Divastin 40

Divastin 4040mg

Type:14 Tablets

Generic Name:Atorvastatin

Manufacturer:Drug International Ltd.

Price:336.00

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Indication

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.

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.

Contraindication

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.

Mode of Action

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.

Precaution

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

Side Effect

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.

Pregnancy Category Note

>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.

Interaction

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

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