ATORHASAN 20

Uses For atorvastatin

Atorvastatin is used to lower cholesterol and triglyceride (fat-like substances) levels in the blood. Using atorvastatin may help prevent medical problems (e.g., chest pain, heart attack, or stroke) caused by such substances clogging the blood vessels. atorvastatin may also be used to prevent certain types of heart problems in adults with risk factors for heart problems .

Atorvastatin belongs to the group of medicines called 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors. It works by blocking an enzyme that is needed by the body to make cholesterol, thereby reducing the amount of cholesterol in the blood.

Atorvastatin is available only with your doctor's prescription.

Importance of Diet

Before prescribing medicine for your condition, your doctor will probably try to control your condition by prescribing a personal diet for you. Such a diet may be low in fats, sugars, and/or cholesterol. Many people are able to control their condition by carefully following their doctor's orders for proper diet and exercise. Medicine is prescribed only when additional help is needed and is effective only when a schedule of diet and exercise is properly followed.

Also, atorvastatin is less effective if you are greatly overweight. It may be very important for you to go on a weight-reducing diet. However, check with your doctor before going on any diet.

Before Using atorvastatin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For atorvastatin, the following should be considered:

In addition to its helpful effects in treating your medical problem, this type of medicine may have some harmful effects.

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to atorvastatin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

atorvastatin is safe to use in boys and some girls 10 to 17 years of age for treating certain types of high cholesterol.

Geriatric

atorvastatin has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different problems in older people than it does in younger adults. However, blood levels of atorvastatin tend to be higher in older people than they do in younger adults.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using atorvastatin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Atazanavir
• Bezafibrate
• Ciprofibrate
• Clarithromycin
• Clofibrate
• Dalfopristin
• Diltiazem
• Erythromycin
• Fenofibrate
• Fluconazole
• Fusidic Acid
• Gemfibrozil
• Itraconazole
• Ketoconazole
• Mibefradil
• Nefazodone
• Niacin
• Quinupristin
• Rituximab
• Telithromycin
• Tipranavir
• Troleandomycin
• Verapamil

Using atorvastatin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aliskiren
• Amprenavir
• Azithromycin
• Black Cohosh
• Bosentan
• Colchicine
• Cyclosporine
• Darunavir
• Digoxin
• Efavirenz
• Eltrombopag
• Etravirine
• Fosamprenavir
• Fosphenytoin
• Indinavir
• Lopinavir
• Nelfinavir
• Oat Bran
• Pectin
• Phenytoin
• Pioglitazone
• Rifampin
• Saquinavir
• St John's Wort
• Voriconazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Using atorvastatin with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use atorvastatin, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of atorvastatin. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Liver disease, history—Use with caution. These conditions may increase the amount of atorvastatin in your blood .

• Convulsions (seizures), not well-controlled, or
• Electrolyte or metabolic enzyme deficiencies or disorders or
• Infection, severe or
• Low blood pressure or
• Major surgery or trauma, recent—Patients with these conditions may be at risk of developing muscle problems (causing the release of muscle pigment into the urine) that may lead to kidney failure.

• Kidney disease, severe—Use with caution. atorvastatin may make the condition worse .

• Liver disease, active or
• Liver enzymes, persistently high levels—atorvastatin should not be used in these conditions. Use of atorvastatin may make liver problems worse .

• Stroke, recent or
• Transient ischemic attack (TIA), recent—Atorvastatin may increase the risk of stroke in patients with any of these conditions.

Proper Use of atorvastatin

Use atorvastatin only as directed by your doctor. Do not use more or less of it, and do not use it more often or for a longer time than your doctor ordered. Also, atorvastatin works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medicine at the same time each day.

Remember that atorvastatin will not cure your condition but it does help control it. Therefore, you must continue to take it as directed if you expect to keep your cholesterol levels down.

Follow carefully the special diet your doctor gave you. This is the most important part of controlling your condition and is necessary if the medicine is to work properly.

Atorvastatin should not be taken with large amounts of grapefruit juice or other grapefruit products because these may increase the concentrations of atorvastatin in the body.

atorvastatin may be taken with or without food .

Dosing

The dose of atorvastatin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of atorvastatin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For high cholesterol:
  • For oral dosage form (tablets):
    • Adults—At first, 10 or 20 milligrams (mg) once daily. Your doctor may increase your dose up to a maximum of 80 mg per day if needed.
    • Children (10 to 17 years of age)—At first, 10 milligrams (mg) once daily. Your doctor may increase your dose up to a maximum of 20 mg per day if needed.
    • Children (less than 10 years of age)—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of atorvastatin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using atorvastatin

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly to lower your cholesterol and triglyceride levels and to decide if you should continue to take it.

Check with your doctor immediately if you think that you may be pregnant. HMG-CoA reductase inhibitors may cause birth defects or other problems in the baby if taken during pregnancy.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking atorvastatin.

Do not take over-the-counter (OTC) niacin preparations without consulting your doctor. Niacin may increase atorvastatin's adverse effects on muscle, which can lead to serious kidney problems.

Do not use excessive amounts of alcohol while taking atorvastatin because it can worsen the adverse effects of atorvastatin on the liver.

Check with your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if it is accompanied by unusual tiredness or fever, because the medicine's adverse effects on muscle can lead to serious kidney problems.

Atorvastatin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Cough
• difficulty swallowing
• dizziness
• fast heartbeat
• hives
• itching
• muscle cramps, pain, stiffness, swelling, or weakness, especially if accompanied by unusual tiredness or fever
• persistent elevation of liver function tests
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• shortness of breath
• skin rash
• tightness in chest
• unusual tiredness or weakness
• wheezing

• Blistering, peeling, loosening of skin
• chills
• dark-colored urine
• diarrhea
• fever
• itching
• joint pain
• large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• red skin lesions, often with a purple center sore
• red, irritated eyes
• redness, tenderness, itching, burning, or peeling of skin
• sore throat
• sores, ulcers, or white spots in mouth or on lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Headache
• hoarseness
• lower back or side pain
• pain or tenderness around eyes and cheekbones
• painful or difficult urination
• stuffy or runny nose

• Abdominal pain
• accidental injury
• back pain
• belching or excessive gas
• constipation
• general feeling of discomfort or illness
• heartburn, indigestion, or stomach discomfort
• lack or loss of strength
• loss of appetite
• nausea
• shivering
• sweating
• trouble sleeping
• vomiting

• Appetite increased
• black, tarry stools
• blindness
• bloody nose
• bloody or cloudy urine
• bluish color changes in skin
• blurred vision
• bruising, large, flat, blue patches on the skin
• chapped, red, or swollen lips
• continuing ringing or buzzing or other unexplained noise in ears
• depersonalization
• difficult, burning, or painful urination
• difficulty seeing at night
• dysphoria
• euphoria
• excessive muscle tone or tension
• frequent urge to urinate or defecate
• fruit-like breath odor
• groin or scrotum pain
• inability to have or keep an erection
• increased body movements
• increased sensitivity of eyes to light
• increased sensitivity to touch or pain
• increased thirst
• increased urination
• loss of bladder control
• loss of sexual ability, drive, or desire
• lumps in breasts
• mental depression
• nervousness
• nightmares
• normal menstrual bleeding occurring earlier or lasting longer
• pale skin
• paranoia
• pinpoint red spots on skin
• slurred speech
• swollen or tender lymph glands in neck, armpit, or groin
• transient, mild, pleasant aromatic odor
• unable to move or feel face
• unusual bleeding or bruising
• weight loss
• yellow skin or eyes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.