Lipitor (Atorvastatin) Uses

FDA approved indications

• Hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson types IIa and IIb) to reduce total cholesterol, LDL-C, apo-B, Triglycerides levels, and CRP as well as increase HDL levels.

• Heterozygous familial hypercholesterolemia

• Hypertriglyceridemia (Fredrickson Type IV)

• Primary dysbetalipoproteinemia (Fredrickson Type III)

• It has also been used in the treatment of combined hyperlipidemia.

• Prophylaxis for myocardial infarction, stroke, unstable angina, and revascularization.*prophylaxis in patients with multiple risk factors without evident CHD.

• Myocardial infarction and stroke prophylaxis in patients with type II diabetes.

• Concomitant therapy considerations

Atorvastatin may be used in combination with bile acid resins. It is not recommended to combine statin treatment with fibrates because of the increased risk of myopathy related adverse reactions it may be very serious leading to acute renal failure due to myoglobinuria. If rhabdomyolysis is suspected or diagnosed, atorvastatin therapy should be discontinued immediately.

Co-administration of Atorvastatin with one of CYP3A4 inhibitors like itraconazole, telithromycin, and voriconazole, may increase serum concentrations of atorvastatin, which may lead to adverse reactions. This is less likely to happen with other CYP3A4 inhibitors like diltiazem, erythromycin, fluconazole, ketoconazole, clarithromycin, cyclosporine, protease inhibitors, verapamil. And only rarely with other CYP3A4 inhibitors like amiodarone, and aprepitant, which are CYP3A4 inducers can decrease the plasma concentrations of atorvastatin. Oral contraceptives increased AUC values for norethindrone and ethinyl estradiol, these increases should be considered when selecting an oral contraceptive for a woman taking atorvastatin.

Antacids can rarely decrease the plasma concentrations of atorvastatin but do not affect the LDL-C lowering efficacy.

Niacin also is proved to increase the risk of myopathy or rhabdomyolysis Grapefruit juice components are known inhibitors of intestinal CYP3A4. Co-administration of grapefruit juice with atorvastatin may cause an increase in Cmax and AUC, which can lead to adverse reactions or overdose toxicity

Further Reading

• Lipitor - What is Lipitor?
• Lipitor (Atorvastatin) Pharmacokinetics
• Lipitor (Atorvastatin) Side Effects

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