阿托伐他汀
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目錄 |
基本信息
阿托伐他汀片.立普妥.20mg*7片.輝瑞製藥有限公司
【外文名】Lipitor , Atorvastatin Calcium
藥理毒理
本品為HMG-CoA還原酶選擇性抑制劑，通過抑制HMG-CoA還原酶和膽固醇在肝臟的生物合成而降低血漿膽固醇和脂蛋白水平，並能通過增加肝細胞表面低密度脂蛋白（LDL）受體數目而增加LDL的攝取和分解代謝。本品也能減少LDL的生成和其顆粒數。本品還能降低某些純合子型家族性高膽固醇血症（FH）的低密度脂蛋白膽固醇（LDL-C）水平，而一類型的人群對其他類型的降脂藥物治療很少有應答。
本品能降低純合子和雜合子家族性高膽固醇血症、非家族性高膽固醇血症以及混合性脂類代謝障礙患者的血漿總膽固醇（TC）、LDL-C和載脂蛋白B（ApoB），還能降低極低密度脂蛋白膽固醇（VLDL-C）和三醯甘油（TG）的水平，並能不同程度地提高血漿高密度脂蛋白膽固醇（HDL-C）和載脂蛋白A1（ApoA1）的水平。
適應證
雜合子家族性或非家族性高膽固醇血症和混合性高脂血症，也用於純合子高膽固醇血症。
不良反應
本品可被較好地耐受，不良反應多為輕度和一過性，最常見的是便秘、腹脹、消化不良和腹痛⑴。因本品的不良反應而停藥者＜2%。其他有ALT升高（0.7%），發生在用藥16周內。
相互作用
本品與含有炔諾酮和炔雌醇的口服避孕藥合用時，能分別使諾酮和炔雌醇的AUC增加30%和20%；與紅霉素合用時，本品的血漿濃度約增高40%；與地高辛合用時，多次給藥後，地高辛的穩態血藥濃度增加約20%，應對地高辛濃度進行監測，與考來烯胺（消膽胺）合用時，本品的血漿濃度降低約25%，但降低LDL-C的效果較單用本品或考來替泊的效果都大。本品與環孢菌素、煙酸、紅霉素及吡咯類抗真菌藥合用，發生肌病的危險性增加。
用法用量
po，可在任何時間單劑量服用，進食或非進食時均可。起始劑量為10mg,qd，劑量範圍為10～80mg.d-1。根據治療目標和治療反應採取個體化治療方案。對腎功能不全患者，不必調整劑量。
注意事項
活動性肝病或原因不明的轉氨酶持續升高患者及對本品的任何成分過敏者、孕婦和哺乳期婦女禁用。
①使用本品治療前、治療6周及12周或增加藥物劑量後進行肝功能檢測，並在以後定期測定肝功能。②治療過程中出現瀰漫性肌痛、肌肉觸痛或無力，特別是伴有全身不適或發熱時，或/和肌酸磷酸激酶（CPK）水平明顯升高，應考慮肌病的可能性。如為肌病，應停止本品的治療。③使用本品前，應通過適當飲食、運動和減輕肥胖的體重等方法控制高膽固醇血症，並治療其他原發疾病。④本品過量無特殊治療。一旦發生過量，應予以對症及相應
7的支持療法，血液透極不能顯著增加其清除。⑤開始治療和/或增加劑量後2～4周應監測血脂水平，並據此對劑量進行相應的調整。⑥對純合子高膽固醇血症患者，除非無法進行其他治療，本品應作為其他降脂治療措施（LDL血漿分離置換）基礎上進行的治療手段。
【規格】片劑：10mg，20mg,40mg。
國藥准字J20030048
英文名稱
Atorvastatin
適應症
1.Atorvastatin blocks the production of cholesterol (a type of fat) in your body.
2.Atorvastatin is used to reduce the amounts of LDL (bad) cholesterol, total cholesterol, triglycerides (another type of fat), and apolipoprotein B (a protein needed to make cholesterol) in your blood. Atorvastatin is also used to increase the level of HDL (good) cholesterol in your blood. These actions are important in reducing the risk of hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease.
3.Atorvastatin may also be used for purposes other than those listed in this medication guide.
用法用量
1.Take atorvastatin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
2.Take each dose with a full glass of water.
3.Atorvastatin can be taken with or without food.
4.Atorvastatin is usually taken once a day. Try to take your dose at the same time each day. Follow your doctor's instructions.
5.Your doctor may want to monitor your liver function with blood tests before starting treatment with atorvastatin, at twelve weeks after both the start of your treatment and any increase in dose, and periodically (every 6 months) thereafter. Depending on the results of these tests, your doctor can determine how much monitoring you will require.
6.Grapefruit and grapefruit juice may interact with atorvastatin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
7.Eat a low-fat, low-cholesterol diet. To realize beneficial effects from atorvastatin, avoid fatty, high-cholesterol foods.
8.Do not stop taking atorvastatin without first talking to your doctor. It may be weeks or months before beneficial effects are seen from this medication.
9.Store atorvastatin at room temperature away from moisture and heat.
注意事項
1.Do not take atorvastatin without first talking to your doctor if you have liver disease.
2.Alcohol and atorvastatin can both damage your liver. Discuss with your doctor the amount of alcohol that you drink so that it can be determined if atorvastatin is the best choice for lowering your cholesterol.
3.Do not take atorvastatin if you are pregnant, if you are planning a pregnancy, or if you are breast-feeding a baby.
4.Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if it is accompanied by a fever or flulike symptoms or yellowing of your skin or eyes.
If Miss a Dose: 1.Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.
Contraindications: 1.Do not take atorvastatin without first talking to your doctor if you have liver disease.
2.Before taking atorvastatin, tell your doctor if you
- drink alcoholic beverages,
- have a chronic muscular disease,
- require major surgery, or
- have a blood disorder.
3.You may not be able to take atorvastatin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
4.Atorvastatin is in the FDA pregnancy category X. This means that atorvastatin will cause birth defects if it is taken during pregnancy. Cholesterol is very important for the proper development of a baby. Do not take atorvastatin if you are pregnant or are planning a pregnancy.
5.It is not known whether atorvastatin passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
Special Concerns: 1.Alcohol and atorvastatin can both damage your liver. Discuss with your doctor the amount of alcohol that you drink so that it can be determined if atorvastatin is the best choice for lowering your cholesterol.
2.Grapefruit and grapefruit juice may interact with atorvastatin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
不良反應
1.If you experience any of the following serious side effects, stop taking atorvastatin and seek emergency medical attention or call your doctor immediately:
- an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
- muscle aches, pain, or weakness;
- "flu-like" symptoms;
- decreased urine or rust-colored urine;
- blurred vision; or
- yellowing of your skin or eyes.
2.Other, less serious side effects may be more likely to occur. Continue to take atorvastatin and talk to your doctor if you experience
- headache;
- upset stomach or flatulence; or
- a rash.
3.Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
相互作用
1.Do not take atorvastatin without first talking to your doctor if you are taking any of the following medicines:
- cyclosporine (Sandimmune, Neoral);
- gemfibrozil (Lopid);
- niacin (Nicolar, Nicobid, Nicotinex, others);
- clarithromycin (Biaxin);
- erythromycin (E-Mycin, E.E.S., Ery-Tab, Ilotycin, Eryc, PCE, Ilosone, others); or
- fluconazole (Diflucan), itraconazole (Sporanox), or ketoconazole (Nizoral).
2.The medications listed above interact with atorvastatin and may cause damage your muscles.
3.Before taking atorvastatin, tell your doctor if you are taking any of the following medicines:
- other cholesterol-lowering drugs such as cholestyramine (Questran) or colestipol (Colestid); or
- digoxin (Lanoxin, Lanoxicaps).
4.You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
5.Drugs other than those listed here may also interact with atorvastatin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.
藥物過量
1.Seek emergency medical attention.
2.The symptoms of an overdose of atorvastatin are not known.
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