Liprimar tablets p / o 20mg, No. 100

primary hypercholesterolemia (heterozygous familial and nonfamilial hypercholesterolemia (type IIa according to Frederickson);

combined (mixed) hyperlipidemia (types IIa and IIb according to Frederickson);

dysbetalipoproteinemia (type III according to Frederickson) (as an addition to the diet);

familial endogenous hypertriglyceridemia (type IV according to Frederickson), resistant to diet;

homozygous familial hypercholesterolemia with insufficient effectiveness of diet therapy and other non-pharmacological treatments;

primary prevention of cardiovascular complications in patients without clinical signs of ischemic heart disease, but having several risk factors for its development - age over 55 years, nicotine addiction, arterial hypertension, diabetes mellitus, low concentrations of HDL-C in blood plasma, genetic predisposition, incl. h against the background of dyslipidemia;

secondary prevention of cardiovascular complications in patients with coronary artery disease in order to reduce the total mortality rate, myocardial infarction, stroke, re-hospitalization for angina pectoris and the need for revascularization.

Inside, at any time of the day, regardless of food intake.

Before starting treatment with LiprimarЃ, you should try to control hypercholesterolemia with diet, exercise and weight loss in obese patients, as well as therapy for the underlying disease.

When prescribing the drug, the patient must be recommended a standard cholesterol-lowering diet, which he must adhere to during the entire period of therapy.

The dose of the drug varies from 10 to 80 mg once a day and is titrated taking into account the initial content of LDL-C, the purpose of therapy and the individual effect on the therapy.

The maximum daily dose of the drug for a single dose is 80 mg.

At the beginning of treatment and / or during an increase in the dose of LiprimarЃ, it is necessary to monitor the level of lipids in the blood plasma every 2Ц4 weeks and adjust the dose of the drug accordingly.

Primary hypercholesterolemia and combined (mixed) hyperlipidemia. For most patients - 10 mg once a day; the therapeutic effect is manifested within 2 weeks and usually reaches a maximum within 4 weeks. With prolonged treatment, the effect persists.

Homozygous familial hypercholesterolemia. In most cases, 80 mg is prescribed 1 time per day (decrease in the content of LDL-C by 18-45%).

Lack of liver function. In case of liver failure, the dose of LiprimarЃ must be reduced, with constant monitoring of the activity of hepatic transaminases AST and ALT.

Lack of kidney function. Impaired renal function does not affect the concentration of atorvastatin in the blood plasma or the degree of decrease in the level of LDL-C during therapy with LiprimarЃ, therefore, no dose adjustment is required.

Elderly patients. There were no differences in the efficacy, safety or therapeutic effect of LiprimarЃ in elderly patients compared to the general population and no dose adjustment was required (see Pharmacokinetics).

Use in combination with other drugs. If it is necessary to use it together with cyclosporine, the dose of LiprimarЃ should not exceed 10 mg (see 'Special instructions').

Recommendations for setting treatment goals

A. US National Cholesterol Education Program (NCEP) guidelines (see Table 4).

Table 4

1 Some experts recommend the use of lipid-lowering drugs that reduce LDL-C if lifestyle changes do not lead to a decrease in its content to a level of <100 mg / dL. Others prefer drugs that have a predominant effect on TG and HDL-C, such as niacin and fibrates. The physician may also postpone pharmacotherapy in this subgroup.

2 In the absence of risk factors or the presence of only one risk factor, almost all people have a 10-year risk <10%, so its assessment is not required.

If the target LDL-cholesterol content is reached, and the TG content remains? 200 mg / dl, then the secondary goal of therapy is to reduce the cholesterol content, excluding HDL-cholesterol (total cholesterol - HDL-cholesterol), to a level exceeding the target LDL-cholesterol content by 30 mg / dL in each risk category.

B. Recommendations of the European Society of Atherosclerosis

In patients with a confirmed diagnosis of coronary artery disease and in patients with a high risk of ischemic complications, the goal of therapy is to reduce the content of LDL-C to a level below 3 mmol / L (or less than 115 mg / dL) and total cholesterol to a level below 5 mmol / L (or less 190 mg / dl).

hypersensitivity to any component of the drug;

active liver disease or an increase in the activity of hepatic transaminases in the blood plasma of unknown origin by more than 3 times compared with VHN;

age up to 18 years (there is not enough clinical data on the effectiveness and safety of the drug in this age group).

Alcohol abuse with caution; history of liver disease.

Pharmacological action
Liprimar is a lipid-lowering drug. It is used to treat patients who have elevated levels of low-density lipoprotein cholesterol, total cholesterol, apolipoprotein B and triglycerides. Liprimar is used in the therapy of patients in whom diet and exercise did not allow achieving the desired therapeutic effect.
Indications
Liprimar is indicated for the treatment of patients with a homozygous hereditary form of hypercholesterolemia. In addition, the drug is prescribed to prevent the development of cardiovascular pathologies with arterial hypertension, smoking, diabetes mellitus and insufficient levels of high-density lipoproteins in the body.
Contraindications
Liprimar is not prescribed to patients who have been found to be intolerant to the drug, as well as to those who suffer from liver diseases, accompanied by increased activity of hepatic transaminases of unknown etiology. The drug cannot be administered to children under 10 years of age.
With extreme caution, the drug is prescribed to patients with alcoholism, as well as to those who suffer from any liver diseases.
Method of administration and dosage
Is taken orally, regardless of food intake. At the beginning of drug therapy, it is necessary to achieve control over hypercholesterols with diet, active exercise and weight loss in obese patients, as well as correct treatment of the underlying disease.
With Liprimar therapy, the patient is recommended a usual cholesterol-lowering diet, which he must follow throughout the entire period of treatment. When prescribing the drug, its amount can vary from 10 to 80 mg per day. The choice of the required dose of the agent takes into account the initial LDL-C. The maximum daily dose should not exceed 80 mg. In the course of treatment, the dose is adjusted every two 2 or 4 weeks while monitoring the level of lipids in the blood plasma.
Side effects
When the correct dose of Liprimar is taken, drug treatment is very rarely accompanied by the development of side effects. However, in some cases, the patient may experience paresthesias, headaches, neuropathy, flatulence, abdominal pain, nausea, pancreatitis, muscle cramps, myalgia, myositis, allergic reactions, impaired erectile function, memory impairment, dizziness, increased fatigue, peripheral edema and hemorrhagic strokes.
Overdose
When taking large doses of Liprimar, the therapeutic effect does not increase, but the risk of side effects increases. In case of an overdose of the drug, gastric lavage, the appointment of enterosorbents, drinking plenty of fluids and taking laxatives are recommended.