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Atorvastatin, Lipitor

Description

Lipitor (atorvastatin calcium) is a synthetic lipid-lowering agent. Atorvastatin is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. This enzyme catalyzes the conversion of HMG-CoA to mevalonate, an early and rate-limiting step in cholesterol biosynthesis.

Action

statin, HMG-CoA reductase inhibitor

Indications

Prevention of Cardiovascular Disease

In adult patients without clinically evident coronary heart disease, but with multiple risk factors for coronary heart disease such as age, smoking, hypertension, low HDL-C, or a family history of early coronary heart disease, LIPITOR is indicated to:

áReduce the risk of myocardial infarction
áReduce the risk of stroke
áReduce the risk for revascularization procedures and angina

In patients with type 2 diabetes, and without clinically evident coronary heart disease, but with multiple risk factors for coronary heart disease such as retinopathy, albuminuria, smoking, or hypertension, LIPITOR is indicated to:

áReduce the risk of myocardial infarction
áReduce the risk of stroke

Hypercholesterolemia

LIPITOR is indicated:

1. as an adjunct to diet to reduce elevated total-C, LDL-C, apo B, and TG levels and to increase HDL-C in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb);

2. as an adjunct to diet for the treatment of patients with elevated serum TG levels(Fredrickson Type IV);

3. for the treatment of patients with primary dysbetalipoproteinemia (Fredrickson Type III) who do not respond adequately to diet;

4. to reduce total-C and LDL-C in patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) or if such treatments are unavailable;

5. as an adjunct to diet to reduce total-C, LDL-C, and apo B levels in boys and postmenarchal girls, 10 to 17 years of age, with heterozygous familial hypercholesterolemia if after an adequate trial of diet therapy the following findings are present:

a. LDL-C remains 190 mg/dL or
b. LDL-C remains 160 mg/dL and:

áthere is a positive family history of premature cardiovascular disease or
átwo or more other CVD risk factors are present in the pediatric patient

Therapy with lipid-altering agents should be a component of multiple-risk-factor intervention in individuals at increased risk for atherosclerotic vascular disease due to hypercholesterolemia. Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol only when the response to diet and other nonpharmacological measures has been inadequate (see National Cholesterol Education Program (NCEP) Guidelines, summarized in Table 6).


Side Effects

Muscle disorders, such as leg cramps, myalgia, uncomplicated muscle pain, myopathy and/or rhabdomyolysis, fever, muscle cramps, pain, stiffness, or weakness, unusual tiredness, and myositis, inflammation of muscle, Abdominal pain, constipation, diarrhea, dyspepsia (heartburn, indigestion, stomach discomfort), flatulence (belching, excessive gas), skin rash


Drug-Vitamin-Herb Interactions


Negative interactions:

Chaparral, Comfrey, Coltsfoot
Chaparral, Comfrey, and Coltsfoot may be toxic to the liver, which adds to side effect of statin drugs.

Grapefruit juice
Grapefruit juice impairs the breakdown of several drugs, including statins.

Niacin
High-doses of niacin with statin drugs may increase risk of muscle damage and kidney injury.

Red Yeast Rice
Red Yeast Rice contains natural substances identical to statins.


Positive interactions:

Coenzyme Q10 and Vitamins A, D, E and K
Cholesterol is a precursor to CoQ10 and vitamins ADEK. Statins can reduce their production.

 

 

 

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