Atorvastatin

Indications
 Oral
Mixed dyslipidaemia
Adult: Initially, 10 or 20 mg daily, may increase at 4-wkly intervals. May initiate with 40 mg once daily in patients who require >45% reduction in low-density lipoprotein cholesterol. Max dose: 80 mg/day.
Oral
Nonfamilial hypercholesterolaemia
Adult: Initially, 10 or 20 mg daily, may increase at 4-wkly intervals. May initiate with 40 mg once daily in patients who require >45% reduction in low-density lipoprotein cholesterol. Max dose: 80 mg/day.
Oral
Heterozygous familial hypercholesterolaemia
Adult: Initially, 10 or 20 mg daily. Usual range depending on response: 10-80 mg daily.
Child: 10-17 yr: Initially, 10 mg daily, adjust dose based on response. Max: 20 mg daily.
Contraindications
 Hypersensitivity, active liver disease or unexplained persistent elevations of serum transaminase, porphyria, pregnancy, lactation.
Warnings / Precautions
 Patients who consume substantial quantities of alcohol. History of liver disease. Patients with risk factors for myopathy or rhabdomyolysis. Hypothyroidism should be properly managed prior to starting statin therapy. Children <10 yr. Premenarcheal females.
Adverse Reactions
 Headache, flatulence, diarrhoea, nausea, vomiting, anorexia, xerostomia, angioedema, myalgia, rash/pruritus, alopecia, allergy, infection, chest pain.
Potentially Fatal: Thrombocytopenia. Rhabdomyolysis with acute renal failure.
Overdose Reactions
 Symptomatic and supportive treatment.
Drug Interactions
 Increased AUC for norethindrone and ethinyl estradiol. Concomitant multiple doses of atorvastatin and digoxin increased steady-state digoxin levels. Increased risk of rhabdomyolysis when used concurently with fibrates. Co-admin with antacid suspensions and colestipol decreased atorvastatin levels.
See Below for More atorvastatin Drug Interactions
Lab Interactions
 Biochemical abnormalities of liver function tests.
Mechanism of Actions
 Atorvastatin competitively inhibits HMG-CoA reductase, the enzyme that catalyses the conversion of HMG-CoA to mevalonic acid. This results in the induction of the LDL receptors, leading to lowered LDL-cholesterol concentration.
Absorption: Rapid from the GI tract (oral).
Distribution: Protein-binding: 98%.
Metabolism: Extensively hepatic; converted to active inhibitors of HMG-CoA reductase.
Excretion: Faeces (as metabolites); 14 hr (elimination half-life).
Administration
 May be taken with or without food. (Avoid excessive consumption (>1 L/day) of grapefruit juice.)
ATC Classification
 C10AA05 - atorvastatin ; Belongs to the class of HMG CoA reductase inhibitors. Used in the treatment of hyperlipidemia.
Available As
  • Atorvastatin 10 gm
  • Atorvastatin Calcium 10 mg
  • Atorvastatin 10 mg
  • Atorvastatin 20 mg
  • Atorvastatin Calcium 20 mg
  • Atorvastatin 30 mg
  • Atorvastatin 40 mg
  • Atorvastatin Calcium 40 mg
  • Atorvastatin 5 mg
  • Atorvastatin Calcium 5 mg
  • Atorvastatin 500 mg
  • Atorvastatin 80 mg

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