Atoris
Atoris: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Atoris
ATX code: C10AA05
Active ingredient: atorvastatin (atorvastatin)
Manufacturer: KRKA (Slovenia)
Description and photo update: 2019-16-09
Prices in pharmacies: from 161 rubles.
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Atoris is a hypolipidemic drug from the statin group that has anti-atherosclerotic action and improves hemodynamics.
Release form and composition
Atoris is available in the form of film-coated tablets with a dosage of 10, 20, 30, 40, 60 and 80 mg.
The active ingredient of the drug is atorvastatin.
Pharmacological properties
Pharmacodynamics
Atorvastatin is one of the lipid-lowering drugs from the statin group. The main mechanism of action is inhibition of the activity of HMG-CoA reductase (an enzyme that catalyzes the conversion of HMG-CoA to mevalonic acid). This transformation is one of the early stages in the chain of Xc (cholesterol) formation in the body. With suppression of the synthesis of Xc, an increased reactivity of LDL (low density lipoprotein) receptors in the liver and in extrahepatic tissues is observed. After binding of LDL particles by receptors, they are removed from the blood plasma, resulting in a decrease in the concentration of LDL-C in the blood.
The antiatherosclerotic effect of atorvastatin develops due to its effect on blood components and vascular walls. Atorvastatin inhibits the synthesis of isoprenoids, which are growth factors for cells in the inner lining of blood vessels. Thanks to the effect of the drug, there is an improvement in endothelium-dependent expansion of blood vessels, a decrease in the concentration of LDL-C, Apo-B (apolipoprotein B) and TG (triglycerides), an increase in the concentration of HDL-C (high density lipoprotein) and Apo-A (apolipoprotein A).
The therapeutic effect of atorvastatin is manifested in a decrease in the viscosity of blood plasma and the activity of some factors of platelet aggregation and coagulation. As a result, hemodynamics improves and the state of the coagulation system is normalized. Also, HMG-CoA reductase inhibitors affect the metabolism of macrophages, blocking their activation and preventing rupture of atherosclerotic plaques.
The development of the therapeutic effect is noted, as a rule, after 2 weeks of therapy, it reaches its maximum in 4 weeks of using Atoris.
When using 80 mg of Atoris per day, the likelihood of ischemic complications (including death from myocardial infarction) is significantly reduced by 16%, and the risk of re-hospitalization for angina pectoris accompanied by signs of myocardial ischemia by 26%.
Pharmacokinetics
Atorvastatin is highly absorbed (about 80% of the dose is absorbed from the gastrointestinal tract). The degree of absorption and plasma concentration in the blood increase in proportion to the dose. The average time to reach C max (maximum concentration of the substance) is from 1 to 2 hours. In women, this indicator is 20% higher, and the AUC (area under the concentration-time curve) is 10% lower. By sex and age, the differences in pharmacokinetic parameters are insignificant and do not require dose adjustment.
With alcoholic cirrhosis of the liver, T max (time to reach the maximum concentration) is 16 times higher than the norm. Food intake somewhat reduces the duration and rate of absorption of atorvastatin (by 9% and 25%, respectively), while the decrease in the concentration of LDL-C is similar to that when using Atoris without food.
Atorvastatin has low bioavailability (12%), systemic bioavailability of inhibitory activity against HMG-CoA reductase is 30% (due to presystemic metabolism in the mucous membrane of the gastrointestinal tract and the effect of "primary passage" through the liver).
V d (volume of distribution) atorvastatin averages 381 liters. More than 98% of the substance binds to blood plasma proteins. Atorvastatin does not penetrate the blood-brain barrier. Metabolism occurs mainly under the action of the isoenzyme CYP3A4 of cytochrome P 450 in the liver. As a result, pharmacologically active metabolites (para- and orthohydroxylated metabolites, beta-oxidation products) are formed, which account for approximately 70% of the inhibitory activity against HMG-CoA reductase for 20-30 hours.
T 1/2 (half-life) of atorvastatin is 14 hours. It is excreted mainly with bile (it does not undergo pronounced intestinal-hepatic recirculation, it is not excreted during hemodialysis). About 46% of atorvastatin is excreted through the intestine, less than 2% by the kidneys.
In alcoholic cirrhosis of the liver (according to the Child-Pugh classification - class B), the concentration of atorvastatin increases significantly (C max - approximately 16 times, AUC - approximately 11 times).
Indications for use
- primary hypercholesterolemia;
- combined hyperlipidemia;
- dysbetalipoproteinemia;
- endogenous familial hypertriglyceridemia;
- familial homozygous hypercholesterolemia;
- prevention of diseases of the cardiovascular system.
Contraindications
- pregnancy;
- lactation;
- age under 18;
- liver diseases (chronic hepatitis in the active stage, cirrhosis, liver failure);
- skeletal muscle disease;
- lactose intolerance, lactase deficiency, galactose / glucose malabsorption syndrome;
- hypersensitivity to the components of the drug.
According to the instructions, Atoris should be prescribed with caution in case of a history of liver disease and alcohol dependence.
Instructions for the use of Atoris: method and dosage
Atoris tablets are taken orally at the same time, regardless of meals.
A lipid-limited diet should be followed before and during treatment.
Atoris is not used in pediatrics, adult patients are prescribed 10 mg 1 time per day for 4 weeks. If the therapeutic effect is not observed after the initial course, based on the lipid profile data, the daily dose is increased to 20–80 mg per day.
Side effects
The use of Atoris can cause a number of side effects:
- from the digestive system: impaired stool, nausea, loss of appetite, pancreatitis, impaired outflow of bile, vomiting, hepatitis, pain in the epigastric region, flatulence;
- from the nervous system: dizziness, paresthesia, disturbance of wakefulness and sleep, peripheral neuropathy, headache;
- on the part of the musculoskeletal system: cramps, muscle weakness, myopathy, muscle pain, myositis;
- on the part of the cardiovascular system: arrhythmia, palpitations, phlebitis, vasodilation, increased blood pressure;
- allergic reactions: alopecia, urticaria, itching, rash on the skin, Quincke's edema.
Overdose
There is no evidence of an overdose.
In case of an overdose, supportive and symptomatic therapy is indicated. Monitoring and maintenance of vital functions of the body, prevention of further absorption of Atoris (taking drugs with a laxative effect or activated charcoal, gastric lavage), control of liver function and serum creatine phosphokinase activity are required.
Hemodialysis is ineffective. There is no specific antidote.
special instructions
During the course of treatment, it is necessary to monitor liver function.
If you experience muscle pain, you should contact your doctor.
Influence on the ability to drive vehicles and complex mechanisms
The use of Atoris requires caution when driving and working with complex mechanisms.
Application during pregnancy and lactation
Atoris is not prescribed during pregnancy / lactation.
Women of reproductive age who do not use reliable methods of contraception are not recommended to use the drug. When planning a pregnancy, Atoris should be canceled at least one month before the planned pregnancy.
Pediatric use
Atoris therapy is contraindicated in patients under 18 years of age.
For violations of liver function
Reception of Atoris is contraindicated in liver cirrhosis of any genesis, liver disease in the active stage (including active chronic hepatitis, chronic alcoholic hepatitis), an increase in the activity of hepatic transaminases of unknown origin by more than three times compared with the upper limit of the norm.
Drug interactions
The use of atorvastatin simultaneously with antibiotics, antifungal agents, cyclosporine, nefazodone or HIV protease inhibitors can lead to an increase in the concentration of atorvastatin in the blood serum, which in turn will increase the risk of developing renal failure, myopathy with rhabdomyolysis.
Concomitant use with rifampicin, efavirenz, St. John's wort preparations and other inducers of the CYP3A4 isoenzyme can lead to a decrease in the concentration of atorvastatin in the blood plasma.
Care should be taken when taking Atoris in conjunction with ketoconazole, cimetidine, spironolactone and other drugs that reduce the concentration of endogenous steroid hormones, since the risk of a decrease in these hormones increases significantly.
Women taking oral contraceptives containing ethinyl estradiol and norethindrone should take into account when taking Atoris that this combination increases the absorption of the active ingredients of the contraceptive and increases their concentration in the blood plasma.
In patients using fusidic acid concomitantly with atorvastatin, cases of rhabdomyolysis have been reported.
Grapefruit juice in a volume of more than 1.2 liters per day can increase the concentration of atorvastatin in the blood plasma (it is recommended not to exceed the specified volume).
Analogs
Structural analogues of Atoris are the drugs Atorvastatin, Anvistat, Liprimar, Liptonorm, Torvakard, Tulip, Atomax, Anvistat, Lipoford.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Atoris
Reviews about Atoris are different. Many people note that the high cost of the drug is justified by its effectiveness and good tolerance. It is noted that during therapy, the doctor's instructions regarding diet and physical activity should be followed, and when choosing and adjusting the dose, the concentration of low density lipoproteins should be taken into account. According to a number of users, Atoris does not have the desired therapeutic effect and is poorly tolerated, causing severe side reactions.
The price of Atoris in pharmacies
On average, the price for Atoris is:
- 30 pcs. 10 mg each - 315-410 rubles;
- 30 pcs. 20 mg each - 394-530 rubles;
- 30 pcs. 30 mg each - 441-586 rubles;
- 30 pcs. 40 mg each - 596-700 rubles;
- 30 pcs. 80 mg - 744 rubles.
Atoris: prices in online pharmacies
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Drug name Price Pharmacy |
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Atoris 10 mg film-coated tablets 30 pcs. 161 r Buy |
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Atoris tablets p.p. 10mg 30 pcs. 286 r Buy |
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Atoris 20 mg film-coated tablets 30 pcs. RUB 350 Buy |
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Atoris 10 mg film-coated tablets 90 pcs. 406 r Buy |
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Atoris 30 mg film-coated tablets 30 pcs. 460 RUB Buy |
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Atoris tablets p.p. 20mg 30 pcs. RUB 488 Buy |
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Atoris 40 mg film-coated tablets 30 pcs. RUB 500 Buy |
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Atoris tablets p.p. 30mg 30 pcs. 535 RUB Buy |
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Atoris tablets p.p. 10mg 90 pcs. RUB 671 Buy |
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Atoris tablets p.p. 40mg 30 pcs. RUB 677 Buy |
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Atoris 20 mg film-coated tablets 90 pcs. 693 r Buy |
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Atoris tablets p.p. 20mg 90 pcs. 1106 RUB Buy |
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
