Lipicut
Generic Name
Atorvastatin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lipicut 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, reducing the risk of cardiovascular diseases such as heart attack and stroke.
Uses & Indications
Dosage
Adults
Initial dose is usually 10-20 mg once daily. The dose can be adjusted based on lipid levels and therapeutic goal, up to a maximum of 80 mg once daily. Lipicut 20 mg is a common starting or maintenance dose.
Elderly
No dosage adjustment is required in elderly patients.
Renal_impairment
No dosage adjustment is required for patients with renal impairment.
How to Take
Administer orally once daily at any time of day, with or without food. Swallow the tablet whole with water. Do not crush or chew.
Mechanism of Action
Atorvastatin selectively inhibits HMG-CoA reductase, an enzyme that catalyzes the rate-limiting step in cholesterol biosynthesis, primarily in the liver. This reduces cholesterol production and increases LDL receptors on liver cells, leading to increased clearance of LDL from the blood.
Pharmacokinetics
Onset
Lipid-lowering effects are observed within 2 weeks, with maximal effects typically achieved within 4 weeks of therapy.
Excretion
Excreted primarily in the bile following hepatic and/or extra-hepatic metabolism. Less than 2% is recovered in urine.
Half life
The elimination half-life of atorvastatin is approximately 14 hours, but the half-life of inhibitory activity for HMG-CoA reductase is 20 to 30 hours due to the contribution of active metabolites.
Absorption
Rapidly absorbed after oral administration; peak plasma concentrations reached within 1-2 hours. Absolute bioavailability is approximately 12% due to extensive presystemic clearance.
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 medication.
Drug Interactions
Warfarin
May enhance the anticoagulant effect of warfarin.
Oral Contraceptives
Increased AUC of ethinyl estradiol and norethindrone.
Niacin (lipid-lowering doses)
Increased risk of muscle adverse events.
Gemfibrozil and other fibrates
Increased risk of myopathy/rhabdomyolysis.
Strong CYP3A4 inhibitors (e.g., macrolides, azole antifungals, cyclosporine, protease inhibitors)
Increased atorvastatin plasma concentrations, increasing risk of myopathy/rhabdomyolysis.
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 instituted as required. Liver function tests and CK levels should be monitored.
Pregnancy & Lactation
Atorvastatin is contraindicated during pregnancy (Pregnancy Category X) and lactation due to the potential for fetal harm and unknown excretion into breast milk. Women of childbearing potential should use adequate contraception.
Side Effects
Contraindications
- Active liver disease or unexplained persistent elevations of serum transaminases.
- Pregnancy and lactation.
- Hypersensitivity to atorvastatin or any component of the medication.
Drug Interactions
Warfarin
May enhance the anticoagulant effect of warfarin.
Oral Contraceptives
Increased AUC of ethinyl estradiol and norethindrone.
Niacin (lipid-lowering doses)
Increased risk of muscle adverse events.
Gemfibrozil and other fibrates
Increased risk of myopathy/rhabdomyolysis.
Strong CYP3A4 inhibitors (e.g., macrolides, azole antifungals, cyclosporine, protease inhibitors)
Increased atorvastatin plasma concentrations, increasing risk of myopathy/rhabdomyolysis.
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 instituted as required. Liver function tests and CK levels should be monitored.
Pregnancy & Lactation
Atorvastatin is contraindicated during pregnancy (Pregnancy Category X) and lactation due to the potential for fetal harm and unknown excretion into breast milk. Women of childbearing potential should use adequate contraception.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Generally 24-36 months from the date of manufacture, specific to manufacturer's guidelines.
Availability
Pharmacies, hospitals
Approval Status
Approved by FDA and DGDA
Patent Status
Generic available, patent expired
WHO Essential Medicine
YesClinical Trials
Atorvastatin has been extensively studied in large-scale clinical trials such as ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial), CARDS (Collaborative Atorvastatin Diabetes Study), TNT (Treating to New Targets), and MIRACL (Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering) demonstrating its efficacy in reducing cardiovascular events.
Lab Monitoring
- Lipid panel (LDL-C, HDL-C, triglycerides, total cholesterol) should be assessed before initiating therapy and periodically thereafter.
- Liver function tests (ALT, AST) should be performed before the initiation of atorvastatin therapy and as clinically indicated.
- Creatine Kinase (CK) levels should be measured if muscle symptoms (e.g., pain, tenderness, weakness) occur.
Doctor Notes
- Emphasize the importance of consistent adherence to medication, diet, and exercise.
- Monitor lipid profiles and liver function tests regularly (baseline, 6-12 weeks after initiation or dose change, then annually or as clinically indicated).
- Counsel patients to report any muscle pain or weakness promptly, especially if severe or accompanied by other symptoms.
- Advise against co-administration with strong CYP3A4 inhibitors without careful consideration and dose adjustment.
- Atorvastatin is contraindicated in pregnancy and breastfeeding.
Patient Guidelines
- Take Lipicut exactly as prescribed by your doctor, usually once daily.
- Continue to follow your doctor's recommendations for diet and exercise.
- Report any unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or dark urine, to your doctor immediately.
- Avoid consuming large amounts of grapefruit juice while on this medication.
- Do not stop taking Lipicut without consulting your doctor, even if you feel well.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose (within 12 hours). Do not double the dose to catch up.
Driving Precautions
Atorvastatin is generally not expected to affect the ability to drive or operate machinery. However, if you experience dizziness or other side effects that could impair your judgment, use caution.
Lifestyle Advice
- Adopt a heart-healthy diet low in saturated and trans fats and cholesterol.
- Engage in regular physical activity as advised by your doctor.
- Maintain a healthy weight.
- Quit smoking and limit alcohol intake.
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