COMMON BRAND NAME(S):
Lipitor

CLICK HERE TO BUY LIPITOR FROM OUR CANADIAN PHARMACY

Uses: (1) Treats high blood cholesterol (in people with Types IIa and lIb hypercholesterolemia) due to increased fractions of low-density lipoprotein (LDL) cholesterol; (2) also works in primary dysbetalipoproteinemia (Fredrickson Type III) and in patients with elevated serum triglycerides (Fredrickson Type IV). Used in conjunction with a cholesterol-lowering diet. Should not be used until an adequate trial of nondrug methods has proved to be ineffective. NCEP ATP 3 recognizes therapeutic lifestyle changes (TLC) as very important; (3) also helps familial hypercholesterolemia; (4) approved to increase HDL-C (good cholesterol) in people with primary hypercholesterolemia and mixed dyslipidemia.

Other (unlabeled) generally accepted uses: (l) a New England Journal of Medicine study found that atorvastatin was as effective as getting an angioplasty when it was used to treat stable heart (coronary) artery disease; (2) prevention of coronary heart disease; (3) treats abnormal fat (lipid) changes caused by protease inhibitors; (4) may help prevent bone loss (osteoporosis) in type two diabetics and osteoporosis in general; (5) may help prevent clogging (restenosis) of tubes (stents) placed in coronary arteries; (6) starting atorvastatin quickly after a sudden coronary problem (see acute coronary syndromes in Glossary) may help lower the risk of circulatory events (recurrent ischemic events) based on results of the MIRACL trial; (7) ongoing use may help lower the risk of dementia (such as Alzheimer's disease); (8) one case-control study found a 20% reduction in cancer risk by "statin type" medicines. Further research is needed.

How This Drug Works: Blocks a liver enzyme that starts making cholesterol. Lowers low-density lipoproteins (LDL), the cholesterol fraction thought to increase risk of coronary heart disease. Since the amount of cholesterol is reduced in the liver, the VLDL fraction may also be decreased. There is a growing body of evidence that "statins" also have beneficial changes on what is in the blood, blood flow and even the blood vessel walls themselves (some of this may account for benefits in decreasing Alzheimer's risk). Specific compounds'or effects of platelet derived growth factor (PDGF), undesirable blood clotting via thrombin-antithrombin III, thrombomodulin, and other chemicals may be beneficially lowered or effects mitigated by statins.

Available Dosage Forms and Strengths

Tablets - 10 mg, 20 mg, 40 mg, 80 mg

Recommended Dosage Ranges (Actual dosage and schedule must be determined for each patient individually.)

Infants and Children: Data are not available.

18 to 65 Years of Age:
Cholesterol management: Patients are started on a typical low cholesterol diet (see wW1.v.americanheart.org). Atorvastatin dosing is started with 10 mg once daily. Patients who require more than a 45% decrease in LDL can be started at 40 mg once a day. The starting dose is increased (dose intensified) as needed and tolerated to a maximum of 80 mg daily. Lipid levels best rechecked within 2 to 4 weeks of starting or changing the dose. Some clinicians are studying weekly divided dosing, but conclusions are not yet made.
Acute Coronary Syndromes: (based on MIRACL data): 80 mg once a day is started 24-96 hours after the patient goes into the hospital (along with other medicines such as aspirin, beta blockers, nitrates, and heparin).

Over 65 Years of Age: Some research shows that usual doses may result in higher levels than seen in younger patients. It appears prudent that the lowest dose (10 mg) should be used and LDL-C levels be checked to guide any dose increases. Dose increases must be made after weighing the benefit~ and risks, mindful that any given dose may result in a higher than expected blood level.

Conditions Requiring Dosing Adjustments

Liver Function: Caution should be used in patients with liver compromise. In those with liver damage caused by alcohol, removal from the body has been prolonged. A 10-mg dose appears prudent. Like other HMG-CoA medicines, atorvastatin should not be given during active liver disease.
Kidney Function: The manufacturer does not recommend dosing changes.

Dosing Instructions: The tablet may be crushed or split. Better taken on an empty stomach. Since cholesterol is made at the fastest rate between midnight and 5 a.m., many clinicians advise patients to take such medicines at bedtime. If you forget a dose, take it immediately unless it is almost time for your next dose. If your next dose is shortly due, skip the missed dose and just take the next scheduled dose. DO NOT double doses.

Usual Duration of Use: Use on a regular schedule for 2 to 4 weeks usually determines the effectiveness of this drug in reducing blood levels of total and LDL-C cholesterol. Increases in good cholesterol (HDL) may take longer. Use is usually ongoing. Long-term use (months to years) requires periodic physician evaluation and follow-up.

Please Note: The information contained on this page is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs or following any treatment or regimen. Only your doctor, nurse or pharmacist can provide you with advice on what is safe and effective for you.

CLICK HERE TO BUY LIPITOR FROM OUR CANADIAN PHARMACY