Medicine Information

Corestin

Name: Corestin
Brand: Corestin
Rating: 4.5 (117 reviews)

Tablet20 mgStatins (HMG-CoA Reductase Inhibitors)ATC: C10AA05

Generic Name

Atorvastatin

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
corestin 20 mg tablet	৳ 50.00	৳ 500.00

Description

Overview of the medicine

Corestin 20 mg Tablet contains atorvastatin, a medicine used to lower high cholesterol and triglyceride levels in the blood, thereby reducing the risk of heart attack and stroke. It works by blocking an enzyme in the liver that produces cholesterol.

Uses & Indications

Primary hypercholesterolemia (heterozygous familial and non-familial) and mixed dyslipidemia

Homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments

Prevention of cardiovascular events in patients at high risk of a first cardiovascular event

Dosage

Adults

The usual starting dose is 10 mg once daily. The dose can be adjusted based on LDL-C levels and therapeutic response, ranging from 10 mg to a maximum of 80 mg once daily. For Corestin 20 mg, it can be used as a starting dose or for dose adjustment.

Elderly

No dosage adjustment is required for elderly patients.

Renal_impairment

Renal impairment does not affect plasma concentrations or lipid-lowering effects of atorvastatin; therefore, no dosage adjustment is required.

How to Take

Corestin 20 mg Tablet should be taken orally once daily, with or without food. It can be taken at any time of the day, but it is advisable to take it at the same time each day to maintain consistency.

Mechanism of Action

Atorvastatin is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme responsible for converting 3-hydroxy-3-methylglutaryl coenzyme A to mevalonate, a precursor of sterols, including cholesterol. Inhibition of HMG-CoA reductase by atorvastatin decreases cholesterol synthesis in the liver and increases the number of LDL receptors on the hepatocyte surface, enhancing uptake and catabolism of LDL.

Pharmacokinetics

Onset

Lipid-lowering effect is generally observed within 2 weeks, with maximal effects usually achieved within 4 weeks.

Excretion

Primarily excreted in the bile following hepatic and/or extrahepatic metabolism. Less than 2% of a dose is recovered in urine.

Half life

The parent drug has a plasma elimination half-life of approximately 14 hours. Active metabolites contribute to 20-30 hours of HMG-CoA reductase inhibitory activity.

Absorption

Rapidly absorbed after oral administration, with maximum plasma concentrations occurring within 1-2 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 and breastfeeding
Hypersensitivity to atorvastatin or any component of the formulation
Concomitant use with glecaprevir/pibrentasvir (HCV regimen)

Drug Interactions

Warfarin

Atorvastatin may cause a slight increase in INR (International Normalized Ratio) in patients receiving warfarin. Monitor INR closely.

Cyclosporine

Concomitant use increases atorvastatin exposure significantly (up to 8-fold), increasing the risk of myopathy/rhabdomyolysis. Avoid co-administration.

Oral Contraceptives

Atorvastatin can increase plasma concentrations of ethinyl estradiol and norethindrone. Consider this when selecting an oral contraceptive.

Gemfibrozil and other Fibrates

Increased risk of myopathy/rhabdomyolysis when used with atorvastatin.

Niacin (Lipid-modifying doses)

Increased risk of muscle-related adverse events, including rhabdomyolysis.

Strong CYP3A4 Inhibitors (e.g., Itraconazole, Ketoconazole, Ritonavir, Clarithromycin)

Can significantly increase plasma concentrations of atorvastatin, leading to an increased risk of adverse effects, especially myopathy. Lower atorvastatin dose or use alternative therapy.

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 overdose with atorvastatin. In the event of an overdose, symptomatic and supportive measures should be taken. Due to extensive protein binding, hemodialysis is not expected to significantly enhance atorvastatin clearance.

Pregnancy & Lactation

Corestin is contraindicated during pregnancy and breastfeeding. Women of childbearing potential should use effective contraception during treatment. If a patient becomes pregnant while taking this drug, the drug should be discontinued immediately and the patient should be apprised of the potential hazard to the fetus.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per strip30 tablets per box

Shelf Life

Typically 36 months from the date of manufacture when stored under recommended conditions.

Availability

Available in pharmacies and hospitals.

Approval Status

Approved by regulatory authorities worldwide, including FDA and DGDA.

Patent Status

Generic versions available

WHO Essential Medicine

Yes

Clinical Trials

Atorvastatin has been extensively studied in numerous large-scale clinical trials (e.g., ASCOT-LLA, MIRACL, TNT, CARDS) demonstrating its efficacy in reducing cardiovascular events and improving lipid profiles in various patient populations.

Lab Monitoring

Liver function tests (ALT/AST) should be performed before the initiation of therapy and periodically thereafter.
Lipid panel (total cholesterol, LDL-C, HDL-C, triglycerides) should be monitored to assess therapeutic response.
Creatine kinase (CK) levels should be measured if a patient experiences unexplained muscle pain, tenderness, or weakness.

Doctor Notes

Emphasize the importance of lifestyle modifications (diet, exercise, smoking cessation) as an adjunct to pharmacotherapy for optimal lipid management.
Educate patients on potential muscle-related side effects and advise them to report any symptoms promptly.
Monitor liver function tests at baseline and periodically as per guidelines. Consider dose adjustment or alternative statin if significant elevations occur.
Counsel patients on potential drug-drug and drug-food interactions, especially with strong CYP3A4 inhibitors and grapefruit juice.

Patient Guidelines

Follow your doctor's advice regarding diet, exercise, and weight management while taking Corestin.
Do not stop taking Corestin without consulting your doctor, even if your cholesterol levels improve.
Report any unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise, to your doctor immediately.
Limit or avoid consumption of grapefruit juice as it may interact with this medicine.

Missed Dose Advice

If you miss a dose of Corestin, take it as soon as you remember. If it is almost time for your next scheduled 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

Corestin generally has no or negligible influence on the ability to drive and use machines. However, if you experience dizziness or other side effects that could impair your judgment or physical abilities, you should avoid driving or operating machinery.

Lifestyle Advice

Adopt a heart-healthy diet low in saturated and trans fats, and cholesterol.
Engage in regular physical activity, aiming for at least 30 minutes of moderate-intensity exercise most days of the week.
Maintain a healthy body weight.
Quit smoking and limit alcohol consumption.