Atorvastatin Calcium

ATORVASTATIN CALCIUM h�p://www.robholland.com/Nursing/Drug_Guide/data/monographfr...
ATORVASTATIN CALCIUM
(a-tor-va'sta-�n)
Lipitor
Classifica�ons: CARDIOVASCULAR AGENT; ANTILIPEMIC AGENT; HMG-COA; REDUCTASE INHIBITOR (STATIN)
Prototype: Lovasta�n
Pregnancy Category: X
Availability
10 mg, 20 mg, 40 mg tablets
Ac�ons
Atorvasta�n is an inhibitor of reductase 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA), which is
essen�al to hepa�c produc�on of cholesterol. Lipitor increases the number of hepa�c low-density-lipid (LDL)
receptors, thus increasing LDL uptake and catabolism of LDL.
Therapeu�c Effects
Atorvasta�n reduces LDL and total triglyceride (TG) produc�on as well as increases the plasma level of high-
density lipids (HDL).
Uses
Adjunct to diet for the reduc�on of LDL cholesterol and triglycerides in pa�ents with primary
hypercholesterolemia and mixed dyslipidemia.
Contraindica�ons
Hypersensi�vity to atorvasta�n, myopathy, ac�ve liver disease, unexplained persistent transaminase
eleva�ons, pregnancy (category X), lacta�on.
Cau�ous Use
Hypersensi�vity to other HMG-CoA reductase inhibitors, history of liver disease, pa�ents who consume
substan�al quan��es of alcohol. Safety and efficacy in children <9 y have not been established.
Route & Dosage

Hypercholesterolemia
Adult: PO Start with 10–40 mg q.d., may increase up to 80 mg/d
Child/Adolescent: PO 10–17 y: Start with 10 mg q.d., may increase up to 20 mg/d
Administra�on
Oral
• May be given at any �me of day.

• Store at 20°–25° C (68°–77° F).
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ATORVASTATIN CALCIUM h�p://www.robholland.com/Nursing/Drug_Guide/data/monographfr...
Adverse Effects ( 1%)

Body as a Whole: Back pain, asthenia, hypersensi�vity reac�on, myalgia, rhabdomyolysis. CNS: Headache.
GI: Abdominal pain, cons�pa�on, diarrhea, dyspepsia, flatulence, increased liver func�on tests.
Respiratory: Sinusi�s, pharyngi�s. Skin: Rash.
Interac�ons
Drug: May increase digoxin levels 20%, increases levels of norethindrone and ethinyl estradiol oral
contracep�ves; erythromycin may increase atorvasta�n levels 40%; MACROLIDE ANTIBIOTICS, cyclosporine,
delaviradine, gemfibrozil, niacin, clofibrate, AZOLE ANTIFUNGALS (ketoconazole, itraconazole) may
increase risk of rhabdomyolysis; nelfinavir may increase atorvasta�n levels. Food: Grapefruit juice (>1 qt/d)
may increase risk of myopathy and rhabdomyolysis.
Pharmacokine�cs
Absorption: Rapidly absorbed from GI tract. 30% of ac�ve component reaches the systemic circula�on.
Onset: Cholesterol reduc�on—2 wk. Peak: Plasma concentra�on, 1–2 h; effect 2–4 wk. Distribution: 98%
protein bound. Crosses placenta, distributed into breast milk of animals. Metabolism: Metabolized in the
liver by CYP3A4 to ac�ve metabolites. Elimination: Excreted primarily in bile; <2% excreted in urine. Half-
Life: 14 h; 20–30 h for ac�ve metabolites.
Nursing Implica�ons
Assessment & Drug Effects
• Monitor for therapeu�c effec�veness which is indicated by reduc�on in the level of LDL-C.
• Lab tests: Monitor lipid levels within 2–4 wk a�er ini�a�on of therapy or upon change in dosage;
monitor liver func�ons at 6 and 12 wk a�er ini�a�on or eleva�on of dose, and periodically therea�er.
• Assess for muscle pain, tenderness, or weakness; and, if present, monitor CPK level (discon�nue drug
with marked eleva�ons of CPK or if myopathy is suspected).
• Monitor carefully for digoxin toxicity with concurrent digoxin use.
Pa�ent & Family Educa�on
• Report promptly any of the following: Unexplained muscle pain, tenderness, or weakness, especially
with fever or malaise; yellowing of skin or eyes; stomach pain with nausea, vomi�ng, or loss of
appe�te; skin rash or hives.
• Do not take drug during pregnancy because it may cause birth defects. Immediately inform physician
of a suspected or known pregnancy.
• Inform physician regarding concurrent use of any of the following drugs: erythromycin, niacin,
an�fungals, or birth control pills.
• Minimize alcohol intake while taking this drug.
• Do not breast feed while taking this drug.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifica�ons in SMALL CAPS;
Canadian drug name; Prototype drug
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Atorvastatin Calcium

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Atorvastatin Calcium

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ATORVASTATIN CALCIUM h�p://www.robholland.com/Nursing/Drug_Guide/data/monographfr...

Route & Dosage

• May be given at any �me of day.

Adverse Eﬀects ( 1%)

Pa�ent & Family Educa�on

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