Atorvastatin: Indications, Mechanism of Action, Side Effects, Interactions, Warnings and Administration

It is a prescription drug and is available as a brand name drug called  Lipitor.

Atorvastatin also has a generic form. Generic drugs are usually cheaper than the brand name version.

Indications

Atorvastatin is used to improve cholesterol levels in people with different types of cholesterol problems. It is also used to lower the risk of  heart attack  and stroke.

Atorvastatin helps prevent the build-up of cholesterol in the arteries. Clogged arteries can block blood flow to your heart and brain.

Atorvastatin can be used as part of combination therapy. So you can take atorvastatin in conjunction with other medications. These may include bile acid resins and other cholesterol-lowering medications.

Mechanism of action

Atorvastatin belongs to the class of drugs known as HMG-CoA reductase inhibitors or statins.

This medicine works by lowering low-density lipoprotein (LDL) or “bad” cholesterol and raising high-density lipoprotein (HDL) or “good” cholesterol. Atorvastatin improves your body’s ability to remove LDL cholesterol through your liver.

Atorvastatin Highlights

  1. It is available as a generic drug and a brand name drug.
  2. It only comes in the form of a tablet that you take by mouth.
  3. It is used to improve cholesterol levels and lower your risk of heart attack and stroke.
  4. They are usually given to people who follow a diet plan and exercise.
  5. Muscle problems warning:  Your risk of rhabdomyolysis (muscle breakdown) is increased when taking atorvastatin. The risk is higher if you are older, have thyroid problems, or have kidney disease.
  6. Liver problems warning: Laboratory tests for your liver may be abnormally high while you are taking atorvastatin and you may have liver problems. Your doctor will monitor this while you are taking atorvatastine.
  7. Diabetes warning:  Atorvastatin can increase your blood sugar levels. You and your doctor should monitor your blood sugar levels carefully while taking this medicine.

Side effects of atorvastatin

Atorvastatin does not cause drowsiness, however it may cause other side effects.

Most common side effects

Some of the more common side effects that can occur with the use of atorvastatin oral tablet include:

  • Cold symptoms such as a runny nose, sneezing, and coughing.
  • Diarrhea .
  • Gases.
  • Acidity.
  • Joint pain
  • I forget.
  • Confusion.

If these effects are mild, they can go away in a few days or a couple of weeks. If these symptoms get worse or don’t stop, see your doctor.

Serious side effects

If you have serious side effects, contact your doctor urgently. If you think the symptoms are life-threatening or you have a medical emergency, call 911. Serious side effects and your symptoms may include the following:

Muscle problems. Symptoms can include:

  • Unexplained muscle weakness, tenderness, or pain.
  • Fatigue.

Liver problems Symptoms can include:

  • Tiredness or weakness
  • Loss of appetite
  • Upper stomach pain.
  • Dark colored urine.
  • Yellowing of your skin or the whites of your eyes.

Atorvastatin may interact with other medications.

Atorvastatin oral tablet can interact with other medications, vitamins, or herbs you may be taking.

When another substance in the body changes the way a drug works, this is known as an interaction. It can prevent the proper functioning of the drug or it can create dangerous effects on the body.

Your doctor must monitor the consumption of your medications carefully to avoid interactions. You should tell him about the vitamins, herbs, and medications you are taking.

Ask your doctor or pharmacist to find out which medications may interact with the one you are taking.

Examples of medications that can cause interactions with atorvastatin are listed below:

Antibiotics

Taking atorvastatin with certain antibiotics increases your risk of muscle problems. Examples of these medications include:

  • Clarithromycin.
  • Erythromycin.

Fungicides

Taking atorvastatin with certain medicines used to treat fungal infections can cause atorvastatin to build up in your body. This increases the risk of having a muscle breakdown. If you need to take these medicines together, your doctor may lower your dose of atorvastatin.

Examples of these medications include:

  • Itraconazole.
  • Ketoconazole.

Drugs to lower cholesterol

Taking atorvastatin with other cholesterol-lowering medications increases the risk of muscle problems. Your doctor may change your dose of these medications or avoid taking them together. Examples of these medications include:

  • Gemfibrozil.
  • Fibrate-containing medications.
  • Niacin.

Rifampin

Taking rifampin with atorvastatin can decrease the amount of atorvastatin in your body. This means that atorvastatin may not work as well.

HIV drugs

Taking atorvastatin with certain medicines used to treat HIV can cause atorvastatin to build up in your body. This increases the risk of having a muscle breakdown. If you need to take these medicines together, your doctor may lower your dose of atorvastatin.

Examples of these medications include protease inhibitors such as:

  • Darunavir.
  • Fosamprenavir.
  • Lopinavir.
  • Ritonavir.
  • Saquinavir.
  • Tipranavir.

Digoxin

Taking digoxin with atorvastatin can increase the amount of digoxin in your blood to dangerous levels. If you need to take these medications together, your doctor will monitor these levels and adjust the doses of your medication if necessary.

Oral contraceptive pills

Taking atorvastatin with oral contraceptive pills can increase the levels of oral contraceptive hormones in your blood.

Colchicina

Taking colchicine with atorvastatin increases the risk of muscle failure.

Cyclosporine

Taking cyclosporine with atorvastatin increases your risk of muscle failure. Your doctor should avoid this combination.

Atorvastatin warnings

This drug comes with several warnings.

Allergy warning

Atorvastatin can cause a severe allergic reaction. Symptoms can include:

  • Swelling of your face, lips, tongue, or throat.
  • Difficulty breathing.
  • Difficulty swallowing

Call 911 or go to the nearest emergency room if you develop these symptoms.

If you have had allergic reactions with the consumption of atorvastatin, do not take this medicine again, its consumption could even cause death.

Food Interaction Warning

Avoid drinking large amounts of grapefruit juice while taking atorvastatin. Drinking grapefruit juice can cause atorvastatin to build up in the blood, increasing the risk of muscle failure. Ask your doctor how much grapefruit juice is safe for you.

Alcohol Interaction Warning

The risk of suffering from liver disease increases when the consumption of alcoholic beverages is combined with atorvastatin, by action of the same drug. If you drink more than two alcoholic drinks a day, check with your doctor.

Warnings for people with certain health conditions

For people with liver disease:  You should not take this if you have liver disease as this drug can increase your liver test results. This means you could have liver damage.

For people with kidney problems: You  can increase your risk of muscle failure if you have kidney problems and take atorvastatin. Your doctor can monitor you more closely for muscle problems.

For people with diabetes: Atorvastatin can increase your blood sugar levels. Your doctor can adjust your diabetes medications if this happens.

Warnings for other groups

For pregnant women: Atorvastatin should never be used during pregnancy. Safety in pregnant women is unknown and there is no apparent benefit from this drug during pregnancy.

Call your doctor immediately if you become pregnant while taking this medicine.

For women who are breastfeeding:  Atorvastatin should not be used during breastfeeding. If you breastfeed, talk to your doctor about which medicine might be right for you.

For seniors: People over 65 are at increased risk of muscle breakdown (rhabdomyolysis) while taking atorvastatin.

For children:  Its use has not been studied in children under 10 years of age, so it should not be given to very young children. This medication has been shown to be safe and effective in children 10 to 17 years of age.

Management

This dosage information is for atorvastatin oral tablets. Your dosage, medicine form, and how often you take the medicine will depend on:

  • Your age.
  • The condition being treated.
  • How serious your condition is.
  • Other medical conditions you have.
  • How you react to the first dose.

Forms and strengths

Generic:  Atorvastatin.

  • Form:  oral tablet.
  • Fortalezas: 10 mg, 20 mg, 40 mg y 80 mg.

Marca: Lipitor.

  • Form:  oral tablet.
  • Fortalezas: 10 mg, 20 mg, 40 mg y 80 mg.

Dosage for prevention of heart disease

Dosage for adults (between 18 and 64 years):

  • Typical starting dose   10-20 mg taken once a day.
  • Typical maintenance dose   10-80 mg taken once a day.

Child dosage (ages 0-17 years)

Atorvastatin has not been approved for use in children under 18 years of age for the prevention of heart disease.

Higher dosage (over 65 years)

The body of older adults may process drugs slower because the kidneys do not work as well as they used to.

This results in the medications being kept in your body for a longer period of time, which increases the chances of side effects.

To prevent drug levels from building up in the body, your doctor may start with a low dose or a different medication schedule.

Dosage for dyslipidemia (cholesterol problems)

Adult dosage (ages 18-64)

  • Typical starting dose: 10-20 mg taken once a day.
  • Typical maintenance dose: 10-80 mg taken once a day.
  • Note: When treating homozygous familial hypercholesterolemia, the dose is 10 to 80 mg once a day.

Child dosage (ages 10 to 17)

In children, atorvastatin is only used to treat heterozygous familial hypercholesterolaemia.

  • Typical starting dose: 10 mg once a day.
  • Maximum dose: 20 mg once a day.

Child dosage (ages 0-9 years)

Atorvastatin has not been studied in children younger than 10 years for this purpose. It should not be used in this age range for this purpose.

Higher dosage (over 65 years)

The body of older adults may process drugs slower because the kidneys do not work as well as they used to.

This results in the medications being kept in your body for a longer period of time, which increases the chances of side effects.

To prevent drug levels from building up in the body, your doctor may start with a low dose or a different medication schedule.

Take as directed

Atorvastatin oral tablet is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all:  Although eating a healthy diet can sometimes improve your cholesterol levels, atorvastatin can help you even more.

If you do not take atorvastatin, your cholesterol levels may not be controlled. This can increase your risk of heart attack or stroke.

If you miss a dose or don’t take the medicine as scheduled:  For the medicine to work in the body, a certain amount needs to be present in the body. If you don’t take the medicine on schedule, it may not work properly.

If you take too much: you  could have dangerous levels of the medicine in your body. You may have the following symptoms:

  • Diarrhea.
  • Gases.
  • Acidity.
  • Joint pain
  • I forget.
  • Confusion.
  • Unexplained muscle weakness, tenderness, or pain.
  • Loss of appetite
  • Upper stomach pain.
  • Dark colored urine.
  • Yellowing of your skin or the whites of your eyes.

If you think you have taken too much of this medicine, call your doctor. But if your symptoms are severe, you have to go, urgently, to the emergency room closest to where you are or call 911.

What to do if you miss a dose:  if you forget to take one dose and the time for the other is very close, just take one, if not, you can take the forgotten dose.

 How to tell if the medicine is working:  You will not be able to feel atorvastatin working. Your doctor will measure your cholesterol levels to see how well Atorvastatin works for you. Your doctor may adjust your dose depending on your cholesterol levels.

Important considerations for taking atorvastatin

General

  • Do not cut or crush the tablet.

Storage

  • Keep the medicine away from high temperatures and store atorvastatin at room temperature between 20 ° C and 25 ° C.
  • Keep the medicine away from humid environments and store it in a cool and dry environment.

Travels

When traveling with your medicine:

  • When traveling by plane, you should always carry your medicine with you in your carry-on bag.
  • Always carry the original medicine container with the prescription label with you because you may have to show the airport staff the pharmacy label.
  • Avoid leaving the medicine in the car or in the glove compartment of the car, especially in very hot or very cold temperatures.

Clinical monitoring

While you are being treated with atorvastatin, your doctor will monitor your cholesterol levels and liver function. This will be done through blood tests.

Your diet

Your doctor may ask you to eat a low-fat, low-cholesterol diet while taking this medicine.