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Atorvastatin
📖 About
Always check the BNF link here.
- ⬇️ Reduces LDL & total cholesterol; ⬆️ increases HDL.
- ❤️ Proven to reduce MI, stroke, and revascularisation procedures.
- 🌙 Taken at night (when cholesterol synthesis is maximal), though atorvastatin has a longer half-life and can be taken any time.
⚙️ Action
- 🔒 HMG-CoA reductase inhibitor acting on hepatocytes.
- 🛑 Blocks the rate-limiting step in cholesterol synthesis.
- ⬆️ Increases hepatic LDL receptor expression → clears LDL from plasma.
- ⬇️ Lowers LDL, TGs, total cholesterol; modestly ↑ HDL.
💉 Indications / Dose
- Hypercholesterolaemia, mixed hyperlipidaemia (alongside dietary modification).
- Secondary prevention of CVD (MI, stroke, PAD).
- 💊 Starting dose: 10–20 mg nocte PO.
- Usual range: 10–80 mg nocte PO (dose adjusted to cholesterol targets & CVD risk).
- ⚠️ Check LFTs before treatment, at 3 months, then annually. Stop if persistent >3× ULN.
- 🦵 If significant myalgia → stop drug and check CK. Discontinue if CK >5× ULN.
🔄 Interactions
- ⬆️ Risk of myopathy with: ciclosporin, erythromycin, clarithromycin, itraconazole, ketoconazole, fibrates.
- ⚠️ Myopathy risk ↑ with macrolides, amiodarone, diltiazem, verapamil.
- 🍊 Grapefruit juice (CYP3A4 inhibition) → ↑ atorvastatin levels → avoid.
⚠️ Contraindications
- 🚫 Active liver disease.
- 🚫 Pregnancy.
- 🚫 Breastfeeding.
💥 Side Effects
- 🦵 Myalgia, cramps, muscle aches.
- 🧪 Myopathy/rhabdomyolysis (rare, but monitor CK).
- 🍽️ GI upset: diarrhoea, flatulence, abdominal pain.
- 🩺 Elevated LFTs, rare hepatitis or pancreatitis.
- 🧠 Headache, sleep disturbance (less common).
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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