Lipitor: Uses, Side Effects, Dosage, Precautions

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Lipitor (atorvastatin) is a cholesterol-lowering drug that belongs to the class of statins . Statins lower blood cholesterol levels by blocking 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, an enzyme that the liver needs to make cholesterol.

Lipitor comes in the form of an oral tablet and is available in generic form.

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Applications

Lipitor is a complementary therapy to diet and is generally prescribed in cases where lifestyle changes (diet, physical activity) or other medications are not effective in lowering cholesterol levels. For example, it can be used for people with primary hyperlipidemia (high lipid levels due to genetic factors) or mixed dyslipidemia (high levels of both triglycerides and cholesterol).

Lipitor is used to treat:

  • Total cholesterol
  • Low-density lipoproteins (LDL, considered "bad" cholesterol)
  • Triglycerides
  • Apolipoprotein B (apo B, a protein involved in lipid metabolism that is also found in lipoproteins like LDL)

It can also raise high-density lipoproteins (HDL, considered "good" cholesterol).

Cholesterol and triglycerides can clog blood vessels and increase the risk of heart disease . Because of this connection, statins like Lipitor are also commonly prescribed to reduce the risk of heart attack , stroke , and angina in people with heart disease or those with multiple risk factors for heart disease .

Lipitor is approved for use in adults and children over 10 years of age.

Use not indicated on the label

Statins, such as Lipitor, are sometimes off-label in an attempt to stop the progression of chronic inflammatory or autoimmune diseases such as progressive secondary multiple sclerosis (VPMS) .

This is because, in addition to lowering lipid (fat) levels, Lipitor and other statins appear to have some new effects, such as influencing immune responses, enhancing anti-inflammatory processes, and altering additional signaling pathways that are not yet fully understood. .

Sometimes statins are also used incorrectly for neurodegenerative diseases such as Alzheimer's or Parkinson 's, as high cholesterol levels are associated with disease progression. Patients with HIV or a bacterial infection such as tuberculosis (TB) can also benefit from the potential effects of these drugs on the immune system.

Before drinking

There are several types of statins and Lipitor is one of the most effective options. It is also one of the most commonly prescribed lipid-lowering drugs in the United States.

Each type of statin has unique interactions with other medications and risks for side effects, so your healthcare provider will consider what other medications you are taking, how high your cholesterol levels are, and what other conditions you have when deciding which statin. take. . Check in.

Other types of statin pills include Mevacor (lovastatin), Pravachol (pravastatin) , Crestor (rosuvastatin) , Zokar (simvastatin) , and Livalo (pitavastatin) . Most of these pills are also available in generic form. Statin capsules include Lescol (fluvastatin) and Ezallor (rosuvastatin), and there is an oral suspension option called FloLipid (simvastatin).

The extended-release tablets are available as Lescol XL (fluvastatin) and Altoprev (lovastatin).

Lipitor is very effective at lowering cholesterol, however the study found that compared to other statins, it had the majority of patients stop taking it due to side effects such as muscle pain or injury, followed by the statin Crestor (rosuvastatin ). Another high level. . -powerful option. Simvastatin and pravastatin were better tolerated in the study, but were not as potent or effective in lowering cholesterol as atorvastatin or rosuvastatin. Fluvastatin and lovastatin are additional low-potency options.

Studies have shown that rosuvastatin reduces LDL cholesterol by an average of 51%, followed by atorvastatin by 45%, simvastatin by 37%, and pravastatin by 25%.

Precautions and contraindications.

If you have certain medical conditions, you should not take Lipitor. In these cases, your healthcare provider may prescribe other lipid-lowering treatments:

  • Allergies or hypersensitivity: If you have previously been allergic to Lipitor or any of its ingredients, you should not take this medicine.
  • Active liver disease: If you have active liver disease or an unexplained abnormally elevated liver enzyme level, you should not take Lipitor. This includes chronic alcoholic liver disease.
  • Pregnancy: Lipitor should not be taken during pregnancy. The drug has been shown to cross the placental barrier in rats, and miscarriages and fetal abnormalities have been reported in animal studies. Additionally, it has also been reported in pregnant women taking statins. If you are planning pregnancy or are already pregnant and taking Lipitor, stop taking it and contact your doctor.
  • Lactation: Breastfeeding is not recommended while taking Lipitor. The drug can pass into breast milk and it is not known what effect it might have on the baby.

Talk to your doctor about all the medications, supplements, and vitamins that you are currently taking. While some medications carry little risk of interactions, others may directly contraindicate their use or cause careful consideration of whether the benefits of treatment outweigh the disadvantages in your case.

Dose

Lipitor tablets are available in doses of 10, 20, 40 and 80 milligrams (mg), to be taken once a day as directed by your healthcare professional.

The standard starting dose for adults is 10-20 mg. For those who require a reduction of at least 45% in LDL cholesterol, a 40 mg dose can be started.

Your healthcare provider may gradually increase the dose as needed, based on your LDL cholesterol level and your response to the medication.

The starting dose for adolescents 10 to 17 years of age with an inherited form of high cholesterol ranges from 10 mg to a maximum dose of 20 mg once a day.

All indicated doses are indicated by the manufacturer of the drug. Check your prescription and talk to your doctor to make sure you are taking the correct dose. Never increase your dose without your doctor's approval.

Modifications

Patients 65 years of age or older are at increased risk for musculoskeletal side effects when taking Lipitor, and may need to take a lower dose or stop using the drug if they experience muscle weakness or breakdown .

How to take and store

Lipitor can be taken with or without food. It is absorbed quickly, reaching a maximum concentration in the blood after about two hours. Lipitor begins to lower cholesterol levels about two weeks after you start taking the medicine.

Lipitor should always be taken with a diet to help lower cholesterol and triglyceride levels.

Store tablets at controlled room temperature, ideally 68 to 77 degrees Fahrenheit.

If you miss a dose of Lipitor, take it as soon as you remember. But if it has been more than 12 hours since the missed dose, skip it and just take the next scheduled dose. Do not take two doses at the same time.

If you take too much Lipitor or an overdose, seek medical attention immediately.

Side effects

Like all drugs and all statins, Lipitor carries a risk of side effects. Some of them can be serious or require treatment, so it is important to know about them.

general

  • Swollen / painful nasal passages and the back of the throat (rhinopharyngitis)
  • Joint pain
  • Diarrhea
  • Legache
  • Urinary tract infection (UTI)

If you experience any lipitor side effect that becomes long-lasting or bothersome, you should inform your doctor.

Severe form

  • Unexplained muscle pain, weakness, or pain
  • Brown or dark urine
  • Malaise (general feeling of being unwell or ill)
  • Hot
  • Difficulty breathing
  • Swelling of the face or throat

Some people have allergic reactions to atorvastatin. If you notice any signs of an allergic reaction, seek immediate medical attention.

There are also rare but serious side effects that affect skeletal muscle. Lipitor can cause muscle myopathy (muscle disease that causes muscle pain or weakness) and rhabdomyolysis (muscle breakdown).

Symptoms of rhabdomyolysis include muscle pain / weakness and dark urine. There have also been cases of rhabdomyolysis, which has led to kidney problems, including kidney failure, while taking Lipitor.

If you experience unexplained muscle pain, tenderness, pain, or weakness, especially if accompanied by malaise and fever, tell your doctor immediately. Your dose of Lipitor may need to be reduced or withdrawn.

Your risk of developing rhabdomyolysis may increase if you are taking other medications or if you are over 65 years old .

Warnings and interactions

While you are taking Lipitor, your healthcare provider will ask you to have regular blood tests to monitor your cholesterol levels and to check if your dose needs to be adjusted.

You may also need to be monitored more closely if you have certain medical conditions that can be made worse by taking medications or increase your risk of side effects.

If you have any of the following conditions, your healthcare provider may decide to start with a lower dose of Lipitor and will need to monitor you to determine if Lipitor is potentially harmful to you:

  • Elevated liver enzymes: Lipitor can increase the liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). While this increase is mild and temporary in most cases, your doctor will monitor these levels to make sure your liver enzyme levels do not rise to dangerous levels that indicate liver damage. If the levels of these enzymes are high, you may need to switch to less effective statins, such as pravastatin, or stop taking statins altogether.
  • Elevated blood glucose: Studies have shown that atorvastatin can increase hemoglobin A1C and fasting glucose levels. If you have diabetes or are at risk of developing this condition, your healthcare provider can monitor these levels in your blood and adjust the dose of Lipitor.
  • Renal impairment: If you have a history of kidney failure, you will need to closely monitor muscle or kidney effects while taking Lipitor, as this condition may be a risk factor for rhabdomyolysis with kidney failure.
  • Thyroid problems: Uncontrolled hypothyroidism (an underactive thyroid gland) can increase the risk of myopathy and rhabdomyolysis with Lipitor.

You may also need to temporarily stop or stop taking Lipitor for certain conditions that can lead to myopathy or kidney failure with rhabdomyolysis. This can include the following:

  • Severe infections
  • Hypotension (low blood pressure)
  • Extensive surgical intervention
  • Physical trauma from trauma
  • Severe metabolic, endocrine, and electrolyte disturbances
  • Uncontrolled seizures

Lipitor can cause liver problems, so you should tell your doctor if you drink alcohol on a daily basis. You may need blood tests to check your liver.

Do not drink grapefruit juice while taking this medicine as it may affect your body's ability to absorb the medicine and increase the concentration of lipitor in your blood .

Medications and supplements can also interact with Lipitor, and some of them can increase the likelihood of side effects, especially myopathy. If you are taking any of these medications with Lipitor, your doctor may need to adjust your dose, monitor you more closely for side effects, or stop taking one of the medications:

  • Other cholesterol-lowering medications: Taking fibrates (also called fibric acid derivatives) with Lipitor increases the risk of myopathy.
  • Niacin supplements: Intake of vitamin B3 (niacin) may have some lipid-modifying effects. There may be an increased risk of myopathy when taking niacin supplements with Lipitor.
  • Sandimmune ( cyclosporine ): If you are taking this immunosuppressive drug to reduce the risk of your body rejecting an organ transplant, do not take more than 10 mg of Lipitor per day due to the increased risk of myopathy and rhabdomyolysis.
  • Biaxin (clarithromycin): This antibiotic, used for various bacterial infections, strongly inhibits the liver enzyme CYP3A4, which can increase blood lipitor levels and also reduce the risk of myopathy and rhabdomyolysis. The dose of Lipitor should not exceed 20 mg per day without careful monitoring.
  • Onmel (itraconazole): antifungal medicine. it is also a potent inhibitor of CYP3A4. Lipitor should not exceed 20 mg per day without close supervision.
  • HIV protease inhibitors: Norvir (ritonavir) plus invirase (saquinavir) or Kaletra (lopinavir, ritonivir) are also strong CYP3A4 inhibitors, and the lipitor should not exceed 20 mg per day without careful monitoring.
  • Oral Contraceptives : If oral contraceptives contain norethindrone (a form of progesterone) or ethinyl estradiol (a form of estrogen), these hormones may increase when taken with lipitor.
  • Lanoxin (Digoxin): Blood levels of digoxin, which is used to treat heart failure or heart rhythm disturbances, can increase by about 20% when taken with Lipitor. Careful monitoring is required.
  • Rifadin (rifampin): Rifadin, which is used to treat tuberculosis (TB), must be taken with Lipitor. If Lipitor is taken after rifampin, it can lower the blood levels of Lipitor.
  • Colcrys ( colchicine ): Both colchicine and lipitor carry the risk of myopathy, and taking them together can increase this side effect.
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