Blood lipids in blood vessels
The metabolic channels of the two are different
Any drug needs to go through absorption, distribution, metabolism, excretion and other links to play a role. The same is true for statin . The main pathways of drug metabolism are renal metabolism, liver metabolism, and liver and kidney dual channel metabolism.
The metabolism of rosuvastatin calcium is metabolism in the liver and kidney, and is a lipid-lowering drug that belongs to the dual channel metabolism of liver and kidney. Therefore, it is not advisable to use it for patients with severe renal function damage and active liver disease.
Atorvastatin calcium is mainly metabolized in the liver, so it should not be used for patients with liver disease. Since it is not metabolized in the kidney, there is no need to adjust the dose when kidney damages. Therefore, for patients with renal impairment, atorvastatin calcium is preferred.
The two drugs have different metabolic enzymes
The metabolic enzymes of atorvastatin calcium and rosuvastatin calcium are different. atorvastatin calcium is mainly metabolized by CYP3A4 in the liver, while rosuvastatin is usually a weak substrate of CYP3A4, mainly in the liver through its isoenzyme CYP2C19. rosuvastatin is a hydrophilic statin and is almost not metabolized in the liver. The incidence of liver damage is greatly reduced compared with other statins, and the relationship with the dose is not obvious.
When taking clopidogrel rosuvastatin
clopidogrel is a prodrug that needs to be converted into an active ingredient with pharmacological effects in the body before it can play a role. Its in vivo metabolism inhibits the activity of the liver enzyme CYP2C19, and the liver enzyme CYP2C19 is the main liver enzyme metabolized by rosuvastatin in the body. The combination of the two will greatly increase the concentration of the drug in the body of rosuvastatin. If used together, the dose of rosuvastatin may need to be reduced. Moreover, the muscle pain and liver adverse reactions of rosuvastatin are proportional to the drug dosage and drug concentration. The combination of the two may increase the adverse reactions, so the adverse reactions of the two need to be paid attention to.
Drug metabolism gene
The lipid-lowering intensity of the two is different
Atorvastatin calcium and rosuvastatin calcium are both commonly used lipid-lowering drugs, but the lipid-lowering intensity is different. The research results of VOYAGER meta-analysis of data suggest that the required atorvastatin calcium is 3-3.5 times the dose of rosuvastatin, that is, if rosuvastatin is 10 mg, then to achieve the same therapeutic effect, 30 mg of atorvastatin is required. It can be seen that under the same dose, the lipid-lowering intensity of rosuvastatin is stronger than atorvastatin calcium.
The adverse reactions of the two are different
atorvastatin calcium and rosuvastatin calcium have some similar adverse reactions. The most common adverse reactions are gastrointestinal discomfort, which can occasionally cause serum transaminase height. Rarely, myositis, myalgia, rhabdomyolysis, etc., but relatively speaking, rosuvastatin calcium has relatively few adverse reactions. In addition to the above adverse reactions, atorvastatin calcium also has adverse reactions such as peripheral neuritis, angioedema, interstitial pneumonia, etc., so there are differences in the adverse reactions between the two.
Taking atorvastatin calcium causes gastrointestinal discomfort
The time of taking the two will be different
Rosuvastatin calcium is a new and long-acting statin lipid-lowering drug. The time of taking it is not affected. You can choose to take the medicine at any fixed time of the day, including meals and on an empty stomach. It is recommended to take atorvastatin at night, and it is better to take it 15-30 minutes after dinner.
To sum up, atorvastatin calcium and rosuvastatin calcium are both commonly used lipid-lowering drugs, but there are still some differences in the use of the two. You should pay attention to the correct choice and reasonable use in order to achieve the best efficacy and minimize adverse reactions.
