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Atorvastatin information from DrugsUpdate  

2
See Available Brands of Atorvastatin in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation
LI - Lab*

Atorvastatin (Lipitor, Pfizer), is a member of the drug class known as statins, used for lowering blood cholesterol. It also stabilizes plaque and prevents strokes through anti-inflammatory and other mechanisms.

Pharmacodynamics

Pharmacokinetics

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 hours (elimination half-life).

Atorvastatin Indications / Atorvastatin Uses

Information Not Available

Atorvastatin Adverse Reactions / Atorvastatin Side Effects

Headache, flatulence, diarrhoea, nausea, vomiting, anorexia, xerostomia, angioedema, myalgia, rash/pruritus, alopecia, allergy, infection, chest pain.

Potentially Fatal: Thrombocytopenia. Rhabdomyolysis with acute renal failure.

Precautions

Monitor
CPK levels

If muscle tenderness, pain, and/or weakness develop during therapy, determine CPK levels. If CPK levels are markedly increased or if muscle symptoms continue or worsen, be prepared to discontinue therapy.

Serum C/TGs
Ensure serum C and TGs are measured before therapy is started, within 2 to 4 wk after starting therapy or changing the atorvastatin dose, and then periodically thereafter.

Serum Transaminase Levels
If elevated serum transaminase levels develop during treatment, or if signs or symptoms of liver disease (eg, abdominal pain, dark urine, fatigue, flu-like symptoms, persistent nausea, right-upper quadrant, yellowing of skin or eyes) are noted, repeat transaminase levels more frequently. If transaminase levels rise to 3 times ULN or greater and persist, be prepared to discontinue therapy.


Overdosage
Symptomatic and supportive treatment.

Special 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 years. Premenarcheal females.

Other 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.

Other Interactions

Information Not Available

Dosage

Oral
Mixed dyslipidaemia
Adult: Initially, 10 or 20 mg daily, may increase at 4-weekly 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-weekly 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 years: Initially, 10 mg daily, adjust dose based on response. Max: 20 mg daily.

Food(before/after)

Information Not Available

List of Contraindications

Atorvastatin and Pregnancy

Contraindicated in pregnancy

Category X: Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.

Atorvastatin and Lactation

Contraindicated in lactation

Atorvastatin and Children

Safety and efficacy not established, except in children 10 to 17 years of age with heterozygous familial hypercholesterolemia.

Atorvastatin and Geriatic

Information Not Available

Atorvastatin and Other Contraindications

Hypersensitivity, active liver disease or unexplained persistent elevations of serum transaminase, porphyria, pregnancy, lactation.

Storage

Information Not Available

Lab interference

Information Not Available

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