A-Card
Generic Name
Atorvastatin Calcium
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| a card 20 mg tablet | ৳ 1.43 | ৳ 14.30 |
Description
Overview of the medicine
A-Card 20 mg Tablet contains Atorvastatin Calcium, a lipid-lowering agent belonging to the class of HMG-CoA reductase inhibitors (statins). It is primarily used to reduce elevated cholesterol levels (LDL-C, total-C, triglycerides) and increase HDL-C in patients with primary hypercholesterolemia, mixed dyslipidemia, and homozygous familial hypercholesterolemia. It also helps in the prevention of cardiovascular events.
Uses & Indications
Dosage
Adults
Initial dose 10-20 mg once daily. Dose may be adjusted according to LDL-C goals, typically 10-80 mg once daily. Take at any time of day, with or without food.
Elderly
No dosage adjustment required for elderly patients.
Renal_impairment
No dosage adjustment required for patients with renal impairment.
How to Take
Oral administration. Can be taken as a single dose at any time of the day, with or without food. It is recommended to take it at the same time each day to help remember doses.
Mechanism of Action
Atorvastatin selectively inhibits HMG-CoA reductase, an enzyme that catalyzes the early rate-limiting step in cholesterol biosynthesis. By inhibiting this enzyme, atorvastatin reduces the synthesis of cholesterol in the liver, leading to a compensatory increase in the expression of LDL receptors on the hepatocyte surface. This enhances the uptake and catabolism of LDL-C from the bloodstream, thereby lowering plasma cholesterol and lipoprotein levels.
Pharmacokinetics
Onset
Lipid-lowering effects typically begin within 2 weeks, with maximum effect observed by 4 weeks.
Excretion
Primarily excreted in bile following hepatic and/or extrahepatic metabolism. Less than 2% is excreted in urine.
Half life
Approximately 14 hours for atorvastatin, but the half-life of HMG-CoA reductase inhibitory activity is 20-30 hours due to active metabolites.
Absorption
Rapidly absorbed after oral administration, peak plasma concentrations occur within 1 to 2 hours. Absolute bioavailability is approximately 14% due to extensive first-pass metabolism.
Metabolism
Extensively metabolized by cytochrome P450 3A4 (CYP3A4) to active ortho- and parahydroxylated metabolites and various beta-oxidation products.
Side Effects
Contraindications
- Active liver disease, including unexplained persistent elevations of serum transaminases
- Pregnancy
- Lactation
- Hypersensitivity to atorvastatin or any component of the formulation
- Concomitant use of glecaprevir/pibrentasvir
Drug Interactions
Colchicine
Cases of myopathy, including rhabdomyolysis, have been reported.
Gemfibrozil, other Fibrates, Niacin (lipid-lowering doses)
Increased risk of myopathy/rhabdomyolysis.
Cyclosporine, Telaprevir, Tipranavir/Ritonavir, Glecaprevir/Pibrentasvir
Significantly increased atorvastatin exposure and risk of myopathy/rhabdomyolysis.
Clarithromycin, Itraconazole, Ketoconazole, Voriconazole, HIV protease inhibitors (e.g., Lopinavir/Ritonavir)
Increased atorvastatin plasma concentrations.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
There is no specific treatment for atorvastatin overdose. In the event of an overdose, the patient should be treated symptomatically, and supportive measures should be instituted as required. Due to extensive protein binding, hemodialysis is not expected to significantly enhance atorvastatin clearance.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. Women of childbearing potential should use effective contraception. If pregnancy occurs, stop atorvastatin immediately.
Side Effects
Contraindications
- Active liver disease, including unexplained persistent elevations of serum transaminases
- Pregnancy
- Lactation
- Hypersensitivity to atorvastatin or any component of the formulation
- Concomitant use of glecaprevir/pibrentasvir
Drug Interactions
Colchicine
Cases of myopathy, including rhabdomyolysis, have been reported.
Gemfibrozil, other Fibrates, Niacin (lipid-lowering doses)
Increased risk of myopathy/rhabdomyolysis.
Cyclosporine, Telaprevir, Tipranavir/Ritonavir, Glecaprevir/Pibrentasvir
Significantly increased atorvastatin exposure and risk of myopathy/rhabdomyolysis.
Clarithromycin, Itraconazole, Ketoconazole, Voriconazole, HIV protease inhibitors (e.g., Lopinavir/Ritonavir)
Increased atorvastatin plasma concentrations.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
There is no specific treatment for atorvastatin overdose. In the event of an overdose, the patient should be treated symptomatically, and supportive measures should be instituted as required. Due to extensive protein binding, hemodialysis is not expected to significantly enhance atorvastatin clearance.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. Women of childbearing potential should use effective contraception. If pregnancy occurs, stop atorvastatin immediately.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by FDA and DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials (e.g., ASCOT-LLA, MIRACL, TNT) have demonstrated atorvastatin's efficacy in lipid reduction and cardiovascular event prevention.
Lab Monitoring
- Liver function tests (ALT, AST) before initiating therapy and periodically thereafter
- Lipid panel (total cholesterol, LDL-C, HDL-C, triglycerides) to assess treatment response
- Creatine kinase (CK) if muscle pain or weakness occurs
Doctor Notes
- Emphasize adherence to lipid-lowering diet and lifestyle modifications.
- Counsel patients on symptoms of myopathy and to report them promptly.
- Monitor LFTs at baseline and as clinically indicated, especially with dose escalation.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Continue to follow a cholesterol-lowering diet and exercise program.
- Do not stop taking this medicine without consulting your doctor, even if you feel well.
- Report any unexplained muscle pain, tenderness, or weakness immediately to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Atorvastatin has no or negligible influence on the ability to drive and use machines.
Lifestyle Advice
- Adopt a healthy diet low in saturated and trans fats.
- Engage in regular physical activity (e.g., 30 minutes of moderate-intensity exercise most days of the week).
- Maintain a healthy weight.
- Quit smoking.
- Limit alcohol consumption.
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