Atorvastatin and Atoris: which is better, comparison. Side effects of Liprimar. What you need to know about taking statins for high cholesterol

In cases where there are metabolic disorders in the body, and the level of cholesterol (and other fats) is increased, patients are prescribed special diet, refusal bad habits. It is recommended to increase physical activity. If these measures are not effective, the doctor will prescribe drug treatment.

In this case, drugs are prescribed - statins, which affect biochemical processes in the body, help reduce the production of cholesterol and its deposits on the walls of blood vessels. There are several types of statins available in pharmacies: atorvastatin and its analogues (torvacard, atoris, liprimar), rosuvastatin, simvastatin and analogues (zocor, simgal), as well as other drugs. But among all the statins, atorvastatin, rosuvastatin and their analogs are considered the most effective and powerful.

These drugs effectively reduce the development of cardiovascular pathologies. In addition, their ability to reduce the risk of complications of atherosclerosis and reduce mortality in patients with this disease has been proven. Let's take a quick look at them medicinal properties and we will discuss the cholesterol medicine Torvacard, Atoris, Crestor, Mertenil, Liprimar.

Effective statin drugs

Torvacard

The lipid-lowering statin drug Torvacard is prescribed to reduce cholesterol and triglyceride levels in the blood. The active substance in this product is atorvastin. A drug effective action, prevents the occurrence severe complications. Helps reduce the risk of sudden death in patients with coronary heart disease.

The drug, by lowering cholesterol levels, prevents the development of pathologies of the cardiovascular system. It is prescribed as part of the complex treatment of hypercholesterolemia, and is also used in the treatment of hypertriglyceridemia. In parallel with the appointment of Torvacard, patients are prescribed a special diet, therapeutic exercises, and other non-drug treatment methods are used.

Atoris

A lipid-lowering drug from the statin group. The active substance in the drug is atorvastatin. Has a high antiatherosclerotic effect. Affects the walls blood vessels, significantly reduces the viscosity and thickness of the blood. Affects the activity of its coagulation, affects platelet aggregation. Thus, Atoris improves and activates hemodynamics, and also normalizes and improves the condition of the coagulation system.

The drug is prescribed to reduce the risk of ischemic complications. Reduces the need for re-hospitalization due to the risk of angina pectoris, which is accompanied by symptoms of myocardial ischemia.

Crestor

This is a new, modern hypocholesterolemic, hypolipidemic drug from the group of statins. It is prescribed for complex therapy atherosclerosis, as well as for the prevention of this terrible disease.
It is used in the treatment of all types of hypercholesterolemia and combined hyperlipidemia. The effect of Crestor has been proven to prevent the development of atherosclerosis of coronary vessels and arteries. This drug blocks the synthesis of cholesterol, which reduces its amount in the blood.

The drug is prescribed to adult patients for the treatment of hypercholesterolemia (including familial), hypertriglyceridemia. It can also be used by patients with diabetes.

Mertenil

This is a new product on the market medicines, but already well proven. The drug is very effective and fast-acting. It is not intended for "widespread" use. Mertinil is used in the complex treatment of coronary disease, the first symptoms of atherosclerosis, to reduce cholesterol and low-density lipoprotein levels.

When treated with this drug, there is a direct effect on the liver. It is in the liver that low-density lipoproteins and cholesterol found in the body are synthesized or broken down.

Liprimar

This drug is intended to reduce cholesterol and other fats in human blood. It also reduces lipid synthesis and activates their breakdown.

You need to understand that Mertenil, like other drugs from the statin group, should not be used independently as a means of helping to lose weight. The drug liprimar is intended for use in the treatment of severe disorders, damage to metabolic processes, including hereditary ones. It is prescribed for the treatment of dysbetalipoproteinemia, hypercholesterolemia.

It is also prescribed for the prevention of cardiovascular pathologies, which often develop due to increased cholesterol concentrations. These are diseases such as stroke, heart attack, angina, as well as
other dangerous diseases.

Important!

It is important to remember that statin drugs must be taken for a long time and always under medical supervision. Best time for administration - in the evening, since the main synthesis of cholesterol occurs at night.

You should follow all your doctor's recommendations for taking medications and follow a low-fat diet. You should periodically undergo examinations and tests to determine the effectiveness of treatment, as well as to identify possible side effects

If you suddenly experience pain, muscle spasms, general weakness, you should immediately inform your doctor about this. Be healthy!

The drug "Atoris" is registered as a product of the Slovenian pharmacological company "KRKA". This is a high-quality and affordable generic version of Atorvastatin, which was previously sold only as the Pfizer drug Liprimar. On this moment its analogues (Atoris, Torvacard and others) have firmly entered clinical practice and are high-quality hypocholesterolemic drugs.

Release forms

The drug "Atoris" is available in tablets of three standard dosages. These are 10, 20 and 40 mg. Sold in cardboard packages with tablets placed in blisters. Capacity of cardboard packages: 10, 30 and 90 Atoris tablets (instructions for use). Analogues of the drug and generics may contain an identical amount of the active substance, but not have the same effect due to differences in the components.

Composition of the drug "Atoris"

The active substance is atorvastatin, a statin III generation. The auxiliary substances are the following: polyvinyl alcohol, macrogol 3000, talc, croscarmellose sodium, microcrystalline cellulose, lactose monohydrate, povidone, calcium carbonate, sodium lauryl sulfate.

Excipients determine the tablet dosage form and determine the rate of absorption of atorvastatin into the blood. Accordingly, any analogue of the Atoris drug should contain the same amount of active substance and be released at the same speed, creating similar concentrations in the blood.

Rationale for the use of statins and Atoris

The drug "Atoris" contains atorvastatin as an active ingredient. It belongs to the category of third generation substances. A lot of studies have been carried out with it, confirming the advisability of taking it in the presence of risk factors for atherosclerosis or in case of an already developed disease. Atorvastatin, its analogues, Atoris and other statins significantly reduce the ability of low-density lipoproteins (LDL) to cause atherosclerosis and lead to its worsening. This is their clinical value, because with their direct participation the frequency of developing heart attacks is reduced.

Pharmacological effects

The most important consequence of intake is the inhibition of cholesterol synthesis through inhibition of the enzyme HMG-CoA reductase. The result is a cessation or significant reduction in LDL synthesis. This fraction of lipoproteins provokes atherosclerosis, causing wall narrowing and hardening in the arteries of the heart, brain and lower extremities. Along with a decrease in the amount of LDL, the concentration increases

They perform important work: increasing the resistance of membranes to mechanical and chemical influences by incorporating cholesterol into it. Thus, HDL is utilized but does not accumulate cholesterol. LDL leads to its accumulation behind the vascular endothelium, provoking atherosclerosis, while high-density lipoprotein reduces the rate of cholesterol deposition, but does not remove it from under the inner lining of the elastic artery.

Method of use of the drug "Atoris"

Recommendations on how to take Atoris come down to clarifying some aspects. In particular, the medicine is taken in the prescribed dose once a day after dinner before bedtime. A single dose can be 10, 20 and 40 mg. Since the drug is a prescription drug, a doctor's consultation is required to purchase it. It is he who, after analyzing lipid profile fractions and assessing the level of total blood cholesterol, is able to recommend correct dosage atorvastatin, its class analogues or generics.

For initial cholesterol levels of 7.5 and above, it is recommended to take 80 mg/day. A similar dosage is prescribed to patients who have suffered or are in the acute period of its course. At concentrations between 6.5 and 7.5, the recommended dose is 40 mg. 20 mg is taken when the cholesterol level is 5.5 - 6.5 mmol/liter. 10 mg of the drug is recommended for children aged 10 to 17 years with heterozygous hypercholesterolemia, as well as adults with primary hypercholesterolemia.

Requirements for generics

A high-quality analogue of Atoris should contain an identical amount of the active substance and create similar concentrations in the blood. Provided that the product is such, it is recognized as bioequivalent and capable of completely replacing the original. In relation to the drug “Liprimar”, the analogue is “Atoris”, created on the basis of atorvastatin.

Requirements for clinical analogues of Atoris

Any substitute for Atoris, its class or analogue in composition, must contain any of the statins. It is in this case that it can be used as a full equivalent. Moreover, replacing the drug Atoris with an analogue should be carried out while maintaining the prescribed dosage. If 10 mg of Atoris is used, then the other medicine should also exhibit similar or greater activity.

Generics "Liprimar"

Since the original atorvastatin is Liprimar, all drugs with the same active ingredient should be compared with it. Analogs, “Atoris” among which is the most balanced in price, should also be considered from this point of view. So, there are similar medications with a higher cost, with an equivalent cost and with a lower cost. Complete analogues of Atoris:

• expensive ("Liprimar");
• equally accessible ("Torvacard", "Tulip");
• cheaper ones (Lipromak, Atomax, Lipoford, Liptonorm).

As you can see, atorvastatin analogues are widely represented. An even greater number of them are offered in the low price category. Here you should indicate a lot of drugs with the trade name “Atorvastatin”, which are produced under license from large pharmacological companies.

If you are looking for an analogue of Atoris, any atorvastatin will be cheaper domestic production under license. The highest quality and fully consistent with what is described is Atorvastatin from the Borisov Pharmaceutical Plant, located in Belarus. Here, the production of the drug is controlled by the KRKA company, which produces Atoris.

Features of drug replacement

In the question of what to replace Atoris with, it is important to consider several conditions. First, the drug must have appropriate clinical efficacy and be well tolerated. Secondly, its price should be lower, or, if the drug belongs to class analogues, slightly higher. Thirdly, the previous dose must be maintained if the replacement is made with a generic drug. If switching to a class analogue of the drug, it is important to receive an equivalent dose.

Replacement with generics

Among the drugs containing atorvastatin, the following are of the highest quality: Liprimar, Torvacard, Lipromak and Atoris. Analogues, reviews of which are few, are inferior to them in terms of effectiveness and safety. Although in terms of price they are preferable. They can be recommended to patients who do not care about the bioequivalence of the generic or do not want to overpay. There is no visible difference in the effects of this, although the quality of treatment suffers to some extent.

If we consider generics of atorvastatin, it is recommended to choose from those listed above. But, for example, deciding what to choose - Atoris or Torvacard - is not easy. The reason for this is the almost complete correspondence of these drugs in price and effectiveness. Moreover, their prices are often similar. Above them in quality is “Liprimar”, and below them is “Lipromak”. At the same time, the latter, with a slight difference in ingredients, is more affordable.

Replacement with class analogues of “Athoris”

The drug "Atoris" has analogues in Ukraine and other CIS countries, and there are class ones. That is, the drug contains a different statin, respectively, with different characteristics. It is most reasonable to change Atoris to Pitavastatin or Rosuvastatin if the LDL reduction is insignificant. Moreover, the latter are safer and have a therapeutic effect at a lower dose.

There are also early analogues: Atoris looks more preferable compared to them, although they have a full clinical effect. For example, Simvastatin is the most affordable drug with proven safety in clinical studies. The original original is "Zokor". If we consider affordable and high-quality as a replacement for Atoris, then it is better to take Mertenil as an example. This is a no less studied “Rosuvastatin”, a generic with an affordable price.

Description of action

Atorvastatin (Atoris) is a synthetic, selective 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) inhibitor that inhibits the conversion of HMG-CoA to the sterol precursor mevalonate. The drug reduces the concentration of cholesterol in liver cells; As a result, the expression of LDL receptors (low-density lipoprotein receptors - “bad” cholesterol) increases, which increases the uptake and catabolism of LDL, and LDL particles are absorbed. Atorvastatin causes a significant decrease in total cholesterol levels and LDL cholesterol. In addition, VLDL (very low density lipoprotein) cholesterol, apolipoprotein B and triglyceride levels are also reduced. Atorvastatin reduces the risk of ischemic episodes up to 16 weeks after acute coronary syndrome, as well as the risk of cardiovascular complications in patients with arterial hypertension. 95-99% of the drug is absorbed from the gastrointestinal tract and excreted from the body by the cells of the mucous membrane of the stomach and intestines. After the first pass, the absolute bioavailability is about 12%, the inhibitory activity against HMG-CoA reductase is about 30% (about 70% of this activity belongs to Atorvastatin metabolites). The time to reach maximum concentration is 1–2 hours. Approximately 98% of the drug is bound to plasma proteins. Atorvastatin is metabolized in the liver to active metabolites. The drug is metabolized mainly by CYP3A4. The half-life is 14 hours. The inhibitory effect of HMG-CoA lasts for 20-30 hours due to active metabolites. Approximately 98% of the drug is excreted in the bile. In patients with chronic alcoholic liver disease, the pharmacokinetics of Atorvastatin changes significantly (average maximum concentration increases approximately 16 times, and the area under the curve increases approximately 11 times). A decrease in serum cholesterol levels is observed approximately 2 weeks after the start of treatment, and maximum effect occurs within 4-6 weeks and is maintained throughout further treatment. When you stop using the drug, cholesterol levels return to normal.

Atorvastatin (Atoris): indications for use

Primary hypercholesterolemia and mixed hyperlipidemia with dominant hypercholesterolemia, as well as heterozygous and homozygous familial hypercholesterolemia. The drug should be used in case of ineffectiveness of non-drug therapy, in combination with a diet with limited intake of saturated fat and cholesterol. Prevention of cardiovascular complications in high-risk patients. The decision to initiate treatment and the goal of therapy depend on the concentration of LDL and an assessment of the risk of cardiovascular disease. Should first be excluded secondary causes the occurrence of hypercholesterolemia, for example, poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemia, cholestatic jaundice, use of other drugs, alcoholism.

Atorvastatin (Atoris): contraindications

Hypersensitivity to any component of the drug, liver disease, increased activity transaminases, more than 3 times higher than upper limit norms, myopathy, pregnancy, lactation period. Do not use in women of childbearing age without effective contraception. Before starting treatment with Atorvastatin, creatine kinase levels should be measured in patients with impaired renal function, hypothyroidism, myopathy (genetic or associated with statin use) or fibrates. In patients with impaired liver function or alcohol abuse, as well as in patients over 70 years of age, caution should be exercised during treatment. The drug should not be taken by patients with baseline creatine kinase, more than 5 times the upper limit of normal. It is recommended to avoid concurrent use of drugs that may increase the risk of myopathy and/or rhabdomyolysis (mibefradil, itraconazole, ketoconazole, clarithromycin, HIV protease inhibitors, nefazodone and other strong CYP3A4 inhibitors), and it is also not recommended to consume grapefruit juice in large quantities; if necessary, use macrolide antibiotics or azole antibiotics antifungal drugs Treatment with Atorvastatin should be discontinued and resumed after completion of therapy; It is not recommended to use Atorvastatin in combination with gemfibrozil or another fibrate or nicotinic acid in doses > 1 g/day. If clinical signs of myopathy appear during therapy and creatine kinase activity is five times the upper limit of normal, treatment should be interrupted; Discontinuation of treatment should also be considered if muscle symptoms occur that cause discomfort to the patient, even if creatine kinase activity =<5 верхней границы нормы. После исчезновения симптомов и возврата к обычному уровню креатинкиназы можно рассмотреть возможность лечения Аторвастатином. Следует проявлять осторожность также тем больным, у которых появились другие предрасполагающие факторы возникновения миопатии и / или рабдомиолиза (в частности, сепсис, гипотензия, хирургические вмешательства, травмы, тяжелые метаболические, эндокринные и электролитические нарушения, эпилепсия, необъяснимое повышение уровня креатинкиназы). Пациентам с заболеваниями печени или злоупотребляющим алкоголем рекомендуется соблюдать осторожность при приеме препарата. Данные о воздействии препарата на детей ограничены. Во время лечения следует контролировать активность аминотрансфераз; устойчивый рост активности аминотрансфераз до значения, более чем в 3 раза превышающего верхнюю границу нормы, требует уменьшения дозы или прекращения лечения. У пациентов с ишемическим инсультом соотношения рисков и пользы применения Аторвастатина в дозе 80 мг не однозначно; до начала лечения для этой группы пациентов следует принимать во внимание возможность потенциального риска геморрагического инсульта. В случае возникновения подозрения развития интерстициальной болезни легких, терапия статинами должна быть прекращена.

Interaction with other drugs

The risk of myopathy and/or rhabdomyolysis increases with concomitant use of strong CYP3A4 inhibitors (cyclosporine, mibefradil, itraconazole, ketoconazole, clarithromycin, HIV protease inhibitors, nefazodone, grapefruit juice [> 1.2 L/day], a nicotinic acid, gemfibrozil or other fibrates). During use large doses Atorvastatin should take into account the possibility of interaction with class III antiarrhythmic drugs. Increased exposure to coumarin derivatives is possible, in which case patients starting treatment with Atorvastatin should be monitored. Upon admission to high doses Atorvastatin may increase plasma concentrations of digoxin; It is recommended to carry out appropriate monitoring of patients. P-glycoprotein inhibitors (eg, cyclosporine) may increase plasma concentrations of Atorvastatin. Atorvastatin may increase concentrations of norethindrone and ethinyl estradiol contained in oral contraceptives; therefore when joint reception It is recommended to adjust the doses of these drugs. There is no significant interaction with antipyrine, cimetidine, amlodipine, as well as with antihypertensive and hypoglycemic drugs. Parallel use of antacids containing aluminum hydroxide and leads to a decrease in the concentration of Atorvastatin without affecting its effectiveness in lowering LDL cholesterol. The simultaneous use of colestipol reduces the concentration of Atorvastatin and its active metabolites, but at the same time enhances its lipid-lowering effect. IN combination therapy with resins that bind bile acids, Atorvastatin should be taken one hour before drugs from this group or 4 hours after taking these drugs. Concurrent use of ezetimibe may increase the risk of myopathy. During concurrent use of fusidic acid, patients should be closely monitored for the development of rhabdomyolysis; It may be advisable to temporarily discontinue use of Atorvastatin.

Atorvastatin (Atoris): side effects

When taking Atorvastatin (Atoris), side effects are rare, usually mild and disappear quickly. The following side effects are usually observed: constipation, flatulence, dyspepsia, nausea, diarrhea, allergic reactions, insomnia, headache, dizziness, paresthesia, decreased sensitivity to touch, skin rash, itching, pain in muscles, joints, weakness, chest pain, back pain, peripheral edema. Less common side effects: anorexia, vomiting, thrombocytopenia, alopecia, hyperglycemia or hypoglycemia, pancreatitis, amnesia, peripheral neuropathy, tinnitus, urticaria, myopathy, impotence, fatigue, weight gain. Rarely: hepatitis, cholestatic jaundice, myositis, rhabdomyolysis. Very rare side effects: anaphylaxis, angioedema, bullous rash (including erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis). During the use of Atorvastatin, a slight short-term increase in aminotransferase activity is observed. In 0.8% of patients taking Atorvastatin, significant clinical increases in aminotransferase activity (3 times the upper limit of normal) were observed, dose-dependent and reversible in all patients. In 2.5% of patients, the increase in creatine kinase levels was 3 times higher than the upper limit of normal, in 0.4% of patients – 10 times higher. In case of overdose, it is recommended to take symptomatic measures; dialysis has no effect on accelerating the elimination of Atorvastatin from the body.

Pregnancy and lactation

Atorvastatin (Atoris): instructions

Take orally, regardless of meals, at any time, 10–80 mg 1 time per day, depending on the concentration of LDL cholesterol. Initially, the drug is usually used at a dose of 10 mg once a day. The dosage can be changed at intervals of at least 4 weeks. There is no need for dose adjustment in patients with impaired renal function or in elderly patients. In children 4-17 years of age with homozygous familial hypercholesterolemia, the initial dose should be 10 mg/day, if necessary, the dose should be adjusted individually. Before and during therapy, it is necessary to determine lipid profile(on average once every 3 months), the LDL cholesterol level primarily serves as an indicator of the effectiveness of treatment.

Atoris: description, composition, application

Pharmacological companies offer many means to combat atherosclerosis and high cholesterol. How to choose the most effective and safe?

The drug Atoris, which reduces cholesterol levels in the body, is very popular. It belongs to the group of statins. The active substance is atorvastatin. Inhibits cholesterol synthesis through inhibition of the enzyme HMG CoA reductase, helping to reduce its level in the blood. Reduces the amount of low-density lipoprotein LDL, harmful forms of cholesterol for humans, and vice versa, increases the concentration of HDL, stimulating its anti-atherosclerotic effects. Active medicine Atorvastatin reduces the concentration of substances that create a reserve of adipose tissue in the body.

Atoris is a 3rd generation statin, which means it is quite effective.

Produced in tablets of 10, 20, 30, 60 and 80 ml by the Slovenian pharmacological company KRKA.
Atoris recommends for use by patients with atherosclerosis and patients with high concentrations of cholesterol in the blood.

Initially, the medicine was created as a cheaper analogue of the expensive and widely researched drug Liprimar, produced by the German company Pfizer. But, thanks to its successful action, it has found its niche among the pharmacological products of statins.

Common substitutes for Atoris

All analogues contain atorvastatin as the main substance.

• Liprimar - Pfizer, Germany.

Participated in many clinical trials. Has proven itself to be safe and effective remedy. Has a high price.

• Torvacard – Zentiva, Slovenia.

The composition is identical to Atoris. Popular with patients in Russia.

• Atorvastatin - JSC Biocom, Alsi Pharma, Vertex - all Russian manufacturers. The medicine is very popular in Russia due to its low price.

Many patients ask the question: Atoris or Atorvastatin, which is better? The answer to this question is clear. The ingredients in both medications are the same. active substance. This makes their actions identical. The difference between them is in the company and country of origin.

• Atomax - Hetero Drugs limited, India. It differs from Atoris in the presence of only low dosages of 10-20 mg. Recommended for the prevention of atherosclerosis in elderly patients.
• Ator - JSC Vector, Russia.

Available in only one dosage - 20 mg. It is suggested to use several tablets to obtain the required dose.

Analogues with other active ingredients

These medications contain another statin.

• Pitavastatin.

Livaso - Pierre Fabre Recordati, France, Italy.

• Rosuvastatin.

Crestor - Russia, Great Britain, Germany.

Rosecard - Czech Republic.

Rozulip - Hungary.

Tevastor - Israel.

• Simvastatin.

Vazilip – Slovenia.

Simgal – Czech Republic, Israel.

Simvastatin – Serbia, Russia.

Simvacard - Czech Republic.

Simlo - India.

But it is worth remembering that simvastatin is a first-generation medicine.

Article provided by Filzor.ru

To learn more…

Today, cardiovascular diseases are in first place among the diseases that cause human death. Most often, the disorder provokes atherosclerosis, which is formed due to the accumulation of bad cholesterol and cholesterol plaques in organism.

To avoid severe complications of diabetes, it is important to start treatment in a timely manner. After examination and analysis, the attending physician will inform you which statins for cholesterol are the most effective and safe.

The drugs limit liver function, artificially lower the concentration of harmful lipids in the blood, cleanse blood vessels and improve the patient’s quality of life.

Types of drugs

Statins can be natural or synthetic, created artificially. Also, cholesterol medications are divided into four generations.

First generation drugs include natural statins, which are isolated from fungi. Medicines of other generations are produced by synthetic isolation.

Simvastatin and Lovastatin are first generation statins. They have a less pronounced therapeutic effect and cause various side effects. Second-generation drugs, which include Fluvastatin, require longer-term use. They can remain in human blood for a long time.

Third-generation drugs, among which Atorvastatin is considered the most famous, contribute to a significant decrease in the concentration of triglycerides and low-density lipoproteins. The new fourth generation of high cholesterol drugs contribute to a significant increase in effectiveness and safety compared to earlier analogues.

In addition to the main functions of lowering lipid levels, drugs have unique features and additional effects.

Properties of statins

Drugs of the statin group affect the production of cholesterol by the liver by inhibiting it. This happens due to the fact that the enzymes involved in the synthesis of cholesterol are blocked. These enzymes accelerate the production of mevalonic acid, which acts as a precursor to cholesterol.

Statins also affect the endothelium of blood vessels, reduce inflammation and reduce the risk of blood clots, stimulate the synthesis of nitric oxide, which dilates and relaxes blood vessels, maintains stability chemical composition blood.

Additionally, the drugs prevent myocardial infarction. For example, Rosuvastatin has proven to be an effective drug in reducing the risk of developing cardiovascular pathologies. During the rehabilitation period after a heart attack, statins are taken, as they help speed up the recovery process.

Including tablets can increase the level of good lipids.

Benefits of statins

These types of medications are used to prevent and treat atherosclerosis when other methods of therapy have not shown the desired effect. Statins reduce the risk of heart attack, transient ischemic attack, stroke, atherosclerosis.

The pills also normalize work of cardio-vascular system for coronary artery disease and angina pectoris, relieve symptoms of diabetes mellitus, reduce weight in obesity, and reduce inflammation on the walls of blood vessels. The drugs can thin the blood and prevent the development of thrombosis, normalize metabolic processes, dilate arteries, and remove atherosclerotic plaques.

The drug allows you to speed up the rehabilitation process for stenting, ischemic stroke, coronary bypass surgery, angioplasty, myocardial infarction, pulmonary embolism.

Who is contraindicated for statin treatment?

Before starting therapy, you should consult your doctor. He will help you choose a medicine and dosage, taking into account the individual characteristics of the body and the presence of secondary diseases. Since satins have multiple contraindications, you should never self-medicate.

The use of the medicine should be completely abandoned in the presence of an allergic reaction and intolerance to the active substances of the drug, kidney disease, malfunction thyroid gland and endocrine system.

Also, you should not use tablets if the musculoskeletal system is malfunctioning, acute or chronic diseases liver. If you have diabetes, you should be especially careful when choosing a method to lower your cholesterol levels. During pregnancy, the drug may harm the fetus, therefore better medicine replace with a safe alternative or stop treatment completely.

You need to understand that taking medication may cause certain side effects.

• In very rare cases, myopathy develops. Such a violation depends on the patient’s age, the dose of medication, and the presence of acute complications of diabetes.
• Sometimes the work of the central nervous system. This manifests itself in the form of headaches, dizziness, sleep disturbances, and general weakness.
• When exposed to respiratory system in some cases, rhinitis and bronchitis develop.
• The patient may also experience nausea, vomiting, and constipation.

Overall, with a balanced, careful and correct intake tablets you can see a positive result. But in case of overdose and long-term use, the patient may experience negative reactions such as:

1. Stomach pain and small intestine, constipation, vomiting;
2. Amnesia, insomnia, paresthesia, dizziness;
3. Thrombocytopenia or a sharp decrease in platelet concentration
4. Swelling, obesity, development of impotence in men;
5. Muscle cramps, back pain, arthritis, myopathy.

Also undesirable effect can be observed if lipid-lowering and other types of incompatible drugs are additionally used.

Advantages and disadvantages of statins

If treatment is carried out regularly and all medical recommendations are followed, this group of drugs reduces the risk of mortality from heart attack and stroke by 40 percent. The medicine allows you to reduce the concentration of bad cholesterol in the blood by 50 percent. To assess the condition, it is recommended to donate blood once a month to check the level of harmful lipids.

This is a safe medicine that, if the dosage is observed, does not have a toxic effect on the body. New generation drugs have a minimal number of side effects and allow treatment of diabetes mellitus without consequences. Today there are many analogues on sale at affordable prices, so everyone can choose a medicine based on their financial capabilities.

The disadvantages include high cost, the original drugs Rosucard, Crestor, Leskol Forte are especially expensive.

But there are always cheaper tablets on the shelves that may contain the same active ingredient.

The most effective and safe statins

To answer the question of which statins can improve a person’s condition without harm to health, many studies have been carried out scientific research. As a result, it turned out that the most effective and less dangerous drug is Atorvastatin. In second place is the no less reliable and effective Rosuvastatin, and in third place is Simvastatin.

A doctor may prescribe Atorvastatin tablets for pathologies of the cardiovascular system and high cholesterol levels in the blood. This drug has shown itself positively in many clinical studies and has proven in practice that it can reduce the risk of stroke by 50 percent. According to the doctor's testimony, the dosage is 40-80 mg in the morning or evening, depending on the degree of the disease.

Rosuvastatin is a man-made drug. It has a pronounced hydrophilic effect, which leads to a reduction in side effects and stops the production of bad cholesterol. Unlike other tablets, the drug does not provoke myopathy and muscle cramps.

• A dosage of 40 mg can reduce low-density lipoprotein levels by 40 percent and increase good cholesterol levels by 10 percent.
• The result of using the medicine can be observed after just seven days; after a month, the effect reaches its maximum, and this condition can be maintained for a long time.

Simvastatin can reduce the risk of developing vascular and heart diseases by 10 percent after a heart attack, stroke, as well as diabetes. If you take the drug for a long time, you can normalize the ratio of bad and good cholesterol and reduce the risk of thrombosis coronary arteries.

As doctors note in their reviews, statins are safe medicines. But it is important to read the instructions before use, take into account the individual characteristics of the body, strictly follow the dosage, be careful in the presence of secondary diseases and not self-medicate.

Similar drugs

Each of the above drugs has different trade name. Therefore, the attending physician can prescribe a similar natural or, conversely, synthetic medicine at a better price.

The active substance of Simvastatin is the element of the same name, which has a hypolipidemic effect. The list of analogues includes Zovatin, Ovenkor, Simvakor, Simgal, Vazilip, Zosta, Zokar, Simvastol, Vastatin.

The first generation drug Pravastatin can be replaced with Pravapres, Lipostat. Statins based on lovastatin include Mevacor, Lovahexal, Lovacor, Apekstatin, Rovacor, Holetar, Cardiostatin, Medostatin, Lovasterol, Liprox.

Medicines based on atorvastatin include Tulip, Canon, Atoris, Atorvox, Atomax, Lipitor, Liprimar, Torvacard, Anvistat, Liptonorm. No less effective and safe analogues of Rosuvastatin for lowering blood cholesterol levels are Rozart, Rozulip, Roxera, Crestor, Tevastor, Mertenil, Novostatin, Akorta.

Statins are discussed in the video in this article.

• Stabilizes sugar levels for a long time
• Restores insulin production by the pancreas

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List of main statins for lowering blood cholesterol

Atherosclerosis is a systemic disease that affects blood vessels. Excess cholesterol settles on the walls of the arteries, forming an atherosclerotic plaque. Blood flow in the vessels that supply the heart and brain is disrupted. To counter this, you need to take statins - drugs whose list includes 4 generations.

The risk of cardiovascular diseases develops. What pills should you take to lower cholesterol? Pharmaceutical companies produce drugs that can reduce the content of “bad” cholesterol in the blood and normalize lipid metabolism. Statins – best medicines, reducing the production of cholesterol by the liver, blocking the enzyme that is involved in its synthesis.

Statins

Medicines from the statin group are inhibitors of HMG-coenzyme A reductase, an enzyme involved in the formation of cholesterol. They were synthesized to reduce cholesterol levels in the blood. Their use has reduced mortality caused by heart disease.

In addition to reducing the concentration of low-density lipoproteins (LDL), it was noticed that if you take the drugs, the inflammatory process of the atherosclerotic plaque is reduced and its condition is stabilized. The ability of statins to thin the blood reduces the risk of blood clot formation.
There is a classification of statins, which is based on recommended dosages. In pharmacology, it is customary to divide drugs into generations according to the time of their introduction. Currently, the list of LDL-lowering drugs includes four generations.

First generation

Commercial names: Simvastatin, Pravastatin, Lovastatin.

1. Simvastitins: Zokor, Zovatin, Simgal.
2. Pravastatins: Lipostat.
3. Lovastatins: Apexstatin, Vero-Lovastatin, Cardiostatin, Lovacor, Lovasterol, Medostatin, Rovacor.

They have hypolipidemic properties. Medicines are produced synthetically (except for Lovastatins) by fermentation of inactive lactone. The substance lovastatin is found in oyster mushrooms.

Treatment with statins of this group helps reduce the amount of triglycerides in the blood plasma, LDL, very low-density lipids (VLDL), and also reduces total cholesterol.

The effectiveness of medications in normalizing the balance between low-density lipids (LDL) and high-density lipids (HDL) has been proven. The result appears within a few weeks after the patient starts taking them.

Indications

First-level statins are indicated for primary hypercholesterolemia, ineffectiveness of the prescribed diet and physical activity. Medicines are prescribed to patients at high risk of coronary atherosclerosis.

Drugs in this group are used to prevent myocardial infarction, stroke, and ischemic attacks. They significantly reduce the spread of atherosclerosis of the coronary arteries.

Second generation

This group of Fluvastatin includes Lescol and Lescol forte. Fluvostatins, containing sodium salt, activate HDL synthesis, increasing the uptake of low-density lipid particles. As a result, the level of LDL in the blood plasma decreases.

Indications

The main indications for the use of fluvostatin sodium are hypercholesterolemia and mixed dyslipidemia. Drugs in this group showed an active decrease in the level of total cholesterol, LDL, and triglycerides.

At the same time, the level of high-density lipids increased and the balance between LDL and HDL was restored. Treatment with fluvostatin sodium reduces the risk of coronary atherosclerosis.

Fluvostatins can be taken as a prophylaxis against serious heart pathologies in order to avoid complications in patients with coronary artery disease after surgery.

The combination of drugs with diet can be used in children over 10 years of age who have a history of family hypercholesterolemia.

Third generation

The third generation includes statins common name Atorvastatin and Cerivastatin.

1. Atorvastatin: Anvistat, Atomax, Atorvox, Atoris, Lipitor, Liprimar, Torvacard, Tulip.
2. Cerivastatin: Lipobay.

Medicines in this group are prescribed when diet therapy, physical exercise, weight loss did not give the expected effect.

If you take statins, you can reduce cholesterol and LDL levels. This occurs due to inhibition of the enzyme that is responsible for its synthesis in the liver. Helps reduce LDL concentrations in patients with homozygous familial hypercholesterolemia.

This disease is practically untreatable with lipid-lowering drugs. These drugs have been proven to effectively reduce the risk of complications of coronary artery disease. The initial result of the prescribed treatment occurs 14 days from the start of taking the drugs.

Indications

Indications for the use of third generation statins are the following diseases:

• complicated hypercholesterolemia;
• mixed hyperlipidemia;
• hereditary predisposition;
• cardiovascular diseases with an increased risk of coronary artery disease.

Treatment with third-generation drugs helps improve the functioning of the cardiovascular system. It is used as a preventive treatment for cardiovascular pathologies and diabetes.

Fourth generation

The safest, most effective drugs of the new generation of the statin group have been developed. The list includes Rosuvastatin, Pitavastatin. This the best drugs, reducing cholesterol concentrations.

1. Rosuvastin: Akorta, Crestor, Mertenil, Rozart, Rosuvastatin-C3, Tevastor, Roxera.
2. Pitavastatin: Livazo.

Statins of this group are identical in their effect of lowering blood cholesterol to atorvastatin. But Pitavastatin and Rosuvastatin reduce the concentration of cholesterol and LDL when taking a significantly lower dose of the drug.

New generation medications are prescribed when it is necessary to reduce the level of total cholesterol in the blood, LDL, triglycerides, while simultaneously increasing the concentration of HDL. At the moment this is the best means for the treatment of atherosclerosis, heart diseases.

Pitavastatin has a better effect on increasing HDL levels in the blood than other statin drugs. The risk of developing coronary heart disease is significantly reduced.

It has been proven that while taking Pitavastatin, the progression of atherosclerotic plaque development stops. Treatment with the drug has a pronounced hypolipidemic effect on the size, fat and fibrous composition of the atherosclerotic plaque.

The possibility of reducing the therapeutic dose made it possible to reduce the side effects of the drugs. The result of treatment appears within the first week after the start of therapy. The full effect is achieved after 4 months of use and has a long-lasting effect.

Indications

The drugs are prescribed for high levels of “bad” cholesterol in the blood (hypercholesterolemia) and when there is no result from the use of non-drug treatments. It is recommended to take tablets when there is a risk of ischemic disease or progression of atherosclerosis.
Pitavastatin is included in multicomponent therapy, since the combined use of this drug is possible with many drugs prescribed for cardiac diseases.

The latest generation of medicines can be prescribed to patients with diabetes. Pitavastatin does not affect glucose metabolism, unlike other statins.

General contraindications for use

You cannot take statins on your own. Medicines have contraindications. First of all, you need to understand that therapy is prescribed by a doctor after collecting an anamnesis and making a diagnosis.

Statins have contraindications for use in the following cases:

• chronic liver pathologies, increased liver enzymes(Pravastatin, Pitavastatin are allowed to be used in small doses);
• renal failure;
• during pregnancy and breastfeeding;
• age up to 18 years (except Fluvostatin).

Statins are prescribed with caution to patients with diabetes (except Pitavastatin), as they increase blood sugar levels. Therefore, it is necessary to follow a low-carbohydrate diet together with medications.

Side effects

In most cases, therapy is well tolerated. Side effects occur when the dosage is incorrectly prescribed or in case of overdose. Almost all tablets should be taken once a day 3-4 hours before bedtime, washed down with water.

Do not take the tablets with grapefruit juice. It contains substances that prevent statins from breaking down. As a result, they accumulate in the blood, which, in turn, negatively affects the kidneys and liver.

When taking medications regularly, the following side effects may occur:

• headaches, weakness, drowsiness;
• allergic rashes in the form of urticaria;
• memory impairment, dizziness, nausea, irritability;
• pain in the stomach, intestinal colic.

An uncommon side effect is muscle pain. Myopathy causes weakness muscle tissue. Against this background, rhabdomyolysis can develop - the destruction of muscle fiber, and as a result of the removal of dead tissue, acute renal failure appears. At the first muscle pain, you should immediately consult a doctor for advice.

Conclusion

Before starting treatment, you need to consult a doctor who will determine what treatment products a particular patient needs. Medicines from the statin group are the best means to combat atherosclerosis, reducing the level of low- and very low-density lipids. They help increase the concentration of high-density lipids, which significantly reduces the risk of cardiovascular disease. The tablets should be taken as prescribed by your doctor.

The best drugs to lower blood cholesterol

There are several ways to combat high cholesterol. First of all, through diet and traditional methods, as well as using medications that have a hypoglycemic effect.

Doctors recommend refraining from self-medication and leaving the right to choose the appropriate drug to a qualified specialist. Use any pharmaceuticals may have a number of undesirable side effects Therefore, in this case it is necessary to refrain from self-medication.

Drug groups

At integrated approach In the matter of normalizing cholesterol levels, the doctor will first offer the patient diet therapy. The second step is prescribing medications. Cholesterol-lowering drugs can be classified as follows:

• statins;
• fibric acids;
• drugs that promote a choleretic effect;
• herbal preparations that lower cholesterol levels.

Patients are not recommended to try to combine these medications on their own and refrain from self-prescribing. When combining drugs with so-called folk recipes, an additional recommendation from a doctor is also required. Side effects from taking medications can develop quite slowly, so all medications should be taken under the constant supervision of the attending physician. In case there are any accompanying illnesses, it is also recommended to inform your doctor about this. All this will help avoid further complications and lead to a good therapeutic effect.

Taking any of the drugs pharmacological groups must be accompanied by maintaining a healthy lifestyle, giving up bad habits and maintaining moderate physical activity. A separate point is nutrition. The consumption of fried, salty, and spicy foods should be eliminated from the diet. Drinks: Freshly squeezed juices are allowed. You should refrain from drinking sweet carbonated water.

Statins

The very first and main group of drugs: statins. These drugs help suppress the formation of low-density lipoproteins and reduce the level of triglycerides in the blood plasma. Possible side effects may occur as a result of a sharp increase in the prescribed dosage and the combination of statins with certain groups of drugs. This group of drugs is very extensive and includes more than 70 trade names. The active ingredients in drugs may vary and are classified by generation. The main components are the following active substances: atorvastatin, rozurvastatin, simvastatin, lovastatin.

Possible side effects from taking statin drugs include the following conditions: digestive tract which can be expressed in the form of flatulence, constipation, nausea; in addition, patients may complain of sleep disturbances, dizziness and headache. The occurrence of any side effects is a reason to seek advice from your doctor. In the future, it may be necessary to adjust the dosage or replace the drug with a more suitable one.

At long-term use drugs in this group require constant monitoring of kidney function. According to various studies, chronic use of statins also increases the risk of developing diabetes.

Cholesterol-lowering drugs also have a number of contraindications. For example, they are not recommended for people with severe normal functioning kidneys and in case of individual intolerance to the components of the drug.

Patients can discuss new products that have recently appeared on the market with their healthcare provider. pharmaceutical market. This allows you to select the most effective and without dangerous drug. For example, drugs based on Fluvastatin belong to the latest generation of statins. These are modern drugs with minimal side effects and fairly fast pharmacological action. A pharmacist at a pharmacy can also advise the patient on new, effective drugs. However, it should be remembered that only the attending physician has the right to prescribe drugs to lower cholesterol, taking into account the individual characteristics of the patient.

Statins are prescribed with extreme caution to elderly patients. This is due to the fact that the use of the same atorvastatin can increase pain in the muscle area. Also a large number of older patients age groups reported sleep disturbances, depressive states, appetite disorders.

Fibric acids

The second broad group includes drugs that lower blood cholesterol from the group of fibroic acids. This group of drugs can be used as an addition to statin drugs. A feature of the fibric acid group of drugs is their ability to quickly reduce the level of triglycerides and low-density lipoproteins, as well as increase the number of high-density lipoproteins, which effectively fight bad cholesterol. Fibric acid derivatives can bind to bile and block cholesterol synthesis in the human body.

Experts provide statistical data that shows that a 30-day intake of drugs from the fibric acid group reduces total cholesterol levels by 35-40%; triglycerides – by 20%.

Most of the drug is excreted through the kidneys, so if the normal functioning of these organs is disrupted, taking fibroic acids is not recommended. Possible side effects when taking medications from the group of fibroic acids are associated, first of all, with disruption of the normal functioning of the gastrointestinal tract.

• As with statins, constipation, nausea, and diarrhea may develop. All this may require additional, symptomatic treatment using other groups of drugs (for example, omeprazole, which protects the intestinal walls).
• Additionally note negative impact on the cardiovascular system – increases the risk of developing venous thromboembolism.
• Allergic reactions may develop: redness skin, itching, rash.
• In some cases, patients complained of headaches and decreased libido.

If any of these side effects develop, patients are advised to temporarily stop taking the drug and consult a doctor.

Choleretic drugs and medicines

Lowering blood cholesterol with drugs that have a choleretic effect has an additional, positive effect on normalizing the level of triglycerides and low-density lipoproteins. The principle of action of choleretic drugs is simple: they bind excess cholesterol and gradually remove it from the body. Drugs in this group are tolerated quite well. Among the possible side effects, in some cases allergic reactions and painful sensations in the stomach area.

Exist special drugs, which significantly reduce the absorption of cholesterol directly in the gastrointestinal tract. These include: Xenical, Orlistat, Ezetrol. Such drugs will become indispensable assistants in the event that excess cholesterol enters the body through food. Side effects when using these drugs are quite unpleasant: frequent urge to defecation, which are accompanied by the release of excess fat, pain in the abdominal area, allergic reactions. While taking drugs of this group, a strict diet is required with the complete exclusion of fatty foods.

Additional Methods

TO herbal preparations To lower cholesterol, you can use lipoic acid and capsules, which contain omega-3, omega-6 and omega-9 components, as well as the following drugs:

• Dry garlic capsules are also used as an additional treatment for hypercholesterolemia.
• Preparations containing pumpkin seed extract are also quite effective. For example, the drug Tykveol helps regulate lipid metabolism and reduces triglyceride levels.
• Herbal preparations, which include extracts of fir, hawthorn, linden and other phytoelements, can also be used in the complex treatment of high cholesterol.
• The use of lipoic acid helps prevent the development of atherosclerosis, diseases of the cardiovascular system and, of course, regulate cholesterol levels.

Drugs based on herbal components have fewer possible side effects and are much better tolerated than statins or fibric acids. However, the effectiveness of herbal elements and the speed of their effect on high cholesterol is significantly inferior to the chemical compounds of fibrates or statins. Therefore, if a rapid reduction in cholesterol levels is required, the use of garlic capsules or fish oil can act as an addition to the main treatment.

Additional uses vitamin complexes, which contain B vitamins and nicotinic acid, are also widely used in the fight against high cholesterol. The use of vitamin preparations that lower cholesterol in the blood allows you to regulate lipid metabolism, and nicotinic and folic acid normalizes triglyceride levels.

Cholesterol-lowering drugs act quite quickly and effectively. Subject to medical prescription and all manufacturer's recommendations, therapy using medicinal funds will pass successfully and with a minimum number of possible side effects. Whether or not to use certain drugs that help lower cholesterol is a personal choice for each patient. However, one should take into account the fact that elevated cholesterol levels threaten the development of disorders of the cardiovascular system, which can lead to stroke, heart attack and atherosclerosis. Paying attention to your body is the key to a long life and good health.

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Statins: how they work, indications and contraindications, review of drugs, what to replace them with

Cholesterol, or cholesterol, is a substance that performs important functions in the human body. These include:

• Participation as building material during the life of almost all cells of the body, since cholesterol molecules are included in the composition of the cell membrane and give it strength, flexibility and “fluidity”,
• Participation in the digestion process and the formation of bile acids necessary for the breakdown and absorption of fats in the gastrointestinal tract,
• Participation in the formation of hormones in the body - adrenal steroid hormones and sex hormones.

Excess cholesterol in the blood leads to the fact that excess cholesterol molecules can be deposited on the walls of blood vessels (mainly arteries). Atherosclerotic plaques form, which obstruct the flow of blood through the artery and sometimes, together with the blood clots attached to them, completely block the lumen of the vessel, contributing to the development of heart attack and stroke.

The norm of total cholesterol in the blood of an adult should be no more than 5.0 mmol/l, in persons with coronary heart disease no more than 4.5 mmol/l, and in patients with suffered a heart attack myocardium – no more than 4.0 mmol/l.

What are statins and how do they work?

In cases where the patient has an increased risk of developing myocardial infarction due to atherosclerosis and cholesterol metabolism disorders, long-term use of lipid-lowering drugs is indicated.

Statins are lipid-lowering (lipid-lowering) drugs, the mechanism of action of which is to inhibit the enzyme that promotes the formation of cholesterol. They work on the principle “no enzyme – no cholesterol”. In addition, due to indirect mechanisms, they contribute to the improvement of the damaged inner layer of blood vessels at a stage when atherosclerosis cannot yet be diagnosed, but the deposition of cholesterol on the walls has already begun - at early stage atherosclerosis. Also have a beneficial effect on rheological properties blood, reducing viscosity, which is an important factor that prevents the formation of blood clots and their attachment to plaques.

The latest generation of statins are currently recognized as the most effective, containing atorvastatin, cerivastatin, rosuvastatin and pitavastatin as active ingredients. The latest generation of drugs not only reduce the level of “bad” cholesterol, but also increase the level of “good” cholesterol in the blood. These are the best statins today, and the effect of their use develops within the first month of continuous use. Statins are prescribed once a day at night; it is possible to combine them in one tablet with other cardiac drugs.

Independent use of statins without consulting a doctor is unacceptable, since before taking the drug it is necessary to determine the level of cholesterol in the blood. Moreover, if the cholesterol level is less than 6.5 mmol/l, you should try to reduce it for six months with the help of diet and a healthy lifestyle, and only if these measures are ineffective, the doctor decides to prescribe statins.

From the instructions for using statins, the main points can be highlighted:

Indications for prescribing statins

The main indication is hypercholesterolemia (high cholesterol) with ineffective non-drug methods and familial (hereditary) hypercholesterolemia with ineffective diet.

The prescription of statins is mandatory for persons with hypercholesterolemia concomitant with the following diseases, since their use in combination with other drugs prescribed by a doctor significantly reduces the risk of developing sudden cardiac death:

• Persons over 40 years of age with a high risk of cardiovascular pathology,
• Coronary heart disease, angina pectoris,
• Previous myocardial infarction,
• Coronary artery bypass surgery or stent installation for myocardial ischemia,
• Stroke,
• Obesity,
• Diabetes,
• Cases of sudden cardiac death in close relatives under the age of 50 years.

Contraindications

Contraindications include liver dysfunction (hepatitis, cirrhosis) in the active stage, allergic reactions when previously taking medications. Statins should not be taken by pregnant or lactating women, or women reproductive age who do not use reliable methods of contraception. Statins do not affect other types of metabolism (protein, carbohydrate, purine metabolism), so they can be used in patients with diabetes, gout and other concomitant diseases.

Side effects

Less than 1% of patients taking long-term, continuous statins develop malaise, sleep disturbances, muscle weakness, hearing loss, taste sensations, rapid heartbeat, sharp decrease and increase blood pressure, decreased platelet levels in the blood, nosebleeds, heartburn, abdominal pain, nausea, unstable stools, increased urination, decreased potency, muscle and joint pain, rhabdomyolysis (destruction of muscle tissue), increased sweating, allergic reactions.

More than 1% of patients experience dizziness, nausea, pain in the heart area, dry cough, nasal congestion, peripheral edema, increased sensitivity skin to sun rays, skin reactions - itching, redness, eczema.

Can statins be combined with other drugs?

According to the recommendations of the WHO and the American Heart Association, statins are a mandatory drug in the treatment of coronary heart disease with a high risk of complications and myocardial infarction. Prescribing cholesterol-lowering drugs alone is not enough, so treatment standards include basic necessary medications- these are beta blockers (bisoprolol, atenolol, metoprolol, etc.), antiplatelet agents (aspirin, aspirin Cardio, aspicor, thrombo ACC, etc.), ACE inhibitors (enalapril, perindopril, quadripril, etc.) and statins. Many studies have been conducted to prove that the use of these drugs in combination is safe. Moreover, when combining, for example, pravastatin and aspirin in one tablet, the risk of developing myocardial infarction is significantly reduced (7.6%) compared to taking the drugs separately (almost 9% and 11% when taking pravastatin and aspirin, respectively).

Thus, if previously statins were prescribed at night, that is, at a separate time from taking other medications, the global medical community now comes to the conclusion that taking combination drugs in one tablet is more preferable. Of these combinations, drugs called polypills are currently being tested, but their mass use is still limited. Drugs with a combination of atorvastatin and amlodipine - Caduet, Duplekor - have already been successfully used.

If cholesterol levels are high (more than 7.4 mmol/l), it is possible to combine statins with drugs to lower cholesterol from another group - fibrates. Such a prescription should only be made by a doctor, carefully assessing the risks of side effects.

You cannot combine statins with grapefruit juice, as it contains substances that slow down the metabolism of statins in the body and increase their concentration in the blood, which can lead to the development of adverse toxic reactions.

Also, you should not take such medications with alcohol, antibiotics, in particular clarithromycin and erythromycin, as this may cause toxic effect to the liver. Antibiotics from other groups are safe in combination with cholesterol-lowering medications. To assess liver function, it is necessary to take a biochemical blood test every three months and determine the level of liver enzymes (ALAT, AST).

Harm and benefit - pros and cons

Any patient, when taking medications prescribed by a doctor, thinks about the correctness of the prescriptions. Taking statins is no exception, especially since you can often hear about the dangers of these drugs. This idea can be dispelled, since in last years New drugs are being developed that do more good than harm.

Benefits of taking statins

1. Reduce mortality from cardiac causes by 40% within the first five years;
2. Reducing the risk of stroke and heart attack by 30%;
3. Efficiency - reduction in cholesterol levels with constant use by 45 - 55% of the original high level. To assess effectiveness, the patient should have a blood test for cholesterol levels every month;
4. Safety – taking the latest generation statins in therapeutic doses does not have a significant toxic effect on the patient’s body, and the risk of side effects is extremely low. A number of studies carrying out long-term observation of patients taking statins for a long time have demonstrated that their use can provoke the development of type 2 diabetes mellitus, liver cancer, cataracts and impaired mental abilities. However, this has been refuted and it has been proven that such diseases develop due to other factors. Moreover, studies conducted in Denmark on patients with pre-existing type 2 diabetes since 1996 have shown that the risk of developing diabetes complications such as diabetic polyneuropathy, retinopathy is reduced by 34% and 40%, respectively;
5. A large number of analogues with one active ingredient in different price categories, which helps to select a drug taking into account the financial capabilities of the patient.

Disadvantages of taking statins

• The high cost of some original drugs (Crestor, Rosucard, Leskol Forte). Fortunately, this drawback is easily eliminated by replacing the drug with the same active ingredient with a cheaper analogue.

Of course, such advantages and incomparable benefits should be taken into account by a patient with indications for use if he doubts whether it is safe to take statins and carefully weighs the pros and cons.

Brief overview of drugs

The list of drugs most often prescribed to patients is presented in the table:

Active substance

Name of the drug, content of active substance (mg)

Manufacturer country

Approximate price, rub

I generation
Simvastatin	Basil (10, 20 or 40)	Slovenia	355 — 533
	Simgal (10, 20 or 40)	Czech Republic, Israel	311 — 611
	Simvacard (10, 20, 40)	Czech	262 — 402
	Simlo (10, 20, 40)	India	256 — 348
	Simvastatin (10, 20 or 40)	Serbia, Russia	72 — 177
Pravastatin	Lipostat (10, 20)	Russia, USA, Italy	143 — 198
Lovastatin	Holetar (20)	Slovenia	323
	Cardiostatin (20, 40)	Russia	244 — 368
II generation
Fluvastatin	Leskol Forte (80)	Switzerland, Spain	2315
III generation
Atorvastatin	Liptonorm (20)	India, Russia	344
	Liprimar (10, 20, 40, 80)	Germany, USA, Ireland	727 — 1160
	Torvacard (10, 40)	Czech	316 — 536
	Atoris (10, 20, 30, 40)	Slovenia, Russia	318 — 541
	Tulip (10, 20, 40)	Slovenia, Switzerland	223 — 549
IV generation
Rosuvastatin	Crestor (5, 10, 20, 40)	Russia, UK, Germany	1134 – 1600
	Rosecard (10, 20, 40)	Czech	1200 — 1600
	Rozulip (10, 20)	Hungary	629 – 913
	Tevastor (5, 10, 20)	Israel	383 – 679
Pitavastatin	Livazo (1, 2, 4 mg)	Italy	2350

Despite such a wide range in the cost of statins, cheaper analogues are not much inferior to expensive drugs. Therefore, if the patient cannot obtain original drug, it is quite possible to replace it, as prescribed by a doctor, with a similar and more affordable one.

Video: statins in the Health program

Is it possible to lower cholesterol without pills?

In the treatment of atherosclerosis as a manifestation of excess “bad” cholesterol in the body, the first of the doctor’s prescriptions should be recommendations for lifestyle correction, because if the cholesterol level is not too high (5.0 – 6.5 mmol/l), and the risk of heart complications is quite low, it is possible to try normalize it through the following measures:

Some foods contain so-called natural statins. Among these products, garlic and turmeric are the most studied. Fish oil preparations contain omega 3 fatty acids, which help normalize cholesterol metabolism in the body. You can take fish oil purchased at a pharmacy, or you can cook fish dishes (trout, salmon, salmon, etc.) a couple of times a week. Eating sufficient quantities of plant fiber, which is found in apples, carrots, cereals (oatmeal, barley) and legumes, is encouraged.

If there is no effect from non-drug methods, the doctor prescribes one of the lipid-lowering drugs.

In conclusion, I would like to note that, despite the fears of patients and the idea that statins are harmful, their use is fully justified in cases of advanced atherosclerosis with damage to the coronary arteries, since these drugs really prolong life. If you have high cholesterol levels in your blood without initial signs vascular lesions, then you should eat right, move actively, lead a healthy lifestyle, and then in the future you will not have to think about whether you need to take statins.

Video: is it always worth taking statins?

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Atoris and other statins: which drug is better?

Elevated levels of cholesterol and low-density lipoprotein (LDL) are a key risk factor for the development of atherosclerotic vascular disease and cardiovascular diseases, such as myocardial infarction, ischemic stroke, and lower limb ischemia. In this regard, the main approach to therapy is aimed at correcting blood lipid levels.

• About Atoris
• Indications and contraindications
• Atoris and its analogues: features of action
• Statins: features of action
• Statins: additional effects

The most commonly used drugs are from the group of statins, one of which is Atorvastatin or Atoris. However, it has analogs that contain both a similar active ingredient (Tulip, etc.), and containing other active molecules - Mertenil, Roxera, Vasilip, etc. In Russia, few doctors and patients understand that these drugs can be replaced with each other, but this is not always the optimal treatment approach. In this regard, it is necessary to talk in detail about Atoris and its analogues.

About Atoris

In accordance with the instructions for use, Atoris contains the active substance atorvastatin, which is a classic representative of the statin group. The tablets are well tolerated by most patients and have a lasting effect on the level of cholesterol and LDL in the blood, which makes the drug highly popular among doctors.

Atoris should always be prescribed after consultation with your doctor. Otherwise, therapy may be ineffective or side effects may develop.

Atorvastatin, like other statins, blocks a certain enzyme in the liver (HMG-CoA reductase), responsible for the formation of new low-density lipoproteins that transfer lipids to the vessels and peripheral tissues from the liver, thereby promoting the development of the atherosclerotic process. Reducing the level of LDL and simultaneously increasing the amount of high-density lipoproteins allows you to stop this process and improve the prognosis for later life for the patient. There is no evidence of the effect of most statins on the amount of triglycerides in the blood.

Indications and contraindications

Despite the wide variety of statins (atorvastatin, rosuvastatin, simvastatin, etc.), they all have similar indications and contraindications for their use in patients. In this regard, the latter very often choose what is cheaper, not always realizing that this is not the same medicine with a different name.

Atoris and its analogues have the following indications for use.

• Most forms of hypercholesterolemia, accompanied by an increase in the amount of cholesterol in the patient’s blood, which can lead to the rapid onset of atherosclerotic changes in blood vessels and the development of severe diseases.
• Hereditary disorders of fat metabolism.
• Prevention of myocardial infarction and stroke in cases of identified atherosclerosis.

Situations where the use of statins to control cholesterol levels is contraindicated:

• liver diseases of various causes (hepatitis, hepatosis, cirrhosis, etc.);
• previous diseases of the musculoskeletal system with damage to certain muscle groups;
• pregnancy and lactation;
• the patient's age is less than 18 years.

In all these cases

Different statins cannot be regarded as equivalent drugs. There are significant differences between individual drugs.

Atoris and its analogues: features of action

Many statins differ in price - some tablets are cheaper, some are more expensive. However, all medications from this group are not the same. There is a large amount of scientific data indicating that Atorvastatin, produced in Russia and abroad, is more effective in preventing the development of cardiovascular diseases than simvastatin and rosuvastatin. It is the difference between Atoris and its analogues that needs to be discussed in more detail.

There are no differences in the pharmacodynamics and pharmacokinetics of statins, however, only one drug stands out among all the others - Atoris. International guidelines and instructions for use show that only this medication is initially active substance, while other statins, for their activation and onset of effect, must undergo certain modifications in the liver tissue. This feature determines the fact that it is Atorvastatin that has the most early onset therapeutic action.

The systems for inactivating drugs in the liver are not the same in people of different nationalities. It is important to remember this when using statins, since their safety directly depends on hepatic metabolism. In most cases, this situation makes it difficult to prescribe medications and requires the doctor to more time for additional examination a person and the study of his individual characteristics. The appointment of Atoris, unlike its analogues, can take place without taking into account the ethnic factor, and this circumstance alone greatly facilitates its use.

Statins: features of action

The main criterion for comparing hypocholesterolemic drugs with each other is assessing the effect of their use on the development of cardiovascular diseases. Atorvastatin, when taken regularly, has been shown to have greater good results for this indicator than Rosuvastatin and Simvastatin, which may be due to metabolic characteristics of this medication. And although there is no clear answer to the question of what is the best way to prevent vascular complications in atherosclerosis, since it is necessary to take into account the individual characteristics of the patient, we can say that it is Atoris that effectively copes with this task.

In accordance with the instructions for use of these drugs, only Atorvastatin is able to provide control over the level of total triglycerides in the patient’s blood, which also makes it possible to more effectively prevent the development of cardiovascular diseases. At the same time, Atoris tablets are the best way to reduce LDL and cholesterol levels. The only drug that is superior to Atoris in this quality is Rosuvastatin, however, when taking this medication, myopathies and severe rhabdomyolysis very often develop, which limits the use of Rosuvastatin in clinical practice.

Statins: additional effects

In accordance with the instructions for use, Atoris is capable of providing such therapeutic effects, which other statins do not have. For example, Atorvastatin reduces the level of inflammatory processes in the body, including in atherosclerotic plaques, where inflammation plays one of the key roles.

It was also shown that this drug is able to reduce the number of bone fractures throughout the patient’s life, reduce the number of cases of senile dementia, various forms of diabetes, improve the contractile activity of the heart muscle, etc.

In the same case, the attending physician must carefully select a lipid-lowering drug for a particular patient. There is no universal advice here, since each drug has its own characteristics of action. However, Atoris, prescribed in accordance with its instructions for use, provides a more rapid and stable reduction in cholesterol and LDL levels, and also better protects the patient from the development of cardiovascular consequences of atherosclerosis (stroke, myocardial infarction, etc.).