POSOLOGY AND METHOD OF ADMINISTRATION
In general
Before instituting therapy with Atorvastatin, an attempt
should be made to control hypercholesterolemia with
appropriate diet, exercise and weight reduction in obese
patients, and to treat the underlying medical roblems. The
patient should continue on a standard cholesterol-lowering
diet during treatment with atorvastatin. The dosage range
is 10 to 80 mg once daily. Atorvastatin dose may be
administered at any time of the day, with or without food.
Starting and maintenance dosage should be individualized
according to baseline LDL-level, goal of therapy, and
patient response. After initiation and/or upon titration
of atorvastatin, lipid levels should be analyzed within 2
to 4 weeks and dosage adjusted accordingly.
Primary hypercholesterolaemia and combined (mixed)
hyperlipidaemia
The majority of patients are controlled with atorvastatin
10 mg once a day. A therapeutic response is evident within
2 weeks, and the maximum therapeutic response is usually
achieved within 4 weeks. The response is maintained during
chronic therapy.
Homozygous familial hypercholesterolaemia
Only limited data are available (see Pharmacodynamic
properties).
The dose of atorvastatin in patients with homozygous
familial hypercholesterolemia is 10 to 80 mg daily (see
Pharmacodynamic properties). Atorvastatin should be used
as an adjunct to other lipid-lowering treatments (e.g. LDL
apheresis) in these patients or if such treatments are
unavailable.
Prevention of cardiovascular disease
In the primary CVD prevention trials, the dose was 10
mg/day. Higher doses may be necessary in order to attain
(LDL-) cholesterol levels according to current guidelines.
Paediatric population
Hypercholesterolaemia
Paediatric use should only be carried out by physicians
experienced in the treatment of paediatric hyperlipidaemia
and patients should be re-evaluated on a regular basis to
assess progress.
For patients with Heterozygous Familial
Hypercholesterolemia aged 10 years and above, the
recommended starting dose of atorvastatin is 10 mg per day
(see Pharmacodynamic properties). The dose may be
increased to 80 mg daily, according to the response and
tolerability.
Doses should be individualised according to the
recommended goal of therapy. Adjustments should be made at
intervals of 4 weeks or more. The dose titration to 80 mg
daily is supported by study data in adults and by limited
clinical data from studies in children with Heterozygous
Familial Hypercholesterolemia (see Undesirable effects and
Pharmacodynamic properties).
There are limited safety and efficacy data available in
children with Heterozygous Familial Hypercholesterolemia
between 6 to 10 years of age derived from open-label
studies. Atorvastatin is not indicated in the treatment of
patients below the age of 10 years. Currently available
data are described in Undesirable effects, Pharmacodynamic
properties and Pharmacokinetic properties but no
recommendation on a posology can be made.
Other pharmaceutical forms/strengths may be more
appropriate for this population.
Hepatic impairment
Avasboston should be used with caution in patients with
hepatic impairment (see Special warnings and precautions
for use and Pharmacokinetic properties: Special
populations). Avasboston is contraindicated in patients
with active liver disease (see Contraindications).
Renal impairment
Renal disease does not affect the plasma concentrations
nor LDL-C reduction of atorvastatin; thus, dosage
adjustment in patients with renal dysfunction is not
necessary (see Special warnings and precautions for use).
Elderly
Efficacy and safety in patients older than 70 using
recommended doses are similar to those seen in the general
population (see Pharmacokinetic properties: Special
populations).
Co-administration with other medicines
In patients taking cyclosporine or the HIV protease
inhibitor (tipranavir plus ritonavir) or the hepatitis C
virus (HCV) protease inhibitor (telaprevir), therapy with
Avasboston should be avoided.
In patients with HIV taking the combination
lopinavir/ritonavir, caution should be used when
co-prescribing Avasboston, and use the lowest necessary
dose.
In patients taking clarithromycin, itraconazole, or in
patients with HIV taking a combination of saquinavir plus
ritonavir, darunavir plus ritonavir, fosamprenavir or
fosamprenavir plus ritonavir, therapy with Avasboston
should be limited to 20 mg, and appropriate clinical
assessment is recommended to ensure that the lowest
necessary dose of Avasboston is used.
In patients taking the HIV protease inhibitor, nelfinavir,
or the HCV protease inhibitor boceprevir, therapy with
Avasboston should be limited to 40 mg, and appropriate
clinical assessment is recommended to ensure that the
lowest necessary dose of Avasboston is used., (see
Special warnings and precautions for use: Skeletal muscle
effects and Interaction with other medicinal products).
CONTRAINDICATIONS
Atorvastatin is contraindicated in patients:
with hypersensitivity to any components of this
medication.
with active liver disease or unexplained persistent
elevations of serum transaminases exceeding 3 times the
upper limit of normal (ULN).
during pregnancy, while breast-feeding and in women of
child-bearing potential not using appropriate
contraceptive measures
Treatment with atorvastatin should be suspended until it
has been determined that the woman is not pregnant and all
of risks to the fetus has been informed.
WARNINGS AND PRECAUTIONS
Liver effects
As with other lipid-lowering agents of the same class,
moderate (>3 × ULN) elevations of serum transaminases
have been reported following therapy with atorvastatin.
The liver function of patients taking dose of 10 mg, 20
mg, 40 mg, and 80 mg atorvastatin has been monitored in
clinical studies pre-approval and post-marketing.
Persistent elevations (>3 times the upper limit of
normal [ULN] occurring on 2 or 3 occasions) in serum
transaminases occurred in 0.7% of patients who received
atorvastatin in clinical trials. The incidence of these
abnormalities was 0.2%, 0.2%, 0.6%, and 2.3% for 10, 20,
40, and 80 mg, respectively. In general, increases in
liver function tests (LFT) in these patients were not
associated with jaundice or other clinical signs or
symptoms. Upon dose reduction, drug interruption, or
discontinuation, transaminase levels returned to or near
pretreatment levels. Most patients continued treatment on
a reduced dose of atorvastatin without sequelae.
It is recommended that liver enzyme tests be obtained
prior to initiating therapy with atorvastatin and repeated
as clinically indicated. Patients who develop increased
transaminase levels should be monitored until the
abnormality(ies) resolve. Should an increase in
transaminases of greater than 3 times the upper limit of
normal (ULN) persist, reduction of dose or withdrawal of
atorvastatin is recommended. Atorvastatin can cause an
elevation in transaminases (see Undesirable effects).
Atorvastatin should be used with caution in patients who
consume substantial quantities of alcohol and/or have a
history of liver disease. Active liver disease or
unexplained persistent transaminase elevations are
contraindications to the use of atorvastatin (See
Contraindications)
Skeletal muscle effects
There have been reports of myalgia in atorvastatin-treated
patients (see Undesirable effects). A creatine
phosphokinase (CPK) level should be measured before
starting statin treatment in the following situations:
renal impairment, hypothyroidism, personal or familial
history of hereditary muscular disorders, previous history
of muscular toxicity with a statin or fibrate, previous
history of liver disease and/or where substantial
quantities of alcohol are consumed, in elderly (age >
70 years) with the presence of other predisposing factors
for rhabdomyolysis. If CPK levels are significantly
elevated (> 5 times ULN) at baseline, treatment should
not be started.
Myopathy, characterised by muscle pain, or muscle weakness
with creatine phosphokinase above 10 times ULN, should be
considered in any patient with diffuse myalgia, tenderness
or muscle weakness and/or markedly elevated CPK. Instruct
patients to promptly report any unexplained muscle pain,
tenderness or weakness, particularly if accompanied by
malaise or fever. Discontinue atorvastatin if markedly
elevated CK levels occur or myopathy is diagnosed or
suspected.
The risk of myopathy may be increased when atorvastatin is
administered concomitantly with ciclosporin, fibric acid
derivatives, erythromycin, niacin, azole
antifungals, colchicine, telaprevir, boceprevir or the
combination of tipranavir and ritonavir. Many of these
drugs inhibit cytochrome P450 3A4 (CYP 3A4) metabolism
and/or drug transport. CYP 3A4 is the primary hepatic
isozyme known to be involved in the biotransformation of
atorvastatin. Physicians considering combined therapy with
atorvastatin and fibric acid derivatives, gemfibrozil,
erythromycin, immunosuppressive drugs, azole antifungals,
or antihyperlipidemic dose of niacin (high dose, >
1g/day), colchicine should weigh h the potential benefits
and risks and should carefully monitor patients for any
signs and symptoms of muscle pain, tenderness, or
weakness, particularly during the initial months of
therapy and during any periods of upward dosage titration
of either drug. In this case, e, lower starting and
maintenance doses of atorvastatin should also be
considered when taken concomitantly with the
aforementioned drugs.
Atorvastatin is not recommended to co-administer with
fusidic acid; therefore, atorvastatin treatment should be
discontinued throughout the duration of fusidic acid
treatment (see in Interactions). Periodic CPK
determinations may be considered in such situations, but
there is no assurance that such monitoring will prevent
the occurrence of severe myopathy. Atorvastatin may cause
an elevation of CPK (see in Undesirable effects)
Atorvastatin, like other drugs in this class, has been
reported to rare cases of rhabdomyolysis with acute renal
failure secondary to myoglobinuria. Due to the high risk
of rhabdomyolysis, patients with renal impairment or
history of kidney disease should be closely monitored
during and after treatment with atorvastatin. Temporarily
withhold or discontinue atorvastatin in patients
experiencing an acute or serious condition suggestive of a
myopathy or with a risk factor predisposing to the
development of renal failure secondary to rhabdomyolysis
(e.g., severe acute infection; hypotension; major surgery;
trauma; severe metabolic, endocrine, or electrolyte
disorders; or uncontrolled epilepsy).
Hemorrhagic Stroke
A post-hoc analysis of a clinical study in 4731 patients
without CHD who had a stroke or transient ischemic attack
(TIA) within the preceding 6 months and were initiated on
atorvastatin 80 mg revealed a higher incidence of
hemorrhagic stroke in the atorvastatin 80 mg group
compared to placebo (55 atorvastatin vs. 33 placebo).
Patients with hemorrhagic stroke on entry appeared to be
at increased risk for recurrent hemorrhagic stroke (7
atorvastatin vs. 2 placebo). However, in patients treated
with atorvastatin 80 mg, there were fewer strokes of any
type (265 vs. 311) and fewer CHD events (123 vs. 204) (see
Pharmacodynamic properties: Recurrent stroke).
Endocrine Function
Increases in HbA1c and fasting serum glucose levels have
been reported with HMG-CoA reductase inhibitors, including
atorvastatin. This risk, however, is outweighed by the
reduction in vascular risk with statins.
Statins should be prescribed with caution in patients with
pre-disposing factors for muscle damage. Statins cause
potentially undesirable effects in muscular system,
particularly in patients with risk factors including age
65 years or greater, uncontrolled hypothyroidism, renal
diseases. During treatment, undesirable effects need to be
monitored.
A CK level should be measured before starting statin
treatment with patients in the special populations or with
increased risk for drug interactions. In such situations,
the risk of treatment should be considered in relation to
possible benefit, and clinical monitoring is recommended.
Patients must be asked to promptly report muscle pain,
cramps, or weakness. If such symptoms occur whilst a
patient is receiving treatment with atorvastatin, their CK
levels should be measured to have appropriate
interference.
SHELF-LIFE
36 months from the manufacturing date. Do not use after
the expiry date.