Atorvastatin is a lipid lowering drug, i.e. it lowers the levels of cholesterol and lipids in the blood and is used in patients suffering from hyperlipidemia. Atorvastatin is inhibitor known as a HMG-CoA reductase one, from a class of drugs also known as ‘statins’. It is one of the most commonly prescribed medications today for people over the age of 50, since high levels of cholesterol and triglycerides have become very common with sedentary lifestyles and unhealthy eating habits. This in turn has lead to an increase in the incidence of obesity, heart disease, hypertension and diabetes mellitus; with the use of Atorvastatin being highest in these groups of patients. Atorvastatin has been found to be one of the most potent and efficacious lipid lowering agents.
How Atorvastatin Works: Atorvastatin is a drug from the class of statins. This class of drugs blocks the action of the enzyme HMG-COA reductase, as the name suggests. This enzyme is a vital step in the cholesterol synthesis pathway. Inhibition of this enzyme by Atorvastatin significantly reduces the synthesis of cholesterol by approximately 20-50%. This in turns results in compensatory uptake of LDL-cholesterol in the liver with breakdown of the same. LDL-cholesterol is known as the ‘bad’ cholesterol, as this is the type of cholesterol implicated in heart disease and atherosclerosis. Use of Atorvastatin may lead to an increase in cholesterol levels in the beginning of therapy due to increased levels of the enzyme by feedback mechanism, but the levels fall on continued use of Atorvastatin.
How To Take Atorvastatin: Atorvastatin is a lipid lowering (hypolipaemic) drug. It has been shown to have good potency and good efficacy as compared to other statins. As the action of HMG-CoA reductase enzyme is highest at night, Atorvastatin is to be administered as a bedtime dose. It has a long half-life and can be used with a once daily dose. Uses of Atorvastatin are in lowering of LDL-cholesterol and total cholesterol levels and in the treatment of hypertriglyceridemia and secondary hypercholesterolemia (in nephrotic syndrome and diabetes mellitus). Atorvastatin is used in patients of heart disease such as previous myocardial infarction, angina pectoris and in patients with high risk of heart disease (smokers, diabetics, obese individuals and those with history of stroke). In these patients Atorvastatin prevents further progression of heart ailments; and prevents or delays the onset or cardiovascular disease in those who are at high risk. Atorvastatin is available as oral tablets in the strengths of 10 mg, 20 mg, 40 mg and 80 mg. It is preferably to be taken as a single daily bedtime dose. In patients of hyperlipidemia, the recommended starting dose of Atorvastatin is 10-20 mg/day as a single daily dose. The dose may be increased to a maximum of 80 mg/day as per response to medication which is determined by testing serum lipid levels after 2 weeks of starting therapy. If the patient has very high levels of cholesterol prior to onset of treatment, a starting dose of 40 mg/day of Atorvastatin may be used. A similar dose is to be used in patients of familial hypercholesterolemia.
Precautions And Side Effects of Atorvastatin: Atorvastatin should not be used in patients with liver dysfunction, pregnant or lactating mothers, or in patients with muscle disorders, myalgias and muscle weakness. Caution should be exercised when using Atorvastatin in patients with history of liver disease, alcoholics, those with history of stroke, hypothyroidism, hereditary muscle disorders or porphyrias. Side effects seen commonly with Atorvastatin include headache, gastrointestinal disturbances, nasal congestions, epistaxis (nose bleeds), muscular cramping and pain, abnormal liver function tests. Other rare and serious side effects of Atorvastatin are rhabdomyolysis, myositis, myoglobinuria, hepatitis, pancreatitis, fever and hearing loss. Atorvastatin should be discontinued immediately if any of these side effects is seen.