Atrovast
Generic Name
Atorvastatin Calcium 20 mg
Manufacturer
Drug International Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| atrovast 20 mg tablet | ৳ 18.05 | ৳ 180.50 |
Description
Overview of the medicine
Atorvastatin is a medication used to lower cholesterol and triglycerides in the blood. It helps reduce the risk of heart attacks, strokes, and certain other cardiovascular conditions.
Uses & Indications
Dosage
Adults
The usual starting dose is 10-20 mg once daily. Doses may range from 10 mg to 80 mg once daily. For Atrovast 20mg, it is typically used as a maintenance dose or starting dose for patients requiring greater LDL-C reduction.
Elderly
No specific dose adjustment is required in elderly patients. Start with the lowest effective dose.
Renal_impairment
No dose adjustment is necessary for patients with renal impairment.
How to Take
Take Atrovast 20 mg tablet orally once daily, with or without food. It can be taken at any time of day, but it is recommended to take it at the same time each day to maintain consistent blood levels.
Mechanism of Action
Atorvastatin selectively inhibits HMG-CoA reductase, an enzyme that catalyzes the early, rate-limiting step in cholesterol biosynthesis in the liver. This inhibition reduces cholesterol production and subsequently increases the number of LDL receptors on the hepatocyte surface, leading to increased uptake and catabolism of LDL-C from the bloodstream.
Pharmacokinetics
Onset
Lipid-lowering effects are observed within 2 weeks, with maximal effects usually seen by 4 weeks of continuous therapy.
Excretion
Primarily excreted in the bile following hepatic and/or extrahepatic metabolism; less than 2% is recovered in urine.
Half life
Approximately 14 hours for the parent drug; active metabolites contribute to a mean inhibitory activity half-life of 20-30 hours.
Absorption
Rapidly absorbed after oral administration; peak plasma concentrations achieved within 1-2 hours. Absolute bioavailability is approximately 12-14%.
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 or unexplained persistent elevations of serum transaminases.
- Pregnancy and lactation.
- Hypersensitivity to atorvastatin or any component of the formulation.
Drug Interactions
Warfarin
Potentiation of anticoagulant effect, requiring close monitoring of INR.
Cyclosporine, Gemfibrozil, Niacin, Ezetimibe
Increased risk of myopathy/rhabdomyolysis when co-administered with atorvastatin.
CYP3A4 inhibitors (e.g., Macrolides like erythromycin, Azole antifungals like ketoconazole, Protease inhibitors like ritonavir)
Increased plasma concentrations of atorvastatin, potentially increasing the risk of adverse effects.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
There is no specific treatment for atorvastatin overdose. In case of an overdose, symptomatic and supportive measures should be initiated as necessary.
Pregnancy & Lactation
Atorvastatin is contraindicated during pregnancy and breastfeeding. It can cause fetal harm and is excreted in breast milk.
Side Effects
Contraindications
- Active liver disease or unexplained persistent elevations of serum transaminases.
- Pregnancy and lactation.
- Hypersensitivity to atorvastatin or any component of the formulation.
Drug Interactions
Warfarin
Potentiation of anticoagulant effect, requiring close monitoring of INR.
Cyclosporine, Gemfibrozil, Niacin, Ezetimibe
Increased risk of myopathy/rhabdomyolysis when co-administered with atorvastatin.
CYP3A4 inhibitors (e.g., Macrolides like erythromycin, Azole antifungals like ketoconazole, Protease inhibitors like ritonavir)
Increased plasma concentrations of atorvastatin, potentially increasing the risk of adverse effects.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
There is no specific treatment for atorvastatin overdose. In case of an overdose, symptomatic and supportive measures should be initiated as necessary.
Pregnancy & Lactation
Atorvastatin is contraindicated during pregnancy and breastfeeding. It can cause fetal harm and is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, depending on the specific manufacturer and formulation.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of atorvastatin in reducing LDL-C and the risk of major cardiovascular events across various patient populations, including those with primary hypercholesterolemia, mixed dyslipidemia, and for primary and secondary prevention of cardiovascular disease.
Lab Monitoring
- Liver function tests (ALT, AST) should be performed before initiation of therapy and periodically thereafter.
- Lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides) should be checked periodically to assess the efficacy of treatment.
Doctor Notes
- Emphasize the importance of lifestyle modifications (diet, exercise, smoking cessation) as an integral part of lipid management.
- Regularly monitor liver function tests (LFTs) at baseline and as clinically indicated, especially if symptoms suggestive of liver injury develop.
- Educate patients on symptoms of myopathy and rhabdomyolysis and advise them to report muscle pain or weakness promptly.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor, do not alter the dose or stop without consultation.
- Report any unexplained muscle pain, tenderness, or weakness immediately to your doctor, especially if accompanied by fever or dark urine.
- Adhere to a cholesterol-lowering diet and exercise program as advised by your healthcare provider.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, 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 is not expected to affect the ability to drive or operate machinery. However, if you experience dizziness or other side effects that could impair your ability, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain a heart-healthy diet low in saturated and trans fats, cholesterol, and sugar.
- Engage in regular physical activity for at least 30 minutes most days of the week.
- Avoid smoking and limit alcohol consumption to improve cardiovascular health.
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