Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Lipitor
Active ingredient: Atorvastatin
Available dosage forms: 10, 20, 40 mg
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Atorvastatin general information
There are various other unwanted side effects of Atorvastatin including unexplained and sudden rashes along with joint pains. There are a number of cholesterol lowering medicines accessible in the industry today. Between the variety related to medicines currently available to manage high-cholesterol, Lipitor is one. Lipitor is one such medicine that’s been proven to heal cholesterol and wellness problems. There are a number of very common Atorvastatin side effects that are experienced by just about everyone. The sale of Lipitor will allow you to find control over your cholesterol level and certainly will force you to be be long live.
Generic Atorvastatin may be the generic kind of brand drug Lipitor. An enzyme called HMG-CoA is generated by the intake of Lipitor. Generic Lipitor is a thriving medium to tone down the degree of cholesterol. So as to cure such diseases, you must Buy Lipitor. In case these Lipitor negative effects have emerged, you’ve got to speak to your physician. Patients do not need to worry much regarding the side effects when they decide to get Atorvastatin because most of Atorvastatin side effects are extremely minor and could be very comfortably treated.
Cholesterol is among the most frequent problems faced by men and women across different countries. Ergo, a side effect of aforementioned stress is high cholesterol within the body which can likewise result in heart related disease to occur. Sometimes this higher cholesterol level can be caused on account of hereditary reasons. Superior cholesterol typically doesn’t have some symptoms and it’s also difficult to single out this problem in an individual. Many men and women who endure high rates of cholesterol attempt to manage it entirely from home tips only but at times it gets difficult to control the rising degrees of cholesterol. There are various reasons why one ought to aim to diminish the total cholesterol levels in the entire body along with the benefits which come along with are immense also.
Lipitor is one such medicine which may cure your chance of heart attacks as well as heart failures within virtually no time. Heart diseases like strokes, heart attacks, heart failures and other vascular diseases can happen in the event that you won’t take appropriate medication to heal such diseases. With the medication of the drug, you can certainly lower the amount of cholesterol and lessen the risk of heart attacks, strokes as well as heart failures. Muscle malady, weakness alongside fever must also be taken good care of once possible. It aids in controlling the patients afflicted by many risks factors efficiently. Patients who buy Atorvastatin need to become a small cautious during the complete tenure of remedy.
High cholesterol is among the most ordinary health issues which are handled by human beings. On the opposite hand Good cholesterol aids in preventing the heart disease. This cholesterol is usually produced by liver. It lowers the LDL in the entire body and also the total quantity of cholesterol within the stream of blood also. High-cholesterol can be exceedingly harmful and might trigger heart stroke, heart issues, cardiovascular disease, cardiac arrest along with issue within the arterial blood vessels. There is a multitude of ways by which you can trim the cholesterol levels in your own bloodstream.
Cholesterol is really a semi solid substance present within our blood that is useful for a lot of operations carrying out within our body. They’ve been proved and tested clinically since they successfully lower the sum of cholesterol in the entire body. Scientifically it’s been proven that if an individual has the capability to trim the LDL cholesterol in his own entire body, he’d definitely decrease the overall degrees of cholesterol within the liver. With the intake of the drug, arteries become hard, preventing any potential condition that could result in health related difficulties or superior cholesterol within the body. Well managing problems including high cholesterol isn’t an arduous consideration to achieve anymore. To maintain great health we always have to maintain decent diet.
Lipitor works by reducing the total cholesterol within the blood stream of the human body for example LDL. It raises the HDL called the good cholesterol within the blood stream. It can help in lessening the amount related to poor cholestrerol levels and also enhancing the wonderful degrees of cholesterol within the bloodstream. It assists in lowering the amount of bad cholesterol and increasing the great cholesterol levels within the blood. Meals that are full of fatty foods together with carbs can cause cardiovascular disease along with elevated blood glucose levels and elevated cholestrerol levels. In addition, make sure you eat nutritious food and adapt a wholesome lifestyle to trim the body fat.
The most usual prevention your doctor would prescribe you is to adopt a wholesome lifestyle and nutritious food habits. It is dependent upon the sort of food that we eat and the sum of fat it contains.Foods that are quite high in saturated fats and carbohydrates can result in heart disease and heightened blood sugar and heightened cholesterol. The 3rd kind might be the triglycerides.
Atorvastatin – instructions for use, real counterparts and release form (tablets 10 mg, 20 mg, 40 mg and 80 mg Teva and Leksvm) statin drug to lower cholesterol levels in the blood of adults, children and in pregnancy. Ingredients
In this article, you can read the instructions for use of the drug Atorvastatin. Presents reviews of visitors – users of the drug, as well as opinions of doctors skilled in the use of atorvastatin in their practice. Most requested actively add their own reviews of the preparation: helped or did not help to get rid of the medicine from the disease, which were observed complications and side effects may not be claimed by the manufacturer in the summary. Analogues of atorvastatin in the presence of the available structural analogues. Use of a statin to lower cholesterol levels in the blood of adults, children and during pregnancy and breastfeeding. The composition of the product.
Atorvastatin – lipid-lowering agents of the statin group. Selective competitive inhibitor of HMG – CoA – reductase – an enzyme that converts 3 – hydroxy – 3 – methylglutaryl coenzyme A to mevalonic acid, which is a precursor of sterols, including cholesterol. Triglycerides (TG) and cholesterol in the liver are included in the very low density lipoproteins (VLDL), enter the blood plasma and transported to peripheral tissues. Low density lipoproteins (LDL) are formed from VLDL during the interaction with the LDL receptor. Atorvastatin reduces plasma levels of cholesterol and lipoproteins, inhibiting HMG – CoA – reductase, a cholesterol synthesis in the liver and increase the number of “liver” LDL receptors on the cell surface, which leads to increased trapping and LDL catabolism. Reduces LDL, it causes marked and persistent increase in the activity of LDL – receptors. It reduces the concentration of LDL cholesterol in patients with homozygous hypercholesterolemia seed, which is usually not amenable to therapy, lipid-lowering drugs. Reduces the concentration of total cholesterol by 30 – 46%, LDL – 41 – 61% of apolipoprotein B – 34 – 50% and TG – 14 – 33%; It causes an increase in the concentration of cholesterol – HDL (high density lipoprotein) and apolipoprotein A. Dozozawisimo reduces the concentration of LDL cholesterol in patients with homozygous familial hypercholesterolemia, resistant to treatment by other hypolipidemic agents.
atorvastatin calcium trihydrate + auxiliaries.
Absorption – high. Food somewhat reduces the rate and duration of absorption of the drug (25% and 9% respectively) but LDL cholesterol reduction similar to that in the application of atorvastatin without food. The concentration of atorvastatin in the evening application in lower than in the morning (approximately 30%). Revealed a linear relationship between the degree of absorption of the drug and the dose. Metabolizruetsya primarily in the liver under the influence of CYP3A4 with the formation of pharmacologically active metabolites (ortho – and paragidroksilirovannyh derivatives products of beta – oxidation). Excreted in the bile following hepatic and / or extrahepatic metabolism (not exposed to severe gastro – hepatic recirculation). Less than 2% of an oral dose is determined in urine. Not output during hemodialysis.
- in conjunction with diet to reduce elevated total cholesterol, cholesterol / LDL cholesterol, apolipoprotein B, and triglycerides and increase HDL cholesterol in patients with primary hypercholesterolemia, heterozygous familial and non-familial hypercholesterolaemia and combined (mixed) hyperlipidemia (types 2a and 2b on Frederickson);
- in conjunction with a diet for the treatment of patients with elevated serum concentrations of triglycerides (Fredrickson type 4) and patients with disbetalipoproteinemiey (type 3 according to Fredrickson), whose diet therapy does not give adequate effect;
- to reduce the concentration of total cholesterol and cholesterol / LDL cholesterol in patients with homozygous familial hypercholesterolemia, when diet therapy and other non-pharmacological treatments are not sufficiently effective.
Film-coated tablets 10 mg, 20 mg, 40 mg and 80 mg.
Instructions for use and dosage
Before the appointment of atorvastatin patients should be advised to standard lipid-lowering diet, which he must comply during the entire treatment period.
The drug can be taken at any time of the day with food or independently of meal times. Dose picked for baseline cholesterol levels – LDL goal of therapy and individual effect. At the beginning of the treatment and / or during increasing doses of atorvastatin is necessary every 2 – 4 weeks to control blood lipid levels and accordingly to correct dose plasma.
The initial dose is an average of 10 mg 1 time per day and thereafter ranges from 10 mg to 1 80 mg once a day.
In an application with cyclosporine daily dose of atorvastatin should not exceed 10 mg.
When primary hypercholesterolemia and mixed hyperlipidemia with increasing serum TG levels (Fredrickson Type 4), as well as disbetalipoproteinemii (type 3 according to Fredrickson), in most cases it is sufficient purpose of the drug at a dose of 10 mg 1 time per day. Significant therapeutic effect is usually observed after 2 weeks, the maximum therapeutic effect is usually observed after 4 weeks. With long-term treatment of this effect is maintained.
When homozygous familial hypercholesterolemia drug is prescribed in a dose of 80 mg (4 tablets of 20 mg), 1 per day.
In patients with renal failure and kidney disease atorvastatin concentration in plasma is not changed, the degree of reduction of Xc – LDL retained, so that the change is not required dose.
dose should be reduced When liver failure.
When using the drug in elderly patients differences in safety, efficiency and achieving the objectives of lipid-lowering therapy compared with the general population is not indicated.
- emotional lability;
- facial paralysis;
- dry conjunctiva;
- bleeding in the retina of the eye;
- loss of taste;
- chest pain;
- orthostatic hypotension;
- increased blood pressure;
- anemia, thrombocytopenia;
- exacerbation of asthma;
- nausea, vomiting;
- constipation or diarrhea;
- abdominal pain;
- decreased or increased appetite;
- dry mouth;
- duodenal ulcer;
- rectal bleeding;
- bleeding gums;
- cramping leg muscles;
- swelling joints;
- urogenital infections;
- peripheral edema;
- dysuria (including pollakiuria, nocturia, urinary incontinence or urinary retention, compelling urge to urinate);
- leucocyturia, hematuria;
- abnormal ejaculation;
- increased sweating;
- weight gain;
- aggravation of gout;
- skin rash;
- contact dermatitis;
- swelling of the face;
- erythema multiforme exudative (including Stevens – Johnson);
- toxic epidermal necrolysis (Lyell’s syndrome).
- Active liver disease;
- increase in liver enzymes of unknown origin (more than 3 times compared to the ULN);
- hepatic insufficiency (classes A and B on the scale of Child – Pugh);
- the age of 18 years (effectiveness and safety have installed);
- increased sensitivity to the drug.
Application of pregnancy and breastfeeding
Atorvastatin is contraindicated during pregnancy and lactation (breastfeeding).
It is not known whether atorvastatin is excreted in breast milk. Given the potential for adverse effects in infants, if necessary, use during lactation should decide the issue of termination of breastfeeding.
The women of reproductive age during treatment should use adequate contraception methods. Atorvastatin can be administered to women of childbearing age only when the probability of pregnancy are very low and the patient informed of the potential risk to the fetus of treatment.
Use in children
is contraindicated for children and adolescents under the age of 18 years (effectiveness and safety have not been established).
Before starting therapy with atorvastatin is necessary to try to achieve adequate hypercholesterolemia control through diet therapy, physical activity, weight loss in obese patients, and the treatment of other conditions. Gipoholestesterinovuyu diet, patients should be observed during the treatment period.
The use of inhibitors of HMG – CoA – reductase inhibitors to reduce the level of lipids in the blood can lead to changes in biochemical parameters that reflect the function of the liver. liver function should be monitored before treatment and after 6 weeks, 12 weeks after the start of atorvastatin and improve after each dose, and periodically, for example every 6 months. Increase in serum liver enzymes may occur during therapy with atorvastatin. In such cases, you should monitor the status of patients before the normalization of liver enzymes. If the values of ALT or ACT is more than 3 times the ULN, the dose of atorvastatin is recommended to reduce or stop treatment. Active liver disease or persistent elevation of transaminases of unknown origin are contraindications to the appointment of atorvastatin.
Treatment with atorvastatin can cause myopathy. In patients with widespread myalgia, muscle tenderness or weakness and / or marked increase in activity of CK has a chance of developing myopathy (pain and weakness in the muscles, combined with an increase in CPK activity more than 10 times compared to the ULN). Atorvastatin therapy should be discontinued in the event expressed increasing CPK or in the presence of confirmed or suspected myopathy. The risk of myopathy during treatment with other drugs in this class increased, while the use of cyclosporine, fibrates, erythromycin, niacin or azole antifungal agents. Many of these drugs inhibit metabolism mediated isoenzyme CYP3A4, and / or transport of drugs. Atorvastatin is biotransformed by the action of CYP3A4. Appointing atorvastatin in combination with fibrates, erythromycin, immunosuppressants, azole antifungals or niacin in lipid-lowering doses should carefully weigh the potential benefits and risks of treatment and regularly monitor the status of patients in order to detect pain or weakness in muscles, especially during the first months of treatment and periods of increased doses of any drug. In such situations, we can recommend periodic determination of CPK activity, although such control does not prevent the development of severe myopathy.
If the use of atorvastatin, as well as other tools in this class, cases of rhabdomyolysis described with acute renal failure due to myoglobinuria. Atorvastatin therapy should be suspended or completely cancel the appearance of signs of a possible myopathy or presence of risk factors for renal failure with rhabdomyolysis (eg, severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine and electrolyte disorders, and uncontrolled seizures).
Patients should be warned that they should immediately consult a doctor if unexplained pain or weakness in muscles, particularly if there are malaise or fever.
Effects on ability to drive vehicles and management mechanisms
When driving or operating machinery, patients should be careful, because the application of atorvastatin exists the risk of dizziness.
With the simultaneous use of atorvastatin with cyclosporine, inhibitors of HIV – proteases (indinavir, ritonavir), antibiotics (erythromycin, clarithromycin, quinupristin / dalfopristin), anti-fungal drugs from the group of azoles (fluconazole, itraconazole, ketoconazole), nefazodone, fibric acid derivatives, nicotinic acid or diltiazem concentration of atorvastatin in plasma increases, which increases the risk of myopathy and rhabdomyolysis with acute renal failure.
With the simultaneous ingestion of atorvastatin and suspensions containing magnesium hydroxide and aluminum hydroxide, atorvastatin plasma concentration was reduced by about 35%, but the degree of reduction of cholesterol levels – LDL is not changed.
With the simultaneous use of atorvastatin does not affect the pharmacokinetics of antipyrine (phenazone), so the interaction with other drugs metabolized by the same isoenzymes of cytochrome P450 are not expected.
In an application colestipol atorvastatin plasma concentration decreases by about 25%. However hypolipidemic effect of the combination of atorvastatin and colestipol than that of each drug alone.
When you re-admission of digoxin and atorvastatin 10 mg Css digoxin did not change in the blood plasma. However, the application of digoxin in combination with atorvastatin 80 mg per day, the concentration of digoxin was increased by about 20%. When using this combination should monitor the status of patients.
With simultaneous use of atorvastatin and erythromycin (500 mg 4 times a day) or clarithromycin (500 mg 2 times a day), which inhibit the CYP3A4 isoenzyme, there was an increase atorvastatin plasma concentrations.
With simultaneous use of atorvastatin (10 mg 1 time per day) and azithromycin (500 mg 1 time per day) atorvastatin plasma concentrations did not change.
Atorvastatin had no clinically significant impact on the concentration of terfenadine in the blood plasma, which is metabolized primarily by CYP3A4; in this regard, it seems unlikely that atorvastatin can significantly influence the pharmacokinetic parameters of other substrates of CYP3A4 isoenzyme.
With simultaneous use of atorvastatin and oral contraceptives containing norethindrone and ethinyl estradiol, there was a significant increase in AUC of norethindrone and ethinyl estradiol by approximately 30% and 20%, respectively. This effect should be considered when selecting an oral contraceptive for a woman receiving atorvastatin.
The simultaneous use of drugs that reduce the concentration of endogenous steroid hormones (including cimetidine, ketoconazole, spironolactone), increases the risk of reduction of endogenous steroid hormones (requires caution in these combinations).
In the study found no interaction with atorvastatin and warfarin cimetidine evidence of clinically significant interaction.
With simultaneous use of atorvastatin 80 mg and amlodipine 10 mg the pharmacokinetics of atorvastatin at steady state is not changed.
There were no clinically significant adverse interaction atorvastatin and antihypertensive agents.
The simultaneous use of atorvastatin with inhibitors of proteases, known as inhibitors of CYP3A4 (grapefruit juice), accompanied by an increase atorvastatin plasma concentration, therefore avoid the use of this juice.
The simultaneous use of atorvastatin with inducers of CYP3A4 (efavirenz, rifampin) reduces the concentration of atorvastatin with the blood plasma.
The pharmaceutical incompatibility is not known.
Analogues drug Atorvastatin
The structural analogs of active material:
In the absence of drug analogs of active material, it is possible to follow the links below on the disease, which makes it an appropriate drug and see the existing analogues for therapeutic impact.