Description
Generic
Atorvastatin Calcium
Indications
Anzitor ® is indicated as an adjunct to diet for the reduction of elevated total cholesterol, LDL-cholesterol, apolipoprotein B, and triglycerides in patients with-
1. Primary hypercholesterolemia (heterozygous familial and non-familial hypercholesterolemia and mixed dyslipidemia (Fredrickson types IIa and IIb))
2. Elevated serum TG levels (Fredrickson type IV)
3. Primary dysbetalipoproteinemia (Fredrickson type III) who do not respond adequately to diet.
4. Homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) or if such treatments are unavailable.
Pharmacology
Anzitor ® is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme responsible for the conversion of 3- hydroxy- 3- methyl- glutaryl- coenzyme A to mevalonate, a precursor of sterols, including cholesterol. Triglycerides (TG) and cholesterol in the liver are incorporated into VLDL and released into the plasma for delivery to peripheral tissues. Low-density lipoprotein (LDL) is formed from VLDL and is catabolized primarily through the high-affinity LDL receptor.
Anzitor ® lowers plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase and cholesterol synthesis in the liver and increases the number of hepatic LDL receptors on the cell surface for enhanced uptake and catabolism of LDL. Anzitor ® reduces LDL production and the number of LDL particles. Anzitor ® produces a profound and sustained increase in LDL receptor activity coupled with a beneficial change in the quality of circulating LDL particles.
Dosage & Administration
Patients should be placed on a standard cholesterol-lowering diet before receiving Anzitor ® and should continue on this diet during treatment with Anzitor ®. The usual starting dose for all the indications is 10 mg once daily. The doses range is 10 to 80 mg once daily. Doses should be individualized according to baseline LDL-C levels, the goal of therapy, and patient response. Adjustments of dosage should be made at intervals of 4 weeks or more. Doses may be given at any time of day with or without food.
Children:
- Treatment experience in a pediatric population with a dose of Anzitor® up to 80 mg/day is limited.
Geriatric (>70 years) use:
- The safety and efficacy of Anzitor ® in this population is similar of < 70 years of age patients with a dose of up to 80 mg/day.
In patients with Renal Insufficiency: No dosage adjustment is required.
Interaction
The risk of myopathy during treatment with atorvastatin increases with the simultaneous administration of cyclosporine, fibric acid derivatives, erythromycin, azole antifungals, and niacin. When atorvastatin was used in combination with antihypertensive or hypoglycaemic drugs, no clinically significant interactions were observed. If atorvastatin is added to digoxin, erythromycin, oral contraceptives, colestipol, antacids, and warfarin, the patient should be closely monitored.
Contraindications
Atorvastatin is contraindicated in patients with hypersensitivity to any component of this medication, active liver disease, or unexplained persistent elevations of serum transaminases, during pregnancy, while breastfeeding, and in women of childbearing potential not using appropriate contraceptive measures.
Side Effects
Atorvastatin is generally well tolerated. Adverse reactions have usually been mild and transient. Reversible myositis is rare but a significant side effect of the statins. The statins also cause headaches, altered liver-function tests, and gastrointestinal effects including abdominal pain, flatulence, diarrhea, nausea, and vomiting. Thrombocytopenia, rash, and hypersensitivity reactions have been reported rarely. Other side effects reported with Atorvastatin therapy include insomnia, angioedema, anorexia, asthenia, paraesthesia, peripheral neuropathy, alopecia, pruritus, rash, impotence, chest pain, hypoglycemia, and hyperglycemia.
Pregnancy & Lactation
Atorvastatin is contraindicated in pregnancy and while breastfeeding. Women of child bearing potential should use appropriate contraceptive measures. If the woman becomes pregnant while taking Atorvastatin, it should be discontinued.
Precautions & Warnings
Hepatic Effects: Liver function tests should be performed before starting treatment and regular check-ups thereafter. Patients who drink a lot of alcohol or have a history of liver disease should use atorvastatin with caution. If there is a significant increase in CPK levels or myopathy is diagnosed or suspected, treatment with atorvastatin should be discontinued.
Therapeutic Class
Other Anti-anginal & Anti-ischaemic drugs, Statins.
Storage Conditions
Store below 250 C. Protects from light and moisture. Keep all medicines out of the reach of children.
Pharmaceutical Name
Square Pharmaceuticals Ltd.