Divastin
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 |
|---|---|---|
| divastin 40 mg tablet | ৳ 24.00 | ৳ 336.00 |
Description
Overview of the medicine
Divastin 40 mg Tablet contains Atorvastatin, a medication used to lower high cholesterol and triglyceride levels in the blood, thereby reducing the risk of heart attack and stroke. It works by inhibiting an enzyme crucial for cholesterol production in the liver.
Uses & Indications
Dosage
Adults
The usual starting dose is 10 or 20 mg once daily. For patients requiring a large reduction in LDL-C (more than 45%), a starting dose of 40 mg once daily may be initiated. The dose range is 10 to 80 mg once daily. Doses should be individualized according to the patient's LDL-C levels, goal of therapy, and response.
Elderly
No dosage adjustment is required for elderly patients. However, caution should be exercised in those with renal or hepatic impairment.
Renal_impairment
No dosage adjustment is required for patients with renal impairment.
How to Take
Divastin 40 mg Tablet is for oral administration. It can be taken once daily at any time of the day, with or without food. It is recommended to take it at the same time each day for consistency.
Mechanism of Action
Atorvastatin is a selective, competitive inhibitor of HMG-CoA reductase, an enzyme that catalyzes the conversion of 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, an early and rate-limiting step in cholesterol biosynthesis. It reduces LDL-C by inhibiting hepatic cholesterol synthesis and by increasing the number of hepatic LDL receptors on the cell surface to enhance uptake and catabolism of LDL.
Pharmacokinetics
Onset
Significant reduction in plasma LDL-C observed within 2 weeks, 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
Mean plasma elimination half-life is approximately 14 hours. The half-life of inhibitory activity for HMG-CoA reductase is 20-30 hours due to the contribution of active metabolites.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations achieved within 1-2 hours. Absolute bioavailability is approximately 14%.
Metabolism
Extensively metabolized by cytochrome P450 3A4 (CYP3A4) to ortho- and parahydroxylated derivatives and various beta-oxidation products.
Side Effects
Contraindications
- Active liver disease or unexplained persistent elevations of serum transaminases.
- Pregnancy and lactation.
- Hypersensitivity to any component of this medication.
Drug Interactions
Warfarin
Atorvastatin has no clinically significant effect on prothrombin time when administered to patients receiving chronic warfarin treatment.
Oral Contraceptives
May increase plasma concentrations of norethindrone and ethinyl estradiol.
Cyclosporine, Gemfibrozil, Niacin, Colchicine, HIV Protease Inhibitors, Macrolide Antibiotics, Azole Antifungals
Increased risk of myopathy/rhabdomyolysis.
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 the event of an overdose, the patient should be treated symptomatically and supportive measures instituted as required. Due to extensive drug binding to plasma proteins, hemodialysis is not expected to significantly enhance atorvastatin clearance.
Pregnancy & Lactation
Atorvastatin is contraindicated during pregnancy (Category X) and lactation. Women of childbearing potential should use adequate contraception during treatment.
Side Effects
Contraindications
- Active liver disease or unexplained persistent elevations of serum transaminases.
- Pregnancy and lactation.
- Hypersensitivity to any component of this medication.
Drug Interactions
Warfarin
Atorvastatin has no clinically significant effect on prothrombin time when administered to patients receiving chronic warfarin treatment.
Oral Contraceptives
May increase plasma concentrations of norethindrone and ethinyl estradiol.
Cyclosporine, Gemfibrozil, Niacin, Colchicine, HIV Protease Inhibitors, Macrolide Antibiotics, Azole Antifungals
Increased risk of myopathy/rhabdomyolysis.
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 the event of an overdose, the patient should be treated symptomatically and supportive measures instituted as required. Due to extensive drug binding to plasma proteins, hemodialysis is not expected to significantly enhance atorvastatin clearance.
Pregnancy & Lactation
Atorvastatin is contraindicated during pregnancy (Category X) and lactation. Women of childbearing potential should use adequate contraception during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to packaging for exact expiry date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic versions available, patent expired for innovator drug
WHO Essential Medicine
YesClinical Trials
Atorvastatin has been extensively studied in numerous clinical trials, including the ASCOT-LLA, MIRACL, and CARDS trials, demonstrating its efficacy in lipid lowering and cardiovascular risk reduction.
Lab Monitoring
- Liver function tests (LFTs) should be performed before initiation of therapy and periodically thereafter.
- Lipid panel should be monitored regularly to assess treatment response.
Doctor Notes
- Monitor LFTs at baseline and as clinically indicated, especially if transaminase levels increase.
- Assess for muscle pain, tenderness, or weakness; consider CK levels if myopathy is suspected.
- Advise patients on lifestyle modifications for optimal lipid management.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Report any unexplained muscle pain, tenderness, or weakness immediately to your doctor.
- Continue to follow a cholesterol-lowering diet during treatment.
Missed Dose Advice
If you miss a dose of Divastin, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Divastin is unlikely to affect the ability to drive or use machines. However, if you experience dizziness, do not drive or operate machinery until you are sure you can do so safely.
Lifestyle Advice
- Maintain a low-fat diet and regular exercise regimen.
- Avoid smoking and excessive alcohol consumption.
- Manage weight and blood pressure.
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