Atorvastatin

CLINICAL USE

Hyperlipidaemia and hypercholesterolaemia

DOSE IN NORMAL RENAL FUNCTION

10–80 mg daily

PHARMACOKINETICS

Molecular weight :558.6 (1209.4 as calcium salt)

%Protein binding :>98

%Excreted unchanged in urine : Negligible

Volume of distribution (L/kg) :381 litres

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

Home