Uses of Tivas-20: - High cholesterol - Prevention of heart attack Oral Mixed dyslipidaemia, Heterozygous familial hypercholesterolaemia, Nonfamilial hypercholesterolaemia Adult: Initially, 10 or 20 mg once daily, may be adjusted at 4-wk interval. May initiate 40 mg once daily in patients who require >45% reduction in LDL-cholesterol. Max: 80 mg/day. Elderly: No dosage adjustment needed. Oral Mixed dyslipidaemia, Heterozygous familial hypercholesterolaemia, Nonfamilial hypercholesterolaemia Child: Heterozygous familial hypercholesterolaemia: 10-17 yr 10 mg once daily, may increase at intervals of at least 4 wk to max 20 mg/day.

How to use Atorvastatin: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Atorvastatin may be taken with or without food, but it is better to take it at a fixed time. Administration: May increase risk of myopathy and rhabdomyolysis w/ CYP3A4 potent inhibitor (e.g. HIV or HCV protease inhibitors, itraconazole, clarithromycin), fenofibrate, colchicines, fixed combination of lopinavir/ritonavir. May decrease plasma concentration w/ CYP3A4 inducer (e.g. rifampicin, efavirenz). May significantly increase AUC and peak plasma concentration of digoxin. Increased AUC for norethindrone and ethinyl estradiol. Potentially Fatal: Increased risk of myopathy or rhabdomyolysis w/ ciclosporin, gemfibrozil, telaprevir, tipranavir. Adult Dose: Patients who consume substantial quantities of alcohol. History of liver disease. Patients with risk factors for myopathy or rhabdomyolysis. Hypothyroidism should be properly managed prior to starting statin therapy. Children <10 yr. Premenarcheal females. Lactation: Because of the potential for adverse reactions in nursing infants, women taking this drug should not breastfeed; contraindicated in nursing mothers. Renal Dose: Atorvastatin competitively inhibits HMG-CoA reductase, the enzyme that catalyses the conversion of HMG-CoA to mevalonate. This results in the induction of the LDL receptors and stimulation of LDL catabolism, leading to lowered LDL-cholesterol levels.

Hypersensitivity, active liver disease or unexplained persistent elevations of serum transaminase, porphyria, pregnancy, lactation.

Oral Mixed dyslipidaemia, Heterozygous familial hypercholesterolaemia, Nonfamilial hypercholesterolaemia Child: Heterozygous familial hypercholesterolaemia: 10-17 yr 10 mg once daily, may increase at intervals of at least 4 wk to max 20 mg/day.

Common - Constipation - Headache - Muscle pain Renal Insufficiency: Renal disease does not affect the plasma concentrations or LDL-C reduction of atorvastatin; thus, dosage adjustment in patients with renal dysfunction is not necessary.

Precaution: Primary hypercholesterolemia (heterozygous familial and nonfamilial), Mixed Dyslipidemia, Homozygous familial hypercholesterolemia, Hypertriglyceridemia, Familial hypercholesterolemia, Cardiovascular event prevention, Primary dysbetalipoproteinemia

Atorvastatin can be administered as a single dose at any time of the day, with or without food. Avoid excessive consumption (>1 L/day) of grapefruit juice.

>10% Diarrhea (5-14%),Nasopharyngitis (4-13%),Arthralgia (4-12%) 1-10% Insomnia (1-5%),Urinary tract infection (4-8%),Nausea (4-7%),Dyspepsia (3-6%),Increased transaminases (2-3%),Muscle spasms (2-5%),Musculoskeletal pain (2-5%),Myalgia (3-8%),Limb pain (3-8%),Pharyngolaryngeal pain (1-4%) Frequency Not Defined Angina,Syncope,Dyspnea,Myopathy,Anaphylaxis,Stevens-Johnson syndrome,Myositis Potentially Fatal: Thrombocytopenia. Rhabdomyolysis with acute renal failure.