Atorvastatin and Atoris: which is better, comparison. Roxera or Atoris - which is better? Storage conditions and periods

Prohibited when breastfeeding

Has restrictions for children

Allowed for older people

Has limitations for liver problems

Allowed for kidney problems

Lipid-lowering drugs are designed to lower the lipoprotein index in the body. The properties of these drugs are to suppress the synthesis of cholesterol by liver cells. Lipid-lowering drugs include statins. Representatives of the third generation based on the active component of atorvastatin are the drug Atorvastatin and its analogue Atoris. In this article we will look at what is better to take in a particular case - Atoris or Atorvastatin.

Review of Atoris and Atorvastatin

Atoris was developed as a substitute for the original 3rd generation statin drug Liprimar (Germany), which is not affordable for most patients. Atoris has an almost identical composition to the original and the same effectiveness in reducing cholesterol. Under the influence of Atoris, the following actions occur in the body:

Atorvastatin is a modern drug of the 3rd generation statin group, which is produced by Russian and Israeli pharmacological companies. The medication actively affects the enzyme reductase, which helps reduce cholesterol in the blood and prevents the development of atherosclerotic processes.

A drug based on atorvastatin calcium is available only in tablet form (with a dosage of 10, 20, and 40 mg). Atorvastatin can be taken in pediatrics from the age of 10 with homozygous hereditary hypercholesterolemia.

Russian medicines cost significantly less than their foreign counterparts. Their cost is:

1. From 110 rub. per pack of 10 tablets with a dosage of 10 mg.
2. From 260 rub. per package of medicine with a dose of 20 mg.
3. It costs from 300 to 375 rubles for a package of 10 tablets with a dosage of 40 mg.

The principle of action of the drugs

The active component in both drugs is atorvastatin, which interferes with the activity of the enzyme HMG-CoA reductase and normalizes the production of mevalonic acid, which is the basis of sterols formed at the initial stage of synthesis of cholesterol molecules in hepatocytes.

With the help of medications, the volume of cholesterol produced is reduced, which triggers LDL receptors that capture bad cholesterol molecules and promote their utilization through bile acids. Lipid catabolism is significantly enhanced and there is a significant reduction in “bad” cholesterol. Blood plasma is cleared of free cholesterol.

Also, the main component in medicinal preparations inhibits the synthesis of very low density lipids, which reduces their production, and also reduces the synthesis of triglyceride molecules.

In addition to this therapeutic effect, medications have an effect on the arterial membranes vasodilator effect, and also reduce the viscosity of blood plasma and prevent the formation of atherosclerotic deposits.

Taking statins reduces the development of complicated forms of ischemia and prevents heart attack and stroke.

The pharmacokinetics of 3rd generation statins are the same:

• maximum concentration – 1-2 hours after taking the tablet;
• the pharmaceutical effect does not depend on the age and gender category of the patient;
• if the patient is suffering chronic alcoholism with cirrhosis of the liver, then the concentration of the active component exceeds the norm in the liver by 16 times;
• if you take statins after meals, then their absorption is reduced;
• bioavailability –12%;
• relationship between statin and plasma proteins – 95-98%;
• Metabolism of statins occurs on cellular level in liver tissue and does not affect the blood-brain barrier;
• the drug passes through the placental barrier and is detected in breast milk;
• metabolites that are formed in liver cells can provide good protection up to 30 hours;
• The release of the medication begins after 14 hours. 45% is excreted with bile, and the rest with feces.

Indications and contraindications

Third generation statins are prescribed for certain disorders in lipid balance, as well as for other pathologies. These are:

As a preventative measure, medications are prescribed for:

• the formation of atherosclerotic accumulations in the endothelium of the arteries in patients at risk;
• cardiac diseases.

Contraindications for the use of statin drugs in therapy include:

• high sensitivity of the body to atorvastatin;
• liver pathologies in acute and severe forms;
• liver and kidney failure;
• increased transaminases;
• myopathy, other muscular and skeletal pathologies in history;
• pregnancy;
• breastfeeding a child;
• age under 18 years;
• unreliable contraception in women childbearing age.

Children are prescribed drugs from the age of 10 for familial homozygous cholesterolemia, but are not prescribed a strict diet.

During pregnancy and breastfeeding, statins are not prescribed. cause of lung passing through the placental barrier and high risk development of intrauterine pathologies in the fetus. For the same reason, it is not taken when breastfeeding.

Instructions for use

Taking statins is not tied to the time of eating; the only recommendation is to take them at the same time.

Most effective time to take the medicine - before bedtime, because at night the concentration of cholesterol is highest. Before starting therapy and the entire course of taking statins, it should be accompanied by an anti-cholesterol diet, which, in combination with medicine shows good reduction HS.

The dosage regimen and dosage for both drugs are the same. The initial dosage per day is 10 mg, for primary or mixed hypercholesterolemia - 20 mg. Children with hereditary homozygous hypercholesterolemia are not prescribed a dosage higher than 10 mg. For hypertriglyceridemia, the initial dosage is 10 mg with a gradual increase to 40 mg.

Prevention of cardiac pathologies - 20 mg followed by doubling the dose. Elderly patients or those with kidney disease moderate severity do not prescribe a dosage higher than 20 mg per day. Treatment of a patient with a dosage of 80 mg is possible only in a hospital and under the supervision of doctors.

Treatment of systemic atherosclerosis should begin with a dose of 10 or 20 mg, depending on the stage of disease progression, and then double the dosage (the first increase can be done after 2 weeks of use).

A change in drug can occur only after 30 days of therapy have passed and the maximum effectiveness of the statin has been achieved. It is not recommended to change the drug to an analogue or increase the dosage before.

Key differences and effectiveness?

What is the difference between Atoris and Atorvastatin? Both medications are generics of the original drug Liprimar. There is a difference in the country of origin: Atorvastatin is produced in Russia, and Atoris is its foreign analogue. The cost of these two drugs is also different. Atorvastatin costs 2-3 times less than the foreign drug. The effectiveness of both medications in the treatment is almost the same.

The effectiveness of the drug depends not only on the active component, but also on the correctly selected composition of auxiliary components. Difference in therapeutic effect of both medications is insignificant, but it still exists and must be taken into account when choosing a drug for treatment - Atoris or Atorvastatin.

Atorvastatin with a dosage of 10 mg shows the following therapeutic effect:

• decrease in total cholesterol – by 33%;
• LDL – decrease by 47%;
• triglycerides decrease by 9%;
• apo B decreases by 37%;
• apo A (3%) and HDL increase by 9-10%.

Therapeutic effect of Atoris with a dosage of 10 mg:

• total cholesterol index – decrease by 38%;
• decrease in LDL by 50%;
• TG are reduced by 13%;
• apo B is reduced by 42%;
• HDL levels increase by 10-12%
• increase in apo A - by 4%.

Side effects

3rd generation statins are the same as drugs of previous generations and modern means, have a large list of side effects on all organs. For this reason, statins are not intended for self-medication, because if taken incorrectly, they can lead to fatal outcome. A correctly selected dose of the drug by a doctor reduces the risk of developing negative reactions in organism:

Interaction with other medications and analogues

For complex therapy It is necessary to carefully select drugs with which statins may interact to avoid side effects from joint therapy:

Below are analogues of Atoris and Russian Atorvastatin, which are used in the treatment of systemic atherosclerosis and increased concentration cholesterol in the blood. Basic active ingredient in these analogues – atorvastatin:

1. Liprimar – original drug 3 generations of statins. Manufactured in Germany (Pfizer), where everything went through clinical researches. The safest and most effective statin in its subgroup. The only drawback is the very high price.
2. Indian analogue of Atomax– the drug is prescribed for the prevention of cardiac diseases and systemic atherosclerosis.
3. Torvacard (Zentiva, Slovenia)- the most popular analogue in Russia. An effective medication that has an affordable price.

Behind last decades cardiovascular pathologies came out on top among the causes of death. The laws of biology cannot be abolished: no matter where a person lives, no matter what he eats, changes in blood vessels are inevitable with age.

Atherosclerosis today has a particularly malignant course: with an increased incidence of hypertension, stroke, and heart attack.

Pollution level environment, Lifestyle modern man(nourishment, decreased motor activity, overweight body) cannot always be controlled.

One of the main risk factors is poor nutrition: overeating, abuse fatty foods, which provokes increased production of adipose tissue and “bad” cholesterol (CH). The higher the level of low-density lipids, the greater the risk of developing atherosclerosis.

Statins help normalize LDL and triglycerol levels. Their prominent representative is Torvacard, a lipid-lowering drug that inhibits HMG-CoA reductase and is effective in many pathologies: for diabetics, hypertensive patients, and also for hereditary diseases.

The active component of the drug is atorvastatin, which reduces total cholesterol by 30-46%, LDL by 40-60%; Triglycerol levels are also reduced.

Composition, form of medicine and price

In convex tablets, covered with film, contained calcium salt atorvastatin in the amount of 10, 20 or 40 g. Supplement the base substance:

Medicines are available by prescription. For Torvacard, the price in the pharmacy chain depends on their dosage and quantity in the box, for example, Torvacard 20 mg price is 90 tablets. –1066 rub.

The medicine is suitable for use for 4 years, special conditions it is not required for storage.

Pharmacological characteristics

Pharmacodynamics

The synthetic drug Torvacard inhibits HMG-CoA reductase, limiting the rate of cholesterol synthesis. CS, triglycerides, lipoproteins are in circulatory system in complex.

Depending on their density, they are separated into fractions by ultracentrifugation. The liver incorporates triglycerol and cholesterol into the lowest density lipids (VLDL), where they enter the bloodstream to be sent to peripheral tissues.

Experiments on animals revealed that statin reduces the concentration of cholesterol and lipid by inhibiting HMG-CoA reductase and producing cholesterol. The number of “bad” cholesterol receptors, which enhance the absorption of lipoproteins of this type, also increases. Reduces atorvastine and LDL synthesis.

Torvacard helps reduce OC, VLDL, TG, and LDL levels even for patients with non-familial and familial hypercholesterolemia and dyslipidemia, which rarely respond to therapy with alternative medications.

There is information about directly proportional dependence between mortality in pathologies of the heart and blood vessels and LDL content and OX and inversely proportional – for HDL.

Torvakard and its metabolites are pharmacologically active for human body. The main place of their localization is the liver, which performs the function of cholesterol synthesis and LDL clearance. When compared with the systemic content of the drug, the dosage of Torvacard is more actively correlated with a reduction in LDL levels.

The individual dose is selected based on the results of the therapeutic response.

Pharmacokinetics

1. Suction. The drug is actively absorbed in the gastrointestinal tract after internal use, reaching the highest concentration within one to two hours. The level of absorption increases with increasing dose of Torvacard. Its bioavailability is at the level of 14%, the level of inhibitory activity towards HMG-CoA reductase is 30%. The indicator of low bioavailability is explained by pre-systemic clearance in the gastrointestinal tract and biotransformation in the liver. The rate of absorption of the medicine is delayed by food, but the drop in levels of “harmful” cholesterol is separate or joint reception food and medicine are not affected. If you use a statin in the evening, its concentration decreases by 30%, but this result does not affect the reduction in the level of “bad” cholesterol.
2. Distribution. Over 98% active substance binds to blood proteins. Experiments on rats have shown that the drug can enter mother's milk.
3. Metabolism. The drug is intensively metabolized. About 70% of its inhibitory activity against HMG-CoA reductase is provided by metabolites.
4. Excretion. Most of atorvastine and its derivatives are excreted in the bile after processing in the liver. The half-life of statin is up to 14 hours. After consuming a dose, no more than 2% of the drug enters the urine.
5. Sexual and age characteristics. U healthy people In mature age, the percentage of statin content is higher than in young people, hence the degree of reduction LDL levels they have more. In women, the content of Torvacard in the blood is higher, but this factor does not affect the rate of decrease in LDL levels. There are no data on the reaction of children to Torvacard.
6. Kidney pathologies. Renal failure does not affect the percentage of statin levels and does not require dose adjustment. Hemodialysis will not increase the clearance of the drug, since atorvastine is tightly bound to proteins.
7. Liver diseases. Liver diseases associated with alcohol abuse affect the level of the drug in the blood: its content is noticeably increased.

The information presented as a change by several times is the ratio of cases of concurrent use of drugs and Torvacard alone.

The information shown as a percentage is the difference in data when using Torvacard separately. AUC is the area under the curve showing the level of atorvastatin over a certain time. C max – the most high content ingredients in the blood.

The risk of skeletal muscle disease (rhabdomyolysis) exists when Torvacard comes into contact with medications that increase its levels. It is dangerous to combine it with cyclosporine, stiripentol, telithromycin, clarithromycin, delavirdine, ketoconazole, voriconazole, posaconazole, itraconazole and HIV inhibitors.

Usually, analogs are selected that do not interact with Torvacard. If a decision is made to combine them, all the risks and benefits of such therapy are calculated.

Statins and fusidic acid are not compatible: atorvastatin is canceled during the course of acid therapy.

If the patient takes medications that increase the level of statin in the blood, prescribe minimum dosage Torvakarda. Constant monitoring of such patients is mandatory.

With prolonged therapy with statins, manifestations of lung diseases are not excluded: shortness of breath, cough, weight loss, fatigue, fever. At the first symptoms of interstitial lung disease, Torvacard is discontinued.

Some studies suggest that statins can significantly increase blood sugar levels. Patients with prediabetes may require antidiabetic therapy. But if we compare this threat with the danger of vascular damage, then the use of statins may be justified.

Representatives of the risk group (fast sugar up to 6.9 mmol/l, BMI > 30 kg/m2, high triglycerol concentration, hypertension) are constantly monitored for biochemical parameters and clinical condition.

Some auxiliary components may also cause undesirable consequences. For example, lactose is not suitable for individuals with galactose intolerance or lactase deficiency.

Patients with IHD of the heart and patients at risk for angina pectoris, Torvacard is prescribed in parallel with the diet.

Torvacard: indications and contraindications for use

Adults without signs of coronary artery disease, but with prerequisites for its formation (hypertension, smoking, age, reduced rate HDL, a hereditary predisposition to heart disease) is prescribed to prevent stroke, myocardial infarction, and reduce the risk of revascularization procedures.

For type 2 diabetics without symptoms of coronary artery disease, but with risk factors such as retinopathy, albuminuria (protein in the urine indicating kidney pathology), smoking or hypertension, a statin is prescribed to prevent heart attack and stroke.

In case of clinically significant ischemic heart disease, atorvastatin is prescribed for the prevention of lethal and non-lethal heart attack and stroke, facilitating the revascularization procedure, reducing the risk of hospitalization in case of stagnation in heart.

For hyperlipidemia, the drug Tovacard is indicated in parallel with a diet that reduces the levels of “bad” cholesterol and triglycerol and improves HDL.

Torvacard is not prescribed for liver diseases in active stage and increased sensitivity to the ingredients of atorvastatin.

Pregnant women, as well as those women who may become pregnant, should not use Torvacard, since statins are dangerous for the fetus. Patients of childbearing age should take a responsible approach to the choice of contraceptives.

Even with normal course pregnancy, the percentage of cholesterol and triglycerol is higher than normal. Lipid-lowering drugs are not useful in this case, because cholesterol and its derivatives are needed for the full formation of the fetus.

Atherosclerosis is a chronic disease and it develops over decades, so short-term use of atorvastine will not affect the course of hypercholesterolemia.

For Torvakard, studies have not been conducted on the effect of the drug on a breastfed child. But in general, statins can pass into mother’s milk, causing undesirable consequences in infants. Therefore, for women taking Torvacard, it is advisable to transfer the baby to artificial nutrition.

Directions for use and dosage

For hyperlipidemia and dyslipidemia, the instructions recommend the first dose of Tovacard within 10-20 mg/day. If “bad” cholesterol needs to be reduced by 45% or more, you can start with 49 mg/day. The general limits of the dosage range are 10-80 mg/day.

Take the tablets once, at any time, regardless of meals. When prescribing an initial or maintenance dose, they are guided by the goals of therapy and the body’s response. After 2-4 weeks or when the dose changes, lipid levels should be checked and the regimen adjusted.

For children 10-17 years old with heterozygous hypercholesterolemia, the course begins with 10 mg/day. The maximum dose of Tovakar is up to 20 mg/day. There are no data on the response of children to more serious doses. The norm is adjusted every 4 weeks or more.

If there is a history of homozygous hypercholesterolemia, the dosage range of Torvacard is 10-80 mg/day. Statin is used in combination with lipid-lowering drugs, as well as in cases where such therapy is not available.

In patients with renal failure, dose adjustment is not required, since such pathologies do not affect the effectiveness of atorvastatin.

Help with overdose

There is no special treatment for excessive use of Torvacard. They choose methods depending on the symptoms, supplementing them with supportive measures. Due to the rapid binding of the active component to blood proteins, you should not count on increasing its clearance using hemodialysis.

For Thorakard, detailed instructions for use can be found here

Side effects

Clinical adverse effects identified in 2% of patients taking different doses Torvakarda, regardless of the reasons, are presented in the table.

Atorvastatin has little effect on the level of attention and reaction when working with machinery or driving vehicles.

Torvacard - analogues

Medicines with similar properties may contain atorvastatin or simply have similar functions of influencing the body. Before deciding to switch to Alternative option treatment, you should definitely consult your doctor.

By active active ingredient You can choose more expensive and cheaper analogues for Torvacard:

Based on the results of the effect on the body, Torvacard can be replaced by:

Before using Torvacard or another statin, it is important to study the instructions for use and understand side effects and compatibility with related products.

Statins are used to treat higher level cholesterol. Drugs of this type that are currently being produced tend not only to lower “bad” cholesterol, but also stimulate the production of a useful substance.

They are prescribed in case of advanced disease, if there is a risk of developing a heart attack or stroke. And also if non-drug methods not effective.

The effect is noticeable after a month of therapy with such drugs. Despite this, their maximum reliability positive influence does not exist. According to some studies, they have far more side effects than benefits.

However, there are patients who should definitely be treated with statins:

1. for the prevention of stroke, heart attack;
2. with ischemia;
3. after surgical intervention on the heart and blood vessels;
4. if a person has angina pectoris;
5. in the presence of acute coronary syndrome.

They are also prescribed after 40 years, in case of illness of cardio-vascular system, as well as people whose close relatives died from heart pathologies.

Medicines in this group are prescribed to prolong the life of patients suffering from high cholesterol. But this fact does not mean that they are prescribed to all patients with hypercholesterolemia, but only in case of unsuccessful treatment without medication.

Medicines should only be prescribed by a doctor in case of urgent need. Some of the most effective statins are Atoris and Rosuvastatin. They are prescribed for lipid metabolism disorders and heart diseases.

To understand which drugs are the most effective, Atoris or Rosuvastatin, you need to know the mechanisms of influence and side effects of both drugs and how they differ. Both means have more than one good review from users.

Indications and contraindications of drugs

Atoris is a concentration reducer bad cholesterol and plaques in size, slowing down the development of atherosclerosis.

The main active ingredient is atorvastatin. The original medicine atorvastatin is Liprimar, and Atoris is an identical drug, but more affordable in price.

Atoris is prescribed when high cholesterol, high risks of developing cardiovascular diseases. Thanks to its action, the risks of blood clots are minimized.

Indications for use:

• High cholesterol levels in adults and children over 10 years of age.
• Prevention of heart attack.
• Stroke prevention.
• Prevention of heart and vascular diseases.
• Hypertension.
• Diabetes.
• Recovery period after surgical intervention on the cardiovascular system.

The medicine interacts poorly with other drugs. The use of statins along with other types of medications can cause severe side effects in the form of disruption of the liver and kidneys. This is especially true for antibiotics, drugs against fungus, against hypertension, arrhythmia, and drugs that strengthen the immune system. Before taking the medicine, you need to discuss this with a specialist.

Do not use the product if you have severe liver diseases; individual intolerance to the main one, or excipients; with caution: for alcoholism, disorders endocrine system, diabetes, infections.

Rosuvastatin is a lipid-lowering drug that is prescribed when other treatment methods are not effective. It is also prescribed for some other disorders. The medicine must be taken in combination with a diet.

1. Hypercholesterolemia of any type.
2. Prevention of diseases of the cardiovascular system.

It is also often prescribed for homozygous familial hypercholesterolemia. Before using the medicine, the patient must switch to special diet from cholesterol. This will help make the therapy easier and should be followed for a long time, preferably even after treatment.

The drug also has a number of contraindications:

• individual intolerance to substances;
• liver diseases in the active phase;
• during the period of bearing a child and breastfeeding;
• in case of lactose intolerance;
• kidney dysfunction;
• childhood;

Contraindication for use is concurrent treatment with Cyclosporine.

Instructions for use of drugs

Each of the drugs has its own fixed instructions for use.

Atoris is available in tablet form. The course of therapy usually begins with a dosage of 10 milligrams per day. After just a month, the number of tablets can be increased to enhance the effect. Maximum – 80 milligrams per day.

For each age group The dosage is different, you need to be especially careful about the amount for older people and women during menopause. In addition to the obvious advantages, the drug has some side effects.

It has been noted that taking Atoris often causes muscle pain, stomach upsets, headaches, increased fatigue, slight impairment of memory and thinking functions. Despite this, the tablets are brought more benefits than harm, and they should be stopped if the side effects are difficult for the patient to tolerate.

No cases of drug overdose were found.

When taking pills, you need to follow a special diet, active image life, it is advisable to engage in physical exercise. If the patient has problems with weight, they should lose weight. Treatment will be more effective if a person follows healthy image life.

If the patient is bothered by muscle pain and general weakness, you should contact a specialist. During treatment, you need to keep your liver and kidney function under control, so you should undergo an examination at 6 and 12 weeks.

It must be remembered that the drug can increase glucose levels in diabetics. The drug should be stored out of the reach of children, in a cool, dark place. The price of the drug in Russia is from 357 rubles

Rosuvastatin is available in tablet form. Should be taken orally with plenty of water. It is necessary to start treatment with 10 milligrams per day, then, if necessary, you can increase the dose. In case of renal failure, the dose should be halved at the very beginning of the course of therapy. The maximum effect can be observed within three weeks after the start of therapy. The drug also has side effects in the form of:

1. myalgia;
2. muscle hypertonicity;
3. arthritis; bronchial asthma;
4. insomnia; depression; pneumonia;
5. increased pressure; increased anxiety;
6. rhinitis; angina pectoris; allergies;
7. angioedema;
8. diabetes mellitus; increased heart rate.

Jaundice and hepatitis occur very rarely. To avoid negative effects You should discuss taking the drug with your doctor and use it with extreme caution. The cost of the drug in Russia is from 275 rubles.

Only a specialist can decide Atoris or Rosuvastatin: which is better, because each of them can have different characteristics and have different effects on the human body.

Main analogues of drugs

Both drugs have similar medicinal effects.

Analogs of these drugs have the same effect, but some are cheaper, with some differences in dosage.

If necessary, they can replace the main medicine, but the replacement must be agreed with the doctor. Many can be taken as an alternative.

Experts include the drugs Atorvastatin, Roxera, Rosucard, Simvastatin, Vasilip, Cardiostatin, Lovastatin as substitutes for the drug Atoris.

Prices for drugs vary quite widely. Some of them are much more affordable. You can buy them without a prescription at any pharmacy.

Rosuvastatin also has a replacement.