I-Atorvastatin vs. simvastatin: Umehluko, ukufana, nokuthi yikuphi okungcono kuwe
Izidakamizwa Vs. UmnganiUkubuka konke kwezidakamizwa nokwehluka okuyinhloko | Izimo zilashwa | Ukusebenza | Ukutholakala komshuwalense nokuqhathaniswa kwezindleko | Okuqhamuka uma udla imishanguzo | Ukusebenzisana kwezidakamizwa | Izexwayiso | Imibuzo evame ukubuzwa
I-Atorvastatin ne-simvastatin yizidakamizwa ezimbili ezijwayele ukubekwa ezisebenza ekwelapheni i-cholesterol ephezulu. Udokotela wakho angakunikeza omunye wale mithi uma unamazinga aphezulu we-LDL (low-density lipoprotein) cholesterol, eyaziwa nangokuthi i-cholesterol embi. Ngokunciphisa amazinga e-cholesterol, i-atorvastatin noma i-simvastatin ingasiza ekwehliseni ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi.
Ngokuqondile, i-atorvastatin ne-simvastatin basebenza njenge-HMG-CoA reductase inhibitors. Ngokuvimba i-enzyme ye-HMG-CoA reductase, lezi izimiso ukunciphisa ukukhiqizwa kwe-cholesterol esibindi. Nge-cholesterol encane ejikeleza egazini, umzimba uyakwazi ukubuyisela kabusha i-cholesterol eyeqile futhi wehlise amazinga e-cholesterol jikelele.
I-Atorvastatin ne-simvastatin zingasebenza ngezindlela ezifanayo kepha zinomehluko othile kumthamo, ukuphathwa, kanye nemiphumela emibi engaba khona.
Uyini umehluko omkhulu phakathi kwe-atorvastatin ne-simvastatin?
I-Atorvastatin yaziwa nangegama layo lomkhiqizo, i-Lipitor, eyayigunyazwe yi-FDA ngo-1996. Phakathi kokunye ukusetshenziswa, kunqunyiwe ukunciphisa ubungozi bokuhlaselwa yisifo senhliziyo noma isifo sohlangothi kulabo abane isifo senhliziyo .
I-Atorvastatin (Yini i-Atorvastatin?) Ine-half-life ende yamahora ayi-14. Umuthi uyasebenza uma usungenile, futhi umsebenzi wawo wokwehlisa i-lipid ungahlala kuwo Amahora angama-20 kuye kwangama-30 ngemuva kokuphathwa. Kanye ne-rosuvastatin, noma i-Crestor, i-atorvastatin iyisidakamizwa esinamandla kakhulu kunamanye ama-statin afana ne-simvastatin ne-pravastatin.
I-Atorvastatin iyatholakala ku-10 mg, 20 mg, 40 mg, naku-80 mg amaphilisi. Umthamo wokuqala onconyiwe ungu-10 noma u-20 mg kanye ngosuku yize umthamo ojwayelekile ungasuka ku-10 kuye ku-80 mg kanye ngosuku. I-Atorvastatin ingathathwa nganoma yisiphi isikhathi sosuku.
ISimvastatin (Yini iSimvastatin?) Yaziwa nangegama layo lomkhiqizo, iZocor. Uma kuqhathaniswa ne-atorvastatin, i-simvastatin yisidakamizwa esidala esagunyazwa okokuqala yi-FDA ngo-1991. Njengamanye ama-statin, isetshenziselwa ukunciphisa ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi kulabo abanezingozi zenhliziyo nemithambo yegazi.
Ufuna intengo engcono kakhulu ku-simvastatin?
Bhalisela izexwayiso zentengo ye-simvastatin bese uthola ukuthi intengo ishintsha nini!
Thola izexwayiso zentengo
Ngokungafani ne-atorvastatin, i-simvastatin iyidrug . Okusho ukuthi, ayisebenzi kuze kube yilapho ihlanganiswa, noma icutshungulwa, esibindi. Ngemuva kokucutshungulwa, i-simvastatin iphendukela esimweni sayo esisebenzayo, i-simvastatin acid, enokuphila okuyingxenye yehora elilodwa kuya kwamabili.
ISimvastatin iyatholakala ngamandla we-5 mg, 10 mg, 20 mg, 40 mg, no-80 mg. Umthamo wokuqala onconyiwe ungu-10 noma u-20 mg kanye ngosuku, futhi umthamo ojwayelekile ungasuka ku-5 kuye ku-40 mg ngosuku. I-Simvastatin inconywa ukuthi ithathwe ebusuku.
Umehluko omkhulu phakathi kwe-atorvastatin ne-simvastatin | ||
---|---|---|
I-Atorvastatin | Simvastatin | |
Isigaba sezidakamizwa | I-HMG-CoA reductase inhibitor I-Statin | I-HMG-CoA reductase inhibitor I-Statin |
Isimo somkhiqizo / ejwayelekile | Uhlobo lomkhiqizo nohlobo olujwayelekile luyatholakala | Uhlobo lomkhiqizo nohlobo olujwayelekile luyatholakala |
Ngubani igama lomkhiqizo? | Lipitor | Zocor |
Izidakamizwa zingena ngaziphi izinhlobo? | Ithebhulethi yomlomo | Ithebhulethi yomlomo |
Uyini umthamo ojwayelekile? | 10 kuya ku-80 mg kanye ngosuku | 5 kuya ku-40 mg kanye ngosuku |
Yelashwa isikhathi esingakanani? | Ukwelashwa nge-atorvastatin isikhathi eside ukuphatha amazinga e-cholesterol nokugcina ingozi ephansi yokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi. | Ukwelashwa nge-simvastatin isikhathi eside ukuphatha amazinga we-cholesterol nokugcina ingozi ephansi yokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi. |
Ubani ovame ukusebenzisa umuthi? | Abantu abadala; izingane nentsha eneminyaka engu-10 kuya kwengu-17 ubudala ene-heterozygous family hypercholesterolemia (HeFH) | Abantu abadala; izingane nentsha eneminyaka engu-10 kuya kwengu-17 ubudala ene-heterozygous family hypercholesterolemia (HeFH) |
Izimo eziphathwa yi-atorvastatin ne-simvastatin
I-Atorvastatin ne-simvastatin zisetshenziselwa izinhloso ezifanayo. Bobabili baphatha amazinga aphezulu e-cholesterol (i-hypercholesterolemia), amazinga aphezulu e-lipid (i-hyperlipoproteinemia), kanye amazinga aphezulu we-triglyceride (i-hypertriglyceridemia). Ngasikhathi sinye, ama-statins angasiza ekwandiseni i-cholesterol ye-HDL, uhlobo lwe-cholesterol enhle enemiphumela yokuvikela ezifweni zenhliziyo nemithambo yegazi.
I-Atorvastatin ne-simvastatin nakho kunganciphisa ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi kokulandelayo:
- Abantu abadala ngaphandle kwesifo senhliziyo (CHD) abanezici eziningi zobungozi
- Abantu abadala abane-Type 2 diabetes ngaphandle kwe-CHD, kepha banezici eziningi eziyingozi
- Abantu abadala abane-CHD etholakele
Izici ezinobungozi bemicimbi yenhliziyo zingafaka umfutho wegazi ophakeme (umfutho wegazi ophakeme) noshukela wegazi ophakeme (isifo sikashukela).
I-Atorvastatin ne-simvastatin kunganciphisa amazinga e-cholesterol nama-lipid kulabo abane ukuphazamiseka kwezakhi zofuzo , njenge-homozygous family hypercholesterolemia (HoFH). Lezi zimila zingaphatha izingane nentsha (iminyaka eyi-10-17 ubudala) nge-heterozygous family hypercholesterolemia (HeFH).
Ukwelashwa kwe-atherosclerosis, noma okunamafutha okufakwa ezindongeni zemithambo yegazi, ngesinye isizathu sokuthi i-atorvastatin noma i-simvastatin ingabhalwa. Ngokunciphisa uqweqwe ezindongeni zemithambo yegazi, lawa ma-statin angasiza ekunciphiseni izimpawu ezifana nobuhlungu besifuba (angina).
Isimo | I-Atorvastatin | Simvastatin |
I-Hypercholesterolemia | Yebo | Yebo |
Hyperlipoproteinemia | Yebo | Yebo |
I-Hypertriglyceridemia | Yebo | Yebo |
Ukuhlaselwa yinhliziyo nokuvinjelwa unhlangothi | Yebo | Yebo |
I-atherosclerosis | Yebo | Yebo |
Ingabe i-atorvastatin noma i-simvastatin isebenza kangcono?
I-Atorvastatin ne-simvastatin yomibili iyimithi esebenzayo ye-statin. Ucwaningo lukhombisile ukuthi labo abathatha imishanguzo yabo yama-statin okungenani i-90% yesikhathi ube nengozi encishisiwe engama-45% yokufa ngenxa yesifo senhliziyo, isifo sohlangothi, noma yisiphi isizathu. Ngokuvamile, ama-statins asebenza kakhulu ekwehliseni amazinga e-cholesterol futhi anciphise izehlakalo zokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi.
Azikho izivivinyo eziqinile zekhanda nekhanda eziqhathaniswa ne-atorvastatin ne-simvastatin esenziwe. Kodwa-ke, i-atorvastatin ibhekwa njengesidakamizwa esinamandla kune-simvastatin. Ku- isifundo esisodwa sokuqhathanisa sakamuva , i-atorvastatin itholakale isebenza kangcono ekwehliseni i-LDL cholesterol (LDL-C) kune-simvastatin. Lolu cwaningo luhlanganise imiphumela evela ku-50 engahleliwe, ukuhlolwa kwemitholampilo, futhi kwaqhathaniswa nezinye izidakamizwa ze-statin njenge-fluvastatin, i-pravastatin, i-rosuvastatin ne-lovastatin. IRosuvastatin ibinamandla amakhulu kakhulu okwehlisa amazinga e-LDL ocwaningweni.
Kokukodwa ukubuyekeza okuhlelekile , Kwahlaziywa izifundo ezingama-75 ezahlukahlukene eziqhathanisa imishanguzo yama-statin. Ngokwemiphumela yeqembu lokufunda, umthamo wansuku zonke we-atorvastatin 10 mg unganciphisa i-cholesterol ye-LDL ngo-30% -40% ngenkathi umthamo wansuku zonke we-simvastatin 10 mg unganciphisa i-cholesterol ye-LDL ngama-20% -30%. Kodwa-ke, imiphumela yokwelashwa yalomehluko kungenzeka ingabaluleki.
Xhumana nomhlinzeki wakho wezokunakekelwa kwezempilo ukunquma ukwelashwa okungcono kakhulu kwe-statin. Ukusebenza kwama-statins kuzoya ngomlando wakho wezokwelapha nowomndeni, phakathi kwezinye izinto.
Ukuphakama nokuqhathaniswa kwezindleko kwe-atorvastatin vs. simvastatin?
I-Atorvastatin iyatholakala njengesidakamizwa esijwayelekile esivame ukuhlanganiswa njalo yiMedicare nezinye izinhlelo zomshuwalense. Inqunywe njengephilisi lansuku zonke elingakhishwa ekunikezelweni kwezinsuku ezingama-30 noma ezingama-90. Intengo emaphakathi yemali ye-atorvastatin ingafinyelela ku- $ 250. Kodwa-ke, intengo ingehliselwa ku- $ 15 ngesigqebhezana se-SingleCare atorvastatin.
ISimvastatin iyatholakala njengomuthi ojwayelekile. Njengesimiso esivame ukubekwa, i-simvastatin ivame ukumbozwa yi-Medicare nezinhlelo zomshuwalense. Intengo emaphakathi yokuthengisa ye-simvastatin icishe ibe ngu- $ 470. Kodwa-ke, ngekhadi lesaphulelo le-simvastatin, njengeSingleCare, ungalindela ukukhokha ngaphansi kuka- $ 10 ngokuthengwa kwezinsuku ezingama-30 kwamaphilisi angama-20 mg emakhemisi abambe iqhaza.
I-Atorvastatin | Simvastatin | |
Ngokuvamile embozwe umshwalense? | Yebo | Yebo |
Imbozwe ngokujwayelekile yi-Medicare Part D? | Yebo | Yebo |
Umthamo ojwayelekile | 10 mg kanye ngosuku (inani lama-30) | 20 mg kanye ngosuku (inani lama-30) |
I-Medicare copay ejwayelekile | $ 0– $ 16 | $ 0– $ 9 |
Izindleko ze-SingleCare | $ 15 + | $ 10 + |
Thola ikhadi lesaphulelo sekhemisi
Imiphumela emibi ejwayelekile ye-atorvastatin vs. simvastatin?
Imiphumela emibi kakhulu ye-statins, efana ne-atorvastatin ne-simvastatin, ifaka izinkinga zokugaya ukudla ezifana nohudo, ukugaya ukudla, kanye nesicanucanu. Eminye imiphumela emibi ifaka isiyezi nokuvuvukala kwezandla, imilenze, noma izinyawo (i-edema). Izitatimende nazo zingadala ubuhlungu bemisipha (myalgia) noma ubuthakathaka bemisipha (myopathy).
Ingozi yobuhlungu bemisipha iyanda ngamanani aphezulu ama-statins. Kodwa-ke, uma kuqhathaniswa ne-atorvastatin, i-simvastatin ibhekwa njengengozi enkulu ye-myalgia. Abanye abantu bangaba ne- ukuthambekela kofuzo ku-myalgia kusuka ku-simvastatin. Yize wonke ama-statin enobungozi bokubangela ubuhlungu bemisipha njengomphumela wecala, i-FDA kunciphise ukusetshenziswa yamaphilisi we-simvastatin 80 mg ngenxa yengozi eyengeziwe.
Eminye imiphumela emibi ejwayelekile ingatholakala kuthebula elingezansi.
I-Atorvastatin | Simvastatin | |||
Umphumela oseceleni | Kusebenza? | Imvamisa | Kusebenza? | Imvamisa |
Ubuhlungu obuhlangene | Yebo | 7% | Yebo | 0.1% |
Uhudo | Yebo | 7% | Yebo | * |
Ukuqunjelwa | Akunjalo | - | Yebo | amaphesenti amabili |
Ukugaya ukudla | Yebo | 5% | Yebo | * |
Isicanucanu | Yebo | 4% | Yebo | 6% |
Ubuhlungu bemisipha | Yebo | 4% | Yebo | 4% |
Ukutheleleka ngomgudu womchamo | Yebo | 6% | Yebo | 3% |
I-Nasopharyngitis | Yebo | 8% | Akunjalo | - |
Isiyezi | Yebo | * | Yebo | 5% |
I-Edema | Yebo | * | Yebo | 3% |
* akubikiwe
Ukuvama akususelwa kudatha evela esivivinyweni sekhanda kuya ekhanda. Lokhu kungenzeka kungabi uhlu oluphelele lwemiphumela emibi engenzeka. Sicela ubheke udokotela wakho noma umhlinzeki wezokunakekelwa kwempilo ukuze ufunde kabanzi.
Umthombo: DailyMed ( I-Atorvastatin ), IDailyMed ( Simvastatin )
Ukusebenzisana kwezidakamizwa kwe-atorvastatin vs. simvastatin
I-Atorvastatin ne-simvastatin kucutshungulwa ikakhulukazi esibindini yi-CYP3A4 enzyme. Izidakamizwa ezivimbela, noma ezivimba le enzyme zingadala amazinga anyukayo e-atorvastatin noma i-simvastatin egazini. Uma ithathwa nge-CYP3A4 inhibitor efana ne-clarithromycin noma i-itraconazole, i-atorvastatin ingadala ubungozi obukhulayo bezinhlungu zemisipha (myalgia) noma ubuthakathaka bemisipha (myopathy). Ijusi lamagilebhisi futhi iyi-CYP3A4 inhibitor engakhuphula amazinga e-atorvastatin ne-simvastatin. Ngakolunye uhlangothi, izidakamizwa ezinjenge-rifampin ne-carbamazepine zingama-inducers we-CYP3A4 anganciphisa amazinga e-atorvastatin ne-simvastatin emzimbeni.
Ama-Protease inhibitors, afana ne-ritonavir ne-lopinavir, angadala amazinga akhuphukayo ama-statins emzimbeni. Amazinga aphezulu we-statin egazini angaholela engozini eyengeziwe yemiphumela emibi, kufaka phakathi i-myalgia. Izidakamizwa ze-fibrate ne-niacin nazo zingakhuphula ubungozi be-myalgia lapho zithathwa nge-atorvastatin noma i-simvastatin.
Ukuthatha i-atorvastatin ngezindlela zokuvimbela inzalo ngomlomo kungadala ukukhuphuka kwamazinga egazi emithini yokuvimbela inzalo.
Ukuthatha ama-statins nge-warfarin kubikwe ukuthi kubangele amazinga anyukayo we-warfarin kanye nengozi eyengeziwe yokopha. Kodwa-ke, i-atorvastatin iyi- akunakwenzeka ukuthi kuphazamise ngemiphumela ye-warfarin.
Izidakamizwa | Isigaba sezidakamizwa | I-Atorvastatin | Simvastatin |
I-Clarithromycin I-Erythromycin I-Itraconazole Ketoconazole Ijusi lamagilebhisi | I-CYP3A4 inhibitors | Yebo | Yebo |
I-Rifampin ICarbamazepine | Ama-inducers we-CYP3A4 | Yebo | Yebo |
I-Ritonavir Lopinavir Simeprevir I-Darunavir | Ama-Protease inhibitors | Yebo | Yebo |
Gemfibrozil I-Fenofibrate | Ama-Fibrates | Yebo | Yebo |
I-Niacin | I-antihyperlipidemic | Yebo | Yebo |
I-Digoxin | I-glycoside yenhliziyo | Yebo | Yebo |
Norethindrone I-Ethinyl estradiol | Izindlela zokuvimbela inzalo ngomlomo | Yebo | Akunjalo |
I-Warfarin | I-Anticoagulant | Akunjalo | Yebo |
Thintana nochwepheshe wezokunakekelwa kwempilo mayelana nokunye ukuxhumana kwezidakamizwa okungenzeka.
Izexwayiso nge-atorvastatin ne-simvastatin
Kokubili i-atorvastatin ne-simvastatin kungadala izehlakalo ezimbi ezibandakanya ubuhlungu bemisipha (myalgia) noma ubuthakathaka bemisipha (myopathy). Ezimweni ezinzima, lezi zimiso zingadala ne-rhabdomyolysis, noma ukonakala okusheshayo kwemisipha yamathambo. Uhlobo olungavamile lwe-myopathy, olubizwa nge-immune-mediated necrotizing myopathy (IMNM) nalo lubikwe ngokusetshenziswa kwe-statin.
I-Atorvastatin ne-simvastatin ikakhulu kugaya umzimba esibindini. Ngakho-ke, ukusetshenziswa kwabo kungadala ukungajwayelekile ezingeni le-enzyme yesibindi. Ama-enzyme wesibindi kufanele abhekwe kulo lonke ukwelashwa kwe-statin. Abantu abanesifo sesibindi kufanele futhi babhekwe noma bagweme ama-statins ngokuphelele.
I-Atorvastatin ne-simvastatin kufanele kugwenywe kwabesifazane abakhulelwe nakomama abahlengikazi. Lezi zimiso zingaba nengozi eyengeziwe yokukhubazeka kokuzalwa.
Imibuzo ebuzwa njalo mayelana ne-atorvastatin vs. simvastatin?
Yini i-atorvastatin?
I-Atorvastatin, eyaziwa nangokuthi yi-Lipitor, ngumuthi we-statin osetshenziselwa ukwehlisa i-cholesterol futhi wehlise ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi. Ububanzi bomthamo ojwayelekile we-atorvastatin buphakathi kuka-10 kuya ku-80 mg ngosuku. I-Atorvastatin ine-half-life ende yamahora ayi-14 futhi ingathathwa nganoma yisiphi isikhathi sosuku.
Yini i-simvastatin?
ISimvastatin yaziwa nangegama layo lomkhiqizo, iZocor. Kungumuthi we-statin onganciphisa amazinga we-cholesterol, nawo ongasiza ekwehliseni ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi. Ububanzi bomthamo ojwayelekile we-simvastatin unhlanu kuya ku-40 mg ngosuku. ISimvastatin ine-half-life emfushane uma kuqhathaniswa futhi kunconywa ukuthi ithathwe kusihlwa.
Ngabe i-atorvastatin ne-simvastatin ziyefana?
I-Atorvastatin ne-simvastatin bobabili bangabesigaba sezidakamizwa esibizwa nge-HMG-CoA reductase inhibitors, noma ama-statins. Zombili zisetshenziselwa ukwehlisa amazinga we-LDL cholesterol. Kodwa-ke, banokuhluka okuthile emandleni atholakalayo nokuthi athathwa kanjani.
Ngabe i-atorvastatin noma i-simvastatin ingcono?
I-Atorvastatin ne-simvastatin zombili izidakamizwa ezisebenzayo ze-statin zokwehlisa i-cholesterol egazini. Kodwa-ke, i-atorvastatin ibhekwa njenge-statin enamandla kakhulu. I-Atorvastatin ihlala isikhathi eside emzimbeni futhi ingathathwa ekuseni noma ebusuku. ISimvastatin inobungozi obukhulu bezinhlungu zemisipha noma ubuthakathaka kune-atorvastatin, ikakhulukazi kumanani aphezulu. Udokotela onqumayo uzonquma isitatimende esisebenza kahle kakhulu esimweni ngasinye.
Ngingayisebenzisa i-atorvastatin noma i-simvastatin ngenkathi ngikhulelwe?
I-Atorvastatin ne-simvastatin akufanele zisetshenziswe ngesikhathi sokukhulelwa. Izinga le-cholesterol lingakhula ngesikhathi sokukhulelwa futhi liyadingeka ukusekela umbungu okhulayo. Ngakho-ke, akukho nzuzo ngokuthatha lezi zimila ngesikhathi sokukhulelwa. Zingahle futhi zidale ukulimala kwengane ngesikhathi sokukhulelwa.
Ngingayisebenzisa i-atorvastatin noma i-simvastatin ngotshwala?
Ngokuvumelana ne ochwepheshe bezenhliziyo , ukuphuza utshwala ngokulinganisela ngokuvamile kuphephile ngokusetshenziswa kwe-statin. Ukuphuza ngokweqile okuholele ekutheni kube nesifo sesibindi kulapho kungavela khona izinkinga. Ama-enzyme wesibindi kufanele abhekwe kulo lonke ukwelashwa nge-statin.
Yisiphi isitatimende esinenani elincane lemiphumela emibi?
Izitatimende zivame ukuphepha ezinemiphumela engemihle emibi. Ngokwe-American Heart Association (AHA), izinzuzo zama-statins idlula ingozi engaba khona yemiphumela emibi. Kodwa-ke, izimiso ezithile, njenge i-pravastatin ne-fluvastatin , ingaba nengozi ephansi ye-myalgia kune-simvastatin ne-atorvastatin. Uma kuqhathaniswa nama-statins anikezwe ngemithamo ephansi, ama-statin aphezulu kakhulu angadala imiphumela emibi. Isibonelo, umthamo we-80 mg we-simvastatin unengozi enkulu yokubanga i-myalgia. Ngalesi sizathu, i-FDA ikhawulele le dose ye-simvastatin kuphela kubantu abathile.
Yimiphi imiphumela emibi yesikhathi eside ye-atorvastatin?
Imiphumela emibi yesikhathi eside yokwelashwa kwe-statin ingahluka ngokuya ngomuntu. Isikhati eside imiphumela emibi yezimpawu kungabandakanya ubuhlungu bemisipha, ukulimala kwesibindi, ukwanda kukashukela egazini, nezinkinga zememori. Kodwa-ke, ubungozi bemiphumela emibi yesikhathi eside buthathwa njengobuphansi lapho umuthi unikezwa futhi uphathwa kahle.
Ingabe i-atorvastatin yimbi ngezinso zakho?
Umthamo we-atorvastatin awudingi ukulungiswa kulabo abanezinkinga zezinso. Kwabanye abantu abanezinkinga ezinzima zezinso, ukusetshenziswa kwe-atorvastatin kungadinga ukuqashwa.
Ngokuvamile, i-atorvastatin ayiyona ingozi ezinso. Kodwa-ke, ukusetshenziswa kwe-atorvastatin kungaholela engcupheni eyandayo ye-rhabdomyolysis, engaholela ekuhlulekeni okukhulu kwezinso ezimweni ezinzima. Khuluma nodokotela wakho uma unomlando wezinkinga zezinso ngaphambi kokuqala kumuthi we-statin.