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Coronary Heart Disease

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Atorvastatin

Brand Name: Lipitor
Drug Class: Antilipidemic (cholesterol-lowering agent)
Available in: Tablets
Available OTC? No
As Generic? No

Side Effects

Serious: Fever, chest pain, unusual or unexplained muscle aches and tenderness. If you experience one or more of these side effects, call your doctor immediately.

Common: Constipation or diarrhea, dizziness or lightheadedness, bloating or gas, heartburn, nausea, allergic reaction, stomach pain, rise in liver enzymes. These side effects occur in 1% to 2% of patients.

Less Common: Sleeping difficulty, skin rash.

Principal Uses

To treat high blood cholesterol levels. Usually prescribed after lifestyle measures, including dietary changes, weight loss, and exercise, fail to reduce the amounts of total and low density lipoprotein (LDL) cholesterol in the blood to acceptable levels.

How the Drug Works

Atorvastatin blocks the action of an enzyme required for the manufacture of cholesterol, thereby interfering with its formation. By lowering the amount of cholesterol in liver cells, atorvastatin increases the formation of receptors for LDL, reducing blood levels of total and LDL cholesterol. In addition to lowering LDL cholesterol, atorvastatin also modestly reduces triglyceride levels and raises HDL (the so-called "good") cholesterol.

Dosage

Initial dose is 10 mg a day, taken once daily. It may be increased by your doctor as needed to a maximum dose of 80 mg per day. Unlike other "statin" cholesterol-lowering drugs, atorvastatin does not have to be taken in the evening to be maximally effective.

Onset of Effect

2 to 4 weeks.

Duration of Action

The effect persists for the duration of therapy.

Dietary Advice

Cholesterol-lowering drugs are only one part of a total program that should include regular exercise and a healthy diet. The American Heart Association publishes a "Healthy Heart" diet, which is recommended.

Storage

Store in a tightly sealed container in a dry place away from heat and direct light.

If You Miss a Dose

Take it as soon as you remember. Take your next scheduled dose at the proper time and resume your regular dosage schedule. Do not double your next dose.

Stopping the Drug

The decision to stop taking the drug should be made in consultation with your doctor. Once the medication is discontinued, blood cholesterol will likely return to its original elevated levels.

Prolonged Use

Side effects are more likely with prolonged use. As you continue with atorvastatin, your doctor will periodically order blood tests to evaluate liver function.

Precautions

Over 60: No special problems are expected in older patients.

Driving and Hazardous Work: The use of atorvastatin should not impair your ability to perform such tasks safely.

Alcohol: No special precautions are necessary.

Pregnancy: Should not be used during pregnancy or by women who plan to become pregnant in the near future.

Breast Feeding: This drug is not recommended for women who are nursing.

Infants and Children: Safety and effectiveness are not known; this drug is rarely used in children. Consult your pediatrician.

Special Concerns: Important elements of treatment for high cholesterol include proper diet, weight loss, regular moderate exercise, and avoidance of certain medications that may increase cholesterol levels. Because atorvastatin has potential side effects, it is important that you maintain a healthy diet and follow other treatments your doctor may suggest.

Overdose

Symptoms: An overdose of atorvastatin is unlikely.

What to Do: Emergency instructions not applicable.

Drug Interactions

Consult your doctor if you are taking cyclosporine, gemfibrozil, niacin, antibiotics, (especially erythromycin), or medications for fungal infections. All of these drugs may increase the risk of myositis (muscle inflammation) when taken with atorvastatin and may lead to kidney failure.

Food Interactions

No known food interactions.

Disease Interactions

Consult your doctor if you have any of the following problems: liver, kidney, or muscle disease, or have undergone an organ transplant or recent surgery.

 

From The Johns Hopkins Consumer Guide to Drugs. You can order this book now on our secure server.


 

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