Lipitor

Adjunct to diet for patients w/ elevated total cholesterol (total-C) & LDL-C, Apo B & triglycerides (TG) & to increase HDL-C in patients w/ primary hypercholesterolemia (heterozygous familial & non-familial), combined (mixed) hyperlipidemia (Fredrickson types IIa & IIb), elevated serum TG levels (Fredrickson type IV) & patients w/ dysbetalipoproteinemia (Fredrickson type III) who respond inadequately to diet. Reduction of total-C & LDL-C in patients w/ HoFH. Reduction of total-C & LDL-C & apo B levels in boys & postmenarchal girls 10-17 yr w/ heterozygous familial hypercholesterolemia if after adequate diet therapy, LDL-C remains ≥190 mg/dL or ≥160 mg/dL & w/ +ve family history of premature CV disease or ≥2 other CV disease risk factors. Prevention of CV disease w/o clinically evident CV disease but w/ multiple CHD risk factors eg, age, smoking, HTN, low HDL-C, or family history of early CHD to reduce risk of MI, stroke, revascularization procedures & angina. Type 2 diabetes w/o clinically evident CHD but w/ multiple risk factors eg, retinopathy, albuminuria, smoking or HTN to reduce risk of MI & stroke. Patients w/ clinically evident CHD to reduce risk of non-fatal MI, fatal & non-fatal stroke, revascularization procedures, hospitalization for CHF & angina.

Dose range: 10-80 mg once daily. Primary hypercholesterolemia & combined (mixed) hyperlipidemia 10 mg once daily. HoFH Most patient responded to 80 mg daily. Heterozygous familial hypercholesterolemia in ped patient 10-17 yr Initially 10 mg daily, dose adjustments made at ≥4 wk intervals. Max: 20 mg daily. Severe dyslipidemia in ped patient ≥10 yr Initially 10 mg once daily, may be increased to 80 mg daily. Dose adjustments made at ≥4 wk intervals. Childn HoFH Up to 80 mg daily.

May be taken with or without food.

Hypersensitivity. Active liver disease or unexplained persistent elevated serum transaminases >3 times ULN. Women of childbearing potential who are not using adequate contraceptive measures. Pregnancy & lactation.

Discontinue use if markedly elevated creatine phosphokinase (CPK) levels occur; myopathy is diagnosed or suspected. Temporarily withheld or discontinue use if acute, serious condition suggestive of myopathy or risk factor predisposing to renal failure secondary to rhabdomyolysis development occur. Increased risk for recurrent hemorrhagic stroke; increased HbA1c & fasting serum glucose levels; immune-mediated necrotizing myopathy. Induce de novo or aggravate preexisting myasthenia gravis or ocular myasthenia. Substantial alcohol consumption &/or history of hepatic disease. Perform LFTs prior to initiation & periodically thereafter. Reduce dose or discontinue use if increased ALT or AST >3 times ULN persist. Not recommended to be used concurrently w/ fusidic acid. Avoid use w/ cyclosporine, HIV PIs, hepatitis C PIs. Concurrent use w/ fibric acid derivatives, erythromycin, immunosuppressives, azole antifungals, HCV NS5A/NS5B inhibitors, letermovir, niacin ≥1 g daily. Women of childbearing potential should use effective contraception.

Nasopharyngitis; hyperglycemia; pharyngolaryngeal pain, epistaxis; diarrhoea, dyspepsia, nausea, flatulence; arthralgia, pain in extremity, musculoskeletal pain, muscle spasms, myalgia, joint swelling; abnormal LFT, increased blood CPK.

Increased risk of myopathy w/ cyclosporine, fibric acid derivatives, niacin, erythromycin, azole antifungals. Increased plasma conc by CYP3A4 inhibitors, erythromycin or clarithromycin, PIs, diltiazem, grapefruit juice. Increased AUC w/ itraconazole. Increased exposure w/ OATP1B1, OATP1B3, MDR1, BCRP, P-gp, MRP2, OAT2 inhibitors. Reduced plasma conc by CYP3A4 inducers, Mg- & Al hydroxide-containing antacids, colestipol. Increased digoxin conc. Increased AUC values for norethindrone & ethinyl estradiol. Cases of myopathy w/ colchicine. Increased risk of rhabdomyolysis w/ fusidic acid. Severe myositis & myoglobinuria w/ fibrates.

Dyslipidaemic Agents

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

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