Lipistad

Reduce LDL-C, Apo B, & triglycerides, & increase HDL-C in the treatment of hyperlipidaemias including hypercholesterolaemias & combined (mixed) hyperlipidaemia (type IIa or IIb hyperlipoproteinaemias), hypertriglyceridaemia (type IV), & dysbetalipoproteinaemia (type III). Adjunctive therapy in patients w/ HoFH who have some LDL-receptor function.

Adjust dose at intervals of no less than 4 wk until desired effect on lipoprotein conc is observed. Primary hypercholesterolemia (heterozygous familial or nonfamilial) & mixed dyslipidemia Adult Initially 10 or 20 mg once daily. May start on 40 mg daily if requiring LDL-C reductions of >45%. Maintenance dose: 10-80 mg once daily. Heterozygous familial hypercholesterolemia Childn 10-17 yr (boy & postmenarchal girl) Initially 10 mg once daily. Max dose: 20 mg daily. HoFH 10-80 mg once daily. May be used as adjunct to other lipid-lowering therapies (eg, plasma LDL-apheresis) or when such therapies are not available.

May be taken with or without food.

Hypersensitivity. Patients w/ active liver disease or unexplained, persistent increases in serum aminotransferase conc. Pregnancy & lactation.

Risk of myogenic adverse reactions (including myasthenia, myositis), especially in patients w/ risk factors eg, >65 yr, uncontrolled hypothyroidism, renal disease. Control hypercholesterolemia w/ appropriate diet, exercise, & wt reduction in obese patients & treat other underlying medical problems before instituting atorvastatin therapy. Persistent elevations in serum transaminases. Perform LFTs prior to & at 12 wk following treatment initiation & any dose elevation, & periodically (eg, semiannually) thereafter. Caution in patients who consume substantial quantities of alcohol &/or have history of liver disease. Reports of uncomplicated myalgia. Promptly report unexplained muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. Discontinue therapy if markedly elevated creatine phosphokinase levels occur or myopathy is diagnosed or suspected. Temporarily w/hold or discontinue therapy in any patient w/ acute, serious condition suggestive of myopathy or having risk factor predisposing to development of renal failure secondary to rhabdomyolysis (eg, severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine & electrolyte disorders, & uncontrolled seizures). Rare postmarketing reports of cognitive impairment (eg, memory loss, forgetfulness, amnesia, memory impairment, confusion). Reports of increases in HbA1c & fasting serum glucose levels. Safety & efficacy have not been evaluated in prepubertal childn or in childn <10 yr.

Insomnia, headache, nausea, diarrhea, constipation, flatulence, dyspepsia, abdominal pain, myalgia, asthenia.

Increased risk of myopathy w/ cyclosporine, fibric acid derivatives, niacin (nicotinic acid), erythromycin, azole antifungals. Decreased plasma conc & unaltered LDL-C reduction w/ antacids. Decreased plasma conc & greater LDL-C reduction w/ colestipol. Increased plasma conc of digoxin. Increased AUC values of OCs (eg, norethindrone & ethinylestradiol). Increased risk of adverse effects w/ grapefruit juice. Increased plasma conc w/ strong CYP3A4 inhibitors (eg, ciclosporin, telithromycin, clarithromycin, erythromycin, delavirdine, stiripentol, ketoconazole, voriconazole, itraconazole, posaconazole & HIV PIs including ritonavir, lopinavir, atazanavir, indinavir, darunavir).

Dyslipidaemic Agents

C10AA05 - atorvastatin ; Belongs to the class of HMG CoA reductase inhibitors. Used in the treatment of hyperlipidemia.

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