Indications
Atorvastatin is indicated as an adjunct to diet for reduction of elevated total cholesterol, LDL-cholesterol, apolipoprotein B, and triglycerides in patients with-
- Primary hypercholesterolemia- heterozygous familial and non-familial hypercholesterolemia and mixed dyslipidemia (Fredrickson types IIa and IIb)
- Elevated serum TG levels (Fredrickson type IV)
- Primary dysbetalipoproteinemia (Fredrickson type III) who do not respond adequately to diet.
- Homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (LDL apheresis) or if such treatments are unavailable.
Therapeutic Class
Other Anti-anginal & Anti-ischaemic drugs, Statins
Pharmacology
Atorvastatin is a synthetic lipid lowering agent. It is a selective, competitive inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, an early and rate-limiting step in cholesterol biosynthesis.
Dosage & Administration
Patients should be placed on a standard cholesterol-lowering diet before receiving Atorvastatinand should continue on this diet during treatment with Atorvastatin. The usual starting dose for all the indications is 10mg once daily. The doses range is 10 to 80 mg once daily. Doses should be individualised according tobaseline LDL-C levels, the goal of therapy, and patient response. Adjustment of dosage should be made atintervals of 4 weeks or more. Doses may be given at anytime of day with or without food.
Contraindications
Atorvastatin is contraindicated in patients with hypersensitivity to any component of this medication, active liver disease or unexplained persistent elevations of serum transaminases, during pregnancy, while breast-feeding, and in women of child-bearing potential not using appropriate contraceptive measures.
Side Effects
Atorvastatin is generally well tolerated. Adverse reactions have usually been mild and transient. Reversible myositis is rare but significant side effect of the statins. The statins also cause headache, altered liver-function tests and gastro-intestinal effects including abdominal pain, flatulence, diarrhoea, nausea and vomiting. Thrombocytopenia, rash and hypersensitivity reactions have been reported rarely. Other side effects are reported with Atorvastatin therapy includes insomnia, angioedema, anorexia, asthenia, paraesthesia, peripheral neuropathy, alopecia, pruritus, rash, impotence, chest pain, hypoglycemia and hyperglycemia.
Pregnancy & Lactation
Atorvastatin is contraindicated in pregnancy and while breast-feeding. Women of child bearing potential should use appropriate contraceptive measures. If the woman become pregnant while taking Atorvastatin, it should be discontinued.
Reviews
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