1 tablet may include 10; twenty; thirty; 40; 60; 80 mg atorvastatinas an active ingredient.
As additional ingredients:
- tablets of 10 and 20 mg include: sodium lauryl sulfate, povidone, calcium carbonate, MCC, croscarmellose sodium, lactose monohydrate, magnesium stearate (shell - Opadry II HP 85F28751 white);
- 40 mg tablets include: sodium lauryl sulfate, povidone K25, calcium carbonate, MCC, croscarmellose sodium, lactose monohydrate, crospovidone, magnesium stearate (shell - Opadry white Y-1-7000);
- 30, 60 and 80 mg tablets include: lactose monohydrate, MCC, croscarmellose sodium, hyproly, crospovidone, sodium hydroxide, polysorbate 80, magnesium stearate (shell - Opadry II HP 85F28751 white).
Atoris is available in the form of tablets in a shell (film). One package, depending on the mass content of the active ingredient, may contain 10; thirty; 60 or 90 tablets.
Pharmacodynamics and pharmacokinetics
Atoris medicine with active ingredient atorvastatin, is an lipid-lowering agentbelonging to the group statins. Paramount importance in the mechanism of action atorvastatintakes oppression of work HMG-CoA reductase enzymethat catalyzes the transformation process GMG-CoA at mevalonic acidwhat is the early stage of replication cholesterol. Thus, the suppression of cholesterolleading to activation low density lipoprotein receptors (LDL) in tissues and liver. Due to this, LDL particles bind and are excreted from the blood plasma, which in turn leads to a decrease in its content LDL cholesterol.
AntiatheroscleroticAtoris's action is manifested as a result of exposure atorvastatinon blood components and blood vessel walls. Atorvastatininhibits replication isoprenoidswhich are one of the reasons for cell growth intravascular membrane. Enhances endothelium-dependent relaxation blood vesselslowers level apolipoprotein B, LDL cholesterol and triglyceridesincreases content apolipoprotein Aand HDL cholesterol. Also lowers plasma viscosityprocess activity aggregationand coagulation platelet count. Effects atorvastatinimprove hemodynamics and normalize the blood coagulation system, while simultaneously affecting macrophage metabolismby blocking their activation and preventing breaks atherosclerotic plaques.
Generally therapeutic efficacy atorvastatinobserved after its 2-week intake and reaches a maximum in a month.
Pills from cholesterolAtoris proven to lower incidence ischemic complicationsrepeated hospitalizationand mortality rate.
Suction atorvastatinin the digestive tract is carried out approximately 80%. In proportion to the dose, its plasma concentration and degree of absorption increase. On average, Tmax is observed after 1-2 hours. Tmax in women is 20% higher, and their AUC is lower by 10%. Some differences in pharmacokinetics atorvastatinPatients associated with age and gender are considered insignificant and do not require dose adjustment of Atoris.
In patients suffering cirrhosis, Tmax exceeds the norm by 16 times. Eating slightly reduces the duration and speed of absorption, but does not affect the content LDL cholesterol.
Atorvastatinreveals low bioavailability, approximately 12% and systemic bioavailability of inhibitory activity in relation to HMG-CoA reductase, about 30%.
Vd average atorvastatinequal to 381 liters. Communication with plasma proteins occurs at 98%. Atorvastatindoes not pass through BBB, is characterized mainly by hepatic metabolism with the participation of cytochrome P450 and the release of active metabolites, due to which 70% of the pharmacological activity of Atoris is carried out.
T1 / 2 - 14 hours, with the withdrawal of the drug mainly with bile, smaller intestinesand about 2% the kidneys.
Indications for use Atoris
Indications for use of Atoris vary slightly depending on the mass content in tablets atorvastatin.
Atoris 10 mg and Atoris 20 mg:
- primary hyperlipidemia IIa and IIb types according to the classification of Frederickson, including polygenic hypercholesterolemia, mixed hyperlipidemia, heterozygous familial hypercholesterolemia, to lower the level of overall cholesterol, apolipoprotein B, LDL cholesterol, triglycerides in blood;
- familial homozygous hypercholesterolemia, to lower the level of overall cholesterol, apolipoprotein B, LDL cholesterolas an addition to diet therapyand other non-drug methods of treatment.
Atoris 30, 40, 60, 80 mg:
- primary hypercholesterolemia (non-familyand familial heterozygous hypercholesterolemia Type II according to the classification of Fredrickson;
- mixed (combined) hyperlipidemiaIIa and IIb types according to the classification of Frederickson;
- dbetalipoproteinemia Type III according to the classification of Fredrickson (as an addition to diet therapy);
- diet resistant endogenous familial hypertriglyceridemia Type IV according to the classification of Fredrickson;
- familial homozygous hypercholesterolemiaas an addition to diet therapyand other non-drug methods of treatment.
All dosages of Atoris are prescribed:
- for the purpose of primary prevention of cardiovascular pathologies in patients without manifestations Ischemic heart disease, but with the possibility of its development due to existing risk factors, including age after 55 years, arterial hypertensionnicotine addiction diabeteslow plasma content HDL cholesterolgenetic predisposition;
- for secondary prevention cardiovascular diseasein patients diagnosed Ischemic heart diseaseto reduce complications, including myocardial infarction, mortality, strokere-hospitalization associated with angina pectorisand the need for revascularization.
- skeletal muscle pathology;
- hypersensitivity to atorvastatin, other Atoris ingredients or a combination thereof;
- liver failure;
- pathology of the liver in the acute stage (including alcoholicor active chronic hepatitis);
- lactase deficiency, lactose intolerance and glucose-galactose malabsorption syndrome;
- cirrhosis of the liver of various origin;
- elevated level hepatic transaminases of unknown origin, which is more than 3 times higher than normal;
- age up to 18 years;
- periods breastfeedingand of pregnancy.
- previously observed liver disease;
- severe electrolyte imbalance;
- metabolic and endocrine disorders;
- acute severe infections;
- arterial hypotension;
- uncontrollable epilepsy;
- serious surgery.
Central and peripheral nervous systems:
- asthenic syndrome;
- sleep disorders;
- peripheral neuropathy;
- emotional lability;
- dry conjunctiva;
- eye hemorrhage;
- disturbance of accommodation;
- changes in taste.
The cardiovascular system:
- postural hypotension;
- increase in blood pressure;
- chest pain.
- nose bleed;
- bronchial asthma.
- constipation or diarrhea;
- abdominal pain;
- increased appetite;
- dry mouth
- hepatic colic;
- duodenal ulcer;
- cholestatic jaundice;
- rectal bleeding;
- increased levels of liver enzymes;
- bleeding gums.
- swelling of the joints;
- muscle cramps;
- tendopathy (sometimes with tendon rupture);
- dysuria(including nocturia, pollakiuria, urinary incontinence, peremptory urges, urinary retention);
- urogenital infections;
- vaginal bleeding;
- uterine bleeding;
- urolithiasis disease;
- decreased libido;
- violation of ejaculation.
- skin rash;
- Lyell's syndrome;
- cutaneous itching;
- contact dermatitis;
- Stevens-Johnson syndrome;
- exudative erythema multiforme.
- increased activity of ACT, ALT, serum CPK;
- hyperglycemia or hypoglycemia.
- peripheral swelling;
- weight gain;
Atoris tablets, instructions for use (Method and dosage)
Instructions for use Atoris recommends that before starting therapy with its use, transfer the patient to dietwhich will provide lipid lowering in blood. The diet should be followed throughout the duration of treatment. Before you start taking Atoris, you should try to achieve control hypercholesterolemiaby doing exercise and weight loss in obese patients as well as through treatment underlying disease.
Atoris tablets are taken orally (orally), after meals or on an empty stomach. It is recommended to start therapy with a daily single dose of 10 mg, after which, depending on the effectiveness of the initial dose and if it is necessary to increase it, a higher dose is prescribed - 20 mg, 40 mg, and so on up to 80 mg. Atoris medicine, in each of the dosages, is taken once a day, at the same time of the day, convenient for the patient. The therapeutic effect is observed after a two-week use of the drug, with the development of its maximum effectiveness after four weeks. In this regard, dose adjustment of Atoris is carried out not earlier than its four-week intake, taking into account the degree of effectiveness of the previous dose. The maximum possible daily dose of Atoris is 80 mg.
For therapy mixed hyperlipidemia IIb type and primary(polygenicand hereditary heterozygous) hypercholesterolemiaType IIa, they recommend taking Atoris at a dose of 10 mg, with an increase in dose after a four-week dose, depending on the effectiveness of the initial dose and the individual sensitivity of each patient.
For treatment hereditary homozygous hypercholesterolemia, depending on the severity of its manifestations, the selection of initial doses is carried out individually, in the range as with other types hyperlipidemia.
In most patients with hereditary homozygous hypercholesterolemia the optimal effectiveness of Atoris is observed in a daily single dose of 80 mg.
Atoris is prescribed as an additional treatment to other methods of therapy (for example, plasmapheresis) or as the main therapy, if it is impossible to conduct treatment with other methods.
Patients with kidney pathologies and in old age do not need dose adjustment of the drug.
Sick with liver diseases the appointment of Atoris is possible with extreme caution, since in this case there is a slowdown in elimination atorvastatin out of the body. Therapy is carried out under the control of laboratory and clinical indicators and in the case of a significant increase transaminase levels with a dose reduction or with the complete withdrawal of the drug.
In case of overdose atorvastatina number of general measures are necessary, including: monitoring of vital functions and their support, further prevention of drug absorption (administration sorbents, gastric lavageappointment laxativesfunds).
In rare cases, a severe side effect of an overdose was observed - myopathy with further rhabdomyolysisand development renal failure. In this case, taking Atoris is immediately stopped, and the patient is administered sodium bicarbonate and diuretic. If necessary, carry out the procedure hemodialysis. For elimination hyperkalemiaas consequences rhabdomyolysismake an intravenous injection calcium gluconate or calcium chlorideinfusion infusion glucose with insulin, the appointment of potassium exchange resins. Communication atorvastatinwith plasma proteins is quite significant, in connection with which, the procedure hemodialysisrelatively ineffective.
Concurrent use atorvastatinwith antibiotics (Clarithromycin, Erythromycin, Quinupristine / dalfopristine), NefazodonHIV protease inhibitors (Ritonavir, Indinavir), antifungal drugs (Ketoconazole, Itraconazole, Fluconazole) or Cyclosporinemay lead to an increase in blood levels atorvastatinand cause myopathieswith further rhabdomyolysisand development renal failure.
Concomitant use of Atoris with nicotinic acid and fibratesin lipid lowering doses (more than 1 g / day), as well as 40 mg atorvastatinand 240 mg Diltiazemaalso lead to an increase in blood concentration atorvastatin.
Combined use of Atoris with Rifampicinand Phenytoinlowers its effectiveness.
Antacids(suspension aluminum hydroxides and magnesium) lower the content atorvastatinin blood.
Combining Atoris with Colestipolalso lowers concentration atorvastatinin blood by 25%, but has a greater therapeutic effect, compared with Atoris alone.
Due to the increased risk of a decrease in steroid endogenous hormone levels, caution is necessary while prescribing Atoris with drugs that lower the level of steroid endogenous hormones (including Spironolactone, Ketoconazole, Cimetidine).
Patients concurrently receiving Atoris at a dose of 80 mg and Digoxinshould be under constant monitoring, as this combination leads to an increase in blood concentration Digoxin, about 20%.
Atorvastatinmay enhance absorption oral contraceptives (Ethinyl estradiol, Norethindrone) and, accordingly, their concentration in plasma, which may require the appointment of another contraceptive.
The combined use of Atoris and Warfarin, at the beginning of use, can enhance the effect of the latter in relation to blood coagulation (decrease in PV). This effect is smoothed after 15 days of joint therapy.
Atorvastatinhas no clinically significant effect on kinetics Terfenadine and Phenazone.
Concomitant use of 10 mg Amlodipineand 80 mg atorvastatindoes not lead to a change in the pharmacokinetics of the latter in equilibrium.
Cases of formation are described. rhabdomyolysisin patients who simultaneously took Atoris and fusidic acid.
Atoris application with estrogenand antihypertensive drugs, within the framework of substitution therapy, did not reveal signs of unwanted interaction.
Grapefruit juice, in the amount of 1.2 liters per day, during the treatment with Atoris can lead to an increase in the plasma content of the drug, and therefore, its consumption should be limited.
Terms of sale
A doctor’s prescription is required to purchase any dosage of Atoris.
Atoris belongs to the list B. The storage temperature of the tablets should not exceed 25 ° C.
All Atoris dosages can be stored, in the original packaging, for 2 years.
Before the appointment of Atoris, it is necessary to prescribe a hypocholesterolemic diet to the patient, followed throughout the course of further therapy.
During the course of therapy with Atoris, an increase in blood serum may be observed level of liver enzymes. This increase, in most cases is insignificant, but requires monitoring after 1.5 and 3 months of treatment, as well as with each increase in the dose of the drug. In the case of a triple increase in the level of ACT and / or ALT, therapy is stopped.
Atoris may cause increased activity aminotransferaseand KFK.
Women of reproductive age who do not use reliable means contraceptionshould not take Atoris. When planning a pregnancy, the patient taking Atoris must stop taking it at least 30 days before the planned of pregnancy.
Upon manifestation weaknessesin the muscles or inexplicable painespecially those accompanied feveror malaiseYou should immediately inform your doctor.
In case of clinical manifestations myopathiesrecommend determining concentrations KFKin plasma and at a 10-fold increased level, discontinue treatment with Atoris.
On the background of taking Atoris, development was occasionally observed atonic fasciitis, with an unproven but possible causal relationship.
Atoris drug includes lactosetherefore, its administration is contraindicated in case of lactase deficiency, lactose intolerance and glucose-galactose malabsorption syndrome.
During therapy with Atoris, when conducting accurate or hazardous work, as well as while driving, care should be taken.
Analogs of AtorisMatches for ATX Level 4 code:AkortaAtomaxLipitorPravastatinSimvastolAriesSimgalTulipLovastatinLiptonormRosulipZokorRosartTevastorLiprimarSimvastatinVasilipRosucardRoxerRosuvastatin
Atoris analogs are represented by drugs close to it in their mechanism of action. The most common analogues are:
The price of analogues is quite diverse and depends on the manufacturer, the mass content of the active ingredient and the number of tablets. So pills Simvastatin10 mg No. 28 can be bought for 250-300 rubles, and Crestor10 mg No. 28 for 1500-1700 rubles.
Synonyms of Atoris
Atoris synonyms are drugs that include the same active ingredient - atorvastatin:
Torvakard or Atoris - which is better?
It should be noted that both drugs contain as an active ingredient - atorvastatin, in connection with which, they have some pharmaceutical effects. Atoris is produced by Krka (Slovenia), and the drug Thorvacard company Zentiva (Czech Republic). Both manufacturing companies are quite famous and have a fairly good reputation, which makes these drugs almost unambiguous. The only difference Torvacardis the dosage of its tablets, which is maximum 40 mg, while some pathological conditions require doses atorvastatin80 mg, which can cause some inconvenience to taking the tablets.
Liprimar or Atoris - which is better?
As in the situation with Torvakard, Liprimaris a synonym for Atoris, that is, it contains the same substance as an active ingredient - atorvastatin. Both drugs have the same indications, features of use, contraindications, side effects, etc. Dosage LiprimaraAtoris dosages are repeated with the exception of 30 mg tablets. Company manufacturer Liprimara- Pfizer (Ireland), which in itself indicates a high quality product.
It is worth noting that Liprimarthis is an original drug atorvastatin, and all the rest, including Atoris, are his generics. According to some experts, the drug generic by definition, it can not surpass the original and most often worse than its quality. Other experts argue that when choosing the original drug, a third of its cost consists only of the name of the manufacturer, that is, the patient overpays only for the big name of the company. In this case, it is better to rely on the opinion and experience of your doctor.
Studies of the effectiveness of Atoris and the safety of its use in children have not been conducted, from which Atoris tablets are contraindicated until 18 years of age.
In pregnancy (and lactation)
Atoris therapy is contraindicated in periods of pregnancy and breastfeeding.
Reviews for Atoris
In most cases, reviews about Atoris, both of doctors and patients, are positive, with a mention of various often most mild side effects, without which, unfortunately, no therapy can do. It is worth noting that treatment with Atoris should be prescribed only by a doctor and take place under his constant supervision. For a positive result of therapy, the patient must strictly adhere to the treatment regimen, diet, exercise and other recommendations of his doctor.
Atoris price, where to buy
In Russian pharmacies, the cost of the drug varies greatly, for example, the price of Atoris 10 mg No. 30 can vary between 400-600 rubles, the price of Atoris 20 mg No. 30 from 450 to 1000 rubles, 40 mg tablets No. 30 from 500 to 1000 rubles.
You can buy tablets in Ukraine on average: 10 mg No. 30 - 140 hryvnia; 20 mg No. 30 - 180 hryvnias; 60 mg No. 30 - 300 hryvnias.
- Online Pharmacies in Russia
- Online pharmacies in UkraineUkraine
- Online pharmacies in Kazakhstan
- Atoris tab. p.p.o. 10mg n90AO KRKA, dd, Novo mesto617 rub.order
- Atoris tab. p.p.o. 30mg n30AO KRKA, dd, Novo mesto527 rub.order
- Atoris tab. p.p.o. 20mg n30AO KRKA, dd, Novo mesto459 rub.order
- Atoris tab. p.p.o. 10mg n30AO KRKA, dd, Novo mesto328 rub.order
- Atoris tab. p.p.o. 40mg n30AO KRKA, dd, Novo mesto769 rub.order
- Atoris (tab. N / a captive. 10mg No. 30) 354 rubles to order
- Atoris (tab. N / a captive. 20mg No. 30) 534 rubles to order
- Atoris (tab.pl./ab.30mg No. 30) 563 rub.order
- Atoris (tab. N / a captive. 10mg No. 90) 685 rubles to order
- Atoris (tab.pl./ab. 20mg No. 90) 1149 rub.order
Eurofarm * 4% discount on the promotional code medside11
- Atoris 10 mg n90 tablet KRKA, dd, Novo mesto, AO640 rub.order
- Atoris 30 mg No. 30 tablet KRKA, dd, Novo mesto581 rub.order
- Atoris 40 mg n30 tablet KRKA710 rub.order
- Atoris 10 mg n30 tablet KRKA, dd, Novo mesto 398 rub.order
- Atoris 20 mg n30 tablet KRKA, dd, Novo mesto, AO598 rub.order
- Atoris 20 mg No. 90 tablets KRKA, Slovenia591 UAH.order
- Atoris 10 mg No. 90 tablets KRKA, Slovenia485 UAH.order
- Atoris 30 mg No. 30 tablets KPKA, dd, Novo mesto, Slovenia 88 UAH order
- Atoris 30 mg No. 90 tablets KPKA, dd, Novo mesto, Slovenia209 UAH order
- Atoris 10 mg No. 30 tablets KRKA, Slovenia152 UAH.order
- Atoris tablets Atoris tablets PO 20mg No. 30 Slovenia, KRKA d.d. Novo Mesto 248 UAH to order
- Atoris tablets Atoris tablets PO 30mg No. 30 Slovenia, KRKA d.d. Novo Mesto UAH 103 order
- Atoris tablets Atoris tablets PO 10mg No. 30 Slovenia, KRKA d.d. Novo Mesto UAH 186 order
- Atoris tablets Atoris tablets PO 40mg No. 90 Slovenia, KRKA d.d. Novo Mesto 749 UAH to order
- Atoris tablets Atoris tablets PO 20mg No. 90 Slovenia, KRKA d.d. Novo Mesto 637 UAH order
- Atoris 10 mg No. 30 tab.po.KRKA (Slovenia) 2 tg.order
- Atoris 40 mg No. 30 tablets p.p.KRKA (Slovenia) 2 tg.order
- Atoris 20 mg No. 30 tab.po.KRKA (Slovenia) 2 tg.order