Pehea e hoʻohana ai iā Atorvastatin Teva?

Ka puka ʻana - nā ʻoniʻoni like kīwī: aneane keʻokeʻo a keʻokeʻo paha, ʻano kālai ʻia, ke kahakaha ʻia ma nā ʻaoʻao ʻelua: ma kahi ʻaoʻao - "93", ma kēlā ʻaoʻao - "7310", "7311", "7312" a i "7313" (10 nā pcs i kahi pōpō, ma kahi kākela kāleka o 3 a 9 mau pūpū).

Pākaukau 1 papa:

• mea kūlohelohe: atorvastatin calcium - 10.36 mg, 20.72 mg, 41.44 mg a 82.88 mg, kēlā me nā 10 mg, 20 mg, 40 mg a i ʻole 80 mg o atorvastatin, ma kēlā me kēia,
• ʻO nā mea kōkua: eudragit (E100) (copolymer o dimethylaminoethyl methacrylate, butyl methacrylate, methyl methacrylate), lactose monohala, alfa-tocopherol macrogol succinate, povidone, croscarmellose sodium, sodium stearyl fumarate,
• ke ʻano mea hana kiʻi kiʻi: opadry YS-1R-7003 (polysorbate 80, hypromellose 2910 3cP (E464), titanium dioxide, hypromellose 2910 5cP (E464), macrogol 400).

Nā hōʻailona no ka hoʻohana ʻana

• He hemozygous familial a non-familial hypercholesterolemia, primary hypercholesterolemia a hoʻoneʻeneʻe (a hui pū ʻia) hoʻohui ʻia ʻo hyperlipidemia (nā ʻano IIa a me IIb e like me ka helu ʻana o Fredrickson) i hui pū me ka lipid-hoʻēmi kai e makemake ana e hoʻohaʻahaʻa i nā kiʻekiʻe kiʻekiʻe o ka kolamu, ka lipoprotein cholesterol haʻahaʻa-haʻahaʻa (LDL, I-lipid,. lipoprotein kūloko nui (HDL),
• dysbetalipoproteinemia (ʻano III e like me ka helu ʻana o Fredrickson), serum triglycerides (type IV e like me ka helu ʻana o Fredrickson) - me ka lāʻau lapaʻau ʻana maikaʻi ʻole.
• ʻO ka homozygous familial hypercholesterolemia - e hoʻohaʻahaʻa i ka kolamu LDL a me ka kolamu holoʻokoʻa me ka lawa ʻole o ka hoʻoulu ʻia ʻana i ka papa ʻaina meaʻai a me nā lāʻau lapaʻau ʻole hou ʻole.

Nā Hoʻohui

• huni kūpeʻe (nā keiki-Pugh nā papa A a me B),
• ka maʻi maʻi o ka puʻuwai ikaika, hoʻonui ʻia o nā huina hepatic (ʻoi aku ma mua o 3 mau manawa i ʻoi aku i ka palena palena o ka maʻamau) o nā kumu ʻike ʻole,
• ka wā hapai a me ka umauma.
• makahiki i 18 makahiki
• hypersensitivity i nā ʻāpana o ka lāʻau.

Me ka makaʻala, e ʻōlelo ʻia e hāʻawi ʻia ʻo Atorvastatin-Teva me ka mōʻaukala o nā maʻi ʻeha, nā mea maʻi me ka hypotension arterial, ka hilinaʻi ʻana i ka waiʻona, ka maʻi ʻōpū o nā metabola a me ka hopena o ka hoʻokaumaha, nā maʻi ʻohiʻeha o ka electrolyte nui loa, ʻehaʻeha kūloko nui (sepsis), nā maʻi ʻeha o ke kāula, ka ʻōpū o ka lolo, a me nā hana hoʻokele ākea. nā hōʻeha.

ʻLoe a me ke kākele

Kuhi ʻia nā papa i kahi manawa 1 i ka lā, me ke ʻano o ka inu ʻana i ka meaʻai i kēlā me kēia manawa o ka lā.

Kūkulu ke kauka i ka pakanā hoʻokahi, me ka noʻonoʻo o ka pae mua o ka LDL cholesterol, ke kumu o ka lāʻau a me ka pane ʻana o ka mea maʻi i ka lāʻau lapaʻau.

Pono ka hoʻokele ʻana o Atorvastatin-Teva e ka hui maʻamau (1 ka manawa i kēlā me kēia 2-4 wiki) ka nānā ʻana i ka pae o lipids i ka plasma koko, e pili ana i ka ʻike i loaʻa, hoʻoponopono i ka maʻi.

Pono e hoʻololi ʻia nā koena ma mua o 1 mau manawa i nā hebedoma 4.

ʻO ka palena kiʻekiʻe loa o kēlā me kēia lā he 80 mg.

Palapala ʻia i kēlā me kēia lā:

• heterozygous familial hypercholesterolemia: ke kakua mua ʻia he 10 mg, e hoʻoneʻe ana i ka hoʻoponopono i kēlā me kēia 4 hebedoma, pono e hoʻihoʻi iki i 40 mg. I ka wā e mālama ʻia me kahi hapa o 40 mg, ua lawe ʻia ka lāʻau lapaʻau me ka hui pū ʻana i nā huina o nā hua bile, me ka monotherapy, hoʻonui ʻia ke ʻano i ka 80 mg,
• ʻO ka hypercholesterolemia mua a me nā hoʻopili (hui pū ʻia) hyperlipidemia: 10 mg, ma ke ʻano he kānāwai, hāʻawi ka ʻai i ka mana e pono ai nā lipid pae. ʻO ka hopena koʻikoʻi e pili ana i ka hopena ma hope o nā hebedoma 4 a e hoʻomau i ka hoʻohana mau ʻana i ka lāʻau.
• ʻO ka hoʻohālikelike familial hypercholesterolemia: 80 mg.

No ka maʻi puʻuwai coronary a me ka pilikia o ka hōʻeha o ka hoʻopiʻi ʻana o ka maʻi cardiovascular, ua ʻōlelo ʻia me ka pahuhopu e pili ana i nā pahuhopu e hiki mai ana no ka hoʻoponopono lipid: ka nui o ka kolala ma lalo o 5 mmol / l (a i lalo paha 190 mg / dl) a me LDL cholesterol i liʻiliʻi iho i ka 3 mmol / l (a i lalo paha 115 mg / dl).

I ka hihia o ka kōʻai ʻole, pono paha i ka mea maʻi e kuhikuhi i nā haʻahaʻa haʻahaʻa a hōʻole paha i ka lāʻau.

Me ka maikaʻi ʻole o ka renal, ʻaʻole pono ka hoʻoponopono ʻana i ka hala, no ka mea, ʻaʻole e loli ka lāʻau lapaʻau i ka neʻe ʻana i ka plasma koko.

Nā hopena hopena

• mai ka pūnaehana nūhou: pinepine - ka ʻeha, ka pinepine - hoʻowalewale o ka ʻono ʻono, hoʻowalewale, ʻōpū, poloka, amnesia, nightmares, hypesthesia, ʻāhane - neʻe aku ka maʻi āpau, ʻike luhi - hoʻoweliweli, hoʻoweliweli, a nalowale ʻole.
• mai nā pahuhopu: pinepine - kūloko kūloko, ʻaʻole loa - ka pīhoihoi anaphylactic, angioedema,
• mai ka ʻōpū o ka gastrointestinal: pinepine - ka ʻoluʻolu, ka dyspepsia, nā ʻōpū, ka lemulipepa, constipation, pinepine - ʻeha o ka ʻōpū, ka pale ʻana, ka pancreatitis, ka luaʻi,
• mai ka ʻōnaehana musculoskeletal a me ka hoʻopili hui: pinepine - ʻeha i ka ʻōpū, ke kuʻi nei i nā ʻōpū, myalgia, ʻeha hoʻi, arthralgia, spasm muse, pinepine - nāwaliwali o ka ʻōpū, ʻehaʻeha, ʻeha - rhabdomyolysis, myopathy, myositis, tendonopathy me kahi rupture tendon, ʻike ʻole ka ʻihi o ka maʻi - immuno-mediated necrotizing myopathy,
• mai ka ʻōnaehana hepatobiliary: pinepine - hepatitis, pinepine ʻole - cholestasis, aneane loa ʻole - nāwaliwali o ka ate,
• mai ka ʻōnaehana lymphatic a me ke koko: jarang - thrombocytopenia,
• mai ka ʻōpū o ka hanu, umauma a me nā ʻōpū mediastinal: pinepine - nosebleeds, ʻeha i ka laha ʻo ka pharyngeal-laryngeal, nasopharyngitis, ka ʻike pinepine ʻole - nā mākau pū me ka interstitial,
• nā mākaʻina o ka laboratorium: pinepine - ka nui o ka hana ma ka serum creatine kinase activity, hyperglycemia, pinepine pinepine - hypoglycemia, leukocyturia, hoʻonui i nā ʻano o nā ʻalohi o ke akeʻa, ʻike pinepine ʻole ai - he hoʻonui i ke kiʻekiʻe o ka glycosylated hemoglobin konsentrasi,
• ma ka ʻāpana o ka hui hoʻolohe, nā maʻi labyrinth: pinepine - tinnitus, nui - lohe ʻole ke lohe,
• ma ka ʻaoʻao o ke kumumanaʻo o ka hihiʻo: pinepine - hoʻohaʻahaʻa i ka ʻike o ka hihio, luhi - ʻike ʻole ʻia ka ʻike ʻike.
• nā umauma dermatological: pinepine - i ka ʻeha o ka ʻili, nā ʻōpala, alopecia, urticaria, līpeke - erythema multiforme, bullous dermatitis, aneʻane loa - necrolysis epidermalʻino, nā maʻi Stevens-Johnson,
• mai ka ʻōnaehana o ka hua: ʻano nui - gynecomastia, ʻike pinepine ʻole - hana kūlohelohe,
• nā maʻi maʻamau: pinepine - nāwaliwali, asthenia, ke kuni, ka ʻeha ʻeha, edema peripheral, kaupaona momona, lethargy, anorexia.

Nā ʻōlelo kikoʻī

Ma mua, pono ʻia ka hypercholesterolemia e hoʻomalu i ka mālama ʻana i nā meaʻaiʻai, ʻoi aku ka hoʻoikaika kino, a ma nā mea maʻi me ka momona, ke kaupaona ʻana a me ka mālama ʻana i nā kūlana ʻē aʻe.

Hoʻohana ka hoʻohana o Atorvastatin-Teva no ka makaʻala i kahi meaʻai maʻamau hypocholesterol, i kuhikuhi ʻia e ke kauka i ka manawa like me ka lāʻau lapaʻau.

Hiki i ka mea hoʻoneʻe i ka HMG-CoA reductase ka hopena i ka hoʻololi ʻana i nā palena biochemical o ka ate ma ka hopena o ke ʻano hana. No laila, pono e mālama ʻia ka mālama ʻana me ka nānā ʻana i ka hana o ka puʻuwai me ka neʻe aʻe: ma mua o ka hoʻomaka ʻana i ka hōʻola, ma hope o ka hoʻonui ʻana o kēlā me kēia maʻi, a laila ma hope o 6 a me 12 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana, a laila i kēlā me kēia ʻeono mahina. ʻO nā maʻi me nā pae kiʻekiʻe o nā enzyme e nānā pono ʻia e kahi kauka a hiki i ka hoʻi ʻana i ka pae. Inā nui nā kuhi i ka aspartate aminotransferase (AST) a me ke kumu alanine aminotransferase (ALT) i nā manawa he nui i ka manawa o ka palena palena kiʻekiʻe o ke kumu, a laila e hoʻemi ʻia ka papaʻi ʻana.

ʻO ka hoʻomohala ʻana i ka myopathy hiki i kahi hopena maikaʻi ʻole o ka lawe ʻana i ka atorvastatin, ʻo kona mau hōʻailona ka hoʻohui ʻana o ka phosphokinase (CPK) 10 mau manawa a ʻoi aku paha a hoʻohālikelike ʻia me ka palena palena o ke kumu i hui pū ai me ka hōʻeha a me ka nāwaliwali i nā ʻeha. Pono e hoʻomaopopo ʻia nā mea maʻi e pili ana i ka pono e kūkākūkā koke i ke kauka inā he eha ʻole a me ka nāwaliwali o nā uaua, me ka maʻi a me ka malaise. Pono e hoʻokuʻi ʻia ka Therapy i ka wā e mālama ana i ka hoʻonui nui ʻana o ka hana KFK a i ʻole ka hiki ʻana o ka manaʻo hoʻopalike a hoʻopaʻa ʻia hoʻi i hoʻopaʻa ʻia.

E kūʻē i ka hope o ka hoʻohana o ka atorvastatin, hiki i ka hoʻomohala ʻana o ka rhabdomyolysis me ka hōʻoki ʻole i ka aʻa ma muli o ka myoglobinuria. Ma ka hopena o ka maʻi koʻikoʻi maʻi, hypotension arterial, nui o ka hōʻeha ʻana, trauma, ka hōʻino o ka metabolic, ʻo ka endocrine a me ka electrolyte haunaele, ʻike ʻole ʻia ka ʻike a i ʻole ke ʻano o nā mea ʻē aʻe o ka hopena o ka renal i ka wā o ka rhabdomyolysis, ua manaʻo ʻia e kāpae i ka hoʻāla ʻana o Atorvastatin-Teva.

ʻO ka lawe ʻana i ka lāʻau lapaʻau ʻaʻole ia e hoʻopilikia i ka hiki o ka mea maʻi e hāpai i nā kaʻa a me nā mākaʻi.

Hoʻohui nūhou

ʻO ka hui pū ʻana o ka HMG-CoA reductase inhibitors me nā fibrates, cyclosporine, macrolide antibiotics (me ka erythromycin), acid acidotinic, azole antifungal agents e hoʻonui i ka hōʻeha o ka myopathy a i ʻole e hoʻokau i ka rhabdomyolysis, i hele pū me ka maikaʻi ʻole e pili me myoglobinuria. No laila, ua ʻōlelo ʻia ma ke ʻano kaulike, ka hoʻohālikelike ʻana i nā pōmaikaʻi a me nā pilikia o ka hōʻola ʻana, e hoʻoholo ai i ke koho ʻana o ka atorvastatin i ka manawa like me kēia mau lāʻau.

Me ka nui o ka makaʻala, ʻoi aku ia e kuhikuhi i ka hui pū me ka cyclosporine, ka mea paʻa o ka pale o ka protease, ka maʻi antibiotic macrolide (me ka erythromycin, clarithromycin), nā lāʻau lapaʻau anti-azole azole, akazodone a me nā mea ʻē aʻe o ka CYP3A4 isoenzyme, no ka mea hiki ke hoʻonui i ke kūpaʻa o ka atorvastatin i ka hopena wai . ^ E Ha yM.

Me ka hoʻohana ʻana o Atorvastatin-Teva:

• cimetidine, ketoconazole, spironolactone a me nā lāʻau lapaʻau ʻē aʻe e hōʻemi ana i ka kaohiʻana o nā hormone stogen endogenous, e hoʻonui i ka hōʻemi o ka hōʻemi o ka pae o ka testosterone endogenous,
• nā mea hoʻohālikelike waha e loaʻa ai ka ethinyl estradiol a me ka norethisterone e hoʻonui nui i ka luhi o nā mea ikaika i ka plasma koko,
• suspensions i loaʻa i ka alumini hydroxide a me ka magnesium i hōʻemi ʻia (ma kahi o 35%) ka nānā ʻana o ka atorvastatin i ka plasma, me ka ʻole o ka hoʻololi ʻana i ka pae o ka hōʻemi o ka LDL,
• hiki i ka digoxin ke hoʻonui i kona kaila plasma,
• ʻO ka warfarin i ka emi iki o ka manawa prothrombin i ka hoʻomaka ʻana o ka maʻi lapaʻau, ma kahi o 15 mau lā aʻe, ua hoʻihoʻi ʻia ka hōʻailona ma ka maʻamau,
• ʻO nā cyclosporin a me nā mea paʻa P-glycoprotein e hoʻonui i ka bioavailability o atorvastatin,
• ʻaʻole hoʻololi i ka terfenadine i ka kaohi ʻana i ka plasma koko.

ʻO ka hui pū ʻana me ka colestipol ka hopena i loaʻa ka hopena ma luna o nā lipids ma mua o ka lawe ʻana i kēlā me kēia lāʻau lapaʻi hoʻokaʻawale, ʻoiai ʻo ka pae o ka atorvastatin i loko o ke kaila koko ua emi e pili ana i ka 25%.

Pono ka palena o ka ʻai kīlohelohe i ka wā o ka mālama ʻana no ka mea mālama ʻia, no ka mea, he nui ka nui o ka wai i hoʻonui ʻia i ka ʻike ʻana o ka atorvastatin i ka plasma.

ʻAʻole pili ka lāʻau i ka pharmacokinetics o phenazone a me nā lāʻau ʻē aʻe i hoʻouluhua e ka cytochrome isoenzymes e like me kēlā.

Nā hopena o ka rifampicin, phenazone, a me nā CYP3A4 e koi nei i ka hoʻomākaukau ʻana o ka isoenzyme hoʻomākaukau ʻia ma Atorvastatin-Teva, ʻaʻole i hoʻokū ʻia.

Hiki i ke ʻano o ke kūkākūkā pili kino me ka hoʻohana ʻana i nā lāʻau antiarrhythmic papa ʻia (me ke ʻano amiodarone).

ʻAʻole i hōʻike nā noiʻi i ka pili o ka atorvastatin me ka cimetidine, amlodipine, nā lāʻau antihypertensive.

Ke hana lāʻau lapaʻau ma ka atorvastatin teva

No ka lālani ka poʻe koho i ka hoʻokūkū koho hoʻokūkū o ka hoʻoneʻe ʻana o ka hoʻoneʻe ʻia o ka HMG-CoA, kahi e kuhi ai i ke ʻano o ka waikawa mevalonic, he mea mua o ka kolamu a me nā sterols.

ʻO ka Triacylglycerides (nā ʻōpala) a me ka kolamu ma ka moʻo e hoʻopili ai i nā lipoproteins low haʻahaʻa, mai kahi e lawe ʻia ai lākou e ke koko i nā mea kikoʻī a me nā pā adipose. ʻO kēia mau, i ka wā lipolysis, nā lipoproteins haʻahaʻa haʻahaʻa (LDL) i hoʻopili ʻia, i hoʻokaʻawale ʻia e ka pilina me nā mea LDL.

Hāpai ka hana o ka lāʻau lapaʻau e hōʻemi i ka nui o nā momona a me ka kolamu ma ke koko ma o ka pale ʻana i ka hana o ka hoʻoneʻe ʻana o ka enzyme HMG-CoA, biosynthesis cholesterol i ka ate a hoʻonui i ka nui o nā mea LDL e hāpai i ka hōʻea a me ka catabolism o nā lipoproteins haʻahaʻa haʻahaʻa.

Hoʻokū ʻia ka hopena o ka lāʻau i ka nui i lawe ʻia a i ka hoʻohaʻahaʻa ʻana i ka haʻahaʻa o ka lipoproteins haʻahaʻa haʻahaʻa i nā mea maʻi me ka hōʻino o ka hōʻemi o ka cholesterol metabolism (hypercholesterolemia), ʻaʻole hiki ke hoʻoponopono ʻia me nā lāʻau ʻē aʻe e hoʻohaʻahaʻa i nā lipid koko.

Ke lawe nei i ka lāʻau lapaʻau e alakaʻi i kahi hāʻule i ka pae o:

• huina kolamu (30-46%),
• kolamu i LDL (41-61%),
• apolipoprotein B (34-50%),
• triacylglycerides (14-33%).

Ma ka manawa like, ʻo ka pae o ka cholesterol i ka hana o nā lipoproteins density kiʻekiʻe (HDL) a me ka apolipoprotein A. hoʻonui i ʻike kēia i nā mea maʻi me ka hoʻoilina a loaʻa nā ʻano o ka hypercholesterolemia, kāwili i hoʻohui ʻia no ka dyslipidemia type, me ka type 2 diabetes mellitus. ʻO ka hopena i ka lāʻau lapaʻau e hōʻemi i ka hopena o nā pathologies cardiovascular a me ka hoʻoweliweli o ka make i pili me lākou.

Wahi a nā haʻawina loiloi, ʻaʻole i like ka hopena o ka hoʻohana ʻana i ka lāʻau i nā mea maʻi e pili ana i nā makahiki i ka palekana a me ka hoʻopōmaikaʻi ʻana ma kahi ala maikaʻi mai nā hopena o ka mālama ʻana i nā poʻe maʻi o nā makahiki ʻē aʻe.

Hoʻāmi koke ʻia ka waiwai lāʻau ma hope o ka lawelawe waha. Kuhi ʻia ka ʻike kiʻekiʻe loa i ke koko ma hope o 1-2 mau hola. Ke ʻai liʻiliʻi nei i ka ʻai ʻana i ke kumu ikaika, akā ʻaʻole i pili i ka hopena o kāna hana. ʻO ka hoʻohana mauʻana he 12%. ʻO ka bioavailability o ka hana pale i pili i ka hoʻoneʻe o ka hoʻoneʻe HMG-CoA i 30%, ka mea i hoʻoneʻe ʻia e ka metabolism mua ma loko o ka huina a me ke akepaʻa. Hoʻohālikelike ia i nā protein koko ma 98%.

Ua hoʻokaʻawale ka mea hoʻonaʻauao i nā metabolites (ortho- a me para-hydroxylated derivatives, beta-oxidation huahana) no ka hapa nui o ka puʻuwai. Ua hoʻohālikelike ia ma lalo o ka hana a isoenzymes CYP3A4, CYP3A5 a me CYP3A7 o ka cytochrome P450. ʻO ka hana o ka papa o ka lāʻau lapaʻau e pili ana i ka hoʻoneʻe ʻana o ka HMG-CoA reductase i ka 70% hilinaʻi i ka hana a nā metabolites hopena.

Ka heleʻana o nā metabolites hope loa ma o ka bile, he hapa wale nō i ʻike (Indications for use of atorvastatin teva

ʻO ka pale ʻana i nā maʻi o ka ʻōnaehana cardiovascular (maʻi coronary heart disease, stroke, myocardial infarction), a me kā lākou hoʻopiʻi ʻana:

• i nā pākeke ma ke ʻano he nui a me ka hopena paha: nā ʻelemakule, hypertensive, nā mea inu, nā kānaka me ka hōʻemi o ka HDL a i ʻole ka hoʻomau i ka hoʻoilina no ka puʻuwai a me nā maʻi maʻi,
• i nā mea maʻi me ka diabetes type type 2 mellitus me ka proteinuria, retinopathy, hypertension,
• i nā mea maʻi me ka maʻi naʻau coronary (e pale i ka hoʻomohala ʻana o nā hoʻopiʻi).

Ka hopena o ka hyperlipidemia:

• me ka hypercholesterolemia mua (loaʻa a hoʻoilina, me ka ʻano homo- a he hemozygous o ka hypercholesterolemia familial) - hoʻohana ʻia ka lāʻau lapaʻau ma ke ʻano hana kūʻokoʻa a ma ke ʻano o ka paʻakikī paʻakikī me nā hana lipid-e hoʻohaʻahaʻa ana (LDL apheresis).
• me ka dyslipidemia i hui ʻia,
• i nā mea maʻi me ka triglycerides kiʻekiʻe i ke koko (type IV like me Fredrickson),
• i nā mea maʻi me ka dysbetalipoproteinemia maʻamau (Fredrickson ʻano III) me ka hoʻohana ʻana i ka lāʻau lapaʻau ʻole maikaʻi.

Pehea e lawe ai

Kuhi ka lā helu i kēlā me kēia lā i ka pae mua o ka cholesterol a aia i ka waena o 10-80 mg. I ka mua, 10 mg e kuhikuhi ʻia i hoʻokahi manawa i kēlā me kēia lā i kahi manawa o ka lā, me ka ʻole o ka ʻōlelo ʻana i ka ʻai. Mālama ʻia ka hoʻoponopono ʻia o ka dosis ma ke ʻano o nā mea kikoʻī o ke kolamu o ke koko, pono e mālama ʻia lākou i kēlā me kēia 2, a laila i kēlā me kēia 4 wiki.

Nā ʻokoʻa ʻāhewa o kēlā me kēia lā:

• me ka hypercholesterolemia mua a me ka hyperlipidemia i hui pū ʻia: 10 mg hoʻokahi i ka lā (a hōʻike ʻia kahi hopena therapeutic i hala ma hope o 28 mau lā mai ka hoʻomaka ʻana o ka mālama ʻana, me ka lōʻihi o ka mālama ʻana i kēia hopena)
• me ka heterozygous herdary hypercholesterolemia: 10 mg hoʻokahi i ka lā (a me ka hopena mua me ka hoʻoponopono hou aku a lawe mai i 40 mg i kēlā me kēia lā),
• me ka home homozygous herpaio hoʻohālikelike: 80 mg 1 manawa i kēlā lā.

ʻAʻole hoʻopilikia ka poʻe maʻi aʻai i ka neʻe ʻana o ka waiwai ikaika i loko o ke koko a i ʻole ka hopena o ka Atorvastatin-Teva. ʻAʻohe pono no ka hoʻoponopono hoʻoponopono ʻana ma muli o nā maʻi maʻi o ka maʻi. I ka hihia o nā hana ʻehaʻeha, kūpono ke hoʻoponopono iā ia e like me ka hana ʻana o nā huina. I nā pilikia koʻikoʻi, hoʻopau ʻia ka lāʻau lapaʻau.