During treatment class of andriol tcagents drugs and concomitant use of cyclosporine, fibrates, erythromycin, clarithromycin, immunosuppressive and anti-fungal drugs (belonging to azoles), nicotinic acid and nicotinamide, drugs inhibit metabolism mediated by cytochrome , and / or transport of drugs, atorvastatin plasma concentration (and the risk of myopathy) increases. By assigning these drugs should carefully weigh the potential benefits and risks of treatment, regularly monitor patients to detect pain or weakness in muscles, especially during the first months of treatment and during dose escalation of any drug, periodic determination activity, although such control does not prevent the development of severe myopathy.
Treatment should be discontinued in the event expressed increasingor in the presence of confirmed or suspected myopathy. Atorvastatin had no clinically significant effect on the concentration of terfenadine in the blood plasma, which is metabolized mainly by cytochrome ; therefore it seems unlikely that atorvastatin can significantly affect the pharmacokinetic parameters of other substrates isozymes of cytochrome . With simultaneous use of atorvastatin (10 mg 1 time per day) and azithromycin atovastatina plasma concentration does not change. With the simultaneous ingestion of atorvastatin and preparations containing magnesium and aluminum hydroxide, the concentration of atorvastatin boldenone acetate in plasma the blood was reduced by about 35%, but the degree of decrease in andriol tc level is not changed. in an application colestipol atorvastatin plasma concentration was reduced by about 25%. However, lipid-lowering effect of the combination of atorvastatin and colestipol than that for each drug separately. If concomitant use of atorvastatin does not affect the pharmacokinetics of phenazone, therefore, interactions with other drugs metabolized by the same cytochrome not expected. In the study of the interaction of atorvastatin with warfarin, cimetidine, phenazone signs clinically significant interactions were found. The simultaneous use of drugs to lower the concentration of endogenous steroid hormones (including cimetidine, ketoconazole, spironolactone), increases the risk of reduction of endogenous steroid hormones (be careful). There was no clinically significant adverse interaction atorvastatin and antihypertensive means, as well as estrogen. with simultaneous use of atorvastatin 80 mg / day of oral contraceptives containing norethindrone and ethinyl estradiol, showed a significant increase in the concentration of norethindrone and ethinyl estradiol is about 30% and 20% respectively. This effect should be considered when selecting an oral contraceptive for women receiving andriol tc. With the simultaneous use of atorvastatin 80 mg and amlodipine 10 mg the pharmacokinetics of atorvastatin at steady state did not change. In the re-admission of digoxin and atorvastatin 10 mg equilibrium concentration of digoxin in the blood plasma is not changed. However, the application of digoxin in combination with atorvastatin 80 mg / day, the concentration of digoxin was increased by about 20%. Patients receiving digoxin in combination with atorvastatin should be monitored. Drug interactions studies have been performed.
SPECIAL INSTRUCTIONS Before starting therapy need to try to achieve adequate hypercholesterolemia control through diet therapy, physical activity, weight loss in obese patients, and the treatment of other conditions. Use of inhibitors of HMG-CoA reductase to reduce the level of lipids in the blood can lead to changes in biochemical indices of liver function, which should be monitored before treatment and after 6 and 12 weeks after the start of ingestion and after increasing dose, and periodically, for example, every 6 months. The increased activity of “liver” enzymes in the serum can be observed during therapy with (usually in the first three months).
Patients with marked increase in the level of activity of “liver” transaminases should be controlled to the level of enzymes return to normal. In the case values more than 3 times higher than normal, it recommended reduce or discontinue medication. Treatment can cause myopathy (pain and weakness in the muscles in combination with increased activity more than 10 times compared with the upper limit of normal). Andriol tc may cause an increase in serum indicators that should be taken into consideration in the differential diagnosis of chest pain. Patients should be warned that they should immediately consult boldenone undecylenate a doctor if unexplained pain or weakness in muscles, particularly if accompanied by malaise or fever. Treatment with TORVAKARD® should suspend or abolish the appearance of signs of myopathy or possible risk factors for the development of renal insufficiency on the background of rhabdomyolysis (eg, severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine and electrolyte disorders and uncontrolled convulsions).
Effects on ability to drive and doing other types of activities that require concentration and speed of psychomotor reactions of the adverse effect tablets film-coated on the ability to drive and activity, and other activities that require concentration and speed of psychomotor reactions not reported.