Гиперлипидемия:- первичная гиперхолестеринемия (гетерозиготная семейная и несемейная гиперхолестеринемия (II тип по Фредриксону); - комбинированная (смешанная) гиперлипидемия (IIa и IIb типы по Фредриксону); - дисбеталипопротеинемия (III тип по Фредриксону) (в качестве дополнения к диете); - семейная эндогенная гипертриглицеридемия (IV тип по Фредриксону), ...
заболевания печени в активной стадии (в т.ч. активный хронический гепатит, хронический алкогольный гепатит); - печеночная недостаточность; - цирроз печени различной этиологии; - повышение активности печеночных трансаминаз неясного генеза (больше3 раз по сравнению с ВГН); - заболевания скелетных мышц; - беременность; - период лактации (грудное вскармливание); - возраст до 18 лет (эффективность и безопасность применения не установлена); - дефицит лактазы, непереносимость лактозы, синдром мальабсорбции глюкозы/галактозы; - повышенная чувствительность к любому из компонентов препарата. С осторожностью следует назначать препарат при алкоголизме, заболеваниях печени в анамнезе.
Гиперлипидемия:- первичная гиперхолестеринемия (гетерозиготная семейная и несемейная гиперхолестеринемия (II тип по Фредриксону); - комбинированная (смешанная) гиперлипидемия (IIa и IIb типы по Фредриксону); - дисбеталипопротеинемия (III тип по Фредриксону) (в качестве дополнения к диете); - семейная эндогенная гипертриглицеридемия (IV тип по Фредриксону), резистентная к диете; - гомозиготная семейная гиперхолестеринемия при недостаточной эффективности диетотерапии и других нефармакологических методов лечения. Профилактика сердечно-сосудистых заболеваний:- первичная профилактика сердечно-сосудистых осложнений у пациентов без клинических признаков ИБС, но имеющих несколько факторов риска ее развития: возраст старше 55 лет, никотиновая зависимость, артериальная гипертензия, сахарный диабет, низкий уровень Хс-ЛПВП в плазме крови, генетическая предрасположенность, в т.ч. на фоне дислипидемии; - вторичная профилактика сердечно-сосудистых осложнений у пациентов с ИБС с целью снижения суммарного показателя смертности, инфаркта миокарда, инсульта, повторной госпитализации по поводу стенокардии и необходимости в реваскуляризации.
Противопоказания
заболевания печени в активной стадии (в т.ч. активный хронический гепатит, хронический алкогольный гепатит); - печеночная недостаточность; - цирроз печени различной этиологии; - повышение активности печеночных трансаминаз неясного генеза (больше3 раз по сравнению с ВГН); - заболевания скелетных мышц; - беременность; - период лактации (грудное вскармливание); - возраст до 18 лет (эффективность и безопасность применения не установлена); - дефицит лактазы, непереносимость лактозы, синдром мальабсорбции глюкозы/галактозы; - повышенная чувствительность к любому из компонентов препарата. С осторожностью следует назначать препарат при алкоголизме, заболеваниях печени в анамнезе.
Способ применения и дозы
До начала применения препарата Аторис пациент должен быть переведен на диету, обеспечивающую снижение концентрации липидов в крови, которую необходимо соблюдать в течение терапии препаратом. Перед началом терапии следует попытаться добиться контроля гиперхолестеринемии с помощью физических упражнений и снижения массы тела у пациентов с ожирением, а также терапией основного заболевания. Препарат принимают внутрь, независимо от приема пищи. Лечение начинают с рекомендуемой начальной дозы 10 мг. Доза препарата варьирует от 10 мг до 80 мг 1 раз/сут и подбирается с учетом исходной концентрации Хс-ЛПНП, цели терапии и индивидуального терапевтического эффекта. Аторис можно принимать однократно в любое время дня, но в одно и то же время каждый день. Терапевтический эффект отмечается после 2 недель лечения, а максимальный эффект развивается через 4 недели. Поэтому дозу не следует изменять раньше, чем через 4 недели после начала применения препарата в предыдущей дозе. В начале терапии и/или во время увеличения дозы необходимо каждые 2-4 недели контролировать концентрацию липидов в плазме крови и соответствующим образом корректировать дозу. Первичная (гетерозиготная наследственная и полигенная) гиперхолестеринемия (тип IIa) и смешанная гиперлипидемия (тип IIb)Лечение начинается с рекомендуемой начальной дозы, которую увеличивают после 4 недель в зависимости от реакции пациента. Максимальная суточная доза составляет 80 мг. Гомозиготная наследственная гиперхолестеринемияДиапазон доз такой же, как и при других типах гиперлипидемии. Начальная доза подбирается индивидуально в зависимости от выраженности заболевания. У большинства пациентов с гомозиготной наследственной гиперхолестеринемией оптимальный эффект наблюдается при применении препарата в суточной дозе 80 мг (однократно). Аторис применяется в качестве дополнительной терапии к другим методам лечения (плазмаферез) или как основное лечение, если терапия с помощью других методов невозможна. У пациентов пожилого возраста дозы препарата Аторис изменять не следует. У пациентов с заболеваниями почек дозы препарата Аторис изменять не следует. Нарушение функции почек не оказывает влияния на концентрацию аторвастатина в плазме крови или степень снижения концентрации Хс-ЛПНП при применении аторвастатина, поэтому изменение дозы препарата не требуется. У пациентов с нарушениями функции печени необходима осторожность (в связи с замедлением выведения препарата из организма). В подобной ситуации следует тщательно контролировать клинические и лабораторные показатели (регулярный контроль активности ACT и АЛТ) и при выявлении значительных патологических изменений доза препарата Аторис должна быть уменьшена или лечение должно быть прекращено. Применение в комбинации с другими лекарственными средствамиПри необходимости одновременного применения с циклоспорином суточная доза препарата Аторис не должна превышать 10 мг. Рекомендации для определения цели леченияА. Рекомендации Национальной образовательной программы по холестерину NCEP, США
Побочное действие
Классификация частоты развития побочных эффектов ВОЗ: очень часто (больше1/10), часто (от больше1/100 до меньше1/10), нечасто (от больше1/1000 до меньше1/100), редко (от больше1 /10 000 до меньше1 /1000), очень редко (от меньше1/10 000, включая отдельные сообщения). Со стороны нервной системы: часто - головная боль, бессонница, головокружение, парестезии, астенический синдром; нечасто - периферическая невропатия, амнезия, гипестезия, кошмарные сновидения. Со стороны органов чувств: нечасто - шум в ушах; редко - назофарингит, носовое кровотечение; Со стороны сердечно-сосудистой системы: сердцебиение, вазодилатация, мигрень, постуральная гипотензия, повышение АД, флебит, аритмия. Со стороны системы кроветворения: нечасто - тромбоцитопения. Со стороны дыхательной системы: часто - боль в груди. Со стороны пищеварительной системы: часто - запор, диспепсия, тошнота, диарея, метеоризм (вздутие живота), боль в животе; нечасто - анорексия, нарушение вкусового восприятия, рвота, панкреатит; редко - гепатит, холестатическая желтуха. Со стороны костно-мышечной системы: часто - миалгии, артралгии, боль в спине, припухлость суставов; нечасто - миопатия, судороги мышц; редко - миозит, рабдомиолиз, тендопатия (в некоторых случаях с разрывом сухожилий). Со стороны мочеполовой системы: нечасто - импотенция, вторичная почечная недостаточность. Со стороны кожных покровов: часто - кожная сыпь, зуд; нечасто - крапивница; очень редко - ангионевротический отек, алопеция, буллезная сыпь, многоформная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Аллергические реакции: часто - аллергические реакции; очень редко - анафилаксия. Со стороны лабораторных показателей: нечасто - повышение сывороточной активности аминотрансфераз (ACT, AЛT), повышение активности сывороточной КФК; очень редко - гипергликемия, гипогликемия. Прочие: часто - периферические отеки; нечасто - недомогание, повышенная утомляемость, лихорадка, увеличение массы тела. Причинно-следственная связь некоторых нежелательных эффектов с применением препарата Аторис, которые расценивают как очень редкие, не установлена. При появлении тяжелых нежелательных эффектов применение препарата Аторис следует прекратить.
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гомозиготная семейная гиперхолестеринемия при недостаточной эффективности диетотерапии и других нефармакологических методов лечения. Профилактика сердечно-сосудистых заболеваний:- первичная профилактика сердечно-сосудистых осложнений у пациентов без клинических признаков ИБС, но имеющих несколько факторов риска ее развития: возраст старше 55 лет, никотиновая зависимость, артериальная гипертензия, сахарный диабет, низкий уровень Хс-ЛПВП в плазме крови, генетическая предрасположенность, в т.ч. на фоне дислипидемии; - вторичная профилактика сердечно-сосудистых осложнений у пациентов с ИБС с целью снижения суммарного показателя смертности, инфаркта миокарда, инсульта, повторной госпитализации по поводу стенокардии и необходимости в реваскуляризации."}}]},{"id":3,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["заболевания печени в активной стадии (в т.ч. активный хронический гепатит, хронический алкогольный гепатит); - печеночная недостаточность; - цирроз печени различной этиологии; - повышение активности печеночных трансаминаз неясного генеза (больше3 раз по сравнению с ВГН); - заболевания скелетных мышц; - беременность; - период лактации (грудное вскармливание); - возраст до 18 лет (эффективность и безопасность применения не установлена); - дефицит лактазы, непереносимость лактозы, синдром мальабсорбции глюкозы/галактозы; - повышенная чувствительность к любому из компонентов препарата. С осторожностью следует назначать препарат при алкоголизме, заболеваниях печени в анамнезе."]}}]},{"id":4,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"До начала применения препарата Аторис пациент должен быть переведен на диету, обеспечивающую снижение концентрации липидов в крови, которую необходимо соблюдать в течение терапии препаратом. Перед началом терапии следует попытаться добиться контроля гиперхолестеринемии с помощью физических упражнений и снижения массы тела у пациентов с ожирением, а также терапией основного заболевания. Препарат принимают внутрь, независимо от приема пищи. Лечение начинают с рекомендуемой начальной дозы 10 мг. Доза препарата варьирует от 10 мг до 80 мг 1 раз/сут и подбирается с учетом исходной концентрации Хс-ЛПНП, цели терапии и индивидуального терапевтического эффекта. Аторис можно принимать однократно в любое время дня, но в одно и то же время каждый день. Терапевтический эффект отмечается после 2 недель лечения, а максимальный эффект развивается через 4 недели. Поэтому дозу не следует изменять раньше, чем через 4 недели после начала применения препарата в предыдущей дозе. В начале терапии и/или во время увеличения дозы необходимо каждые 2-4 недели контролировать концентрацию липидов в плазме крови и соответствующим образом корректировать дозу. Первичная (гетерозиготная наследственная и полигенная) гиперхолестеринемия (тип IIa) и смешанная гиперлипидемия (тип IIb)Лечение начинается с рекомендуемой начальной дозы, которую увеличивают после 4 недель в зависимости от реакции пациента. Максимальная суточная доза составляет 80 мг. Гомозиготная наследственная гиперхолестеринемияДиапазон доз такой же, как и при других типах гиперлипидемии. Начальная доза подбирается индивидуально в зависимости от выраженности заболевания. У большинства пациентов с гомозиготной наследственной гиперхолестеринемией оптимальный эффект наблюдается при применении препарата в суточной дозе 80 мг (однократно). Аторис применяется в качестве дополнительной терапии к другим методам лечения (плазмаферез) или как основное лечение, если терапия с помощью других методов невозможна. У пациентов пожилого возраста дозы препарата Аторис изменять не следует. У пациентов с заболеваниями почек дозы препарата Аторис изменять не следует. Нарушение функции почек не оказывает влияния на концентрацию аторвастатина в плазме крови или степень снижения концентрации Хс-ЛПНП при применении аторвастатина, поэтому изменение дозы препарата не требуется. У пациентов с нарушениями функции печени необходима осторожность (в связи с замедлением выведения препарата из организма). В подобной ситуации следует тщательно контролировать клинические и лабораторные показатели (регулярный контроль активности ACT и АЛТ) и при выявлении значительных патологических изменений доза препарата Аторис должна быть уменьшена или лечение должно быть прекращено. Применение в комбинации с другими лекарственными средствамиПри необходимости одновременного применения с циклоспорином суточная доза препарата Аторис не должна превышать 10 мг. Рекомендации для определения цели леченияА. Рекомендации Национальной образовательной программы по холестерину NCEP, США"}}]},{"id":5,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Классификация частоты развития побочных эффектов ВОЗ: очень часто (больше1/10), часто (от больше1/100 до меньше1/10), нечасто (от больше1/1000 до меньше1/100), редко (от больше1 /10 000 до меньше1 /1000), очень редко (от меньше1/10 000, включая отдельные сообщения). Со стороны нервной системы: часто - головная боль, бессонница, головокружение, парестезии, астенический синдром; нечасто - периферическая невропатия, амнезия, гипестезия, кошмарные сновидения. Со стороны органов чувств: нечасто - шум в ушах; редко - назофарингит, носовое кровотечение; Со стороны сердечно-сосудистой системы: сердцебиение, вазодилатация, мигрень, постуральная гипотензия, повышение АД, флебит, аритмия. Со стороны системы кроветворения: нечасто - тромбоцитопения. Со стороны дыхательной системы: часто - боль в груди. Со стороны пищеварительной системы: часто - запор, диспепсия, тошнота, диарея, метеоризм (вздутие живота), боль в животе; нечасто - анорексия, нарушение вкусового восприятия, рвота, панкреатит; редко - гепатит, холестатическая желтуха. Со стороны костно-мышечной системы: часто - миалгии, артралгии, боль в спине, припухлость суставов; нечасто - миопатия, судороги мышц; редко - миозит, рабдомиолиз, тендопатия (в некоторых случаях с разрывом сухожилий). Со стороны мочеполовой системы: нечасто - импотенция, вторичная почечная недостаточность. Со стороны кожных покровов: часто - кожная сыпь, зуд; нечасто - крапивница; очень редко - ангионевротический отек, алопеция, буллезная сыпь, многоформная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Аллергические реакции: часто - аллергические реакции; очень редко - анафилаксия. Со стороны лабораторных показателей: нечасто - повышение сывороточной активности аминотрансфераз (ACT, AЛT), повышение активности сывороточной КФК; очень редко - гипергликемия, гипогликемия. Прочие: часто - периферические отеки; нечасто - недомогание, повышенная утомляемость, лихорадка, увеличение массы тела. Причинно-следственная связь некоторых нежелательных эффектов с применением препарата Аторис, которые расценивают как очень редкие, не установлена. 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