Avas
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 |
|---|---|---|
| avas 20 mg tablet | ৳ 20.00 | ৳ 280.00 |
Description
Overview of the medicine
Avas 20 mg Tablet contains Atorvastatin, a lipid-lowering agent. It is primarily used to reduce high cholesterol and triglyceride levels in the blood, thereby decreasing the risk of cardiovascular diseases such as heart attack and stroke.
Uses & Indications
Dosage
Adults
Initial dose 10 mg or 20 mg once daily. Dose range 10 mg to 80 mg once daily. Adjust dosage at intervals of 2-4 weeks based on lipid levels.
Elderly
No specific dose adjustment required based on age alone, but caution with concomitant medications.
Renal_impairment
No dose adjustment required for renal impairment.
How to Take
Oral administration, can be taken any time of the day, with or without food.
Mechanism of Action
Atorvastatin selectively inhibits HMG-CoA reductase, an enzyme that catalyzes the rate-limiting step in cholesterol biosynthesis. This inhibition leads to a decrease in hepatic cholesterol synthesis, which in turn increases the number of hepatic LDL receptors, resulting in increased uptake and catabolism of LDL-C from the circulation.
Pharmacokinetics
Onset
Lipid-lowering effects typically evident within 2 weeks, maximal effects seen in 4 weeks.
Excretion
Primarily excreted in the bile following hepatic and/or extra-hepatic metabolism. Less than 2% is excreted in urine.
Half life
Approximately 14 hours (for parent drug); active metabolites contribute to a longer effect (up to 20-30 hours).
Absorption
Rapidly absorbed after oral administration; peak plasma concentrations reached within 1 to 2 hours. Absolute bioavailability is approximately 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
- Lactation
- Hypersensitivity to Atorvastatin or any component of the formulation
Drug Interactions
Warfarin
May potentiate the anticoagulant effect of warfarin.
Colchicine
Cases of myopathy, including rhabdomyolysis, have been reported with concomitant use of atorvastatin and colchicine.
Cyclosporine, Gemfibrozil, Niacin (lipid-lowering doses)
Increased risk of myopathy/rhabdomyolysis.
CYP3A4 inhibitors (e.g., Macrolide antibiotics, Azole antifungals, Protease inhibitors)
Increased plasma concentrations of atorvastatin, increasing risk of myopathy.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
No specific antidote. In case of overdose, provide symptomatic and supportive measures. Monitor liver function and creatinine kinase levels.
Pregnancy & Lactation
Contraindicated in pregnancy (Pregnancy Category X) and breastfeeding due to potential harm to the fetus/infant. Women of childbearing potential should use adequate contraception.
Side Effects
Contraindications
- Active liver disease or unexplained persistent elevations of serum transaminases
- Pregnancy
- Lactation
- Hypersensitivity to Atorvastatin or any component of the formulation
Drug Interactions
Warfarin
May potentiate the anticoagulant effect of warfarin.
Colchicine
Cases of myopathy, including rhabdomyolysis, have been reported with concomitant use of atorvastatin and colchicine.
Cyclosporine, Gemfibrozil, Niacin (lipid-lowering doses)
Increased risk of myopathy/rhabdomyolysis.
CYP3A4 inhibitors (e.g., Macrolide antibiotics, Azole antifungals, Protease inhibitors)
Increased plasma concentrations of atorvastatin, increasing risk of myopathy.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
No specific antidote. In case of overdose, provide symptomatic and supportive measures. Monitor liver function and creatinine kinase levels.
Pregnancy & Lactation
Contraindicated in pregnancy (Pregnancy Category X) and breastfeeding due to potential harm to the fetus/infant. Women of childbearing potential should use adequate contraception.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory authorities worldwide (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Atorvastatin has undergone extensive clinical trials demonstrating its efficacy in lowering lipid levels and reducing cardiovascular events, including primary and secondary prevention studies (e.g., ASCOT, CARDS, TNT, AVERT).
Lab Monitoring
- Liver function tests (ALT, AST) before initiation and periodically thereafter (e.g., at 6 and 12 weeks after initiation or dose escalation, then periodically).
- Lipid panel (Total cholesterol, LDL-C, HDL-C, Triglycerides) before initiation and to assess response (e.g., 4-12 weeks after initiation or dose change).
- Creatinine Kinase (CK) levels should be measured before starting treatment in patients at increased risk for myopathy.
Doctor Notes
- Emphasize the importance of patient adherence to diet, exercise, and medication.
- Counsel patients on muscle-related symptoms and to report them promptly.
- Regular monitoring of liver function tests is crucial.
Patient Guidelines
- Take the tablet whole, with or without food, at any time of day.
- Continue to follow a cholesterol-lowering diet and exercise program.
- Report any unexplained muscle pain, tenderness, or weakness immediately to your doctor.
- Do not stop taking the medicine without consulting 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. Do not take a double dose to make up for a missed one.
Driving Precautions
Atorvastatin is generally not expected to affect the ability to drive or operate machinery. However, if you experience dizziness, avoid driving or operating heavy machinery.
Lifestyle Advice
- Maintain a healthy diet low in saturated and trans fats, and cholesterol.
- Engage in regular physical activity (e.g., 30 minutes of moderate-intensity exercise most days of the week).
- Avoid smoking and limit alcohol consumption.
- Improve stress management.
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