Torvitin 20mg 20 tablets

Form

tableti saghech i

Dosage mg

20

Pack

20

Composition One tablet of Torvitin contains the active substance - Atorvastatin 20 mg. Mechanism of action A hypolipidemic agent of the statin group. By selectively competitively inhibiting the enzyme HMG-CoA reductase, atorvastatin inhibits the conversion of 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonic acid. Mevalonic acid is a precursor of sterols, including cholesterol. Inhibition of cholesterol (CH) synthesis leads to increased reactivity of low-density lipoprotein (LDL) receptors in the liver and extrahepatic tissues. These receptors bind LDL, remove them from blood plasma, and reduce blood CH/LDL levels. Atorvastatin reduces total cholesterol, low-density lipoproteins and apolipoprotein B, as well as very low-density lipoproteins (VLDL) and triglyceride levels, and causes a non-significant increase in high-density lipoprotein (HDL) levels. Atorvastatin is effective and reduces cholesterol levels in patients with hereditary homozygous hypercholesterolemia, which is usually unresponsive to hypolipidemic agents. Perorally administered atorvastatin is well (80%) absorbed from the GI tract. Cmax is reached in 1-2 hours. Due to intensive metabolism during hepatic "first pass" metabolism, the bioavailability of atorvastatin is 14%. It is 98% bound to plasma proteins. Atorvastatin does not cross the blood-brain barrier. It is metabolized primarily in the liver. The inhibitory effect of metabolites on HMG-CoA reductase lasts for 20-30 hours. It is excreted via bile. T1/2 is approximately 14 hours. 46% is excreted with feces, and less than 2% via urine. Indications - Primary hypercholesterolemia (hereditary and non-hereditary heterozygous hypercholesterolemia) in case of ineffective diet therapy; - Mixed hyperlipidemia, including in patients with non-insulin-dependent diabetes mellitus; - Increased serum triglycerides and dysbetalipoproteinemia (in case of ineffective diet therapy); - Hereditary homozygous hypercholesterolemia (in combination with diet); - For secondary prevention in patients with myocardial infarction and cardiovascular diseases and/or dyslipidemia to reduce the risk of recurrent angina. Dosage and administration The drug is prescribed along with a standard hypolipidemic diet. The drug should be taken at any time of the day, at the same time, regardless of food intake. The drug dosage (10-80 mg) is selected considering the initial LDL level, the goal of therapy, and individual efficacy. At the beginning of therapy and/or when increasing the dose, plasma lipid levels should be monitored every 2-4 weeks, and the dose should be adjusted accordingly. The recommended initial daily dose of Torvitin is 10 mg. Depending on efficacy, the daily dose can be increased up to 80 mg. The effect of Torvitin appears 2 weeks after administration, reaching maximum effect in 4 weeks. Therefore, dose adjustment is not necessary within 4 weeks of the first administration of the drug. For primary (hereditary heterozygous and polygenic) hypercholesterolemia and mixed hyperlipidemia, the initial daily dose is 10 mg once a day. Depending on the patient's response, the dose can be increased after 4 weeks. The maximum daily dose is 80 mg. For hereditary homozygous hypercholesterolemia, the initial dose is 10 mg/day. Optimal effect is observed when taking the maximum daily dose of 80 mg. Elderly patients do not require dose adjustment. Side effects Torvitin is generally well tolerated. Side effects are usually mild and transient. The most common general side effects include: abdominal discomfort and pain, dyspepsia, headache, dizziness, nausea. Rarely, muscle cramps, myalgia, myositis, asthenia, diarrhea, rash, itching occur. Contraindications - Active phase of liver diseases or increased transaminase activity of unknown origin (more than 3 times the upper limit of normal); - Women of reproductive age who do not use adequate methods of contraception; - Pregnancy; - Lactation; - Children and adolescents under 18 years of age; - Hypersensitivity to the components of the drug. Use with caution in excessive alcohol consumers and/or patients with a history of liver disease. Special instructions Torvitin should be used with caution in cases of electrolyte imbalance, endocrine and metabolic disorders, alcoholism, history of liver disease, arterial hypotension, severe acute infections, uncontrolled seizures, surgical interventions, trauma. Atorvastatin may cause an increase in creatine phosphokinase and aminotransferase activity. An increase in liver transaminase activity may be observed during atorvastatin therapy, which is usually of no clinical significance. It should be taken into account that liver function parameters should be monitored before starting atorvastatin treatment, 6 and 12 weeks after starting treatment, when increasing the dose, and periodically throughout the entire period of treatment with the drug. In case of a 3-fold increase in aspartate aminotransferase and alanine aminotransferase levels, it is recommended to discontinue the drug or reduce the dose. Myopathy may develop during atorvastatin therapy. The risk of myopathy increases with the concomitant use of atorvastatin with cyclosporine, fibrates, erythromycin, clarithromycin, azole antifungal agents (fluconazole, itraconazole, ketoconazole), nicotinic acid or niacin. Concomitant use of atorvastatin and phenytoin may reduce the efficacy of atorvastatin. Antacids (suspensions containing magnesium and aluminum hydroxide) reduce the plasma concentration of atorvastatin. With repeated administration of atorvastatin and digoxin, the steady-state plasma concentration of digoxin increases by 20%. The use of atorvastatin with oral contraceptives (combination of norethindrone and ethinyl estradiol) leads to enhanced absorption of contraceptives and increased plasma concentration. Therefore, in women undergoing atorvastatin treatment, a contraceptive method should be selected. Women of reproductive age must use reliable contraception during atorvastatin treatment. Alcoholic beverages are contraindicated during treatment with the drug. Overdose Treatment: Symptomatic treatment is carried out if necessary. There is no specific antidote. Storage conditions and shelf life The shelf life of the drug is 3 years. Store at a temperature of 20-25°C, protected from light, in a dry place, inaccessible to children! Dispensing from pharmacy By prescription only!