since the effectiveness and safety of the drug have not been established.

Novostat

The drug is from the pharmaceutical company Atol (Russia). Gelatin-coated capsules. Contents are a mixture of white powder and granules.

The Russian analogue of the drug Atorvastatin in capsules dissolves faster and enters the blood, but this does not affect the therapeutic effect. It is recommended for people suffering from stomach and duodenal ulcers.

The standard daily dose is 1 capsule, the dosage is set by the doctor separately for each patient.

Taking the drug is contraindicated during pregnancy, breastfeeding, and acute liver diseases. Prescribe with caution to patients who abuse alcohol.

Atomax

Manufacturer: pharmaceutical company Nizhpharm.

Prescribed as the main treatment for primary or secondary hypercholesterolemia. For greater effect, it must be combined with a diet that lowers total cholesterol levels.

Take 1 tablet once a day. The dosage is prescribed by the doctor. The daily amount depends on the initial parameters of the biochemical blood test and existing chronic diseases.

There is a possibility of developing side effects from the musculoskeletal system: cramps, muscle pain, joint pain. However, not in all cases a clear connection has been established between taking Atomax and adverse reactions.

Anvistat

Manufacturer Antiviral (Russia).

A synthetic drug from the statin group. Reduces cholesterol in individuals suffering from familial hypercholesterolemia. Prescribed as a preventive measure for cardiovascular complications. It is recommended to take it in the post-infarction, postoperative period to reduce the risk of relapses.

Studies have shown that there is no difference in effectiveness or safety when Anvist is used in elderly patients. No dosage adjustment is required.

Atorvastatin – SZ

Manufacturer: Russian company North Star.

Prescribed for the treatment of hypercholesterolemia of mixed or unspecified type, with atherosclerosis, coronary heart disease against the background of high cholesterol levels. It can be recommended to patients as a preventive measure to reduce the risk of cardiovascular diseases.

Atorvakor

A substitute for the drug Atorvastatin, produced in Ukraine by Farmak OJSC.

Take once a day, regardless of food, but at the same time. The dosage is determined by the doctor based on a biochemical blood test.

Can be prescribed to children and adolescents under 18 years of age who suffer from hereditary hypercholesterolemia and have increased risk factors for developing cardiovascular diseases.

Livostor

Manufacturer Kyiv Vitamin Plant.

Indicated for use in patients with high levels of cholesterol, triglycerides, and in patients with diabetes mellitus to reduce the risk of heart attack and stroke.

It is not recommended to combine with fibrates, cyclosporine, erythromycin - the risk of developing myopathy increases. Do not take simultaneously with antacids or colestipol, since the absorption of the drug is impaired and the effectiveness decreases.

Composition of the drug "Atoris"

The active substance is atorvastatin, a third generation statin. The auxiliary substances are the following: polyvinyl alcohol, titanium dioxide, macrogol 3000, magnesium stearate, talc, croscarmellose sodium, microcrystalline cellulose, lactose monohydrate, povidone, calcium carbonate, sodium lauryl sulfate.

Excipients determine the tablet dosage form and determine the rate of absorption of atorvastatin into the blood. Accordingly, any analogue of the Atoris drug should contain the same amount of active substance and be released at the same speed, creating similar concentrations in the blood.

Vasator

The tablets are classified as lipid-lowering drugs that reduce the concentration of NP lipoproteins. They are covered with a filmy dark pink or yellow shell and contain 10 or 20 mg of the active substance - atorvastatin calcium.

Used for hypercholesterolemia in the following cases:

1. Supplement to the diet to reduce the saturation of total cholesterol, NP lipoproteins, apolipoprotein B, glycerol-fatty acid compounds. It is used in the treatment of adult patients over the age of 18 years and adolescents with hereditary and mixed pathologies, when the functions of LDL receptors are not impaired. Serves as a supplement when the therapeutic effect of non-drug forms of therapy is insufficient.

2. Reducing elevated levels of cholesterol and NP lipoproteins in adults with impaired functioning of receptors that cause the rapid development of atherosclerosis, heart attacks, strokes, and sudden death. It is used for the targeted isolation of plasma from the donor’s blood, with the return of residual blood components to the patient.

Vasator is used in the prevention of cardiovascular pathologies. Among the main directions:

1. Prevention of cardiovascular diseases in adult patients with a high risk of pathologies, primary manifestations, as a correction of other risk indicators.
2. Prevention of recurrent cardiovascular disorders in patients with coronary heart disease in order to prevent myocardial infarctions, intracerebral hemorrhages, during hospitalization for certain forms of coronary artery disease, when surgical intervention is required to restore the arteries.

Vasator should not be used during pregnancy or adolescence under 18 years of age.

It is not recommended for use by women of reproductive age planning to conceive. Breastfeeding mothers should discuss with their doctor whether to temporarily stop breastfeeding. No severe consequences were observed in elderly patients.

Special instructions for the use of the drug Atorvastatin

The use of HMG-CoA reductase inhibitors is associated with liver dysfunction. It is recommended to perform liver function tests before starting treatment or increasing the dose of atorvastatin and after 12 weeks, and then periodically - once every six months. Typically, the level of liver enzymes increases in the first 3 months from the start of treatment. Patients with increased transaminase activity should be constantly monitored until these disorders disappear. An increase in ALT or AST concentrations more than 3 times the upper limit of normal is an indication for dose reduction or discontinuation of atorvastatin. Atorvastatin should be used with caution in patients with a history of liver disease. There are reports of cases of rhabdomyolysis with the development of myoglobinuria and acute renal failure when using drugs of the statin class. the development of myopathy, the manifestations of which are muscle pain and weakness in combination with an increase in CPK concentrations more than 10 times higher than the upper limit of normal, can be assumed in patients with diffuse myalgia, local muscle soreness, muscle weakness and/or a significant increase in CPK activity. Patients taking atorvastatin should be warned to seek immediate medical attention if they experience unexplained muscle pain, soreness, or weakness, especially when accompanied by general malaise or fever. If a myopathy is diagnosed or suspected, treatment with atorvastine should be discontinued immediately. Before prescribing atorvastatin, an attempt should be made to non-drug correction of hypercholesterolemia using an appropriate diet, increasing physical activity, reducing body weight in obese patients, and eliminating other risk factors and causes of secondary hyperlipidemia.

Similar preparations based on another active ingredient

Atorvastatin belongs to the statin drug group, but it is not the only drug on their list. There are more advanced dosage forms - 4th generation statins. They have a similar, pronounced effect and fewer side effects. Below are some of them.

"Rosuvastatin-SZ"

Russian medicine. , hence the “NW” marking in its name. The substance itself at the heart of the drug is rosuvastatin. Its mechanism of action is similar, but the medication itself is more potent and its safety profile is much higher.

Estimated cost: 150 rubles (for the smallest package). Release forms: 5, 10, 20, 40 mg. The number of tablets in a package can also be selected based on material capabilities. "Rosuvastatin-SZ" is produced in 30, 60, 90 tablets.

New analogues and substitutes for Liprimar based on IV (latest) generation statins (mainly rosuvastatin) are radically different in composition, but have a similar effect. They have a lower risk of side effects, so in some situations it makes sense to give preference to this option.

Crestor

Crestor is an original drug containing rosuvastatin. The imported analogue of Liprimar is characterized by faster results and better tolerability, but its price is much more expensive than other statins. This cost makes it completely unaffordable for most patients.

Specifics of the composition: the recipe includes a component undesirable for people with lactase deficiency - lactose monohydrate (milk sugar).

Manufacturer: Astra Zeneca, UK.

Average cost: from RUB 1,652/28 pcs. 5 mg each up to RUB 5,036/28 pcs. 40 mg each.

Indications

"Atorvastatin", according to reviews, is prescribed for the following pathologies and conditions:

- For primary hypercholesterolemia, heterozygous familial and non-familial hypercholesterolemia and combined hyperlipidemia (the drug is used in complex therapy, in combination with other drugs).

— In combination with a diet for the treatment of patients with high levels of triglycerides in the blood (Fredrickson type IV) and patients suffering from dysbetalipoproteinemia (Fredrickson type III), if the diet does not produce noticeable results.

— When reducing the amount of total cholesterol in patients with homozygous familial hypercholesterolemia, if diet and non-drug therapy are not effective enough.

This is confirmed by the instructions for use for Atorvastatin. Reviews and analogues are of interest to many.

Pharmacological properties of the drug Atorvastatin

Lipid-lowering agent, selective competitive inhibitor of HMG-CoA reductase. More effective than other statin drugs. In patients with hypercholesterolemia and hypertriglyceridemia, it effectively reduces the level of total cholesterol, LDL cholesterol (by an average of 60%), TG (by an average of 45%), VLDL cholesterol and apolipoprotein B in the blood serum, and helps to increase the level of HDL cholesterol (by an average of 12 %) and an inconsistent increase in the level of apolipoprotein A1. It can be used in patients with homozygous familial hypercholesterolemia, in which other lipid-lowering drugs are usually ineffective. The action is due to the ability to inhibit the activity of the liver-specific enzyme HMG-CoA reductase, responsible for the conversion of HMG-CoA into mevalonate, which is a precursor of sterols (including cholesterol). Blocking HMG-CoA reductase leads to a disruption in the formation of mevalonic acid and, consequently, to a decrease in the cholesterol content in the liver, resulting in a compensatory increase in the number of LDL receptors on the surface of hepatocytes, as well as an increase in the hepatic uptake and catabolism of LDL circulating in the bloodstream. The primary therapeutic effect is usually observed within 2 weeks from the start of treatment, the maximum effect is after 4 weeks and is maintained with constant maintenance therapy. When taken orally, atorvastatin is rapidly absorbed from the digestive tract; the degree of absorption is proportional to the dose taken. The maximum concentration in blood plasma is achieved 1–2 hours after administration. Absolute bioavailability is low (approximately 14%) due to first-pass clearance in the gastrointestinal mucosa and/or first-pass metabolism in the liver. Simultaneous food intake reduces the rate and degree of absorption of atorvastatin (by 25 and 9%, respectively), but this does not significantly affect the severity of its lipid-lowering effect. The degree of reduction in LDL cholesterol does not depend on the time of administration, although taking atorvastatin in the morning provides a higher concentration in the blood plasma. At least 98% of atorvastatin is bound to plasma proteins. A low blood/blood plasma ratio (average 0.25) indicates insignificant penetration of atorvastatin into red blood cells. According to experimental data, atorvastatin passes into breast milk. In the body it is extensively metabolized to form active ortho- and para- hydroxylated metabolites, which account for about 70% of the pharmacological activity. in vitro study indicate that cytochrome P450 3A4 may be involved in the metabolism of atorvastatin. Elimination of atorvastatin and its metabolites occurs primarily in the bile; less than 2% of the administered dose is determined in the urine. The half-life of atorvastatin is about 14 hours, however, the half-life of preservation of HMG-CoA reductase inhibitory activity due to circulating active metabolites is much longer and amounts to 20–30 hours. The lipid-lowering effects of atorvastatin do not differ significantly in individuals of different age groups, despite the fact that when taken in At equal doses, its maximum concentrations and AUC in healthy elderly volunteers are higher than in young adults. In women, the maximum plasma concentration of atorvastatin is 20% higher and the AUC is 10% lower than in men, but there are no differences in the effect on LDL cholesterol levels in men and women. Plasma concentrations of atorvastatin may increase sharply (4 to 16 times) in patients with cirrhosis and some other severe liver diseases.

Possible effects on the body

Speaking about the use of statin drugs, including Livazo, to lower blood cholesterol levels, one cannot fail to mention the effect they have on the human body. It has been established that taking Livazo does not require giving up driving a car or controlling moving mechanisms.

Before prescribing statins, specialists need to make sure that the patient does not have a tendency to rhabdomyolysis. This is a syndrome of extreme myopathy, when muscle tissue cells are destroyed, the level of myoglobin and creatine kinase in the blood rises, as a result of which signs of kidney failure quickly increase.

To avoid this, first monitor the level of creatine kinase in the blood and determine the presence of certain problems:

• dysfunction of the thyroid gland;
• problems with muscle tissue of a personal or hereditary nature;
• taking fibrates or statins resulting in muscle intoxication;
• tendency to alcoholism and diseases of the liver system;
• age over 65–70 years (elderly patients are more prone to rhabdomyolysis).

Livazo is a representative of statins, which reduces the level of “bad” cholesterol in the blood

During treatment with Livazo, if severe muscle symptoms occur, the drug should be discontinued. When creatine kinase levels return to normal, you can resume using Livazo, but under strict medical supervision and at an initial dose of 1 mg per day.

The effect of statins on certain organs and systems:

• liver – if you are prone to alcoholism or have existing disorders in the liver, after prescribing statins, it is necessary to monitor the indicators of the hepatic system (in particular, plasma transaminases);
• kidneys - in the presence of renal failure (moderate and severe) during treatment with Livazo, it is necessary to monitor the functioning of organs. Patients with this disease are not prescribed the drug at a dosage of 4 mg;
• lungs - in the case of long-term therapy with statins, the development of interstitial diseases of the pulmonary system, accompanied by shortness of breath, dry cough, sudden weight loss and fever, was sometimes observed.

If acute signs of liver or kidney failure, as well as interstitial lung diseases, develop, you should immediately consult a doctor and stop taking Livazo. Over time, after the disappearance of pathological symptoms, treatment can be continued, but with a dosage adjustment of statins.

How does Atorvastatin work?

It is known that the human body needs fats. But how to transport them to organs and tissues? After all, blood is a water-based liquid, and fats do not dissolve in it. In this case, they need to be isolated from the blood in special particles similar to balls. They have a complex shell: the side facing the blood is wettable, and the inner surface has an affinity for fat molecules. Such complex complexes were called lipoproteins. It is in them that all kinds of fats are transported.

There are several types of lipoproteins. Thus, chylomicrons transport fats absorbed from food in the blood. And the lipoproteins that transport fats formed in our body (in the liver) are called VLDL, or very low-density lipoproteins. They transport phospholipids, cholesterol, triglycerides, and other molecules. Their size is very small - about 80 nm.

When their function is completed, VLDL begins to transform under the action of enzymes into the last stage of their life - LDL, or low-density lipoproteins. They carry only cholesterol in the body, and they are precisely the most atherogenic fraction of lipids in our blood. This means that it is their elevated level that causes the development of atherosclerosis. Therefore, it makes no sense to donate blood for “cholesterol”. You need to donate blood specifically for this fraction, then the analysis will be the most informative.

Atorvastatin is the drug that inhibits the work of a special enzyme with a complex name - 3-hydroxy-3-methylglutaryl-coenzyme A reductase, which produces the substrate for cholesterol. In addition, the drug is able to sharply activate receptors on the surface of cells that “catch” LDL and remove them from the bloodstream.

You should know that atorvastatin is a third-generation statin drug; its advantages are more pronounced than those of its predecessors, and its disadvantages are more mitigated.

Operating principle

To understand how Lovastatin helps reduce cholesterol in the blood, it is necessary to remember the mechanism for the development of its high levels. Cholesterol is an organic substance that enters the body with food and is produced by the liver. It is vital for the normal functioning of many internal organs, therefore it is present in every body.

Due to a number of reasons, among which poor nutrition, bad habits, and liver diseases are more common, the amount of this organic compound increases. Due to its excess in the bloodstream, excess cholesterol begins to be deposited on the walls of blood vessels and arteries. As a result, their volume increases, they disrupt blood flow, narrowing the lumen.

Atherosclerosis, thrombus formation and other consequences can be irreversible, require urgent surgical intervention, and provoke serious heart disease, including death.

The mechanism of action of Lovastatin affects two ways of penetration of cholesterol into the body. Firstly, the active ingredient of the drug has a beneficial effect on the liver, normalizing the production of “good” cholesterol. Secondly, harmful fats that enter the body with fatty foods are eliminated.

Lovastatin has a beneficial effect on blood vessels, strengthening their walls, reducing the damage caused by atherosclerotic plaques. Even if it is impossible to completely eliminate them, the effect of the drug is aimed at reducing their volume, which is why the lumen of the vessel or artery increases and the blood flow in it is normalized.

special instructions

Patients undergoing treatment with Lovastatin are advised to follow these rules:

• Diet. Considering that part of the “bad” cholesterol enters the body with food, it is necessary to begin therapy by adjusting the diet. It is necessary to exclude fatty, fried, spicy, smoked foods. Replace animal fats with vegetable fats.
• Taking hormonal drugs. Their simultaneous use with Lovastatin requires that the attending physician review the prescribed dosage. It is important to tell your doctor about all medications you take on an ongoing basis.
• Alcoholism. Treatment of high cholesterol requires eliminating alcohol. If you have excessive alcoholism, you should not take statins. Otherwise, there is excessive stress on the liver.
• Contraception. Patients under the age of 45–50 years should use reliable methods of contraception during treatment with Lovastatin.

Cross interaction

During the period of use of pitavastatin, it is necessary to take into account the use of drugs that were previously recommended to the patient to eliminate signs of concomitant diseases. Below is a list of pharmacological groups with which you must be careful when interacting with Livazo:

• Cyclosporine - simultaneous use of statins is prohibited due to a sharp increase in AUC;
• Erythromycin and other macrolide antibiotics give the same reaction as taking statins while taking Cyclosporine, so they cannot be used;
• fibrates – simultaneous therapy with statins leads to the development of myopathy and rhabdomyolysis with severe muscle damage (requires selection of the correct dose and caution);
• Niacin and fusidic acid also lead to the formation of gross disorders of muscle tissue;
• Rifampicin and protease inhibitors - reduce the absorption of pitavastatin by liver tissue;
• Warfarin - when taken simultaneously with Livazo 4 mg, monitoring of prothrombin time is necessary.

Drugs such as Digoxin, inhibitors of CYP3A4, OATP1B1 do not affect the concentration of pitavastatin in the blood, so their use simultaneously with Livazo is allowed by doctors.

When is it better to take pills for hypertension: morning or evening

To obtain the effect of therapy with antihypertensive drugs, it is necessary to observe the timing of their administration.
This will reduce the likelihood of side effects and make you feel good. The correct use of medications is of great importance for patients with difficult-to-control hypertension who are taking several antihypertensive drugs. Therefore, you need to figure out when it is better to take blood pressure pills in the morning or in the evening. In patients who have a history of hypertension with diabetes mellitus or renal failure, these pressure fluctuations are impaired. In such cases, cardiologists recommend using antihypertensive drugs in the evening.

There is a rule for taking long-acting antihypertensive drugs. These include ACE inhibitors: Enap, Enaprylin and others. To determine the optimal time for taking it, doctors advise observing changes in blood pressure throughout the day.

If hypertension occurs mainly in the evening hours, then the medicine is taken in the morning. If your blood pressure rises in the morning, it is recommended to take ACE inhibitors (angiotensin-converting enzyme) before bed.

If hypertension occurs unsystematically, the daily dose can be divided into 2 doses in the morning and evening. There is no such rule for short-acting drugs. They are taken in case of a sharp rise in blood pressure as emergency therapy.

Cardiologists have long agreed that the timing of antihypertensive medications affects their effectiveness and the incidence of side effects. After all, a morning dose can lead to nausea, dizziness and weakness throughout the day.

This issue is of particular importance for the millions of people who suffer from difficult-to-control hypertension. They are divided into 2 groups:

• Patients take more than 2 antihypertensive drugs, but the pressure does not decrease to normal values.
• Patients whose blood pressure rises only at night. This condition is called nocturnal hypertension.

The use of new drugs to lower blood pressure for such patients leads to increased costs of therapy, side effects and undesirable drug interactions.

Scientists from Spain decided to look into this issue. A study was conducted involving 661 patients with hypertension.

Half of the patients had to take medications in the morning immediately after waking up, the rest - before going to bed. The use of a specific group of antihypertensive drugs was not required. The following were excluded from the number of subjects:

• Pregnant women;
• Persons with a history of alcohol or drug abuse;
• Patients who work at night;
• HIV-infected persons;
• Patients with diabetes mellitus and secondary hypertension.

The study found that patients who took antihypertensive medications before bed had lower blood pressure during the day and during sleep. Also in this group, the risk of developing cardiovascular pathologies (heart attack, cardiac arrest) decreased, and overall mortality decreased.

Canadian scientists came to similar results. They proved that taking ACE inhibitor drugs before bedtime, indicated for hypertension or after a heart attack, increases the effectiveness of therapy several times.

If the drug was taken in the morning on an empty stomach, the effectiveness of the drug is comparable to taking a placebo. Canadian scientists have found that at night, patients with hypertension produce a hormone that causes expansion and damage to the heart. Taking ACE inhibitors before bed can reduce the activity of this substance, protecting the heart muscle.

Atorvastatin tablets are used for the following diagnoses and conditions:

• Disbetalipoproteinemia.
• Diseases of the cardiovascular system.
• To reduce the levels of total and LDL cholesterol, apolipoprotein B and TG and increase the level of HDL cholesterol in patients with primary hypercholesterolemia, heterozygous familial and non-familial hypercholesterolemia and combined (mixed) hyperlipidemia (Fredrickson types IIa and IIb);
• To reduce levels of total cholesterol and LDL cholesterol when dietary therapy and other non-pharmacological treatments are not effective enough.
• To increase serum TG levels (type IV according to Fredrickson classification), dysbetalipoproteinemia (type III according to Fredrickson) when diet therapy is ineffective;

Features of the use of Atorvastatin for children

In childhood, Atorvastatin is used to treat children from 10 to 17 years of age with elevated levels of total cholesterol, apolipoprotein B, low-density lipoprotein cholesterol with heterozygous familial hypercholesterolemia. Prescribing atorvastatin for cholesterol is advisable if the diet is ineffective (if the LDL-C level is kept above 190 mg/dL) and under the supervision of a physician.

This article will provide instructions for the use of Atorvastatin, indications and contraindications for the use of this drug, as well as real reviews from those who have already used it.

Atorvastatin is a drug that reduces the amount of lipoproteins in the blood. The main active component of this drug is a substance with the same name Atorvastatin. In addition, it is also a component of other drugs of similar action - Atoris, Liprimar, Vasilip.

Drug therapy using this drug helps reduce the content of lipoproteins in the body. Simply put, the medicine is designed to lower cholesterol.

The product is available in the form of tablets, which are coated with a white film coating. The dosage varies: 10, 20 or 40 milligrams. Atorvastatin belongs to the group of lipid-lowering drugs.

Atorvastatin, as an effective drug, is a special hypocholesterolemic drug. During application, the product inhibits the enzyme in a special way, which in turn regulates the rate of its conversion into a substance such as mevalonate. This is a precursor of sterols, among which cholesterol is also harmful to humans.

In patients suffering from one form or another of atherosclerotic manifestations, a positive effect is observed quite quickly. A decrease in cholesterol levels is observed in all cases and for all possible causes of pathology - heredity, poor lifestyle or side effects from taking medications.

One course of treatment is sufficient to reduce low-density cholesterol and general category substances.

Simultaneously with the effective reduction of cholesterol, Atorvastatin quickly reduces the percentage of low-density lipoproteins and triglycerols present in the human body. At the same time, the amount of higher density lipoproteins increases slightly.

These processes are achieved while taking the drug due to a significant reduction in the overall activity of a product such as reductase and by reducing the process of cholesterol production in the liver. The process is influenced by the fact that in the liver the total volume of low-density lipoprotein receptors, which are formed on the surface of liver cells, seriously increases.

Taking Atorvastatin helps reduce the risk of developing dangerous ischemia, unstable angina and possible mortality in people of all ages.

At the same time, the drug reduces the risk of fatal vascular and heart diseases, and the overall incidence of diseases classified as cardiovascular is reduced. The impact is on the frequency of stroke categories fatal and fatal.

Immediately after taking the drug, the main active substance is absorbed by the intestines, is very quickly absorbed there and reaches maximum plasma concentration after two hours. The concentration of the drug substance is directly proportional to the therapeutic dosage consumed.

The overall bioavailability of the drug during oral administration is relatively low, approximately 12%. The reason for this factor lies in the presystemic clearance of the drug during its establishment in the digestive tract.

There is also a “first pass through the liver” effect. Approximately 98% of the total dose taken can be bound to plasma proteins.

The process of complete metabolism of Atorvastatin in the body is carried out through active metabolites and all inactive substances included in the composition.

The medical drug Atorvastatin, the instructions for use of which are quite simple, is used strictly in well-chosen complex therapy. It is advisable to combine the course of treatment with diets and exercise prescribed by specialists.

The remedy is prescribed exclusively to those who experience unpleasant symptoms of diseases associated with high cholesterol. The drug is prescribed to effectively increase such beneficial substances as high-density cholesterol. If a previously prescribed and followed diet did not produce any positive results, a therapeutic course of the drug will come in handy.

Quite often, the drug is prescribed to patients who experience unpleasant symptoms of heart disease and vascular problems.

Also, the basis for prescribing the drug is the prevention of the development of vascular diseases due to such factors as:

1. Arterial hypertension;
2. Diabetes;
3. Smoking;
4. Confirmed low cholesterol levels with high density values;
5. If there is a certain hereditary factor, for example, if there have been cases in the family where relatively young people had heart problems.

For such patients, the drug is prescribed as a means of reducing the risk of death in the event of a sudden heart attack or after the development of coronary heart disease. The drug is used in pediatrics, it is prescribed to adolescents from 10 to 16 years old, in whom tests show elevated cholesterol and lipoproteins, characterized by low density values.