The drug Torvakard: instructions for use and special instructions for admission

What is the drug Torvacard?

Torvacard is a synthetic lipid-lowering drug. The active ingredient is atorvastatin. The drug is available in tablets of 10, 20, 40 mg.

The drug belongs to the group of III generation HMG-CoA reductase inhibitors, which are capable of reversibly reducing the activity of the main enzyme required for intracellular cholesterol (CS) production, thereby limiting the rate of its formation.

Normalization of plasma concentration occurs due to:

• competitive inhibition of the activity of the HMG-CoA reductase enzyme in liver cells and a decrease in the production of endogenous cholesterol;
• increasing the number of low density lipoprotein (LDL) receptors on the hepatocyte membrane, which enhances the sorption and utilization of LDL;

Additional vascular actions of Torvacard:

• increased resistance of the endothelium to damage;
• stabilization of atherosclerotic plaque;
• reduction of inflammatory processes;
• reducing the risk of blood clots;
• improvement of the processes of differentiation, neovascularization and vascular reendothelialization;
• improvement of the vasodilating function of the endothelium of the vascular wall, anti-ischemic effect.

Changes in the lipid composition of blood plasma during treatment with Torvakard:

• lowering the total level of cholesterol and LDL cholesterol;
• an increase in the concentration of cholesterol in HDL;
• decrease in triglyceride (TG) levels.

What are the indications for its use?

Torvacard tablets are used in the complex therapy of cardiac diseases and pathology of cholesterol and lipid metabolism.

Indications for use of Torvakard:

1. Hypercholesterolemia;
2. Hyperlipidemia;
3. Hypertriglyceridemia;
4. Familial hypercholesterolemia;
5. Primary dysbetalipoproteinemia;
6. Prevention of ischemic heart disease;
7. Primary and secondary prevention of cardiovascular accidents (myocardial infarction, angina pectoris);
8. Reducing the risk of stroke, transient ischemic attack in patients with cerebral atherosclerosis;
9. Prevention of different localization of atherosclerosis;
10. As part of complex therapy:

• acute myocardial infarction (AMI);
• diabetes mellitus;
• arterial hypertension;
• ventricular rhythm disturbances;
• Alzheimer's disease;
• deep vein thrombosis;
• dissolving cholesterol stones, reducing the saturation of stones in the gallbladder.

Methods of use and dosage of the drug

It is rational to use statins in long courses, trying to use the minimum doses that cause a therapeutic effect for a particular pathology. The selection of the dose is strictly individual for each case.

Instructions for using Torvacard:

• It is recommended to start with a dosage of 10-20 mg / day;
• The entire dose can be taken at one time in the evening without mixing with food;
• In severe cases, up to 80 mg of Torvacard is prescribed as much as possible;
• For children under 12 years of age, the maximum dose may not exceed 10 mg;
• It is worth adjusting the dosage every month (under the control of the lipid profile).

What are the contraindications to the use of Torvacard?

Contraindications:

• individual intolerance to the components of the drug;
• liver pathology in the active phase;
• three-fold persistent increase in hepatic transaminases of unknown origin;
• severe hepatic, renal failure;
• cirrhosis of the liver;
• pregnancy and lactation;

There is also a list of drugs, the combination of which with Torvacard increases the likelihood of rhabdomyolysis:

• Cyclosporine;
• Protease inhibitors for the treatment of hepatitis C and antiretroviral therapy;
• Clarithromycin;
• Intraconazole;
• Colchicine.

Possible side reactions:

• Dyspepsia, nausea;
• Flatulence, abdominal pain, stool disorders;
• Decreased appetite
• Cholestatic jaundice, reactive hepatitis;
• Transient increase in transferases;
• Migraine, sleep disorders;
• Paresthesia, convulsions;
• Arthralgia, muscle pain;
• Myopathy, rhabdomyolysis, increased creatine phosphokinase;
• Scabies;
• Decreased libido;
• Thrombocytopenia
• Allergic reactions;
• Alopecia;
• Hyperglycemia.

It is worth remembering that the simultaneous use of Torvacard and drugs-inhibitors of cytochrome P450 increases the risk of developing myopathies.

Torvacard increases the plasma concentration of Digoxin, which requires dose adjustment. Also, the drug potentiates the action of indirect anticoagulants, which can increase the risk of bleeding.

Drug compatibility with alcohol

Alcohol is not recommended in conjunction with taking any drugs, including Torvacard. The area of ​​action of a statin is liver cells. The simultaneous use of alcoholic beverages increases the risk of toxic damage to hepatocytes, the development of hepatitis, and fibrotic processes. Additionally, the product is able to enhance the manifestation of side effects from the use of the drug. By itself, alcoholism affects the lipid profile of blood plasma, reducing the concentration of HDL, without changing the amount of LDL. Abuse aggravates the course of ischemic heart disease, atherosclerosis, hypertension and worsens further prognosis.

What analogs of Torvacard are present on the Russian market?

Today, there are many generics (substitutes), which, due to their low cost, have great availability. Generics are official copies of the original drug with bioequivalence close to it. The affordable price is explained by the fact that for the release on the market of copies of a drug under a different name, but with the same active ingredient, the company does not include funding for clinical trials in the cost price. A tangible disadvantage of "fakes" is the inferior quality of the raw materials used and, therefore, lower efficiency in relation to the original. Often, the manufacturer does not verify the pharmacological and therapeutic equivalence of the drug. Also, budget generics have the highest percentage of adverse reactions.

Cheap analogues of Torvacard:

• Atorvastatin (domestic production);
• Lipoford;
• Atomax;
• Newsstat;
• Atokord;
• Vasator;
• Newsstat;
• Torvas.

Atorvastatin-Teva (Israel), Atoris (Krka, Slovenia), Liprimar (Pfizer, USA) and Tulip (Sandoz, Switzerland) are absolutely identical to Torvacard in all properties and have the highest therapeutic effect among all analogues, but their cost is corresponding.

Does Crestor have advantages over Torvakard?

Crestor belongs to the same group of lipid-lowering agents as Torvakard, but has a number of differences.

Comparative characteristics of drugs.

From the table it follows that Crestor:

• Easier to dissolve in blood plasma (increases its bioavailability);
• Food intake does not reduce absorption;
• Optimal plasma concentration is maintained longer;
• The liver does not participate in the processes of biotransformation and elimination of the drug (the load on hepatocytes decreases);
• The fastest normalization of cholesterol with a lower dosage of the drug.

The disadvantages of the Crestor are:

• Its highest cost is comparable to Torvakard;
• Limited intake in patients with renal dysfunction;
• Increased exposure of the drug in persons of the Mongoloid race (therapy with lower doses is necessary).

Conclusions

Torvacard is an effective and affordable drug for lowering cholesterol. This medicine can only be taken as directed by the attending physician under the control of the lipid profile. In patients with concomitant obesity, the use of Torvacard is preferable, since, due to the peculiarities of pharmacokinetics, it is able to further reduce the level of free triglycerides.

To successfully lower cholesterol, statin therapy must be combined with lifestyle modification and dietary therapy. Compliance with a low-fat and high-fiber diet contributes to the speedy normalization of cholesterol levels, a decrease in the therapeutic dose of the drug, which, therefore, reduces the cost of treatment. Before using Torvacard, you need to read its description.