Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: atorvastatin
BRAND NAME: Lipitor
DRUG CLASS AND MECHANISM: Atorvastatin is an oral drug that lowers the
level of cholesterol in the blood. It belongs to a class of drugs referred to as
statins, which includes lovastatin (Mevacor), simvastatin, (Zocor), fluvastatin
(Lescol), and pravastatin (Pravachol). All statins, including atorvastatin,
prevent the production of cholesterol in the liver by blocking HMG-CoA
reductase, an enzyme that makes cholesterol. Statins reduce total cholesterol as
well as LDL cholesterol in blood. LDL cholesterol is believed to be the "bad"
cholesterol that is primarily responsible for the development of coronary artery
disease. Reducing LDL cholesterol levels retards progression and may even
reverse coronary artery disease. Atorvastatin also reduces the concentration of
triglycerides in the blood and raises the concentrations of HDL ("good")
cholesterol. High blood concentrations of triglycerides also have been
associated with coronary artery disease. The FDA approved atorvastatin in
December 1996.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets of 10, 20, 40, and 80 mg
STORAGE: Tablets should be stored at room temperature, 20°-25°C
(68°-77°F).
PRESCRIBED FOR: Atorvastatin is used for the treatment of elevated total
cholesterol, LDL, triglycerides and to elevate HDL cholesterol. The
effectiveness of atorvastatin in lowering cholesterol is dose-related, meaning
that higher doses reduce cholesterol more.
Atorvastatin prevents angina, stroke,
heart attack, hospitalization for congestive heart failure, and
revascularization procedures in individuals with coronary heart disease.
Atorvastatin reduces the risk of myocardial infarction, stroke, angina and
revascularization procedures in adults with multiple risk factors for coronary
artery disease.
Atorvastatin also prevents heart attacks and strokes in patients
with type 2 diabetes with multiple risk factors for coronary artery disease.
DOSING: Atorvastatin is prescribed once daily. The usual starting dose is
10-20 mg per day, and the maximum dose is 80 mg per day. Individuals who need
more than a 45% reduction in LDL cholesterol may be started at 40 mg daily.
Atorvastatin may be taken with or without food and at any time of day.
DRUG INTERACTIONS: Decreased elimination of atorvastatin could increase
levels of atorvastatin in the body and increase the risk of
muscle toxicity from
atorvastatin. Therefore, atorvastatin should not be combined with drugs that
decrease its elimination. Examples of such drugs include erythromycin (E-Mycin),
ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin),
telithromycin (Ketek),
cyclosporine (Sandimmune), nefazodone (Serzone), and HIV
protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir).
Large
quantities of grape fruit juice (>1.2 liters daily) also will increase blood
levels of atorvastatin.
Amiodarone (Cordarone), verapamil (Calan Verelan, Isoptin), cyclosporine
(Sandimmune),
niacin (Niacor, Niaspan, Slo-Niacin), gemfibrozil (Lopid) and fenofibrate
(Tricor) also may increase the risk of muscle toxicity when combined with
atorvastatin.
Atorvastatin increases the effect of warfarin (Coumadin) and the blood
concentration of digoxin (Lanoxin). Patients taking atorvastatin and warfarin or
digoxin should be monitored carefully.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Statins - Read about statins, cholesterol lowering medications like Levacor, Zocor, Pravachol, Lipitor, Crestor, and more. Side effects, drug interactions, and patient information is also provided.
- Liver Blood Tests - Learn about liver blood tests used to detect liver damage disease such as fatty liver, cirrhosis, hepatitis, Tylenol liver damage, and more. This includes measuring the aminotransferases enzymes (AST and ALT levels)
- Stroke - Learn about strokes symtoms like sudden numbness or weakness in the face, arms, or legs, confusion, vision problems, problems with walking or coordination, or severe headache.
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