Torquard

Torvacard is a medicine that improves LDL cholesterol, HDL cholesterol, triglycerides and atherogenicity.

The active substance is atorvastatin. Production - the company Zentiva, Czech Republic. Thorvacard and other statins are prescribed to people who have bad cholesterol test results and high cardiovascular risk. Treatment with these drugs inhibits the development of atherosclerosis, reduces the risk of a first and repeated infarction, as well as ischemic stroke.

Compared with other drugs, Torvacard is considered a very effective tool, which is used when some analogs can not solve the problem. Including this tool is recommended for diabetes mellitus. The medicine has a positive effect on the body and heals from an increased level of cholesterol even with an hereditary form of the disease.

Clinical and pharmacological group

Lipid-lowering drug.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Torquard cost in pharmacies? The average price is at the level of300 rubles.

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Composition and form of release

Medicinal form of the release of Torvacard - tablets covered with a film sheath: on both sides convex, oval, almost white or white (10 pcs. in a blister, 3 or 9 blisters in a pack of cardboard).

Active ingredient: atorvastatin (in the form of calcium), in 1 tablet - 10, 20 or 40 mg.

Auxiliary components: low-substituted giprolase, lactose monohydrate, magnesium stearate, croscarmellose sodium, magnesium oxide, silicon dioxide colloid, microcrystalline cellulose.

Sheath composition: macrogol 6000, hypromellose 2910/5, talc, titanium dioxide.

pharmachologic effect

Torvacard is a remedy from the statin group that affects cholesterol and triglycerides in the blood. Reduces the level of total cholesterol and "bad" LDL cholesterol, blocking the activity of the enzyme HMG-CoA reductase. Reduces the concentration of total cholesterol by 30-46%, LDL by 41-61%, apolipoprotein B - by 34-50% and triglycerides by 14-33%. Increases the level of "good" HDL cholesterol and apolipoprotein A. Atorvastatin helps some patients, for whom taking other tablets from cholesterol was useless.

After taking each tablet of Torvacard, its blocking activity against the enzyme HMG-CoA reductase is maintained in the body for about 20-30 hours. The food slows the absorption of the drug, but this does not affect the effectiveness. Atorvastatin is excreted mainly with bile through the intestine. Less than 2% of the dose taken internally is determined in urine. It is not excreted during hemodialysis.

Indications for use

From what help? Torvacard is used in combination with a diet for:

Reducing the amount of cholesterol and LDL in homozygous family-type hypercholesterolemia;
Treatment of patients who have increased triglyceride levels in blood (Fredrickson type IV) and type III Fredrickson (dysetalipoproteinemia), if the diet does not produce a result;
Decreased cholesterol levels, atherogenic lipoproteins, triglycerides, apolipoprotein B and an increase in the amount of HDL with hypercholesterolemia, heterozygous and combined hypercholesterolemia (types IIa and IIb according to Fredrickson);
Treatment of heart and vascular diseases in the presence of increased factors for the onset of coronary heart disease (arterial hypertension, patients older than 55 years old, a history of stroke, albuminuria, left ventricular hypertrophy, smoking, peripheral vascular disease, IHD in the family, diabetes mellitus).

The most frequent indications for the use of Torvacard are secondary prevention of myocardial infarction, death, revascularization, stroke on the background of dyslipidemia.

Contraindications

Absolute:

pregnancy;
lactation;
age to 18 years;
hypersensitivity to the components of the drug;
lactose intolerance, lactase deficiency or glucose-galactose malabsorption;
hepatic failure (severity A and B on the Child-Pugh scale);
an increase in the activity of transaminases in the serum of unclear genesis by more than 3 times in comparison with congenital hyperplasia of the adrenal glands (VGN);
active liver disease;
reproductive age in women who do not use adequate methods of contraception.

In the following diseases / conditions, Torvacard should be used with extreme caution after evaluating the benefits and risks:

diabetes;
severe violations of the water-electrolyte balance;
alcohol abuse;
injuries;
severe acute infection (sepsis);
diseases of skeletal muscles;
epilepsy, which can not be controlled;
liver disease in history;
endocrine and metabolic disorders;
arterial hypotension;
extensive surgical interventions.

Intended use for pregnancy and lactation

Atorvastatin is contraindicated in pregnancy and lactation (breastfeeding).

Because cholesterol and substances synthesized from cholesterol are important for the development of the fetus, the potential the risk of inhibiting HMG-CoA reductase exceeds the benefit of using the drug during pregnancy. When applying lovastatin (inhibitor of HMG-CoA reductase) with dextroamphetamine in the first trimester of pregnancy There are cases of birth of children with bone deformation, tracheo-esophageal fistula, atresia of the anus. In the case of diagnosing a pregnancy during therapy with Torvacard, the drug should be stopped immediately, and the patients are warned about the potential risk to the fetus.

If it is necessary to use the drug during lactation, taking into account the possibility of undesirable phenomena in infants, it is necessary to solve the problem of stopping breastfeeding.

Use in women of reproductive age is possible only if reliable methods of contraception are used. The patient should be informed of the possible risk of treatment for the fetus.

Dosage and route of administration

As indicated in the instructions for use Torvacard should be taken orally at any convenient time of the day, regardless of meals. Prior to the appointment of the drug, the patient is recommended a standard lipid-lowering diet, which he should adhere to throughout the treatment period.

The initial dose is usually 10 mg once a day. Further, the optimal therapeutic dose is selected individually depending on the purpose of therapy, baseline levels of LDL-C and individual effect.

The highest daily dose is 80 mg in 1 dose.

Every 2-4 weeks at the beginning of therapy and during a dose increase, it is necessary to monitor the plasma levels of lipids and, if necessary, adjust the dose.

With primary hypercholesterolemia and mixed hyperlipidemia, a daily dose of 10 mg is sufficient for most patients. A significant therapeutic effect usually develops after 2 weeks, the maximum after 4 weeks. With prolonged treatment, this effect persists.

With homozygous familial hypercholesterolemia, a maximum daily dose of 80 mg may be required.

Side effects

Criteria for assessing the incidence of side effects: very often -> 1/10, often -> 1/100 to <1/10, infrequently - from > 1/1000 to <1/100, rarely from> 1/10 000 to <1/1000, very rarely - from <1/10 000, including individual messages.

Possible side effects:

central and peripheral nervous system: often - headache, fatigue; infrequently - loss or loss of memory, paresthesia, peripheral neuropathy, sleep disturbances (incl. insomnia, nightmarish dreams), drowsiness, ataxia, dizziness, hypoesthesia, depression;
allergic reactions: often - skin itching and rashes; infrequently - hives; very rarely - bullous eruptions, anaphylactic shock, angioedema edema, multiforme exudative erythema, including Stevens-Johnson syndrome and toxic epidermal necrolysis;
digestive system: often - flatulence, abdominal pain, constipation or diarrhea, vomiting, gastralgia, nausea; infrequently - pancreatitis, increased appetite or anorexia, cholestatic jaundice, hepatitis;
musculoskeletal system: very often - myalgia, arthralgia; infrequently - myopathy; rarely - back pain, myositis, calf muscle cramps, rhabdomyolysis;
laboratory parameters: infrequently - increase in the concentration of glycosylated hemoglobin, increase in serum creatine phosphokinase activity (CK), hypoglycemia, hyperglycemia, increased activity of hepatic enzymes [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)];
other: often - chest pain, peripheral edema; infrequent - secondary renal failure, malaise, weight gain, tinnitus, thrombocytopenia, alopecia, impotence.

When using some statins, the following undesirable reactions were also noted: gynecomastia, depression, sexual dysfunction, immuno-mediated necrotizing myopathy, interstitial lung disease (especially with long-term treatment), diabetes mellitus (its frequency depends on the presence / absence of risk factors, such as arterial hypertension in history, hypertriglyceridemia, body mass index more than 30 kg / m2, fasting blood glucose concentration of 5.6-6.9 mmol / l).

Overdose

Exceeding the recommended therapeutic dosage of Torvacard tablets is accompanied by a decrease in the level of systemic arterial pressure. In this case, symptomatic therapy is carried out, since there is no specific antidote for this drug.

special instructions

Before starting therapy with Torvard, it is necessary to try to achieve control of hypercholesterolemia by adequate diet therapy, increased physical activity, weight loss in obese patients and treatment of other conditions.

The use of HMG-CoA reductase inhibitors to reduce lipid levels in the blood can lead to a change in biochemical indicators that reflect liver function. The liver function should be monitored before the start of therapy, after 6 weeks, 12 weeks after the start of treatment of the drug Torvacard and after each dose increase, and also periodically (for example, every 6 months). Increased activity of hepatic enzymes in blood serum can be observed during therapy with Torvacard (usually in the first 3 months). Patients who have an elevated transaminase level should be monitored prior to returning the enzyme level back to normal. In the event that ALT or AST values are more than 3 times higher than ULN, it is recommended to lower the dose of Torvacard or stop treatment.

Treatment with the drug Torvacard can cause myopathy (pain and weakness in the muscles in combination with an increase in the activity of CKM more than 10 times compared with VGN). Torvacard can cause an increase in serum CK, which should be taken into account in the differential diagnosis of chest pain. Patients should be warned that they should immediately consult a doctor if unexplained pain or weakness in the muscles, especially if they are accompanied by malaise or fever. Therapy with Thorvacard should be temporarily discontinued or completely eliminated if there is evidence of possible myopathy or the presence of a risk factor for developing renal failure with rhabdomyolysis (eg, severe acute infection, arterial hypotension, severe surgical intervention, trauma, severe metabolic, endocrine and electrolyte disorders, and uncontrolled seizures).

Preparations of the class of statins can cause an increase in the concentration of glucose in the blood. In some patients at high risk of developing diabetes, such changes can lead to its manifestation, which is an indication for prescribing antidiabetic therapy. However, reducing the risk of vascular disease with statin use is greater than the risk of developing diabetes, so this factor should not serve as a basis for abolishing statin treatment. For patients at risk (fasting blood glucose concentration 5.6-6.9 mmol / L, BMI> 30 kg / m2, hypertriglyceridemia, arterial hypertension in a history) should be established by medical supervision and regularly monitor biochemical parameters.

Interaction with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

Use in combination with digoxin reduces the concentration of the latter by 20%.
Cimetidine, Spironolactone, ketoconazole increases the probability of a decrease in the level of steroid hormones.
Taking oral contraceptives and a daily dose of Torvacard 80 mg increases the content of ethinyl estradiol in the blood.
The joint administration of funds with aluminum hydroxide or magnesium reduces the concentration of Torvacard, but this does not affect the effectiveness.
Combination with colestipol reduces the concentration of atorvastatin, but their combined lipid-lowering effect is superior to each separately.
The use of drugs that inhibit metabolism, mediated by the enzyme CYP450, erythromycin, antifungal and immunosuppressive drugs, fibrates, cyclosporine, clarithromycin, nicotinamide, nicotinic acid, the concentration of Torvacard in the blood increases. This increases the likelihood of myopathy, so you need to monitor the level of CK in the blood.

Reviews

We offer you to familiarize yourself with the reviews of people using the drug Torvacard:

Lyudmila. Torvacard 20 mg take 4 years at night, I have diabetes, I am on insulin and hypertension 2 degree - now I have 4 years of excellent cholesterol, doctors constantly monitor the level of cholesterol and say everything is fine.
Catherine. My doctor very seriously approached the selection of the correct dosage, we very scrupulously approached it. And I drank torkacard with increased cholesterol. To drink it the truth is necessary for a long time, but the effect from it is. It just acts gradually, you have to take blood often, to track this positive effect.
Raisa. The doctor prescribed the drug in the hospital. Saw 4 days in the hospital and 4 nights did not sleep a gram, scold go and lie down and I have no sleep in one eye, already hallucinations started, then the music plays something else and no doctor said: stop drinking these pills. I figured it out myself, I left it, my sleep was fine! Has left home. A week later went to see a cardiologist, they were discharged back. I tried to drink again. For the third day I have not slept. I'll throw it to the devil's grandmother. But can someone like.