Atorvastatin

CLINICAL USE


Hyperlipidaemia and hypercholesterolaemia

DOSE IN NORMAL RENAL FUNCTION

10–80 mg daily

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :558.6 (1209.4 as calcium salt)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>98
  • %Excreted unchanged in urine &nbsp &nbsp : Negligible

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :381 litres

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :14 (active metabolite 20–30)/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: erythromycin, clarithromycin or fusidic acid possibly increased risk of myopathy; concentration increased by clarithromycin – do not exceed 20 mg of atorvastatin;1 avoid concomitant use with telithromycin; increased risk of myopathy with daptomycin.
  • Anticoagulants: may transiently reduce anticoagulant effect of warfarin
  • Antifungals: increased risk of myopathy with itraconazole – do not exceed 40 mg of atorvastatin,1 posaconazole and possibly other imidazoles and triazoles – avoid concomitant useAntivirals: increased risk of myopathy with amprenavir, atazanavir, indinavir, lopinavir, nelfinavir, ritonavir or saquinavir; concentration reduced by efavirenz
  • Ciclosporin: increased risk of myopathy – do not exceed 10 mg of atorvastatin.
  • Lipid lowering agents: increased risk of myopathy with fibrates, gemfibrozil (avoid) and nicotinic acid

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Rhabdomyolysis with renal dysfunction secondary to myoglobinaemia has been reported with other statins
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