Liprimar is produced in the form of film-coated tablets: white, elliptical, on a break - a white core, with an engraving on two sides depending on the dosage - “10” and “PD 155” / “20” and “PD 156” / “ 40 "and" PD 157 "/" 80 "and" PD 158 "(10 and 20 mg each - 10 pieces in blisters, 3 and 10 blisters in a carton box, 7 pieces in blisters, 2 blisters in carton box, 40 and 80 mg - 10 pieces in blisters, 10 blisters in a cardboard box, 7 pieces in blisters, 2 or 4 blisters in a cardboard box).
The composition of 1 tablet includes:
- Active ingredient: atorvastatin - 10, 20, 40 or 80 mg (as calcium salt),
- Auxiliary components: calcium carbonate - 33/66/132/264 mg, microcrystalline cellulose - 60/120/240/480 mg, lactose monohydrate - 32.8 / 65.61 / 131,22 / 262.44 mg, croscarmellose sodium - 9/18/36/72 mg, polysorbate 80 - 0.6 / 1.2 / 2.4 / 4.8 mg, hyprolosis - 3/6/12/24 mg, magnesium stearate - 0.75 / 1.5 / 3/6 mg,
- Film coating: Opadry white YS-1-7040 (hypromellose - 66.12%, polyethylene glycol - 18.9%, titanium dioxide - 13.08%, talc - 1.9%) - 4.47 / 8.94 / 17 , 88 / 35.76 mg, simethicone emulsion (simethicone - 30%, stearic emulsifier - 0.075%, sorbic acid, water) - 0.03 / 0.06 / 0.12 / 0.24 mg, candelilla wax - 0, 08 / 0.16 / 0.32 / 0 mg.
Atorvastatin is a selective competitive inhibitor of HMG-CoA reductase, which is a key enzyme that converts 3-hydroxy-3-methylglutaryl-CoA to mevalonate, the precursor of steroids, including cholesterol. Liprimar belongs to the lipid-lowering drugs of synthetic origin.
The use of atorvastatin in patients with mixed dyslipidemia, non-familial forms of hypercholesterolemia, as well as heterozygous and homozygous familial hypercholesterolemia leads to a decrease in plasma levels of triglycerides (TG), very low-density lipoprotein cholesterol (XC-VLDL), apropopopol, and apolipopic cholesterol (low-density lipoprotein cholesterol). low density lipoprotein cholesterol (LDL-C) and total cholesterol (cholesterol). Also, when taking Liprimar increases the concentration of high-density lipoprotein cholesterol (HDL-C).
Atorvastatin inhibits the production of cholesterol in the liver, inhibits HMG-CoA reductase and increases the number of hepatic LDL receptors on the outer shells of cells, which causes an increase in the capture and catabolism of LDL-C, and LDL-LDL in plasma.
Liprimar reduces the number of LDL particles and inhibits the production of LDL-C, leads to a pronounced and persistent increase in the activity of LDL-receptors, combined with favorable qualitative transformations of LDL-particles, and also reduces the level of LDL-C in patients with homozygous familial hypercholesterolemia of hereditary etiology, resistant treatment with other lipid-lowering drugs.
When taken in the dose range of 10–80 mg, atorvastatin reduces the TG concentration by 14–33%, apo-B - by 34–50%, LDL-C - by 41-61% and cholesterol - by 30-46%. The results of treatment are almost the same in patients with non-familial forms of hypercholesterolemia, heterozygous familial hypercholesterolemia and mixed hyperlipidemia, including patients with type 2 diabetes.
In patients with isolated hypertriglyceridemia, the active ingredient Liprimara reduces the levels of TG, apo-B, LDL-C, LDL-C and LDL-C and total cholesterol and increases the level of HD-C. In patients with dysbetalipoproteinemia when taking Liprimar, the concentration of cholesterol of intermediate density lipoproteins (CHD-LLP) decreases.
In patients with type IIa and IIb hyperlipoproteinemia, in accordance with the Fredrickson classification with atorvastatin therapy (dose range 10–80 mg), the concentration of HDL-C HDL increases on average by 5.1–8.7% compared with the initial value, and this effect does not is dose dependent. The ratios of cholesterol-LDL / cholesterol-HDL and total cholesterol / cholesterol-HDL decreases significantly (the decrease is determined by the dose of Liprimar) by 37–55% and 29–44%, respectively. Atorvastatin 80 mg reliably reduces the risk of ischemic complications and reduces mortality by 16% after completing a 16-week course of treatment, and the risk of repeated hospitalization associated with angina, which is accompanied by signs of myocardial ischemia, decreases by 26% according to research results , there is a decrease in the severity of symptoms of myocardial ischemia during intensive lipid-lowering therapy (MIRACL). In patients with different initial levels of LDL-C, patients with unstable angina and myocardial infarction without a Q wave, regardless of gender (men and women) and age (younger and older than 65 years), atorvastatin reliably reduces the risk of ischemic complications and mortality. Reducing the concentration of cholesterol-LDL in plasma shows a better correlation with the dose of Liprimar than with the concentration of its active component in the blood plasma. The dose should be selected taking into account the clinical action.
The therapeutic effect of the use of Liprimara is registered 2 weeks after the start of treatment, reaches a peak after 4 weeks and lasts for the entire course of therapy.
In patients with arterial hypertension and three or more risk factors, taking atorvastatin in a dose of 10 mg reduces the risk of nonfatal (fatal) heart attacks compared with placebo. The results of the Anglo-Scandinavian study on the outcome of heart disease (ASCOT-LLA) are known, according to which the administration of Liprimar at a dose of 10 mg reduces the risk of certain complications as follows:
- stroke (non-fatal / fatal) - by 26%,
- coronary complications (nonfatal myocardial infarction and coronary heart disease, accompanied by fatal outcome) - by 36%,
- general cardiovascular complications - by 29%,
- general cardiovascular complications and revascularization procedures - by 20%.
According to a study on atorvastatin in patients with type 2 diabetes mellitus (CARDS), the use of Liprimar in patients with this disease reduces the risk of cardiovascular complications, regardless of age and gender or the initial concentration of LDL-C, as follows:
- stroke (non-fatal / fatal) - by 48%,
- painless myocardial ischemia, nonfatal (fatal) myocardial infarction - by 42%,
- major cardiovascular events (stroke, revascularization procedures, silent myocardial ischemia, non-fatal and fatal myocardial infarction, percutaneous transluminal coronary angioplasty, death as a result of acute ischemic heart disease, coronary artery bypass, unstable angina) - 37%.
A study of the effects of intensive lipid-lowering therapy on the reversal of coronary atherosclerosis (REVERSAL) showed that in patients with coronary heart disease, atorvastatin in a daily dose of 80 mg causes a decrease in total atheroma by 0.4% after 1.8 months of treatment.
Assigning atorvastatin at a daily dose of 80 mg reduces the risk of nonfatal (fatal) stroke in patients who have undergone a transient ischemic attack or stroke with no coronary heart disease in history, by 16% compared with a placebo in accordance with the results of a study of prevention of stroke with an intense decrease in cholesterol (SPARCL). This significantly reduces the risk of major cardiovascular complications and the need for revascularization procedures. Reducing the risk of cardiovascular disorders during treatment with atorvastatin is observed in all groups of patients, except for the one that included patients with primary or repeated hemorrhagic stroke.
In patients with coronary heart disease, taking Liprimar at a dose of 80 mg compared with a dose of 10 mg reliably reduces the risk of complications as follows (according to the results of the TNT treatment study to achieve new target lipid concentrations):
- documented angina - by 10.9%,
- cardiovascular complications (nonfatal myocardial infarction and coronary heart disease accompanied by a fatal outcome) - by 8.7%,
- coronary artery bypass surgery or other revascularization procedures - by 13.4%,
- non-fatal myocardial infarction, not due to the procedure - by 4.9%,
- hospitalization associated with congestive heart failure - by 2.4%,
- nonfatal (fatal) stroke - by 2.3%.
Forms of release and composition
The drug is available in tablets, enteric-coated film. The dosage unit contains 10 mg of atorvastatin calcium as the active compound. For rapid absorption and increased bioavailability of the tablet included additional substances:
- microcrystalline cellulose,
- magnesium stearate,
- milk sugar,
- sodium croscarmelose,
- calcium carbonate.
The tablets include microcrystalline cellulose, magnesium stearate, milk sugar, giprolloza, croscarmelose sodium, calcium carbonate.
The film coating contains candelil wax, hypromellose, polyethylene glycol, talc, emulsion simethicone, titanium dioxide. On white tablets of elliptical shape is engraved "PD 155" and the dose of the active substance.
Liprimar belongs to the class of lipid-lowering drugs. The active substance atorvastatin is a selective blocker of HMG-CoA reductase - the main enzyme necessary for the transformation of 3-hydroxy-3-methylglutaryl-coenzyme into mevalonate.
In the presence of a hereditary form of hypercholesterolemia (increased cholesterol), mixed dyslipidemia, the active ingredient Liprimar will help reduce the plasma concentration of total cholesterol (Xc), apolipoprotein B, VLDL and LDL (low density lipoprotein) and the amount of triglycerides. Atorvastatin causes an increase in high-density lipoprotein (HDL).
The mechanism of action is due to the suppression of the activity of HMG-CoA reductase and the inhibition of the formation of cholesterol in hepatocytes.
Atorvastatin can increase the number of low-density lipoprotein receptors on the outer surface of the liver cell membrane, which leads to an increase in the uptake and destruction of LDL.
The drug is able to increase the number of low-density lipoprotein receptors on the outer surface of the liver cell membrane.
The active compound reduces the synthesis of LDL cholesterol and the amount of harmful lipoproteins, thereby increasing the activity of LDL receptors. In patients with homozygous hereditary hypercholesterolemia resistant to the effects of lipid-lowering drugs, indicators of LDL units decrease. The therapeutic effect is observed within 2 weeks after the start of drug therapy. The maximum effect was recorded after a month of treatment with Liprimar.
After oral administration, the tablets do not dissolve under the action of hydrochloric acid in the stomach, falling into the proximal part of the jejunum. In this part of the digestive tract, the film coat is hydrolyzed.
The tablet is split, nutrients and medicinal substances begin to be absorbed through special microvilli.
Atorvastatin from the intestinal wall enters the bloodstream, where it reaches its maximum in plasma in 1-2 hours. In women, the concentration of the active substance is 20% higher than in men.
After oral administration, the tablets do not dissolve under the action of hydrochloric acid in the stomach.From the intestinal wall Liprimar 10 enters the bloodstream.
The active substance of the drug is associated with albumin by 98%, because of which hemodialysis is ineffective.
Bioavailability reaches 14-30%. Low rates are due to atorvastatin wall metabolism in the mucous membranes of the intestinal tract and transformation in the liver cells by the cytochrome CYP3A4 isoenzyme. The active substance is associated with albumin by 98%, because of which hemodialysis is ineffective. The half-life reaches 14 hours. The therapeutic effect lasts for 20-30 hours. Through the urinary system, atorvastatin leaves the body slowly - in urine after a single dose, only 2% of the received dose is detected.
Indications for use
The drug is used in medical practice for the treatment of:
- primary hypercholesterolemia hereditary and non-hereditary nature,
- increased endogenous levels of triglycerides, resistant to diet therapy,
- homozygous hypercholesterolemia of the hereditary form with low effectiveness of diets and other non-drug methods of treatment,
- combined type of hyperlipidemia.
The drug is prescribed as a measure of prevention of heart disease in patients with no signs of coronary heart disease, but with risk factors: old age, bad habits, high blood pressure, diabetes. At risk are people with a predisposition to hypercholesterolemia and with low HDL.
The drug is prescribed as a measure to prevent heart disease.
The drug is used as an adjunct to diet in the development of dysbetalipoproteinemia. Liprimar is used as a means of preventing the development of complications in patients with myocardial ischemia to reduce the risk of death, heart attack, stroke and hospitalization for angina pectoris.
- Active liver disease or increased serum transaminase activity (more than 3 times compared with the upper limit of normal) of unknown etiology,
- Age up to 18 years (due to the lack of clinical data on the safety and effectiveness of Liprimar for this age group of patients),
- Pregnancy and lactation,
- Hypersensitivity to the drug.
Relative (Liprimar should be prescribed with caution):
- Alcohol abuse,
- Instructions in the history of liver disease.
During therapy, women of reproductive age need to use adequate methods of contraception.
Instructions for use Liprimara: method and dosage
Before starting Liprimar, it is necessary to try to achieve control of hypercholesterolemia with the help of diet, physical exertion and weight loss in patients with obesity, as well as therapy of the underlying disease.
When prescribing the drug, the patient should be advised to observe the standard cholesterol-lowering diet during the entire course.
Liprimar is taken orally, once a day, regardless of the meal and the time of day.
Depending on the initial content of Xc-LDL, the purpose of treatment and individual response, the dose can vary from 10 mg to 80 mg (maximum).
At the beginning of therapy and / or during the dose increase every 2–4 weeks, plasma lipids should be monitored and, accordingly, dose adjustment should be carried out.
For most patients, the daily dose of Liprimar with combined (mixed) hyperlipidemia and primary hypercholesterolemia is 10 mg. As a rule, the therapeutic effect is manifested for 14 days, reaching a maximum within a month. With prolonged therapy, the effect is preserved.
For homozygous familial hypercholesterolemia, liprimar is prescribed at a daily dose of 80 mg.
Patients with liver failure reduce the dose of the drug under the constant control of the activity of aspartate aminotransferase and alanine aminotransferase.
Functional disorders of the kidneys do not have any effect on atorvastatin plasma levels or the degree of decrease in the level of LDL-LDL, therefore dose adjustment is not required for such patients.
With simultaneous administration with cyclosporine, the maximum dose of Liprimar is 10 mg.
As a rule, Liprimar is well tolerated, the resulting violations are transient and easy in nature.
The following side effects may develop during therapy (≥1% - often, ≤1% - infrequently):
- Central nervous system: often - headache, insomnia, asthenic syndrome, rarely - peripheral neuropathy, dizziness, malaise, paresthesia, amnesia, hypesthesia,
- Digestive system: often - constipation, dyspepsia, nausea, abdominal pain, diarrhea, flatulence, infrequently - anorexia, vomiting, pancreatitis, hepatitis, cholestatic jaundice,
- Musculoskeletal system: often - myalgia, infrequently - myopathy, back pain, muscle cramps, arthralgia, myositis, rhabdomyolysis,
- Blood system: infrequently - thrombocytopenia,
- Metabolism: infrequently - hyperglycemia, hypoglycemia, increased serum creatine phosphokinase levels,
- Allergic reactions: infrequently - toxic epidermal necrolysis (Lyell's syndrome), skin rash, urticaria, pruritus, bullous rash, anaphylactic reactions, erythema multiforme exudative (including Stevens-Johnson syndrome),
- Other: infrequently - fatigue, peripheral edema, impotence, weight gain, tinnitus, chest pain, secondary renal failure, alopecia.
Signs of an overdose of atorvastatin are increased side effects.
If necessary, symptomatic therapy, monitoring of creatine phosphokinase activity, and regular liver function tests are recommended. Since the active substance is actively involved in the processes of binding to plasma proteins, the use of hemodialysis for its elimination is considered ineffective.
The specific antidote of atorvastatin is unknown.
After using Liprimara, a moderate increase in the serum activity of alanine aminotransferase and aspartate aminotransferase, a persistent increase in the serum level of hepatic transaminases (without the development of jaundice or other clinical manifestations) can be observed. When the dose is reduced, the drug is withdrawn (temporary or complete), the activity of hepatic transaminases usually returns to its original level. In most cases, patients can continue therapy at a reduced dose without any clinical consequences.
Indicators of liver function must be monitored before the start of treatment, 6 and 12 weeks after starting Liprimar or after increasing the dose, as well as throughout the course of therapy.
The drug is canceled with a marked increase in the activity of creatine phosphokinase, in the presence of a suspected or confirmed myopathy. When prescribing Liprimar at the same time as immunosuppressants, fibrates, erythromycin, antifungal drugs (azoles) or nicotinic acid in lipid-lowering doses, it must be borne in mind that this increases the likelihood of myopathy. It is necessary to regularly monitor the condition of patients to identify weakness or pain in the muscles, especially during the first months of therapy and during periods of increasing doses of any drug. If necessary, the combination therapy should consider the use of these drugs in lower initial and maintenance doses.
When using Liprimar, rare cases of rhabdomyolysis with acute renal failure due to myoglobinuria are described. If signs of possible myopathy appear or there are risk factors for renal failure on the background of rhabdomyolysis (for example, in severe acute infection, hypotension, trauma, metabolic, endocrine and electrolyte abnormalities and uncontrolled convulsions, extensive surgical intervention is performed), it is recommended that therapy be completely canceled or temporarily interrupted .
If unexplained weakness or muscle pain occurs, especially if they are accompanied by fever or malaise, you should consult with a specialist.
Impact on the ability to drive motor vehicles and complex mechanisms
There is no information about the effect of Liprimar on the ability to drive vehicles and perform potentially hazardous types of work requiring increased concentration and immediate psychomotor reactions. However, due to the possibility of dizziness, care must be taken when practicing the above activities.
Use during pregnancy and lactation
During the course of therapy, women of reproductive age who are taking Liprimar should use reliable contraception. The purpose of the drug is contraindicated in patients who are not protected from pregnancy. There is information about rare cases of congenital anomalies after intrauterine exposure to HMG-CoA reductase inhibitors (statins) on the fetus. Animal studies confirm the presence of toxic effects on fertility.
It is unacceptable to appoint Liprimar to nursing mothers, because reliable information on the penetration of atorvastatin into breast milk is missing. If necessary, the use of the drug during lactation should cancel breastfeeding, in order to avoid increasing the risk of undesirable effects in infants.
Use in childhood
In pediatric practice, it is contraindicated to use Liprimar for the treatment of children and adolescents under the age of 18 years, due to the lack of clinical data on the effectiveness and safety of therapy in this age group. The exception is the treatment of heterozygous familial hypercholesterolemia, in which the use of atorvastatin in children from 10 years of age is indicated.
With abnormal liver function
It is contraindicated to take the drug to patients with liver diseases in the active phase, as well as with an increase in the activity of hepatic transaminases of unclear genesis in the blood plasma by more than 3 times compared with the upper limit of normal.
Liprimar is prescribed with caution to patients with a history of liver disease and / or alcohol abuse.
Use in old age
With the use of Liprimar in elderly patients, no differences in safety and efficacy compared with the general population have been identified, so there is no need for dose adjustment.
Since over the age of 70 years increases the risk of rhabdomyolysis, Liprimar should be used with caution.
With the simultaneous use of Liprimar with some drugs, the following effects may occur:
- Cyclosporine, fibrates, erythromycin, clarithromycin, antifungal drugs (azoles derivatives) and nicotinic acid in lipid-lowering doses: an increased risk of myopathy,
- Inhibitors of CYP3A4 isoenzyme: increase in plasma atorvastatin concentration,
- OATP1B1 inhibitors (for example, cyclosporin): an increase in the bioavailability of atorvastatin,
- Erythromycin, clarithromycin, CYP3A4 inhibitors, diltiazem, grapefruit juice: an increase in plasma atorvastatin concentrations,
- Itraconazole: an increase in the AUC value (total concentration of a substance in the blood plasma) of atorvastatin,
- Inductors of cytochrome CYP3A4 isoenzyme: decrease in plasma atorvastatin concentration,
- Colestipol: a decrease in plasma atorvastatin concentration, however, the lipid-lowering effect of the combination of drugs exceeds that of each of them separately,
- Digoxin: an increase in its concentration when taking Liprimar in high doses (control of the condition of patients is necessary),
- Oral contraceptives containing norethisterone and ethinyl estradiol: an increase in the AUC of these substances.
Analogs of Liprimara are: Atorvastatin, Atorvastatin-Teva, Atoris, Liptonorm, Torvakard, Atorvoks, Tribestan, Krestor.
The drug is often prescribed to patients suffering from various disorders in the functioning of the cardiovascular system. There are a variety of reviews about Liprimar, in particular, many patients report a high efficacy of treatment. However, some patients do not quite correctly understand how to take the drug due to insufficient clarification of the treatment regimen by the doctor. Therefore, they are trying to independently select or adjust the dose of atorvastatin, which leads to undesirable side effects (bruising and bruising, blood thinning, etc.).
Specialists believe Liprimar one of the most effective drugs, subject to precise adherence to the dosage and duration of therapy. They also advise during exercise to do feasible exercise, follow a diet and regularly do a blood test.
How to take Liprimar 10
Tablets are prescribed for ingestion, regardless of the time of day and food intake. Drug therapy is carried out only with the ineffectiveness of cholesterol-lowering diet, weight loss measures against the background of morbid obesity, exercise. If the increase in cholesterol level is caused by the main disease, before using Liprimar you should try to eliminate the main pathological process. During the whole drug therapy, you need to follow a special diet.
Drug therapy with Liprimar 10 is carried out only with the ineffectiveness of the cholesterol-lowering diet.
The daily dosage is 10-80 mg for single use and is adjusted depending on the indicators of Xc-LDL and the achievement of therapeutic effect.
The maximum allowable dosage is 80 mg.
During Liprimar treatment, plasma lipid concentrations should be monitored every 2–4 weeks, after which you should consult your doctor about changes in dosing regimen.
To eliminate the mixed form of hyperlipidemia, it is necessary to take 10 mg once a day, while homozygous hereditary hypercholesterolemia requires a maximum therapeutic dose of 80 mg. In the latter case, the level of cholesterol is reduced by 20-45%.
Taking the drug in diabetes
Patients suffering from diabetes should be careful when hypercholesterolemia occurs. Such people are at risk of developing coronary heart disease. Liprimar is used as a measure to prevent myocardial infarction. The dosage is established by the attending physician, depending on the level of cholesterol.
Patients suffering from diabetes should be careful when hypercholesterolemia occurs.
Central nervous system
Negative reactions in the nervous system are manifested as:
- general malaise,
- asthenic syndrome,
- headache and dizziness,
- decrease and complete loss of sensitivity
- peripheral nervous system neuropathy,
On the part of the respiratory system
Perhaps the appearance of shortness of breath.
With a tendency to the manifestation of anaphylactic reactions may appear rash on the skin, redness, itching, exudative erythema, necrosis of the subcutaneous fat layer. In severe cases, angioedema and anaphylactic shock develop.
Prem of the drug in question may cause a rash on the skin.
Compatibility with alcohol
The drug should not be mixed with alcohol. Ethyl alcohol inhibits the central nervous, hepatobiliary and circulatory system, and therefore decreases the cholesterol-lowering effect of Liprimar. Increases the likelihood of atherosclerotic plaque formation on the vessel walls.
The drug should not be mixed with alcohol.
Combination not recommended
Due to the risk of neuromuscular pathologies, parallel administration of Liprimar with:
- cyclosporine antibiotics,
- nicotinic acid derivatives,
- antifungal drugs
Parallel administration of Liprimar and Erythromycin is not recommended.
Such drug combinations can lead to myopathy.
It is recommended to be careful while using Liprimar with other pharmaceuticals:
- Atorvastatin is able to increase the AUC of oral contraceptives by 20-30%, depending on the hormones contained in the preparations.
- Atorvastatin dosage of 40 mg in combination with 240 mg Diltiazem leads to an increase in plasma concentration of atorvastatin in the blood. When receiving 200 mg of Itraconazole with 20-40 mg of Liprimar, an increase in atorvastatin AUC was observed.
- Rifampicin reduces plasma atorvastatin levels.
- Colestipol causes a decrease in the cholesterol-cholera drug in plasma.
- With combination therapy with Digoxin, the concentration of the latter is increased by 20%.
Grapefruit juice inhibits the action of cytochrome CYP3A4 isoenzyme, which causes an increase in the plasma concentration of atorvastatin when using more than 1.2 liters of citrus juice per day. A similar effect is observed when taking inhibitors of CYP3A4 (Ritonavir, Ketoconazole).
The use of the drug Liprimar 10 pregnant women are prohibited.
Use during pregnancy and lactation
To use the drug in pregnant women is prohibited, because there is a risk of a violation of the correct tissue and organ placement during embryonic development. There are no data on Liprimar's ability to penetrate the hemato-placental barrier.
During drug therapy, breastfeeding should be discontinued.
Substitutes with a similar effect include:
Replacement is carried out after medical consultation.
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Dosing and Administration
Before prescribing Liprimar, it is necessary to achieve control of hypercholesterolemia by treating the underlying disease, as well as other non-pharmacological methods (diet, exercise and weight loss in patients with obesity).
During drug therapy, the patient is advised to follow a standard cholesterol-lowering diet.
Liprimar is intended for ingestion regardless of the time of day and food intake.
The dose varies from 10 to 80 mg once a day. Dose selection is carried out taking into account the initial content of low-density lipoprotein cholesterol (Xc-LDL), individual effect and treatment goals. The maximum daily dose is 80 mg once.
At the beginning of therapy, as well as with increasing doses, it is necessary every 2-4 weeks to determine the concentration of lipids in plasma, and taking into account the data obtained, adjust the dose.
With a mixed (combined) hyperlipidemia and primary hypocholesterolemia, the dose of Liprimar for most patients is 10 mg once a day. The therapeutic effect is manifested during the first two weeks and reaches a maximum by the 4th week of treatment. With prolonged therapy, the effect is maintained.
Patients with homozygous familial hypercholesterolemia Liprimar prescribed at a dose of 80 mg once a day (the level of LDL-C decreases by 18-45%).
With impaired renal function and in the elderly, dose adjustment is not required.
In hepatic insufficiency, the dose is reduced under the constant control of the activity of the enzymes alanine aminotransferase and aspartate aminotransferase.
With simultaneous use with cyclosporine dose Liprimara should not exceed 10 mg per day.