Atorvastatin (atorvastatin) is a synthetic lipid-lowering agent. Atorvastatin is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. This enzyme catalyzes the conversion of HMG-CoA to mevalonate, an early and rate-limiting step in cholesterol biosynthesis.
Atorvastatin is used for an adjunct to diet to reduce elevated total-C, LDL-C, apo B, and triglycerides (TG) levels and to increase HDL-C in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia; as an adjunct to diet for the treatment of patients with elevated serum triglycerides (TG) levels; for the treatment of patients with primary dysbetalipoproteinemia who do not respond adequately to diet; to reduce total-C and LDL-C in patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (e.g. LDL apheresis) or if such treatments are unavailable.
Prior to initiating therapy with atorvastatin, secondary cause for hypercholesterolemia (e.g. poorly controlled diabetes mellitus, hypothyroidism, nephritic syndrome, dysproteinemia, obstructive liver disease, other drug therapy, and alcoholism) should be identified and treated.
|Weight||10mg, 20mg, 40mg|
|Therapeutic Class||Other Anti-anginal & Anti-ischaemic drugs, Statins|
|Manufacturer||Siesta Pharmaceuticals, Beximco Pharmaceuticals Ltd|
|Available Country||India, Bangladesh|
|Last Updated:||June 23, 2021 at 9:07 am|
Table Of contents
The patient should be placed on a standard cholesterol-lowering diet before receiving Atorvastatin and should continue on this diet during treatment with Atorvastatin.
Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia: The recommended starting dose of Atorvastatin is 10 mg once daily. The dosage range is 10 to 80 mg once daily. Atorvastatin can be administered as a single dose at any time of the day, with or without food. Therapy should be individualized according to goal of therapy and response. After initiation and/or upon titration of Atorvastatin, lipid levels should be analyzed within 2 to 4 weeks and dosage adjusted accordingly. Since the goal of treatment is to lower LDL-C, the LDL-C levels should be used to initiate and assess treatment response. Only if LDL-C levels are not available, should total-C be used to monitor therapy.
Homozygous Familial Hypercholesterolemia: The dosage of Atorvastatin in patients with homozygous FH is 10 to 80 mg daily. Atorvastatin should be used as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) in these patients or if such treatments are unavailable.
Concomitant Therapy: Atorvastatin (Atorvastatin) may be used in combination with a bile acid binding resin for additive effect. The combination of HMG-CoA reductase inhibitors and fibrates should generally be avoided.
Dosage in Patients With Renal Insufficiency: Renal disease does not affect the plasma concentrations nor LDL-C reduction of atorvastatin; thus, dosage adjustment in patients with renal dysfunction is not necessary.
Pediatric Use: Treatment experience in a pediatric population is limited to doses of Atorvastatin up to 80 mg/day for 1 year in 8 patients with homozygous FH. No clinical or biochemical abnormalities were reported in these patients. None of these patients was below 9 years of age.
Geriatric Use: Treatment experience in adults age 70 years with doses of Atorvastatin up to 80 mg/day has been evaluated in 221 patients. The safety and efficacy of Atorvastatin in this population were similar to those of patients <70 years of age.
Atorvastatin is generally well tolerated. Adverse reactions have usually been mild and transient. In controlled clinical studies of 2502 patients, <2% of patients were discontinued due to adverse experiences attributable to atorvastatin. The most frequent adverse events thought to be related to atorvastatin were constipation, flatulence, dyspepsia, and abdominal pain.
Before instituting therapy with atorvastatin, an attempt should be made to control hypercholesterolemia with appropriate diet, exercise, and weight reduction in obese patients, and to treat other underlying medical problems. Information for Patients: Patients should be advised to report promptly unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever.
The risk of myopathy during treatment with other drugs in this class is increased with concurrent administration of cyclosporin, fibric acid derivatives, erythromycin, azole antifungals, or niacin (nicotinic acid). These risks may also occur when combining these drugs with Atorvastatin. No clinically significant interactions were seen when Atorvastatin was administered with antihypertensives and or hypoglycemic agents. Caution should also be exercised when Atorvastatin is administered with inhibitors of P450 3A4 (macrolide antibiotics and azole antifungals). The effect of inducers of cytochrome P450 3A4 (rifampicin or phenytoin) on Atorvastatin is unknown. Patients should be closely monitored if Atorvastatin is added to digoxin, erythromycin, oral contraceptives, colestipol, antacid and warfarin. No interaction was found with cimetidine.
Pregnancy & Breastfeeding use
Since HMG-Co A reductase inhibitors decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, they may cause fetal harm when administered to pregnant women. Therefore, HMG-Co A reductase inhibitors are contraindicated during pregnancy and in nursing mothers. Atorvastatin should be administered to women of childbearing age only when such patients are highly unlikely to conceive and have been informed of the potential hazards. If the patient becomes pregnant while taking this drug, therapy should be discontinued and the patient apprised of the potential hazard to the fetus. Because of the potential for adverse reactions in nursing infants, women taking atorvastatin should not breast-feed.
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.
There is no specific treatment for atorvastatin overdose. In the event of an overdose, the patient should be treated symptomatically, and supportive measures instituted as required. Due to extensive drug binding to plasma proteins, hemodialysis is not expected to significantly enhance atorvastatin clearance.
Interaction with other Medicine
The risk of myopathy during treatment with drugs of this class is increased with concurrent administration of cyclosporine, fibric acid derivatives, niacin (nicotinic acid), erythromycin, azole antifungals. When atorvastatin and antacid suspension containing magnesium and aluminum hydroxide were co-administered, plasma concentrations of atorvastatin decreased approximately 35%. However, LDL-C reduction was not altered. Plasma concentrations of atorvastatin decreased approximately 25% when colestipol and atorvastatin were co-administered. However, LDL-C reduction was greater when atorvastatin and colestipol were co-administered than when either drug was given alone. When multiple doses of atorvastatin and digoxin were co-administered, steady state plasma digoxin concentrations increased by approximately 20%. Patients taking digoxin should be monitored appropriately. In healthy individuals, plasma concentrations of atorvastatin increased approximately 40% with co-administration of atorvastatin and erythromycin. Co-administration of atorvastatin and an oral contraceptive increased AUC values for norethindrone and ethinylestradiol by approximately 30% and 20%. These increases should be considered when selecting an oral contraceptive for a woman taking atorvastatin.
Store in a cool dry place protected from light. Keep out of reach of children.
What is Atova used for?
Atova is used along with a proper diet to help lower bad cholesterol and fats (such as LDL, triglycerides) and raise good cholesterol (HDL) in the blood.
What are the side effects of Atova?
Side effects of Atova include:
- headache, and.
- mild muscle pain.
What foods to avoid while taking Atova?
While taking Atova, avoid high-fat and high-cholesterol foods as part of your overall treatment. You should avoid large quantities of grapefruit or grapefruit juice, which can increase the risk of serious side effects. Also, avoid excess alcohol use, as this may cause serious liver problems.
What does Atova do to the body?
Atova is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.
How fast does Atova start working?
Atova starts to work in about 2 weeks.
Is Atova right for me?
Atova is a prescription medicine. Only your doctor can properly determine if you need a prescription medicine along with a low-fat diet to lower your high cholesterol.
Make an appointment with your doctor and ask if Atova is right for you.
Who should not take Atova?
Do not take Atova if you:
- Are pregnant or think you may be pregnant, or are planning to become pregnant. Atova may harm your unborn baby.
- If you get pregnant, stop taking Atova and call your doctor right away.
- Are breast feeding. Atova can pass into your breast milk and may harm your baby.
- Have liver problems.
- Are allergic to Atova or any of its ingredients. The active ingredient is atorvastatin
When is the best time to take Atova?
Atova is taken once a day. The tablets can be taken with or without food, day or night. It’s helpful to remember to try and take Atova at about the same time every day.
Do I need to take Atova with food?
Atova can be taken with or without food.
If I keep taking Atova, will I experience memory loss? Are these effects permanent?
We encourage patients to work with their doctors to discuss their treatment options. Certain cognitive effects, specifically memory loss and confusion, have been reported. The FDA notes that reports relating to cognitive effects have generally not been serious and that symptoms went away once the drug was no longer being taken.
Is Atova a blood thinner?
The short answer is YES, but very little. Cholesterol lowering drugs, often called “statins” are intended to lower an important component of your total blood cholesterol, the LDL or “low density lipoproteins”.
How quickly does Atova lower cholesterol?
Atova starts to lower cholesterol within about two weeks of starting the medication. Atova should always be taken in conjunction with a diet to lower your cholesterol and triglycerides.
Does Atova lower heart rate?
Atova increases HRV, decreases QTV, and shortens QTc interval, and may thereby reduce the risk of arrhythmias in patients with advanced heart failure.
Can I take Atova everyday?
In hypercholesterolemia patients, Atova 10 mg every other day is safe and effective in lowering TC, TG, with LDL-c and a slight increase in HDL-c.
How many mg of Atova should I take?
The recommended starting dose of Atova is 10 or 20 mg once daily. Patients who require a large reduction in LDL-C (more than 45%) may be started at 40 mg once daily. The dosage range of Atova is 10 to 80 mg once daily. Atova can be administered as a single dose at any time of the day, with or without food.