natgillin/translations-raw huggingface dataset:
Samtidig anvendelse af APTIVUS givet sammen med lavdosis ritonavir og proteasehæmmerne amprenavir, lopinavir eller saquinavir (hver i sær indgivet med lavdosis ritonavir) i en dobbelt boostet behandling resulterer i signifikante fald i plasmakoncentrationer af disse proteasehæmmere.
Concomitant use of APTIVUS, co-administered with low dose ritonavir, with the protease inhibitors amprenavir, lopinavir or saquinavir (each co-administered with low dose ritonavir) in a dual-boosted regimen, results in significant decreases in plasma concentrations of these protease inhibitors.
4. 5).
A significant decrease in plasma concentrations of atazanavir and a marked increase of tipranavir and ritonavir concentrations was observed when APTIVUS, associated with low dose ritonavir, was co-administered with atazanavir (see section 4.5).
Der foreligger på nuværende tidspunkt ingen data om interaktioner af APTIVUS givet sammen med lavdosis ritonavir med proteasehæmmere ud over dem, der er nævnt ovenfor.
No data are currently available on interactions of APTIVUS, co-administered with low dose ritonavir, with protease inhibitors other than those listed above.
Samtidig behandling med APTIVUS givet sammen med lavdosis ritonavir med proteasehæmmere anbefales derfor ikke.
Therefore, the co-administration of APTIVUS, co-administered with low dose ritonavir, with protease inhibitors is not recommended.
6 Oral antikonception og østrogener:
6 Oral contraceptives and oestrogens:
Da niveauerne af ethinyløstradiol falder, anbefales det ikke at give APTIVUS/ ritonavir samtidig.
Since levels of ethinyl oestradiol are decreased, the co- administration of APTIVUS co-administered with low dose ritonavir is not recommended.
Der skal anvendes alternativ eller yderligere antikonception, når der gives østrogenbaseret oral antikonception sammen med APTIVUS, givet sammen med lavdosis ritonavir (se pkt.
Alternative or additional contraceptive measures are to be used when oestrogen based oral contraceptives are co- administered with APTIVUS co-administered with low dose ritonavir (see section 4.5).
Kvinder, der tager østrogener, kan have en øget risiko for ikke- alvorlig udslæt.
Women using oestrogens may have an increased risk of non serious rash.
APTIVUS kan have mindre virkning, som følge af lavere tipranavir- plasmakoncentrationer hos patienter, som tager disse lægemidler samtidig.
APTIVUS may be less effective due to decreased tipranavir plasma concentrations in patients taking these agents concomitantly.
Som følge af den metaboliske profil og iboende risiko for at fremkalde torsades de pointes, kan indgivelse af halofantrin og lumefantrin med APTIVUS givet sammen med lavdosis ritonavir ikke anbefales.
Due to their metabolic profile and inherent risk of inducing torsades de pointes, administration of halofantrine and lumefantrine with APTIVUS co-administered with low dose ritonavir, is not recommended.
100 mg pr. kapsel eller op til 200 mg pr. dosis), som kan give anledning til disulfiram- lignende reaktioner, når det gives sammen med disulfiram eller andre lægemidler, som kan give denne reaktion (f. eks. metronidazol).
APTIVUS soft capsules contain alcohol (7% ethanol, ie 100 mg per capsule or up to 200 mg per dose) which can produce disulfiram-like reactions when co-administered with disulfiram or other medicinal products which produce this reaction (eg metronidazole).
Fluticason:
Fluticasone:
4. 5).
Concomitant use of APTIVUS, co-administered with low dose ritonavir, and fluticasone or other glucocorticoids that are metabolised by CYP3A4 is not recommended unless the potential benefit of treatment outweighs the risk of systemic corticosteroid effects, including Cushing's syndrome and adrenal suppression (see section 4.5).
4. 5).
APTIVUS, co-administered with low dose ritonavir, increases the plasma concentrations of atorvastatin (see section 4.5).
Andre HMG- CoA- reduktasehæmmere bør overvejes, f. eks. pravastatin, fluvastatin eller rosuvastatin.
Other HMG-CoA reductase inhibitors should be considered such as pravastatin, fluvastatin or rosuvastatin.
Men hvis atorvastatin er specifikt påkrævet ved patientbehandling, er nøje monitorering nødvendig.
However, if atorvastatin is specifically required for patient management, careful monitoring is necessary.
Omeprazole:
Omeprazole:
4- 5).
APTIVUS co-administered with low dose ritonavir decreases the plasma concentrations of omeprazole and esomeprazole (see section 4.5).
Derfor kan kombinationen af APTIVUS/ ritonavir med enten omeprazol eller esomeprazol ikke anbefales.
Therefore, the combined use of APTIVUS/ ritonavir with either omeprazole or esomeprazole is not recommended.
Hvis samtidig administration ikke kan undgås, kan det overvejes at øge dosis af enten omerprazol eller esomeprazol baseret på det kliniske respons – jf. dog med produktinformationerne for omeprazol eller esmoeprazol mht. maksimale dosisanbefalinger.
Recommendations for maximal doses of omeprazole or esomeprazole are found in the corresponding product information.
Idet Aptivus indeholder en lille mængde sorbitol bør patienter med hereditær fruktoseintolerans ikke anvende denne medicin.
Due to APTIVUS containing small amounts of sorbitol, patients with rare hereditary problems of fructose intolerance should not take this medicine.
Interaktionsprofilen for APTIVUS givet sammen med lavdosis ritonavir er kompleks og kræver særlig opmærksomhed, især i kombination med andre antiretrovirale midler.
The interaction profile of APTIVUS, co-administered with low dose ritonavir, is complex and requires special attention in particular in combination with other antiretroviral agents.
Der er kun udført interaktionsundersøgelser hos voksne.
Interaction studies have only been performed in adults.
Tipranavirs metaboliske profil:
Metabolic profile of tipranavir:
4. 2) er der en netto hæmning af P450 CYP3A.
When co- administered with ritonavir at the recommended dosage (see section 4.2) there is a net inhibition of P450 CYP3A.
Samtidig indgift af APTIVUS og lavdosis ritonavir med midler, der primært metaboliseres af CYP3A, kan resultere i ændrede plasmakoncentrationer af tipranavir eller de andre midler, som kan få ændret deres terapeutiske effekt og bivirkninger (se nedenstående liste med detaljer over berørte midler).
Co-administration of APTIVUS and low dose ritonavir with agents primarily metabolised by CYP3A may result in changed plasma concentrations of tipranavir or the other agents, which could alter their therapeutic and adverse effects (see list and details of considered agents, below).
4. 3.
Agents that are contraindicated specifically due to the expected magnitude of interaction and potential for serious adverse reactions are detailed in this section, and listed in section 4.3.
Der blev udført et studie med en cocktail af forskellige lægemidler på 16 raske frivillige forsøgspersoner, som fik APTIVUS/ ritonavir 500/ 200 mg kapsler to gange dagligt i 10 dage for at
A cocktail study was conducted in 16 healthy volunteers with twice-daily APTIVUS/ ritonavir 500/ 200 mg capsule administration for 10 days to assess the net effect on the activity of hepatic CYP 1A2
7 bestemme nettoeffekten på aktiviteten af hepatisk CYP 1 A2 (koffein), 2C9 og (warfarin), og 2D6 (dextromethorfan), begge intestinal/ hepatisk CYP 3A4 (midazolam) og P- glycoprotein (Pgp) (digoxin).
7 (caffeine), 2C9 (warfarin), 2D6 (dextromethorphan), both intestinal/ hepatic CYP 3A4 (midazolam) and P-glycoprotein (Pgp) (digoxin).
Ved steadystate var der en signifikant induktion af CYP 1A2 og en svag induktion af CYP 2C9.
At steady state, there was a significant induction of CYP 1A2 and a slight induction on CYP 2C9.
Samtidig så man en kraftig inhibition af CYP 2D6 og af såvel hepatisk som intestinal CYP 3A4 - aktivitet.
Potent inhibition of CYP 2D6 and both hepatic and intestinal CYP 3A4 activities were observed.
Efter første dosis er aktiviteten Pgp signifikant hæmmet, men der fantes en svag induktion ved steadystate.
Pgp activity is significantly inhibited after the first dose, but there was a slight induction at steady state.
Forsøg med humane levermikrosomer har vist, at tipranavir hæmmer CYP 1A2, CYP 2C9, CYP 2C19 og CYP 2D6.
Studies in human liver microsomes indicated tipranavir is an inhibitor of CYP 1A2, CYP 2C9, CYP 2C19 and CYP 2D6.
Den potentielle nettoeffekt af tipranavir/ ritonavir på CYP 2D6 er hæmning, fordi ritonavir også er en CYP 2D6- hæmmer.
The potential net effect of tipranavir/ ritonavir on CYP 2D6 is inhibition, because ritonavir is also a CYP 2D6 inhibitor.
Et indledende studium tyder på, at nettovirkningen in vivo af tipranavir/ ritonavir på CYP 1A2, CYP 2C9 og CYP 2C19, består i, at APTIVUS/ ritonavir efter flere dages behandling kan inducere CYP 1A2 og i mindre grad CYP2C9 og Pgp, Der foreligger ingen data til indikation af, om tipranavir hæmmer eller inducerer glucuronosyl transferaser.
Data are not available to indicate whether tipranavir inhibits or induces glucuronosyl transferases.
In vitro- studier viser, at tipranavir er et substrat for og også en hæmmer af Pgp.
In vitro studies show that tipranavir is a substrate and also an inhibitor of Pgp.
Det er vanskeligt at forudse nettoeffekten af APTIVUS givet sammen med lavdosis ritonavir på oral biotilgængelighed og plasmakoncentrationer af stoffer, som er dobbeltsubstrater af CYP3A og Pgp.
It is difficult to predict the net effect of APTIVUS co-administered with low dose ritonavir on oral bioavailability and plasma concentrations of agents that are dual substrates of CYP3A and Pgp.
Nettoeffekten vil variere afhængigt af den relative affinitet af de samtidigt indgivne lægemidler på CYP3A og Pgp og omfanget af first- pass metabolisme/ efllux i tarmen.
The net effect will vary depending on the relative affinity of the co-administered drugs for CYP3A and Pgp, and the extent of intestinal first-pass metabolism/ efflux.
Samtidig indgivelse af APTIVUS og midler, der inducerer CYP3A og/ eller Pgp kan sænke tipranavirkoncentrationerne og nedsætte den terapeutiske effekt (se liste og beskrivelse af omfattede midler herunder).
Co-administration of APTIVUS and agents that induce CYP3A and/ or Pgp may decrease tipranavir concentrations and reduce its therapeutic effect (see list and details of considered agents, below).
Samtidig indgivelse af APTIVUS og lægemidler, som kan hæmme Pgp, kan øge plasmakoncentrationerne af tipranavir.
Co- administration of APTIVUS and medicinal products that inhibit Pgp may increase tipranavir plasma concentrations.
Nukleosid reverse transcriptase- hæmmere:
Nucleoside reverse transcriptase inhibitors:
Da der ikke er nogen signifikant virkning af nukleoside og nukleotide analoger på P450 - enzymsystemet, er det ikke nødvendigt med en dosisjustering af APTIVUS, når det gives sammen med disse midler.
Since there is no significant impact of nucleoside and nucleotide analogues on the P450 enzyme system no dosage adjustment of APTIVUS is required when co-administered with these agents.
Abacavir og Zidovudin:
Abacavir and Zidovudine:
APTIVUS givet sammen med lavdosis ritonavir nedsætter AUC for abacavir med ca 40% og AUC for zidovudin med ca.
APTIVUS, co-administered with low dose ritonavir, decreases the AUC of abacavir by approximately 40% and the AUC of zidovudine by approximately 35%.
35%. Der er ingen påvirkning af glukuroniderede ZDV - niveauer.
There is no impact on glucuronidated-ZDV levels.
Den kliniske relevans ved disse reduktionen er ikke fastlagt, men muligvis mindske virkningen af de antiretrovirale stoffer.
The clinical relevance of these reductions has not been established, but may decrease the efficacy of these antiretroviral agents.
Samtidig anvendelse af tipranavir givet sammen med lavdosis ritonavir med abacavir eller zidovudin anbefales derfor ikke, medmindre der ikke er andre tilgængelige NRTI' er, som egner sig til patientbehandlingen.
Therefore the concomitant use of tipranavir, co-administered with low dose ritonavir, with either abacavir or zidovudine is not recommended unless there are no other available NRTIs suitable for patient management.
I sådanne tilfælde anbefales ingen dosisjustering af abacavir eller zidovudin.
In such cases no dosage adjustment of abacavir or zidovudine can be recommended.
APTIVUS givet sammen med lavdosis ritonavir forårsager en reduktion af AUC for didanosin.
APTIVUS, co-administered with low dose ritonavir, causes a reduction in the AUC of didanosine.
Den kliniske relevans ved reduktionen af didanosin- niveauet er ikke fastlagt.
The clinical relevance of the reduction in didanosine levels has not been established.
Indgift af didanosin som enterotabletter og APTIVUS bløde kapsler givet sammen med lavdosis ritonavir bør foregå med mindst 2 timers mellemrum for at undgå inkompatibilitet mellem formuleringerne.
Dosing of enteric-coated didanosine and APTIVUS soft capsules, co-administered with low dose ritonavir, should be separated by at least 2 hours to avoid formulation incompatibility.
Lamivudin og stavudin:
Lamivudine and stavudine:
Tipranavir givet sammen med lavdosis ritonavir forårsager ikke signifikante ændringer i AUC for lamivudin eller stavudin.
APTIVUS, co-administered with low dose ritonavir, does not cause a significant change in the AUC of lamivudine or stavudine.
Der anbefales ikke nogen dosisjustering af lamivudin eller stavudin.
No dosage adjustment of lamivudine or stavudine is recommended.
Nukleotid reverse transkriptase- hæmmere:
Nucleotide reverse transcriptase inhibitors:
APTIVUS givet sammen med lavdosis ritonavir forårsagede ikke signifikante ændringer i plasmakoncentrationen af tenofivir.
APTIVUS, co-administered with low dose ritonavir, did not cause a significant change in the plasma concentrations of tenofovir.
Der anbefales ikke nogen dosisjustering af tenofovir.
No dosage adjustment of tenofovir is recommended.
Non- nukleosid reverse transkriptase- hæmmere (NNRTI’ er):
Non-nucleoside reverse transcriptase inhibitors (NNRTIs):
Efavirenz 600 mg 1 gang daglig givet sammen med APTIVUS og lavdosis ritonavir (500/ 200 mg 2 gange daglig) ændrer i steady state ikke tipranavirs AUC og Cmax signifikant, men forøgede Cp12h med 19, 2%, hvilket ikke anses for klinisk relevant.
Steady-state efavirenz 600 mg qd co-administered with steady-state APTIVUS and low- dose ritonavir (500/ 200 mg bid) did not significantly alter tipranavir AUC and Cmax and increased Cp12h by 19.2% which is not considered as clinically relevant.
APTIVUS givet sammen med lavdosis ritonavir indvirkede ikke signifikant på Cmin af efavirenz.
APTIVUS, co-administered with low-dose ritonavir, had no significant impact on the Cmin of efavirenz.
8 Nevirapin:
8 Nevirapine:
Der er ikke udført noget specifikt lægemiddelinteraktionsstudie mellem APTIVUS og lavdosis ritonavir (500/ 200 mg 2 gange daglig) og nevirapin.
No specific drug-drug interaction study has been performed between APTIVUS and low- dose ritonavir (500/ 200 mg bid) with nevirapine.
Imidlertid antyder de begrænsede data fra et fase IIa studie af HIV- smittede patienter, at der ikke kan forventes signifikant interaktion mellem nevirapin og APTIVUS givet sammen med lavdosis ritonavir.
However, the limited data available from a phase IIa study in HIV-infected patients suggest that no significant interaction is expected between nevirapine and APTIVUS co-administered with low dose ritonavir.
Endvidere viser et studie med APTIVUS og lavdosis ritonavir og et andet NNRTI (efavirenz) ikke nogen klinisk relevant interaktion (se nedenfor).
Moreover a study with APTIVUS and low dose ritonavir and another NNRTI (efavirenz) did not show any clinically relevant interaction (see above).
Derfor er det ikke nødvendigt med en dosisjustering.
Therefore no dose adjustments are necessary.
Protease- hæmmere:
Protease Inhibitors:
Amprenavir, lopinavir, saquinavir:
Amprenavir, lopinavir, saquinavir:
I et klinisk forsøg med dobbelt- boosted proteasehæmmerkombinationsbehandling givet til flerregime behandlede HIV- positive voksne forårsagede APTIVUS givet sammen med lavdosis ritonavir en 55%, 70% og 78% reduktion i Cmin for henholdsvis amprenavir, lopinavir og saquinavir.
In a clinical study of dual-boosted protease inhibitor combination therapy in multiple-treatment experienced HIV-positive adults, APTIVUS, co-administered with low dose ritonavir, caused a 55%, 70% and 78% reduction in the Cmin of amprenavir, lopinavir and saquinavir, respectively.
Samtidig behandling med APTIVUS givet sammen med lavdosis ritonavir og amprenavir/ ritonavir, lopinavir/ ritonavir eller saquinavir/ ritonavir anbefales derfor ikke, idet den kliniske relevans ved reduktionen i niveauerne ikke er fastlagt.
Therefore the concomitant administration of APTIVUS, co-administered with low dose ritonavir, with amprenavir/ ritonavir, lopinavir/ ritonavir or saquinavir/ ritonavir, is not recommended, as the clinical relevance of the reduction in their levels has not been established.
Hvis kombinationen alligevel anses for nødvendig, anbefales det kraftigt at monitorere plasmaniveauerne for disse proteasehæmmere.
If the combination is nevertheless considered necessary, a monitoring of the plasma levels of these protease inhibitors is strongly encouraged.
Samtidig behandling med tipranavir/ ritonavir og atazanavir/ ritonavir:
Co-administration of Tipranavir/ ritonavir and Atazanavir/ ritonavir:
På den anden side resulterede kombinationen i et markant fald i atazanavireksponering forbundet med en risiko for tab af effekt (AUC0- 24h ratio på 0, 32 med 90% CI [0, 29- 0, 36], Cmax ratio på 0, 43 med 90% CI [0, 38- 0, 50] og Cp24h ratio på 0, 19 med 90% med CI [0, 15- 0, 24]).
In a study performed in healthy volunteers co-administration of atazanavir 300 mg with TPV/ r 500/ 100 mg bid resulted on one hand in a marked increase of Tipranavir exposure (notably Cp12h ratio of 1.75 with 90% CI [1.39-2.20]) and ritonavir exposure (AUC ratio of 1.51 with 90% CI [1.24- 1.83] and Cmax ratio of 1.38 with 90% CI [1.13-1.67]) associated with a risk of over-toxicity and on the other hand on a marked decrease of atazanavir exposure associated with a risk of loss of efficacy (AUC0-24h ratio of 0.32 with 90% CI [0.29-0.36], Cmax ratio of 0.43 with 90% CI [0.38-0.50] and Cp24h ratio of 0.19 with 90% CI [0.15-0.24]).
Derfor anbefales denne samtidige behandling ikke.
Consequently, this co-administration is not recommended.
Hvis denne samtidige behandling skønnes nødvendig, er en nøje monitorering af sikkerhed ved tipranavir og kontrol af atazanavir i plasma - koncentrationen stærkt anbefalet.
If the co-administration is nevertheless considered necessary, a close monitoring of the safety of tipranavir and a monitoring of plasma concentrations of atazanavir are strongly encouraged.
På nuværende tidspunkt findes ingen data om interaktioner mellem APTIVUS givet sammen med lavdosis ritonavir og proteasehæmmere ud over dem, der er nævnt ovenfor.
No data are currently available on interactions of APTIVUS, co-administered with low dose ritonavir, with protease inhibitors other than those listed above.
4. 4).
Hence their combination with tipranavir co- administered with low dose ritonavir, is not recommended (see section 4.4).
Fusionhæmmere:
Fusion inhibitors:
I studier, hvor kombinationen tipranavir og lavdosis ritonavir blev anvendt med eller uden enfuvirtide, blev det observeret, at steady- state trough- koncentrationen (minimumsværdien) af tipranavir var 45% højere hos patienter, som fik enfuvirtid, end hos de patienter, som ikke fik enfuvirtid.
In studies where tipranavir co-administered with low-dose ritonavir was used with or without enfuvirtide, it has been observed that the steady-state plasma tipranavir trough concentration of patients receiving enfuvirtide were 45% higher as compared to patients not receiving enfuvirtide.
Den kliniske betydning af de observerede data, specielt sikkerhedsprofilen for tipranavir/ ritonavir, forbliver ukendt.
The clinical impact of the observed data, especially regarding the tipranavir/ ritonavir safety profile, remains unknown.
Dog viste kliniske data fra RESIST- studiet ingen signifikant ændring af sikkerhedsprofilen, når tipranavir/ ritonavir gives med eller uden enfuvirtid.
Nevertheless, the clinical data available from the RESIST trials did not suggest any significant alteration of the tipranavir/ ritonavir safety profile when combined with enfuvirtide as compared to patients treated with tipranavir/ ritonavir without enfuvirtide.
Carbamazepin, phenobarbital og phenytoin inducerer CYP3A4 og bør anvendes med forsigtighed sammen med APTIVUS/ ritonavir.
Carbamazepine, phenobarbital, and phenytoin induce CYP3A4 and should be used with caution in combination with APTIVUS/ ritonavir.
Samtidig brug af carbamazepin 200 mg to gange daglig medførte et fald i koncentrationen af tipranavir (Cmin faldt med 61% sammenlignet med historiske kontroller), hvilket kan resultere i en forringelse af virkningen.
Concomitant use of carbamazepine at a dose of 200mg BID resulted in decreased concentrations of tipranavir (Cmin decreased by 61% compared to historical controls), which may result in decreased effectiveness.
Højere doser af carbamazepin kan resultere i et endnu større fald af tipranavirs plasmakoncentrationer.
Higher doses of carbamazepine may result in even larger decreases in tipranavir plasma concentrations.
Den samlede Cmin af carbamazepin og dets aktive metabolits Cmin er forøget med 23%, hvilket ikke forventes at have kliniske konsekvenser.
The total Cmin of carbamazepine and its active metabolite Cmin is increased by 23% which is not expected to have clinical consequences.
Svampemidler:
Antifungals:
Fluconazol:
Fluconazole:
APTIVUS givet sammen med lavdosis ritonavir påvirker ikke i væsentlig grad steady - state- farmakokinetikken for fluconazol.
APTIVUS, co-administered with low dose ritonavir, does not substantially affect the steady-state pharmacokinetics of fluconazole.
Fluconazol øger AUC og Cmin for tipranavir med hhv.
Fluconazole increases the AUC and Cmin of tipranavir by
56% og 104% sammenlignet med historiske data.
9 56% and 104%, respectively, when compared to historical data.
Fluconazol- doser på > 200 mg/ dag anbefales ikke.
Fluconazole doses > 200 mg/ day are not recommended.
9 Itraconazol/ ketoconazol:
Itraconazole/ ketoconazole:
Ud fra teoretiske overvejelser forventes APTIVUS givet sammen med lavdosis ritonavir at øge itraconazol - eller ketoconazolkoncentrationer.
Based on theoretical considerations APTIVUS, co-administered with low dose ritonavir, is expected to increase itraconazole or ketoconazole concentrations.
Itraconazol eller ketoconazol bør anvendes med forsigtighed (doser på > 200 mg/ dag anbefales ikke).
Itraconazole or ketoconazole should be used with caution (doses > 200 mg/ day are not recommended).
Voriconazo:
Voriconazole:
Da der indgår flere enzymsystemer i metabolismen af voriconazol, er det vanskeligt at forudsige interaktionen.
Due to multiple enzyme systems being involved in voriconazole metabolism, it is difficult to predict the interaction.
HMG- CoA reduktasehæmmere:
10 HMG CoA reductase inhibitors:
Simvastatin og lovastatin:
Simvastatin and lovastatin:
4. 3).
The HMG-CoA reductase inhibitors simvastatin and lovastatin are highly dependent on CYP3A for metabolism, thus concomitant use of APTIVUS co-administered with low dose ritonavir, with simvastatin or lovastatin are contra-indicated due to an increased risk of myopathy, including rhabdomyolysis (see section 4.3).
85%.
APTIVUS, co-administered with low dose ritonavir, increases the plasma concentrations of single dose atorvastatin by approximately 8-10 fold and reduces the AUCs of its metabolites by approximately 85%.
Atorvastatin ændrer ikke signifikant AUC, Cmax eller Cmin for tipranavir.
Atorvastatin does not significantly change the AUC, Cmax or Cmin of tipranavir.
Andre HMG- CoA- reduktasehæmmere bør overvejes som pravastatin, fluvastatin eller rosuvastatin.
Other HMG-CoA reductase inhibitors should be considered such as pravastatin, fluvastatin or rosuvastatin.
4. 4).
However, if atorvastatin is specifically required for patient management, careful monitoring is necessary (see section 4.4).
CYP- isoenzym- hæmmere:
CYP isoenzyme inducers: