Atorvastatin vs. simvastatin: Misiyano, kufanana, uye izvo zviri nani kwauri
Zvinodhaka Vs. ShamwariKuongorora kwemishonga & misiyano mikuru | Conditions kurapwa | Kubudirira | Inishuwarenzi kufukidza uye mutengo kuenzanisa | Zvimwe zvinokanganisa | Kubatana kwezvinodhaka | Yambiro | MIBVUNZO
Atorvastatin uye simvastatin maviri anowanzo gadzirirwa statin zvinodhaka zvinorapa yakakwira cholesterol. Chiremba wako anogona kunyorera mumwe wemishonga iyi kana uine huwandu hwakawanda hweLDL (low-density lipoprotein) cholesterol, inozivikanwa seyakaipa cholesterol. Nekuderedza cholesterol mazinga, atorvastatin kana simvastatin inogona kubatsira kudzikisa njodzi yekurwadziwa kwemoyo uye sitiroko.
Kunyanya zvakanyanya, atorvastatin uye simvastatin inoshanda seHMG-CoA reductase inhibitors. Nekudzivirira iyo HMG-CoA reductase enzyme, idzi statins kuderedza kugadzirwa kwecholesterol muchiropa. Iine cholesterol shoma iri kutenderera muropa, muviri unokwanisa kudzosera cholesterol yakawandisa uye kudzikisa huwandu hwecholesterol.
Atorvastatin uye simvastatin dzinogona kushanda nenzira dzakafanana asi zvine misiyano muyero, manejimendi, uye nemhedzisiro mhedzisiro.
Ndeupi mutsauko mukuru pakati peatorvastatin uye simvastatin?
Atorvastatin inozivikanwa zvakare nezita rayo rekuti, Lipitor, yaive FDA-inogamuchirwa muna 1996. Pakati pezvimwe zvinoshandiswa, inorayirwa kudzikisa njodzi yekurwadziwa nemoyo kana kurohwa nevaya vane coronary chirwere chemoyo .
Atorvastatin (Chii chinonzi Atorvastatin?) Ine hafu yeupenyu hwakareba hwemaawa gumi nemana. Mushonga unoshanda kana uchinge wapinza, uye basa rayo rekudzikisa lipid rinogona kugara Maawa makumi maviri kusvika makumi matatu mushure mehutongi. Pamwe chete ne rosuvastatin, kana Crestor, atorvastatin chinodhaka chakasimba kupfuura mamwe ma statins akaita sa simvastatin uye pravastatin.
Atorvastatin inowanikwa mu10 mg, 20 mg, 40 mg, uye 80 mg mapiritsi. Iyo inokurudzirwa yekutanga dhizeti ndeye 10 kana 20 mg kamwe zuva nezuva kunyangwe hosi yenguva dzose inogona kubva pa10 kusvika 80 mg kamwe pazuva. Atorvastatin inogona kutorwa chero nguva yezuva.
Simvastatin (Chii chinonzi Simvastatin?) Inozivikanwa zvakare nezita rayo rekuti, Zocor. Inofananidzwa neatorvastatin, simvastatin mushonga wekare uyo wakatanga FDA kubvumidzwa muna 1991. Senge mamwe ma statins, anoshandiswa kudzikisa njodzi yekurwadziwa kwemoyo uye sitiroko kune avo vane njodzi dzemwoyo.
Unoda mutengo wakanakisa pane simvastatin?
Saina kuti simvastatin mutengo wekuzivisa uye uone kana mutengo uchinja!
Wana machenjedzo emitengo
Kusiyana neatorvastatin, simvastatin ingori prodrug . Zvinoreva, haishande kusvikira yagadziriswa, kana kugadziriswa, muchiropa. Mushure mekugadziriswa, simvastatin inoshanduka kuita fomu yayo inoshanda, simvastatin acid, iyo ine hafu-yehupenyu hweinotenderedza one kusvika maviri maawa.
Simvastatin inowanikwa musimba re5 mg, 10 mg, 20 mg, 40 mg, uye 80 mg. Iyo yakakurudzirwa yekutanga dhizeti ndeye 10 kana 20 mg kamwe pazuva, uye dhosi yakajairika inogona kutangira kubva pa5 kusvika 40 mg pazuva. Simvastatin inokurudzirwa kutorwa husiku.
| Misiyano mikuru pakati peatorvastatin uye simvastatin | ||
|---|---|---|
| Atorvastatin | Simvastatin | |
| Kirasi yemishonga | HMG-CoA reductase inhibitor Statin | HMG-CoA reductase inhibitor Statin |
| Brand / generic chinzvimbo | Brand uye generic vhezheni iripo | Brand uye generic vhezheni iripo |
| Chii chinonzi zita rechiratidzo? | Lipitor | Zocor |
| Ndeapi mafomu (s) ayo mushonga unouya? | Hwendefa remuromo | Hwendefa remuromo |
| Ndeipi muyero wakajairwa? | 10 kusvika 80 mg kamwe pazuva | 5 kusvika 40 mg kamwe pazuva |
| Yakareba sei iyo yekurapa? | Kurapa neatorvastatin ndeyerefu-nguva kugadzirisa cholesterol mazinga uye kuchengetedza yakaderera njodzi yekurwadziwa kwemoyo uye sitiroko. | Kurapa ne simvastatin ndeyerefu-nguva kugadzirisa cholesterol mwero uye kuchengetedza yakaderera njodzi yekurwara kwemoyo uye sitiroko. |
| Ndiani anowanzoshandisa mushonga? | Vakuru; vana nevachiri kuyaruka vane makore gumi kusvika gumi nemanomwe vane heterozygous yemhuri hypercholesterolemia (HeFH) | Vakuru; vana nevachiri kuyaruka vane makore gumi kusvika gumi nemanomwe vane heterozygous yemhuri hypercholesterolemia (HeFH) |
Mamiriro ezvinhu anorapwa neatorvastatin uye simvastatin
Atorvastatin uye simvastatin zvinoshandiswa kune zvakafanana zvinangwa. Ivo vaviri vanorapa yakakwira cholesterol mazinga (hypercholesterolemia), yakakwira lipid mazinga (hyperlipoproteinemia), uye yakakwira triglyceride mazinga (hypertriglyceridemia). Panguva imwecheteyo, statins inogona kubatsira kuwedzera HDL cholesterol, mhando yecholesterol yakanaka ine zvinodzivirira kurwisa chirwere chemwoyo.
Atorvastatin uye simvastatin inogona zvakare kudzora njodzi yekurwara kwemoyo uye sitiroko mune zvinotevera:
- Vakuru vasina coronary moyo chirwere (CHD) vane akawanda njodzi zvinhu
- Vakuru vane Type 2 chirwere cheshuga vasina CHD, asi vane zvakawanda zvine njodzi
- Vakuru vane chirwere CHD
Njodzi zviitiko zvezviitiko zvemwoyo zvinogona kusanganisira kukwira kweropa (hypertension) uye neshuga yeropa (chirwere cheshuga).
Atorvastatin uye simvastatin inogona kudzikisa cholesterol uye lipid mazinga mune avo vane genetic lipid kusagadzikana , senge homozygous yemhuri hypercholesterolemia (HoFH). Aya ma statins anogona zvakare kubata vana nevechiri kuyaruka (10-17 yemakore emakore) neheterozygous yemhuri hypercholesterolemia (HeFH).
Kurapa kweatherosclerosis, kana mafuta anoiswa pamadziro eropa, ndechimwe chikonzero nei atorvastatin kana simvastatin inogona kupihwa. Nekudzikisa danda pamadziro eropa, aya ma statin anogona kubatsira kudzikisira zviratidzo zvakaita sekurwadziwa pachipfuva (angina).
| Mamiriro | Atorvastatin | Simvastatin |
| Hypercholesterolemia | Ehe | Ehe |
| Hyperlipoproteinemia | Ehe | Ehe |
| Hypertriglyceridemia | Ehe | Ehe |
| Kurwadziwa kwemoyo uye kudzivirira sitiroko | Ehe | Ehe |
| Atherosclerosis | Ehe | Ehe |
Atorvastatin kana simvastatin inoshanda here?
Atorvastatin uye simvastatin ese ari maviri anoshanda statin mishonga. Zvidzidzo zvakaratidza kuti avo vanotora yavo statin mishonga kanenge 90% yenguva vane 45% yakaderedza njodzi yekufa kubva pakurwara kwemoyo, sitiroko, kana chero chikonzero. Kazhinji, ma statins anoshanda kwazvo pakuderedza cholesterol mazinga uye kudzikisa kuitika kwekurwadziwa kwemoyo uye sitiroko.
Hapana akasimba musoro-kune-musoro miedzo uchienzanisa atorvastatin uye simvastatin yakaitwa. Nekudaro, atorvastatin inoonekwa semushonga une simba kupfuura simvastatin. Mukati imwe yazvino yekuenzanisa kudzidza , atorvastatin yakawanikwa ichinyanya kushanda pakudzikisa LDL cholesterol (LDL-C) pane simvastatin. Ichi chidzidzo chakanyora mhedzisiro kubva makumi mashanu akasarudzika, makiriniki miedzo, uye nekufananidza mamwe emiraini zvinodhaka senge fluvastatin, pravastatin, rosuvastatin, uye lovastatin. Rosuvastatin yaive nemasimba akakwirira ekuderedza mwero weLDL muchidzidzo.
Mune imwe kuongorora kwakarongeka , 75 zvidzidzo zvakasiyana vachienzanisa mishonga yemasitini yakaongororwa. Zvinoenderana nemhedzisiro yeboka rekudzidza, muyero wezuva nezuva weatorvastatin 10 mg unogona kudzikisa LDL cholesterol ne30% -40% nepo muyero wezuva nezuva we simvastatin 10 mg unogona kudzikisa LDL cholesterol ne20% -30%. Nekudaro, izvo zvemakiriniki mhedzisiro yemusiyano uyu zvinogona kunge zvisina kukosha.
Bvunza wako mupi wezvehutano kuti uone yakanakisa statin kurapwa kwako. Iko kushanda kwe statins kunoenderana neyako yekurapa uye yemhuri nhoroondo, pakati pezvimwe zvinhu.
Kuvhavha uye mutengo kuenzanisa kweatorvastatin vs. simvastatin?
Atorvastatin inowanikwa seyakajairika mushonga unowanzo kuve wakafukidzwa neMedare uye nezvimwe zvirongwa zveinishuwarenzi. Iyo yakatemwa sepiritsi rezuva nezuva iro rinogona kugoverwa mune 30-mazuva kana 90-mazuva ekupa. Ivhareji yemari mutengo weatorvastatin inogona kumhanyisa inosvika kumadhora mazana maviri nemakumi mashanu. Nekudaro, mutengo unogona kudzikiswa kusvika pamadhora gumi neshanu neSingCare atorvastatin coupon.
Simvastatin inowanikwawo seyakajairika mushonga. Seyakajairwa kazhinji statin, simvastatin inowanzo kufukidzwa neMedare uye zvirongwa zveinishuwarenzi. Wepakati mutengo wekutengesa we simvastatin wakakomberedza $ 470. Nekudaro, uine kadhi rekudzikisira re simvastatin, seSingleCare, unogona kutarisira kubhadhara isingasviki $ 10 yekutengeswa kwemazuva makumi matatu emakumi mapfumbamwe emamiriyoni pamafamasi anotora chikamu.
| Atorvastatin | Simvastatin | |
| Kazhinji yakafukidzwa neinishuwarenzi? | Ehe | Ehe |
| Inowanzo kufukidzwa neMedare Chikamu D? | Ehe | Ehe |
| Standard muyero | 10 mg kamwe zuva nezuva (huwandu hwe30) | 20 mg kamwe zuva nezuva (huwandu hwe30) |
| Chaizvoizvo Medicare copay | $ 0– $ 16 | $ 0– $ 9 |
| SingleCare mutengo | $ 15 + | $ 10 + |
Tora kadhi rekudzikisira chemishonga
Zvakajairika mhedzisiro mhedzisiro yeatorvastatin vs. simvastatin?
Anowanzoitika mhedzisiro mhedzisiro yemasitini, senge atorvastatin uye simvastatin, anosanganisira matambudziko ekugaya senge manyoka, kuzvimba, uye kusvotwa. Zvimwe zvinokanganisa zvinosanganisira dzungu uye kuzvimba kwemaoko, makumbo, kana tsoka (edema). Statins inogona zvakare kukonzera kurwadziwa kwemhasuru (myalgia) kana kushaya simba kwemhasuru (myopathy).
Njodzi yekurwadziwa kwemhasuru inowedzera nematanho epamusoro ematemine. Nekudaro, ichienzaniswa neatorvastatin, simvastatin inoonekwa seine njodzi yakanyanya ye myalgia. Vamwe vanhu vanogona zvakare kuve ne genetus predisposition kune myalgia kubva simvastatin. Kunyangwe ese masitamin ane njodzi yekukonzeresa kurwadziwa kwemhasuru senge mhedzisiro, iyo FDA yakaganhurira kushandiswa yemasimvastatin 80 mg mapiritsi nekuda kwenjodzi yakawedzera.
Zvimwe zvinowanzoitika mhedzisiro zvinogona kuwanikwa mune tafura pazasi.
| Atorvastatin | Simvastatin | |||
| Side maitiro | Zvinoshanda? | Kakawanda | Zvinoshanda? | Kakawanda |
| Joint kurwadziwa | Ehe | 7% | Ehe | 0.1% |
| Manyoka | Ehe | 7% | Ehe | * |
| Kuzvimbirwa | Kwete | - | Ehe | piri% |
| Kuzvidya mwoyo | Ehe | 5% | Ehe | * |
| Nausea | Ehe | 4% | Ehe | 6% |
| Kutambudzika kwemhasuru | Ehe | 4% | Ehe | 4% |
| Urinary turakiti hutachiona | Ehe | 6% | Ehe | 3% |
| Nasopharyngitis | Ehe | 8% | Kwete | - |
| Dzungu | Ehe | * | Ehe | 5% |
| Edema | Ehe | * | Ehe | 3% |
* haina kutaurwa
Kakawanda hakubvi pane data kubva kumusoro-kuenda-kumusoro kutongwa. Izvi zvinogona kunge zvisiri runyorwa ruzere rwemhedzisiro mhedzisiro inogona kuitika. Ndokumbira utarise kuna chiremba wako kana mupi wezvehutano kuti udzidze zvimwe.
Kwayaka: DailyMed ( Atorvastatin ), Zuva Nezuva ( Simvastatin )
Kubatana kwezvinodhaka kweatorvastatin vs. simvastatin
Atorvastatin uye simvastatin inonyanya kugadziriswa muchiropa neCYP3A4 enzyme. Zvinodhaka zvinodzivisa, kana kuvharira, iyi enzyme inogona kukonzera kuwanda kweatorvastatin kana simvastatin muropa. Kana ikatorwa neCYP3A4 inhibitor senge clarithromycin kana itraconazole, atorvastatin inogona kukonzera njodzi yekuwedzera kurwadziwa kwemhasuru (myalgia) kana kushaya simba kwemhasuru (myopathy). Muchero wemazambiringa zvakare iri CYP3A4 inhibitor iyo inogona kuwedzera mazinga eatorvastatin uye simvastatin. Kune rimwe divi, zvinodhaka senge rifampin uye carbamazepine ndeye CYP3A4 inducers iyo inogona kudzikisira iwo mazinga eatorvastatin uye simvastatin mumuviri.
Protease inhibitors, senge ritonavir uye lopinavir, zvinogona kukonzera kuwanda kwema statins mumuviri. High statin mazinga muropa anogona kutungamira kune yakawedzera njodzi yemhedzisiro mhedzisiro, kusanganisira myalgia. Fibrate zvinodhaka uye niacin zvinogona zvakare kuwedzera njodzi yemyalgia painotorwa neatorvastatin kana simvastatin.
Kutora atorvastatin nemumuromo zvekudzivirira pamuviri kunogona kukonzera kuwanda kweropa remushonga wekudzivirira.
Kutora zvimisikidzo zvine warfarin zvakanzi zvinokonzeresa kuwanda kwewarfarin uye nenjodzi yakawedzera yekubuda ropa. Nekudaro, atorvastatin iri haigone kupindira pamwe nemhedzisiro yewarfarin.
| Zvinodhaka | Kirasi yemishonga | Atorvastatin | Simvastatin |
| Clarithromycin Erythromycin Itraconazole Ketoconazole Muchero wemazambiringa | CYP3A4 inhibitors | Ehe | Ehe |
| Rifampin Carbamazepine | CYP3A4 inducers | Ehe | Ehe |
| Ritonavir Lopinavir Simeprevir Darunavir | Protease inhibitors | Ehe | Ehe |
| Gemfibrozil Fenofibrate | Fibrates | Ehe | Ehe |
| Niacin | Antihyperlipidemic | Ehe | Ehe |
| Digoxin | Cardiac glycoside | Ehe | Ehe |
| Norethindrone Ethinyl estradiol | Mishonga yekudzivirira | Ehe | Kwete |
| Warfarin | Anticoagulant | Kwete | Ehe |
Bvunza nyanzvi yezvehutano kune kumwe kudyidzana kwezvinodhaka.
Yambiro yeatorvastatin uye simvastatin
Ose atorvastatin uye simvastatin zvinogona kukonzera zviitiko zvakashata zvinosanganisira kurwadziwa kwemhasuru (myalgia) kana kushaya simba kwemhasuru (myopathy). Muzviitiko zvakakomba, aya ma statins anogona zvakare kukonzera rhabdomyolysis, kana kukurumidza kuparara kwemasaga mhasuru. Imwe nzira isingawanzoitika ye myopathy, inonzi immune-mediated necrotizing myopathy (IMNM) yakashumwawo nekushandisa statin.
Atorvastatin uye simvastatin inonyanya kugadziriswa muchiropa. Naizvozvo, mashandisiro avo anogona kukonzera kukanganisika mumatunhu enzyme echiropa. Chiropa enzymes inofanirwa kuongororwa mukati medermin therapy. Vanhu vane chirwere chechiropa vanofanirawo kuongororwa kana kudzivisa ma statin zvachose.
Atorvastatin uye simvastatin inofanirwa kudzivirirwa mune vakadzi vane nhumbu uye vanaamai vari kuyamwisa. Aya ma statins anogona kunge aine njodzi yakawedzera yekuremara kwekuberekwa.
Inowanzo bvunzwa mibvunzo nezve atorvastatin vs. simvastatin?
Chii chinonzi atorvastatin?
Atorvastatin, inozivikanwawo nezita rayo rekuti Lipitor, mushonga we statin unoshandiswa kudzikisa cholesterol uye nekudzora njodzi yekurwadziwa nemoyo nekurohwa. Iyo yakajairwa dosi renji yeatorvastatin iri pakati pe10 kusvika 80 mg pazuva. Atorvastatin ine yehafu hafu-hupenyu hwemaawa gumi nemana uye inogona kutorwa chero nguva yezuva.
Chii chinonzi simvastatin?
Simvastatin inozivikanwa zvakare nezita rayo rezita, Zocor. Iyo statin mishonga inogona kudzikisa cholesterol mwero, iyo, zvakare, inogona kubatsira kudzikisa njodzi yekurwadziwa kwemoyo uye sitiroko. Iyo yakajairwa dosi renji ye simvastatin ndeye mashanu kusvika 40 mg pazuva. Simvastatin ine hafu yeupenyu hupfupi uye inokurudzirwa kutorwa manheru.
Atorvastatin uye simvastatin zvakafanana here?
Atorvastatin uye simvastatin ese ari echikamu chemishonga chinonzi HMG-CoA reductase inhibitors, kana statins. Izvo zvese zvinoshandiswa kudzikisa LDL cholesterol mazinga. Zvisinei, vane mimwe misiyano musimba rinowanikwa uye nemabatirwo avanotorwa.
Atorvastatin kana simvastatin iri nani here?
Atorvastatin uye simvastatin ese ari maviri anoshanda statin zvinodhaka zvekudzikisa ropa cholesterol. Nekudaro, atorvastatin inoonekwa seyakanyanya statin. Atorvastatin inogara kwenguva yakareba mumuviri uye inogona kutorwa mangwanani kana husiku. Simvastatin ine njodzi yakakwira yekurwadziwa kwemhasuru kana kushaya simba pane atorvastatin, kunyanya pamadosi epamusoro. Iyo yekutsanangura chiremba ichaona inonyanya kushanda statin pane kesi-ne-kesi hwaro.
Ndinogona here kushandisa atorvastatin kana simvastatin ndichiri nepamuviri?
Atorvastatin uye simvastatin haifanire kushandiswa panguva yekuzvitakura. Cholesterol mazinga anogona kuwedzera panguva yekuzvitakura uye anodikanwa kutsigira ari kukura fetus. Naizvozvo, hapana chakanakira kutora aya masisitimu panguva yekuzvitakura. Izvo zvinogona zvakare kukonzera fetus kukuvara panguva yekuzvitakura.
Ndinogona here kushandisa atorvastatin kana simvastatin nedoro?
Maererano ne nyanzvi dzezvepfungwa , kunwa doro zvine mwero kunowanzo chengeteka nekushandisa statin. Kunyanyisa kunwa doro izvo zvakakonzera kuchiropa chirwere ndipo panogona kumuka matambudziko. Chiropa enzymes inofanirwa kuongororwa mukati mekurapa ne statin.
Ndeipi statin ine hushoma huwandu hwemhedzisiro?
Statins inowanzo chengeteka ine mashoma madambudziko emhedzisiro. Sekureva kweAmerican Heart Association (AHA), iwo mabhenefiti eema statins zvinopfuura ngozi ingangoitika yemhedzisiro. Zvisinei, mamwe ma statins, akadai se pravastatin uye fluvastatin , inogona kuve nenjodzi yakaderera ye myalgia kupfuura simvastatin uye atorvastatin. Inofananidzwa nema statins akapihwa mumadosi epasi, akanyanya-madhizaini ma statin anogona kukonzeresa mhedzisiro. Semuenzaniso, iyo 80 mg dose ye simvastatin ine njodzi huru yekukonzera myalgia. Neichi chikonzero, iyo FDA inoganhurira iyi dhivhaiti ye simvastatin chete kune vamwe vanhu.
Ndeapi marefu-nguva mhedzisiro mhedzisiro yeatorvastatin?
Yakareba-nguva mhedzisiro mhedzisiro ye statin kurapa inogona kusiyana zvichienderana nemunhu. Nguva refu mhedzisiro yematemu inogona kusanganisira kurwadziwa kwemhasuru, kukuvara kwechiropa, kuwedzerwa shuga yeropa, uye matambudziko ekurangarira. Nekudaro, njodzi yemhedzisiro-yenguva refu mhedzisiro inoonekwa yakaderera kana mushonga wacho uchinge warayirwa uye uchiitwa mushe.
Atorvastatin yakaipa kune itsvo dzako here?
Muyero weatorvastatin haudi kugadziriswa mune avo vane matambudziko eitsvo. Mune vamwe vanhu vane dambudziko rakakomba reitsvo, kushandiswa kweatorvastatin kunogona kuda kuongororwa.
Kazhinji, atorvastatin haina njodzi kune itsvo. Nekudaro, kushandisa atorvastatin kunogona kutungamira kune yakawedzera njodzi ye rhabdomyolysis, iyo inogona kuzotungamira kukundikana kwetsvo kukundikana mumatambudziko akakomba. Taura nachiremba wako kana uine nhoroondo yeitsvo matambudziko usati watanga pane statin drug.
