What is lipitor 10mg. Lipitor 10mg: Essential Guide to Uses, Side Effects, and Dosing
What are the primary uses of Lipitor 10mg. How does Lipitor work to lower cholesterol levels. What are the potential side effects of taking Lipitor 10mg. How should Lipitor be taken for optimal effectiveness. What precautions should be considered when using Lipitor 10mg.
Understanding Lipitor: A Powerful Cholesterol-Lowering Medication
Lipitor, also known by its generic name atorvastatin, is a widely prescribed medication belonging to the statin class of drugs. Its primary function is to help manage cholesterol levels in the body, specifically targeting the reduction of “bad” cholesterol (LDL) and triglycerides while promoting an increase in “good” cholesterol (HDL).
This powerful medication works by inhibiting an enzyme in the liver responsible for cholesterol production, effectively lowering overall cholesterol levels in the bloodstream. By doing so, Lipitor plays a crucial role in reducing the risk of heart disease, stroke, and heart attacks.
The Science Behind Lipitor’s Effectiveness
Lipitor’s active ingredient, atorvastatin, targets the HMG-CoA reductase enzyme in the liver. This enzyme is key to cholesterol synthesis, and by blocking its action, Lipitor significantly reduces the amount of cholesterol produced by the body. This mechanism not only lowers LDL cholesterol but also helps in decreasing triglyceride levels and moderately increasing HDL cholesterol.
Proper Usage and Dosing Guidelines for Lipitor 10mg
Adhering to the correct dosage and administration of Lipitor 10mg is crucial for achieving optimal results. The medication is typically taken orally once daily, with or without food, as directed by a healthcare professional.
- Standard dosage: 10mg to 80mg daily, depending on individual needs and medical condition
- Timing: Consistent daily intake, preferably at the same time each day
- Duration: Long-term use as prescribed, even if feeling well
- Adjustments: Dosage may be modified based on response to treatment and side effects
Why is it important to take Lipitor regularly? Consistent use ensures steady cholesterol management and maximizes the medication’s effectiveness in preventing cardiovascular events.
Interactions with Food and Other Medications
While Lipitor can be taken with or without food, certain dietary considerations should be kept in mind:
- Avoid grapefruit and grapefruit juice, as they can increase the risk of side effects
- If taking bile acid-binding resins, separate Lipitor intake by at least 1 hour before or 4 hours after
- Inform your healthcare provider about all medications, including over-the-counter drugs and supplements
Potential Side Effects and Risk Management
As with any medication, Lipitor may cause side effects in some individuals. While many people tolerate the drug well, it’s essential to be aware of potential adverse reactions.
What are the most common side effects of Lipitor 10mg? Typically reported side effects include:
- Muscle pain or weakness
- Headache
- Digestive issues (nausea, diarrhea, constipation)
- Mild memory problems or confusion (rare)
In rare cases, more serious side effects may occur. These can include liver problems, muscle damage (rhabdomyolysis), and an increased risk of diabetes. It’s crucial to monitor for any unusual symptoms and report them to a healthcare provider promptly.
Recognizing and Addressing Serious Side Effects
How can one identify potentially serious side effects of Lipitor? Be vigilant for the following symptoms:
- Persistent muscle pain, tenderness, or weakness, especially if accompanied by fever or unusual fatigue
- Yellowing of the skin or eyes (jaundice)
- Dark urine or pale stools
- Severe abdominal pain
- Unexplained changes in urination patterns
If any of these symptoms occur, it’s imperative to seek medical attention immediately. Early intervention can prevent the progression of potentially serious complications.
Lifestyle Modifications to Enhance Lipitor’s Effectiveness
While Lipitor is a potent medication for managing cholesterol levels, its effectiveness can be significantly enhanced when combined with appropriate lifestyle changes. Adopting a heart-healthy lifestyle not only complements the medication’s action but also promotes overall cardiovascular health.
Dietary Recommendations
What dietary changes can support Lipitor’s cholesterol-lowering effects? Consider incorporating the following into your diet:
- Increase intake of fruits, vegetables, and whole grains
- Choose lean proteins and fish rich in omega-3 fatty acids
- Limit saturated and trans fats
- Reduce consumption of processed foods and added sugars
- Incorporate heart-healthy fats like olive oil, nuts, and avocados
Exercise and Physical Activity
Regular physical activity plays a crucial role in managing cholesterol levels and overall heart health. Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week. Activities may include:
- Brisk walking
- Cycling
- Swimming
- Jogging
- Dancing
How does exercise complement Lipitor’s action? Physical activity helps raise HDL cholesterol levels, improves circulation, and supports weight management, all of which contribute to better cardiovascular health.
Special Considerations and Precautions
While Lipitor is generally well-tolerated, certain individuals may need to exercise caution or avoid the medication altogether. It’s crucial to provide a comprehensive medical history to your healthcare provider before starting Lipitor.
Pre-existing Conditions
Individuals with the following conditions should inform their doctor before taking Lipitor:
- Liver disease or history of liver problems
- Kidney disease
- Diabetes or pre-diabetes
- Thyroid disorders
- History of muscle pain or weakness
Pregnancy and Breastfeeding
Lipitor is contraindicated during pregnancy and breastfeeding. The medication may harm the developing fetus or pass into breast milk. Women of childbearing age should use effective contraception while taking Lipitor and inform their healthcare provider if they become pregnant or plan to become pregnant.
Alcohol Consumption
Why is it important to limit alcohol intake while on Lipitor? Excessive alcohol consumption can increase the risk of liver problems when combined with this medication. It’s advisable to discuss alcohol use with your healthcare provider and adhere to recommended limits.
Monitoring and Follow-up Care
Regular monitoring is essential for individuals taking Lipitor to ensure its effectiveness and detect any potential issues early. Your healthcare provider will likely recommend periodic blood tests to assess liver function and lipid levels.
Lipid Profile Tests
How often should lipid levels be checked while on Lipitor? Typically, healthcare providers recommend:
- Initial lipid profile before starting treatment
- Follow-up test after 6-8 weeks of treatment
- Subsequent tests every 3-12 months, depending on individual factors
These tests help evaluate the medication’s effectiveness and guide any necessary adjustments to the treatment plan.
Liver Function Tests
Monitoring liver function is crucial when taking Lipitor. Your healthcare provider may recommend liver enzyme tests:
- Before starting treatment
- Periodically during the first year of treatment
- As needed based on individual risk factors
Regular check-ups allow for timely detection of any liver-related issues and prompt intervention if necessary.
Exploring Alternatives and Complementary Therapies
While Lipitor is highly effective for many individuals, some may seek alternatives or complementary therapies to manage their cholesterol levels. It’s important to discuss any alternative treatments with a healthcare provider before making changes to your medication regimen.
Other Statin Medications
If Lipitor isn’t suitable or causes intolerable side effects, other statin medications may be considered, such as:
- Simvastatin (Zocor)
- Rosuvastatin (Crestor)
- Pravastatin (Pravachol)
- Fluvastatin (Lescol)
Each statin has a unique profile of benefits and potential side effects, allowing for personalized treatment options.
Non-Statin Cholesterol-Lowering Medications
In some cases, non-statin medications may be prescribed either alone or in combination with statins. These can include:
- Ezetimibe (Zetia): Reduces cholesterol absorption in the intestines
- PCSK9 inhibitors: Injectable medications that dramatically lower LDL cholesterol
- Bile acid sequestrants: Help remove cholesterol from the body
- Fibrates: Primarily used to lower triglycerides
Natural Supplements and Remedies
Some individuals may explore natural supplements to support cholesterol management. While these should not replace prescribed medications without medical advice, they may offer additional benefits:
- Plant sterols and stanols
- Omega-3 fatty acids
- Soluble fiber supplements
- Red yeast rice (note: may interact with statins)
It’s crucial to consult with a healthcare provider before adding any supplements to your regimen, as some may interact with Lipitor or other medications.
Long-term Outlook and Cardiovascular Health
Lipitor, when used as part of a comprehensive approach to cardiovascular health, can significantly improve long-term outcomes. Understanding the broader context of heart health is essential for maximizing the benefits of this medication.
Cardiovascular Risk Reduction
How does Lipitor contribute to overall cardiovascular risk reduction? By lowering LDL cholesterol and triglycerides while raising HDL cholesterol, Lipitor helps:
- Reduce the risk of heart attacks
- Lower the likelihood of strokes
- Decrease the need for heart-related surgeries
- Improve overall cardiovascular health
These benefits are particularly pronounced in individuals with existing heart disease or multiple risk factors for cardiovascular events.
Long-term Adherence and Outcomes
Consistency in taking Lipitor as prescribed is crucial for achieving optimal long-term outcomes. Studies have shown that individuals who adhere to their statin regimen experience greater reductions in cardiovascular events compared to those with poor adherence.
Why is long-term use of Lipitor important? Continuous use helps maintain stable cholesterol levels, preventing the progression of atherosclerosis and reducing the risk of future cardiovascular events.
Ongoing Research and Future Developments
The field of lipid management and cardiovascular health is constantly evolving. Ongoing research continues to explore:
- New combinations of cholesterol-lowering medications
- Personalized medicine approaches based on genetic profiles
- Novel therapies targeting specific aspects of lipid metabolism
- Long-term effects of statin use on various health outcomes
Staying informed about these developments and discussing them with your healthcare provider can help ensure you receive the most up-to-date and effective treatment for your cardiovascular health.
Lipitor Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
Atorvastatin is used along with a proper diet to help lower “bad” cholesterol and fats (such as LDL, triglycerides) and raise “good” cholesterol (HDL) in the blood. It belongs to a group of drugs known as “statins.” It works by reducing the amount of cholesterol made by the liver. Lowering “bad” cholesterol and triglycerides and raising “good” cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks.In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.
How to use Lipitor
Read the Patient Information Leaflet if available from your pharmacist before you start taking atorvastatin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually once daily.
The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.
If you also take certain other drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take atorvastatin at least 1 hour before or at least 4 hours after taking these medications. These products can react with atorvastatin, preventing its full absorption.
Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day. Keep taking this medication even if you feel well. Most people with high cholesterol or triglycerides do not feel sick.
It is very important to continue to follow your doctor’s advice about diet and exercise. It may take up to 4 weeks before you get the full benefit of this drug.
Side Effects
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A very small number of people taking atorvastatin may have mild memory problems or confusion. If these rare effects occur, talk to your doctor.
Rarely, statins may cause or worsen diabetes. Talk to your doctor about the benefits and risks.
This drug may rarely cause muscle problems (which can rarely lead to very serious conditions called rhabdomyolysis and autoimmune myopathy). Tell your doctor right away if you develop any of these symptoms during treatment and if these symptoms last after your doctor stops this drug: muscle pain/tenderness/weakness (especially with fever or unusual tiredness), signs of kidney problems (such as change in the amount of urine).
This medication may rarely cause liver problems. Tell your doctor right away if you develop symptoms of liver problems, including: nausea/vomiting that doesn’t stop, yellowing eyes/skin, dark urine, stomach/abdominal pain.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking atorvastatin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, alcohol use.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Limit alcoholic beverages. Daily use of alcohol may increase your risk for liver problems, especially when combined with atorvastatin. Ask your doctor or pharmacist for more information.
Older adults may be more sensitive to the side effects of this drug, especially muscle problems.
During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.
It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Interactions
See also How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: daptomycin, gemfibrozil.
Other medications can affect the removal of atorvastatin from your body, which may affect how atorvastatin works. Examples include glecaprevir plus pibrentasvir, telithromycin, ritonavir, among others.
Do not take any red yeast rice products while you are taking atorvastatin because some red yeast rice products may also contain a statin called lovastatin. Taking atorvastatin and red yeast rice products together can increase your risk of serious muscle and liver problems.
Does Lipitor interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Do not share this medication with others.
Lab and/or medical tests (such as blood cholesterol/triglyceride levels, liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Images
Lipitor 80 mg tablet
Color: whiteShape: ellipticalImprint: PD 158 80
This medicine is a white, elliptical, film-coated, tablet imprinted with “PD 158” and “80”.
Lipitor 20 mg tablet
Color: whiteShape: ellipticalImprint: PD 156 20
This medicine is a white, elliptical, film-coated, tablet imprinted with “PD 158” and “80”.
Lipitor 10 mg tablet
Color: whiteShape: ellipticalImprint: PD 155 10
This medicine is a white, elliptical, film-coated, tablet imprinted with “PD 158” and “80”.
Lipitor 40 mg tablet
Color: whiteShape: ellipticalImprint: 40 PD 157
This medicine is a white, elliptical, film-coated, tablet imprinted with “PD 158” and “80”.
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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Uses, How to Take It, Dietary Tips & Potential Complications
Lipitor, which is sold under the generic name atorvastatin calcium, is Pfizer’s premier cholesterol-lowering drug. With cumulative sales that exceed $148 billion, Lipitor holds the coveted status of the world’s top-selling prescription drug of all time.
Lipitor is a prescription drug used to lower bad cholesterol and reduce the risk of stroke, heart attack, and other heart and blood vessel problems.
The U.S. Food and Drug Administration approved the medication in 1996. Its active ingredient is atorvastatin calcium.
Lipitor blocks HMG-CoA reductase, a liver enzyme the body needs to produce low-density lipoproteins (LDL), or “bad” cholesterol. By lowering the amount of LDL in the blood, the medication prevents atherosclerosis, a condition in which plaque deposits accumulate on the inner walls of arteries, causing them to stiffen and narrow. In turn, this reduces the risk of atherosclerosis complications like heart attack, stroke, chest pain and aneurysms.
The medicine can also raise levels of high-density lipoproteins (HDL), or “good” cholesterol, which protects against heart attack. Some experts believe HDL can carry plaque away from arteries to the liver, which helps to slow its buildup and prevent dangerous blockages in blood flow.
Lipitor is the most popular and most potent member of the statin family of drugs, which is the most widely prescribed class of medications in the United States. Pfizer Inc. manufacturers the billion-dollar drug. A 2022 market report noted that Lipitor generated nearly two billion U.S. dollars in revenue during 2019 alone.
Approved Uses
Doctors commonly prescribe Lipitor together with diet, weight loss and exercise to lower cholesterol and help stave off cardiovascular disease in people with multiple risk factors other than pre-existing coronary heart disease.
The FDA approved Lipitor for this use based on clinical trials. In one clinical trial called the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), researchers investigated atorvastatin’s ability to prevent heart disease in more than 10,000 at-risk patients. The drug was found to reduce the risk of fatal or nonfatal cardiac events by 36 percent when compared to a placebo.
“Lipitor is for adults and children over 10 whose cholesterol does not come down enough with exercise and a low-fat diet alone.”
Patients already diagnosed with heart disease take the drug to lower their risk of having a cardiac event. For patients diagnosed with coronary heart disease, the drug can reduce the risk of heart attack, stroke and chest pain while also lowering the risk for heart failure surgeries and hospitalization from congestive heart failure.
The medication is also a preventative treatment option for patients with Type 2 diabetes and several risk factors for heart disease and stroke such as high blood pressure, a history of smoking and two diabetes-related conditions called retinopathy and albuminuria, which affect the eyes and kidneys, respectively.
The FDA also approved the drug for use in children and teenagers who are 10 to 17 years old and have heterozygous familial hypercholesterolemia, an inherited condition in which cholesterol cannot be removed from the body normally. If diet therapy fails, Lipitor may be used in these patients to decrease the amount of cholesterol and triglycerides in the blood.
Triglycerides are fats that can clog blood vessels, and high levels in the blood can mean an elevated risk of stroke.
Important Information on Taking Lipitor
Carefully follow your doctor’s instructions on how to take Lipitor and how often. Never adjust your dose or stop taking the drug without first speaking with your doctor.
The medication comes in 10 mg, 20 mg, 40 mg and 80 mg tablets. The tablets are white, oval-shaped and film-coated, and should be swallowed whole.
Doctors may start patients on a low dose and then slowly up the dose, but not more than once every two to four weeks. The recommended starting dose is 10 mg to 20 mg once daily. The medicine takes about two weeks to start working.
EXPAND
Lipitor comes in four strengths: 10 mg, 20 mg, 40 mg and 80 mg.
It’s normal for a doctor to order blood tests to check cholesterol levels during treatment. He or she may adjust the dose based on the test results.
The drug label says patients can take the medication during the day or at night, though it recommends they take it at the same time every day. You do not need to take the medicine with food, but you can if you want to.
If you forget to take a dose at your normal time, take it as soon as you think of it, but don’t take two doses at the same time. If more than 12 hours have passed since you missed your last dose, then wait to take the pill at your scheduled time. If you take too much of the medication, call your doctor or Poison Control Center, or go to the nearest hospital or emergency room.
Dietary Dos and Don’ts
When taking Lipitor, it’s important to follow the exercise and dietary recommendations made by your doctor or dietitian. Typically, patients who take the medication are told to eat a low-fat, low-cholesterol diet.
The U.S. Department of Health and Human Services recommends that people looking to lower their cholesterol have:
- Less than 7 percent of daily calories from saturated fat
- Less than 200 mg a day of cholesterol
- 25 percent to 35 percent of daily calories from total fat
The drug’s label warns users to avoid drinking large amounts of grapefruit juice while taking the drug. This means users should not drink more than 1.2 liters of grapefruit juice per day. Grapefruit juice contains one or more components that inhibit CYP34A, an important enzyme found in the liver, and it can increase plasma concentrations of atorvastatin.
Experts also recommend at least 30 minutes a day of moderate intensity physical activity such as brisk walking, but talk with your doctor to determine what is appropriate for you.
Common and Serious Side Effects
In some people, Lipitor may cause mild side effects such as diarrhea, upset stomach, and muscle and joint pain. Though rare, people have also reported memory loss, forgetfulness, amnesia and confusion associated with statin use.
Serious Lipitor side effects include muscle disease called myopathy and muscle breakdown called rhabdomyolysis, which can lead to kidney damage and kidney failure. The risk of these complications rises when patients take atorvastatin at the same time as certain antibiotics, antivirals and antifungals.
The medication can also cause liver problems, including fatal and non-fatal liver failure. Signs of liver trouble may include: feeling tired or weak; losing your appetite; experiencing belly pain on the right side of your upper abdomen; and developing yellowish skin and eyes.
Studies also link atorvastatin use to an increased risk of developing Type 2 diabetes. Thousands of people filed lawsuits against Pfizer alleging Lipitor caused their Type 2 diabetes. The Lipitor lawsuits claimed Pfizer knew about the risks but didn’t adequately warn patients and doctors.
Many of these complications can occur with all statins, which raises serious safety concerns about the drug class as a whole.
Pregnancy, Breastfeeding, Liver Problems and Allergic Reactions
People who are allergic to Lipitor or any of its ingredients should not take the medication, according to the drug’s label. Neither should people with liver problems.
The label also advises against taking the drug while pregnant or breastfeeding. Atorvastatin may harm an unborn baby, and the medicine can pass into breast milk and may harm a nursing baby.
DID YOU KNOW?
Because Lipitor reduces the synthesis of cholesterol and potentially other biological substances derived from cholesterol, the drug may cause fetal harm if taken by pregnant women.
Source:
U.S. Food and Drug Administration
According to the label, women should stop taking the drug right away if they find out they are pregnant. Studies have not established the safety of the drug in pregnant women, and expectant mothers get no benefit from lipid-reducing drugs, the label states.
Before the FDA replaced its pregnancy risk letter categories in 2015, it had deemed Lipitor as Pregnancy Category X, indicating that the risks involved with use of the drug in pregnant women clearly outweigh the potential benefits. Pregnancy Category X means studies in animals or humans have demonstrated fetal abnormalities and/ or there is evidence of fetal risk based on human experience.
Lipitor Facts
Please seek the advice of a medical professional before making health care decisions.
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Lipitor: what is it – AMO Academy News
Reading time:
Lipitor is a drug that lowers blood cholesterol levels. It belongs to the 3rd generation lipid-lowering drugs, the group is statins. It is often prescribed to patients suffering from cardiovascular pathologies.
How does Lipitor work?
The active ingredient of the drug is atorvastatin. Thanks to him, lipoproteins, cholesterol and other types of fats are reduced in the bloodstream, which reduces the symptoms of atherosclerosis. The drug inhibits the activity of HMG-COA reductase. As a result, low-density lipoproteins begin to be intensively catabolized, which helps to reduce the level of “bad” cholesterol.
Release form and admission rules
Lipitor is available in tablets for oral administration. You can consume them regardless of food intake at the recommended dosage of 10 mg per day. The dosage is prescribed by the doctor, in some cases it may be increased.
Indications for use and effectiveness of Lipitor
He is appointed:
- for diseases of the heart and blood vessels;
- for hereditary hypercholesterolemia as part of complex treatment;
- for the prevention of myocardial infarction.
The effectiveness of Lipitor has been confirmed by clinical studies. In patients participating in the studies, after regular use of the drug, there was a significant reduction in complications from the heart and blood vessels in the post-infarction period. The number of angina attacks also decreased.
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How we are treated: Atoris.
Live in pain or die young?
Medicine
23:12, 07 February 2019
Is atorvastatin effective in the fight against atherosclerosis
drug, how it is better and worse than other statins, whether it helps the liver and whether it saves from Alzheimer’s disease, says Indicator.Ru.
A drug for a rare disease that became the best-selling drug in the US in 2003 in history – Atoris (aka Lipitor), which lowers blood cholesterol, boasts such a past. But does it reduce mortality and should healthy patients take statins? First, let’s figure out what it is.
From what, from what
The name of the drug Atoris comes from the main active ingredient, atorvastatin. Unlike many other statins, atorvastatin was made entirely synthetically. Its creator, Bruce Roth, barely convinced Warner-Lambert executives that his “CI 9 compound81 will not be the “orphan drug” originally thought to be lovastatin, already on the market, and simvastatin, which is in late-stage trials at Merck & Co. “Orphans” (from the English orphan) were called drugs for rare orphan diseases, one of which is familial hypercholesterolemia, which causes high blood cholesterol, and it was the study of this disease that led to the invention of statins.
You can learn how to understand medicines on your own in the author’s online course “How they treat us” from the editor of Indicator.Ru Ekaterina Mishchenko: https://clck.ru/Pnmtk
However, costly clinical trials have paid off: in early trials, atorvastatin lowered blood cholesterol more than simvastatin and had fewer side effects. Further, the medicine was waiting for continuous triumphs. Statins proved to be suitable for the fight against atherosclerosis, for the study of the mechanisms of which in 1985, the year of the discovery of atorvastatin, Michael Brown and Joseph Goldstein received the Nobel Prize. And when Pfizer bought Warner-Lambert, sales of Lipitor (an atorvastatin drug) skyrocketed. Atorvastatin was the top three best-selling drug in the US more than once and provided a quarter of Pfizer’s revenue for several years before the patent expired in 2011.
Like other statins, atorvastatin inhibits the action of 3-hydroxy-3-methylglutaryl coenzyme A reductase (abbreviated as HMG-CoA reductase). This enzyme is so named because it reduces 3-hydroxy-3-methyl-glutaryl-coenzyme A to mevalonic acid, from which the mevalonate pathway begins – a long route for the synthesis of steroids, which include cholesterol. In addition, mevalonic acid is a precursor to terpenes, the main component of resins and essential oils (but that’s a completely different story).
“Miracle”, “Evidence” and other studies
We have already talked about how cholesterol can be necessary for the body and at the same time accelerate the development of atherosclerosis in an article about Crestor, another drug from the statin group. Atherosclerosis occurs due to a complex set of causes that medicine is not yet able to eliminate. But by preventing the synthesis of cholesterol, which is part of atherosclerotic plaques, statins do not allow atherosclerosis to progress. In the famous Scandinavian study 1994 years (known as The Scandinavian Simvastatin Survival Study, or 4S), conducted on 4444 patients, scientists found that statins (in this case, simvastatin) also dramatically reduced the risk of heart attack. But this work was funded by the Merck Corporation, which was interested in a positive result.
A few years later, the results of the MIRACL (Myocardial Ischemia Reduction with Cholesterol Lowering) study were published, which for the first time confirmed the safety of early administration of atorvastatin to patients (there were 3086 in total) with acute coronary syndrome in the first 96 hours of exacerbation. The study also showed that the drug does not allow angina to progress. In another clinical trial, PROVE-IT, high-dose atorvastatin was more effective in lowering the cholesterol levels of pravastatin at standard doses in patients 10 days post-hospital with acute coronary syndrome.
Double-blind, randomized, placebo-controlled method is a method of clinical drug research in which subjects are not privy to important details of the study being conducted. “Double-blind” means that neither the subjects nor the experimenters know who is being treated, “randomized” means that the distribution into groups is random, and the placebo is used to show that the effect of the drug is not based on self-hypnosis and that this medicine helps better than a pill without an active substance. This method prevents subjective distortion of the results. Sometimes the control group is given another drug with already proven efficacy, rather than a placebo, to show that the drug not only treats better than nothing, but also outperforms analogues.
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The small (180 patients) study ESTABLISH (Early Statin Treatment in Patients With Acute Coronary Syndrome) confirmed the benefits of long-term treatment with atorvastatin for patients with acute coronary syndrome. It turned out that if you start using the drug immediately after hospitalization, after six months it reduces the volume of atherosclerotic plaques in the coronary arteries that feed the heart.
However, the authors of a study published in 2013 questioned the safety of statins, suggesting they increase the risk of heart attack. But later work did not confirm this conclusion. On the contrary, according to a report at the European Conference on Cardiovascular Imaging, the use of satins reduced the mass and volume of the ventricles of the patients’ hearts. But left ventricular hypertrophy is a change that increases the likelihood of heart attacks and strokes. In other words, statins are useful for those who are already at risk, although the need for their prophylactic use in healthy people is questionable.
Liver and Alzheimer’s
As a very widely used drug, atorvastatin has been tested in numerous clinical trials, including for more unusual indications than cardiovascular disease, but associated with disorders of lipid metabolism. For example, one Cochrane review reports on studies of atorvastatins in steatohepatitis, but there is too little information to recommend it in general clinical practice.
The Cochrane Library is a database of the Cochrane Collaboration, an international non-profit organization involved in the development of World Health Organization guidelines. The name of the organization comes from the name of its founder, the 20th-century Scottish medical scientist Archibald Cochrane, who championed the need for evidence-based medicine and the conduct of competent clinical trials and wrote the book Efficiency and Efficiency: Random Reflections on Public Health. Medical scientists and pharmacists consider the Cochrane Database one of the most authoritative sources of such information: the publications included in it have been selected according to the standards of evidence-based medicine and report the results of randomized, double-blind, placebo-controlled clinical trials.
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There is no evidence that atorvastatin can be useful in multiple sclerosis. In Alzheimer’s disease and senile dementia, the effectiveness of statins is completely refuted.
Another Cochrane review does not support statins for PCOS.
But diseases of the circulatory system for atorvastatin (as well as for statins in general) are a true specialization. Despite this, another Cochrane review concludes that statins have not yet been proven to have any effect on outcomes of vascular surgery. However, there is still hope here: in a small study, which we described in the article on coronary artery bypass grafting, it was found that statins reduced the risk of atrial fibrillation (inconsistent electrical activity) after coronary artery surgery.
But in people with ischemic stroke, atorvastatin reduces the likelihood of recurrent cardiovascular events (although the risk of recurrent stroke is reduced slightly). But it is not known whether the therapy bears fruit in hemorrhagic stroke.
Some studies have gone even further, endorsing the use of statins in children as young as eight years of age if they have elevated cholesterol levels.
About side effects
There is no consensus about the side effects of statins. An article in the journal Metabolism explains their appearance by blocking the production of coenzyme Q10, which helps regulate blood sugar levels and is involved in the work of muscle cells, along with the synthesis of cholesterol.
A meta-analysis from the Cochrane Collaboration shows that healthy people who take statins for prevention (at least in clinical trials) have virtually no side effects compared to placebo.
However, in clinical practice, complaints of side effects (muscle pain, liver damage) are not uncommon. A review in the journal Clinical Therapeutics states that statins cause 39% more side effects than placebo, but there are no serious effects within this difference. A systematic review in the European Journal of Preventive Cardiology, co-authored by Ben Goldacre of the Center for Evidence-Based Medicine at the University of Oxford, suggests that only a small proportion of the effects are due to the drug itself in this case. So patients at risk may feel unwell due to problems with the cardiovascular system or taking other drugs.
That being said, according to a comparative analysis of 135 studies, statins do increase the risk of diabetes, cause muscle pain and may be harmful to the liver, but these risks are still quite low. And here, atorvastatin was on a par with other statins, and pravastatin and simvastatin caused the least side effects. And while it appears that statin-related muscle pain may be underestimated in clinical studies, serious damage to muscle fibers occurs in 1-2 people per 10,000 person-years of drug use, concludes a systematic review in The Canadian Journal of Cardiology.
Less serious consequences, which are warned about by the instructions (nausea, digestive problems, loose stools, muscle and joint pain) are much more common – in 1-10% of patients. Also, the US Food and Drug Administration (FDA) in 2014 reported forgetfulness and distraction when taking statins, but these problems stopped after patients refused the drug.
With regard to recommendations for HIV-positive patients and people taking hemofibrozil, atorvastatin may be a less dangerous option than other statins, as patients in these groups are at increased risk of side effects.
Indicator.Ru recommends: use at increased risk of heart attack and stroke
Atoris really slows down the development of atherosclerosis and other cardiovascular diseases that increase the likelihood of heart attack and stroke. Its active substance belongs to fairly strong statins and is effective in different dosages: when taken 10 mg per day, it reduces blood cholesterol levels by 27%, and 80 mg per day – by 37.9%, another Cochrane review reports.
Although the side effects of statins are unpleasant, and you can’t expect a bright improvement and a complete cure from them, you should not stop taking them without your doctor’s permission. But in reality, the choice is not so harsh: according to statistics, health-threatening events (for example, the development of diabetes, serious damage to the liver or muscles) are considered very rare, and more frequent symptoms, such as muscle pain or nausea, are not dangerous. Despite this, while some patients use statins for prevention while being healthy (this is especially common in the US and Europe), others drop out of therapy that could prolong their life for years.
The truth is somewhere in the middle: the benefit of the drug to healthy people remains in question, although it is unlikely that statins cause significant harm to them. However, there is hope for the benefits of prevention: A 2013 Cochrane review shows that statins help prevent cardiovascular complications in an average of 18 patients out of 1000 who initially had hypertension, diabetes, or high cholesterol. Therefore, in the case of statins, everything depends on the condition of the patient.
Of course, we should not forget about a healthy lifestyle: sometimes it is enough to stop eating fatty foods to lower blood cholesterol levels to normal levels without the help of drugs. And even with medication, eating healthy won’t hurt you either.
Our recommendation is not the same as a doctor’s prescription.