ATORVASTATIN

Indications & Dose:

Primary hypercholesterolaemia in patients who have not responded adequately to diet and other appropriate measures | Combined (mixed) hyperlipidaemia in patients who have not responded adequately to diet and other appropriate measures

• BY MOUTH

Adult: Usual dose 10 mg once daily; increased if necessary up to 80 mg once daily, dose to be increased at intervals of at least 4 weeks

Heterozygous familial hypercholesterolaemia in patients who have not responded adequately to diet and other appropriate measures | Homozygous familial hypercholestrolaemia in patients who have not responded adequately to diet and other appropriate measures

• BY MOUTH

Adult: Initially 10 mg once daily, then increased to 40 mg once daily, dose to be increased at intervals of at least 4 weeks; maximum 80 mg per day

Primary prevention of cardiovascular events in patients at high risk of a first cardiovascular event

• BY MOUTH

Adult: 20 mg once daily, dose can be increased if necessary continued Secondary prevention of cardiovascular events

• BY MOUTH

Adult: 80 mg once daily

DOSE ADJUSTMENTS DUE TO INTERACTIONS

Reduced dose required (max. 10mg daily) with concomitant ciclosporin, or tipranavir combined with ritonavir—seek specialist advice.Maximum dose of 40 mg once daily when combined with anion-exchange resin for heterozygous familial hypercholesterolaemia

Contraindications:

Active liver disease;unexplained persistent elevations of serum transaminases; pregnancy and lactation 

Side Effects:

CNS: Headache

CV: Migraine, palpitation, postural hypotension, syncope, vasodilation

EENT: Amblyopia, dry eyes, taste disturbances, tinnitus

GI: Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, gastroenteritis, LFT abnormalities

HEME: Anemia, ecchymosis, petechia, thrombocytopenia

METAB: Hyperglycemia, increased creatinine phosphokinase

MS: Arthralgia, leg cramps, myalgia

SKIN: Pruritus, rash

MISC: Face edema, fever, flu-like syndrome, malaise, photosensitivity

Cautions:

Precautions:

Liver dysfunction

Pregnancy; not recommended for nursing mothers

Interaction:

Drugs 

Azole antifungals (fluconazole, itraconazole, ketoconazole, miconazole): Increased atorvastatin levels; increased risk of rhabdomyolysis

Bile acid sequestrants (cholestyramine, colestipol):25% reduction in atorvastatin plasma levels if coadministered

Cyclosporine: Concomitant administration increases risk of severe myopathy or rhabdomyolysis

Digoxin: Elevation of digoxin level (approximately 20%)

Erythromycin: Increased atorvastatin concentrations (approximately 40%); increased risk of rhabdomyolysis

Fibric acid: Increased risk of severe myopathy,especially with high statin doses

Nefazodone: Increased atorvastatin levels;increased risk of rhabdomyolysis

Niacin: Concomitant administration increases risk of severe myopathy or rhabdomyolysis

Oral contraceptives: Coadministration increases AUC for norethindrone and ethinyl estradiol by approximately 30% and 20%, respectively

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: