Torvakard - Instructions For Use, Indications, Doses, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Torvacard

Instructions for use:

1. Release form and composition
2. Indications for use
3. Contraindications
4. Method of application and dosage
5. Side effects
6. Special instructions
7. Drug interactions
8. Analogs
9. Terms and conditions of storage
10. Terms of dispensing from pharmacies

Prices in online pharmacies:

from 221 rub.

Buy

Torvacard - HMG-CoA reductase inhibitor; hypolipidemic agent from the statin group.

Release form and composition

Dosage form - film-coated tablets: biconvex, round, almost white or white (10 pcs. In blisters, in a carton box of 3 or 9 blisters).

Active ingredient: atorvastatin calcium, its content in 1 tablet in terms of atorvastatin is 10, 20 or 40 mg.

Additional components: low-substituted hyprolose, lactose monohydrate, microcrystalline cellulose, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, magnesium oxide.

Shell composition: titanium dioxide, macrogol 6000, talc, hypromellose 2910/5.

Indications for use

primary hypercholesterolemia, heterozygous familial and non-familial hypercholesterolemia, combined (mixed) hyperlipidemia (types IIa and IIb according to Fredrickson) - in combination with a diet to increase the level of high-density lipoprotein cholesterol (HDL-C), reduce elevated levels of total cholesterol (HC) low density lipoproteins (LDL-C), triglycerides and apolipoprotein B;
homozygous familial hypercholesterolemia - as an adjunct to lipid-lowering therapy (including autohemotransfusion of LDL-free blood) to reduce the levels of total cholesterol and LDL cholesterol in cases where diet therapy and other non-pharmacological methods of therapy do not give an adequate effect;
elevated serum triglyceride levels (Fredrickson type IV) and dysbetalipoproteinemia (Fredrickson type III) - in combination with diet in cases where diet therapy alone is not effective enough;
diseases of the cardiovascular system in patients with an increased risk of developing coronary heart disease (IHD), such as: stroke, arterial hypertension, left ventricular hypertrophy, peripheral vascular disease, coronary artery disease in close relatives, proteinuria / albuminuria, diabetes mellitus, smoking, age over 55 years old, including against the background of dyslipidemia - for secondary prevention in order to reduce the risk of stroke, myocardial infarction, hospitalization for angina pectoris, the need for revascularization, as well as the total risk of death.

Contraindications

Absolute:

lactose intolerance, lactase deficiency, glucose-galactose malabsorption;
liver failure (severity A and B in accordance with the Child-Pugh scale);
active liver diseases or an increase in the activity of transaminases in the blood serum by more than 3 times compared to patients with congenital adrenal hyperplasia (AHH) of unknown origin;
age up to 18 years;
pregnancy and lactation;
lack of adequate contraception in women of childbearing age;
hypersensitivity to any component of Torvacard.

Relative:

severe acute infections (eg, sepsis);
diabetes;
arterial hypotension;
metabolic and endocrine disorders;
severe violations of water and electrolyte balance;
a history of liver disease;
uncontrolled epilepsy;
skeletal muscle disease;
extensive surgical interventions;
alcohol abuse.

Method of administration and dosage

Torvacard should be taken orally at any convenient time of the day, regardless of meals. Before prescribing the drug, the patient is recommended a standard lipid-lowering diet, which he should adhere to during the entire period of treatment.

The starting dose is usually 10 mg once a day. Further, the optimal therapeutic dose is selected individually, depending on the purpose of therapy, the initial levels of LDL-C and the individual effect.

The highest daily dose is 80 mg in 1 dose.

Every 2-4 weeks at the beginning of therapy and during dose escalation, plasma lipid levels should be monitored and the dose adjusted if necessary.

With primary hypercholesterolemia and mixed hyperlipidemia, a daily dose of 10 mg is sufficient for most patients. A significant therapeutic effect usually develops after 2 weeks, the maximum - after 4 weeks. With prolonged treatment, this effect persists.

With homozygous familial hypercholesterolemia, a maximum daily dose of 80 mg may be required.

Side effects

Classification of side effects depending on the frequency of their development: very often (> 1/10), often (from> 1/100 to 1/1000 to 1/10 000 to <1/1000), very rarely (from <1/10 000, including selected messages).

Possible adverse reactions:

from the digestive system: often - abdominal pain, constipation or diarrhea, gastralgia, flatulence, nausea, vomiting; infrequently - increased appetite or anorexia, pancreatitis, hepatitis, cholestatic jaundice;
from the musculoskeletal system: very often - arthralgia, myalgia; infrequently - myopathy; rarely - back pain, cramps of the calf muscles, myositis, rhabdomyolysis;
from the central and peripheral nervous system: often - asthenia, headache; infrequently - decreased or lost memory, hypesthesia / paresthesia, sleep disturbances (including insomnia and nightmares), drowsiness, ataxia, peripheral neuropathy, dizziness, depression;
on the part of laboratory parameters: infrequently - an increase in the concentration of glycosylated hemoglobin, hypoglycemia, hyperglycemia, an increase in the activity of alanine aminotransferase (ALT) or aspartate aminotransferase (AST), an increase in the activity of serum creatine phosphokinase (CPK);
allergic reactions: often - skin rashes, itching; infrequently - urticaria; very rarely - bullous rashes, anaphylactic shock, angioneurotic edema, erythema multiforme exudative, including Stevens-Johnson syndrome, toxic epidermal necrolysis;
others: often - peripheral edema, chest pain; infrequently - malaise, tinnitus, weakness, secondary renal failure, weight gain, alopecia, impotence, thrombocytopenia.

The following adverse reactions have been reported with the use of some statins: gynecomastia, sexual dysfunction, depression, immune-mediated necrotizing myopathy, diabetes mellitus (its frequency depends on the presence / absence of risk factors), isolated cases of interstitial lung disease (especially with long-term treatment).

special instructions

Torvakard is prescribed in the event that it is not possible to achieve control of hypercholesterolemia by adequate diet therapy, increased physical activity, weight loss in obese patients, as well as treatment of other diseases and correction of concomitant disorders.

Before starting therapy, 6 and 12 weeks after starting the drug, after each dose increase and periodically during therapy (at least once every six months), it is necessary to monitor liver function. If the AST or ALT values are more than 3 times higher than those in patients with ULN, the Torvacard dose should be reduced or treatment discontinued.

Atorvastatin may increase the serum CPK, which should be taken into account in the differential diagnosis of chest pain. Also, the drug can cause myopathy, so patients should be warned about the need to immediately see a doctor if they develop unexplained muscle pain or weakness, especially if this condition is accompanied by fever or malaise. If you suspect the development of myopathy and if there is a risk factor for renal failure due to rhabdomyolysis, Torvacard should be temporarily or completely canceled.

Like other drugs of the class of statins, atorvastatin is able to increase the concentration of glucose in the blood, as a result of which its manifestation is possible in patients with a high risk of developing diabetes mellitus, which is an indication for antidiabetic therapy. Reducing the risk of vascular diseases due to the use of statins exceeds the risk of diabetes mellitus, and therefore this factor is not considered a serious argument for discontinuation of Torvacard, but in patients at risk (with hypertriglyceridemia, fasting blood glucose concentration of 5.6–6.9 mmol / L, body mass index> 30 kg / m ², history of arterial hypertension) requires careful medical supervision and regular monitoring of blood biochemical parameters.

Women of childbearing age should use reliable methods of contraception during treatment.

There have been no reports of adverse effects of the drug on psychomotor and cognitive functions in humans.

Drug interactions

nicotinic acid, nicotinamide, antifungal azoles, immunosuppressive drugs, fibrates, cyclosporin, erythromycin, clarithromycin, drugs that inhibit metabolism mediated by the 3A4 CYP450 isoenzyme and / or drug transport: the concentration of atorvastatin in blood plasma increases and, as a consequence the risk of myopathy (these drugs can be prescribed concurrently with Torvacard only after a careful assessment of the expected benefits and possible risks; during treatment, it is necessary to constantly monitor the patient's condition for pain or weakness in the muscles, especially at the beginning of therapy and when the dose of any of the medicinal products is increased means, it is also necessary to periodically determine the activity of CPK, but it should be borne in mind that this approach does not prevent cases of the development of severe myopathy);
preparations containing magnesium and aluminum hydroxides: in the blood plasma, the concentration of atorvastatin decreases by about 35%, but the degree of decrease in the level of LDL-C does not change;
colestipol: the concentration of atorvastatin in the blood plasma decreases by about 25%, but the lipid-lowering effect from the use of this combination is superior to that of each of the drugs used separately;
drugs that reduce the concentration of endogenous steroid hormones (including ketoconazole, spironolactone, cimetidine): the risk of reducing endogenous steroid hormones increases (if it becomes necessary to use such a combination, caution should be exercised);
oral contraceptives containing ethinyl estradiol and norethindrone: in the case of using atorvastatin in a daily dose of 80 mg, the concentration of ethinyl estradiol and norethindrone increases by about 20 and 30%, respectively, which should be taken into account when choosing an oral contraceptive for women receiving Torvacard;
digoxin: in the case of atorvastatin in a daily dose of 80 mg, the concentration of digoxin increases by about 20% (patients should be under medical supervision).

Analogs

Analogues of Torvakard are: Atoris, Atorvastatin, Atorvastatin-Teva, Liprimar.

Terms and conditions of storage

No special storage conditions are required. Keep out of the reach of children.

Shelf life is 4 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Torvakard: prices in online pharmacies

Drug name

Price

Pharmacy

Torvacard tablets p.p. 10mg 30 pcs.

221 r

Buy

Torvacard 10 mg film-coated tablets 30 pcs.

221 r

Buy

Torvacard 10 mg film-coated tablets 90 pcs.

RUB 350

Buy

Torvacard 20 mg film-coated tablets 30 pcs.

354 r

Buy

Torvacard tablets p.p. 20mg 30 pcs.

374 r

Buy

Torvacard tablets p.p. 40mg 30 pcs. Sanya

486 r

Buy

Torvacard 40 mg film-coated tablets 30 pcs.

486 r

Buy

Torvacard tablets p.p. 10mg 90 pcs.

577 r

Buy

Torvacard 20 mg film-coated tablets 90 pcs.

RUB 675

Buy

Torvacard tablets p.p. 20mg 90 pcs.

854 r

Buy

Torvacard 40 mg film-coated tablets 90 pcs.

1224 RUB

Buy

Torvacard tablets p.p. 40mg 90 Pcs.

1421 RUB

Buy

See all offers from pharmacies

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!