The modern pharmaceutical industry provides a wide range of drugs for high cholesterol.
The most popular group of drugs among doctors and patients is statins. These are substances with a dual mechanism of action. They quickly and effectively reduce blood lipid levels and resolve atherosclerotic plaques. The article will discuss the main representative of statins - Atorvastatin, its analogues and substitutes, their advantages and disadvantages.
pharmachologic effect
This drug is hypocholesterolemic - it competitively and selectively inhibits the enzyme that regulates the rate of conversion of HMG-CoA to mevalonate, which is subsequently converted into sterols, including cholesterol.
The decrease in the amount of lipoproteins and cholesterol in plasma after taking the drug is due to a decrease in cholesterol synthesis in the liver and the activity of HMG-CoA reductase, as well as an increase in the level of LDL receptors on the surface of liver cells, thereby increasing the uptake and catabolism of LDL.
In people with homozygous and heterozygous familial hypercholesterolemia, mixed dyslipidemia and non-hereditary hypercholesterolemia, apolipoprotein B, total cholesterol and low-density lipoprotein cholesterol decrease when taking this medicine.
This drug reduces the possibility of ischemia and mortality in people of all ages who have myocardial infarction without unstable angina and Q waves. It also reduces the incidence of non-fatal and fatal stroke, the overall incidence of cardiovascular disease and the risk of developing fatal diseases of the heart and blood vessels.
Liprimar
The drug is offered in the form of tablets with a dosage of 10/20 mg. A package may contain 14–100 pills. This is very convenient if the patient is just starting to take this Atorvastatin substitute. A small package of 14 tablets helps to assess the tolerability of the drug and decide on the possibility of further use. You need to take the tablet in the recommended dosage in the evening.
Liprimar is manufactured by the German pharmaceutical company Pfizer.
Contraindications:
- any trimester of pregnancy;
- breastfeeding period;
- diabetes mellitus, impaired glucose tolerance.
Important! Liprimara is prescribed with caution in the presence of chronic allergies and liver pathologies.
When diagnosing atherosclerosis in patients over 70 years of age, the dosage is calculated individually. Self-administration of the drug by elderly patients is strictly prohibited. The cost of the medicine is 500–1000 rubles.
Pharmacodynamics and pharmacokinetics
It has high absorption, the highest concentration in the blood is observed one to two hours after administration. Bioavailability is low due to the presystemic clearance of the active substance in the gastric mucosa and the “first pass through the liver” effect - 12 percent. Approximately 98 percent of the dose taken is bound to plasma proteins. Metabolization occurs in the liver with the formation of active metabolites and inactive substances. The half-life is 14 hours. It is not excreted during hemodialysis.
Reviews
Reviews about analogues of the drug are mostly positive. But since the active ingredient in all drugs is atorvastatin, the development of side effects cannot be ruled out. The development of unpleasant symptoms is influenced by the degree of purification of the active substance and the “purity” of additional components.
Oleg, 32 years old: On the doctor’s recommendation, after discovering high cholesterol, I started taking Atoris. The product helped me and my indicators returned to normal.
Elena Nikolaevna, 54 years old: I took Atorvastatin-SZ for a long course. I noticed an improvement in my well-being - I had coronary artery disease and angina attacks due to high cholesterol - about six months after I started taking it.
Natalya, 56 years old: After the operation, in order to prevent the development of atherosclerosis, I was prescribed Atorvastatin-Teva. The product was tolerated well, there were no side effects.
Indications for use of Atorvastatin
What are Atorvastatin tablets for? Indications for use of Atorvastatin are as follows:
- to reduce the amount of cholesterol and cholesterol/LDL in people with homozygous familial hypercholesterolemia, when non-pharmacological methods and dietary therapy do not provide the desired effect;
- for the treatment in combination with diet of people with elevated serum triglyceride levels and people with dysbetalipoproteinemia when diet therapy does not help;
- in conjunction with diet to reduce elevated total cholesterol, triglycerides, and apolipoprotein B and increase HDL cholesterol in people with combined hyperlipidemia, heterozygous nonfamilial and familial hypercholesterolemia, and primary hypercholesterolemia.
Anvistat
The medicine is produced by the domestic pharmaceutical company Antiviral. Dosage – 10/20 mg. The package contains 30 tablets. Anvistat is a third generation statin. Effective against high cholesterol and helps normalize its level. Typically, the average course duration is a full calendar month.
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You need to take the product in the evenings. Before starting treatment, it is necessary to exclude any problems with liver function. An effective replacement for Atorvastatin - if necessary - can be quickly selected. But what can replace the medicine must be decided by a specialist.
Contraindications
The medicine should not be taken if:
- under 18 years of age;
- pregnancy and lactation ;
- liver failure;
- active liver disease or increased activity of liver enzymes for unknown reasons;
- hypersensitivity to the contents of the drug.
Should be used with caution in cases of skeletal muscle disease, trauma, major surgery, uncontrolled epilepsy , sepsis , hypotension , metabolic and endocrine disorders, severe electrolyte imbalance, history of liver disease and alcohol abuse.
Side effects
When taking these tablets you may experience:
- exacerbation of gout , mastodynia , weight gain (very rare);
- albuminuria, hypoglycemia , hyperglycemia (very rare);
- petechiae, ecchymosis, seborrhea , eczema , increased sweating, xeroderma, alopecia ;
- erythema multiforme exudative , photosensitivity , facial edema , angioedema , urticaria , contact dermatitis , skin rash and pruritus (rare);
- impaired ejaculation, impotence , decreased libido , epididymitis, metrorrhagia, nephrourolithiasis, vaginal bleeding, hematuria , nephritis , dysuria ;
- joint contractures, muscle hypertonicity, torticollis , rhabdomyolysis, myalgia , arthralgia, myopathy , mositis, tenosynovitis, bursitis , leg muscle cramps, arthritis ;
- tenesmus, bleeding gums , melena, rectal bleeding, liver dysfunction, cholestatic jaundice , pancreatitis , duodenal , cheilitis, biliary colic gastroenteritis , ulcers of the oral mucosa, glossitis , esophagitis , stomatitis , vomiting , dysphagia, belching , sensation dry mouth, increased or decreased appetite, abdominal pain, gastralgia , flatulence , diarrhea or constipation , heartburn , nausea ;
- nosebleeds, exacerbation of bronchial asthma, dyspnea, pneumonia , rhinitis , bronchitis ;
- thrombocytopenia, lymphadenopathy, anemia ;
- angina pectoris , arrhythmia , phlebitis , increased blood pressure, orthostatic hypotension, palpitations, chest pain;
- loss of taste, parosmia, glaucoma , deafness , retinal hemorrhage, accommodation disturbance, dry conjunctiva, tinnitus, amblyopia ;
- loss of consciousness , hypoesthesia, depression , migraine , hyperkinesis, facial paralysis, ataxia , emotional lability, amnesia , peripheral neuropathy, paresthesia, nightmares , drowsiness , malaise , asthenia , headache , dizziness , insomnia .
Medicine Atorvastatin, instructions for use (Method and dosage)
According to the instructions for use of Atorvastatin, the drug is taken with meals or regardless of meals at any time of the day. The dose is selected depending on the initial level of cholesterol/LDL, the individual effect and the purpose of treatment. Before starting to use the medicine, a standard lipid-lowering diet is recommended, which must be followed throughout the entire treatment period.
The initial dose is 10 milligrams once a day, then can be increased to a maximum of 80 milligrams once a day. For homozygous familial hypercholesterolemia, 80 milligrams are prescribed once a day. In case of renal failure and other kidney diseases, the dose does not need to be adjusted. In case of liver failure, the dose must be reduced.
Interaction
Simultaneous use with protease inhibitors increases the concentration of the active substance in the blood plasma. Concomitant use with medications that reduce the concentration of endogenous steroid hormones (including Spironolactone , Ketoconazole and Cimetidine ) increases the possibility of a decrease in endogenous steroid hormones.
When taken simultaneously with Nicotinic acid , Erythromycin , fibrates and cyclosporines, it increases the possibility of developing myopathy when treated with other drugs of this class.
Simvastatin and Atorvastatin - which is better?
Simvastatin is a natural statin, and Atorvastatin is a more modern statin of synthetic origin. Although they have different metabolic pathways and chemical structures, they have similar pharmacological effects. They also have the same side effects, but Simvastatin is much cheaper than Atorvastatin, so in terms of price factor, Simvastatin is a better choice.
Choosing a manufacturer
Which manufacturer is better? Atorvastatin is produced by several Russian pharmaceutical companies, Kanonpharma, Vertex. is Israeli. How do the means differ? The difference between them lies in production technology, degree of purification and the quality of additional components of the drug.
The active ingredient is the same everywhere – atorvastatin. Atorvastatin Teva received good recommendations. The manufacturer pays special attention to the purification of both the main and additional components, which minimizes the risk of developing side effects described in the annotation for the drug.
An analogue is a medicine that contains the active ingredient of the original drug, but differs in the list of additional components. Below are the most well-known Atorvastatin substitutes.
Atorvastatin analogues
Level 4 ATX code matches:
Akorta
Atomax
Lipitor
Pravastatin
Simvastol
Owencore
Simgal
Tulip
Lovastatin
Liptonorm
Rozulip
Zokor
Rosart
Tevastor
Liprimar
Simvastatin
Atoris
Basilip
Rosecard
Roxera
Analogs of Atorvastatin are:
- Atoris
- Liprimar
- Torvacard
- Tulip
- Lipoford
- Novostat
- Anvistat
- Atomax
- Vasator
The price of analogues is slightly lower than Atorvastatin itself.
Atorvastatin price, where to buy
The price of Atorvastatin 10 mg in Russia averages from 150 rubles. The price of Atorvastatin Teva in Ukraine is on average 200 hryvnia, the price of Atorvastatin 20 mg is on average 150 hryvnia.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Atorvastatin tab.
p/o captivity 20 mg 30 pcs. JSC Biocom RUB 338 order - Atorvastatin-OBL tab. p/o captivity. 40 mg 30 pcs. JSC Obolenskoe farm. company
RUB 399 order
- Atorvastatin Medisorb tablets p.p.o 20 mg 30 pcs. JSC Medisorb
RUB 336 order
- Atorvastatin tab. p/o captivity. 80mg No. 30Ozon LLC
RUB 325 order
- Atorvastatin tablets p.p.o. 20 mg 30 pcs. Canonpharma Production CJSC
RUB 191 order
Pharmacy Dialogue
- Atorvastatin tablets 20 mg No. 30Canonpharma Production
189 rub. order
- Atorvastatin-Teva (tab.p.pl/vol.20mg No. 30)Teva
RUR 347 order
- Atorvastatin tablets 10 mg No. 30Canonpharma Production
128 rub. order
- Atorvastatin tablets 10 mg No. 30Biocom
170 rub. order
- Atorvastatin (tab.p.pl.vol.20mg No. 30)Biocom
RUB 355 order
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Pharmacy24
- Atorvastatin 10 Ananta 10 mg No. 30 tablets Flamingo Pharmaceuticals Ltd., India
62 UAH.order - Atorvastatin 20 Ananta 20 mg No. 30 tablets Flamingo Pharmaceuticals Ltd., India
75 UAH order
- Atorvastatin-Teva 20 mg N90 tablets Teva Pharma S.L.U., Spain
405 UAH order
- Atorvastatin-Teva 10 mg N30 tablets Teva Pharma S.L.U., Spain
112 UAH order
- Atorvastatin-Teva 20 mg N30 tablets Teva Pharma S.L.U., Spain
149 UAH order
PaniPharmacy
- ATORVASTATIN tablets Atorvastatin tablets. 10 mg No. 30 Ireland, Pfizer Ireland Pharmaceuticals
274 UAH order
- ATORVASTATIN tablets Atorvastatin tablets. 20 mg No. 30 Ireland, Pfizer Ireland Pharmaceuticals
290 UAH. order
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Tulip
Generic Atorvastatin from the Slovenian pharmacists of the Sandoz company. Available in tablet form in dosages of 5/10/20 mg. Packed in 30 tablets. The price is variable (depending on the amount of active ingredient) - 300–500 rubles. Before starting treatment, a biochemical blood test is required.
The doctor evaluates liver function - the content of transaminases (ALT and AST). Liver disease is indicated by a deviation from the physiological norm. In this case, taking the drug will be prohibited. For elderly patients (over 70 years old), the dosage of the drug is calculated individually. The dosage regimen is standard - 1 tablet in the prescribed dosage in the evening, before bedtime.
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