ATORVASTATIN

Lipid-lowering agent. It is a statin (3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor).

Dosage Forms

▼

Tablet

10 mg
20 mg

Uses

▼
  • Primary hypercholesterolemia
  • Familial hypercholesterolemia
  • Combined (mixed) hyperlipidaemia
  • Prevention of cardiovascular events in patients at high risk of first cardiovascular event

Dose and Duration

▼
Primary hypercholesterolemia, combined hyperlipidaemia
Adult:10 mg once daily increased if necessary at intervals of at least 4 weeks to max daily dose of 80 mg once daily
Child 10–18 years:110 mg once daily increased if necessary at intervals of at least 4 weeks to max 20 mg
Familial hypercholesterolemia
Adult:10 mg once daily increased if necessary at intervals of at least 4 weeks up to 40 mg once daily (max 80 mg)
Child 10–18 years: same as above (max 80 mg in homozygous familial hypercholesterolemia)
Prevention of cardiovascular events
Adult: initially, 10 mg once daily adjusted according to response

Contraindications

▼
  • Hypersensitivity to atorvastatin
  • Active liver disease or unexplained rise in serum transaminases exceeding 3 times the upper normal limit

Side Effects

▼
  • Nasopharyngitis, epistaxis, pharyngolaryngeal pain
  • Allergic reactions, anaphylaxis
  • Stevens-Johnson syndrome
  • Hyperglycaemia
  • Headache
  • Constipation, flatulence, dyspepsia, nausea, diarrhoea
  • Joint and muscle pain, spasms and swelling, back pain
  • Abnormal liver function tests (LFTs)
  • Depression
  • Sexual dysfunction
  • Interstitial lung disease

Interactions

▼
  • Clarithromycin (increased concentration of atorvastatin)
  • Fusidic acid (risk of myopathy and rhabdomyolysis)
  • Itraconazole, posaconazole, ciclosporin, fenofibrate (increased risk of myopathy)

Patient Instructions

▼
  • Seek medical attention if you develop signs of interstitial lung disease such as: difficulty in breathing, cough and weight loss

Pregnancy

▼
  • Do not use (see caution)

Breastfeeding

▼
  • Do not use (see caution)

⚠️ Caution

▼
  • Manage hypothyroidism adequately before starting treatment with a statin
  • Use with caution in patients with a history of liver disease or with a high alcohol intake. Do liver function tests be fore treatment, at 3 months and at 12 months of treatment, and when there are signs of hepatotoxicity
  • Risk of congenital anomalies when used during pregnancy. Uses adequate contraception during treatment with atorvastatin and for 1 month afterwards
  • Manufacturer advises avoid use in breast-feeding
  • Use with caution in haemorrhagic stroke