VUZTAN 20 TABLETS

Indications

• Hyperlipidemia
• Primary prevention of cardiovascular disease
• Secondary prevention of cardiovascular events
• Familial hypercholesterolemia

Dosage

Children: Refer to the BNF for Children for paediatric dosing recommendations.

Adults: Refer to the BNF for specific dosing recommendations based on individual patient factors and clinical guidelines.

Mechanism of action

Atorvastatin works by competitively inhibiting HMG-CoA reductase, the enzyme responsible for catalyzing the conversion of HMG-CoA to mevalonate, a precursor of cholesterol. This inhibition leads to decreased cholesterol synthesis and upregulation of LDL receptors on hepatocyte membranes, enhancing the clearance of LDL cholesterol from the bloodstream.

Pharmacodynamics

Atorvastatin decreases total cholesterol, LDL cholesterol, and triglycerides while increasing high-density lipoprotein (HDL) cholesterol. Its effects contribute to the stabilization of atherosclerotic plaques and reduction of inflammation within the vascular walls. The drug has also been shown to have pleiotropic effects, including improving endothelial function and anti-inflammatory properties.

Pharmacokinetics

Atorvastatin is well-absorbed after oral administration, with peak plasma concentrations occurring approximately 1 to 2 hours post-dose. It undergoes extensive hepatic metabolism, primarily via cytochrome P450 3A4, resulting in active metabolites. The elimination half-life of atorvastatin is approximately 14 hours, with most of the drug excreted via bile and feces, while a minor fraction is excreted in urine.

Contra-indications

• Active liver disease
• Pregnancy
• Breastfeeding
• Hypersensitivity to atorvastatin or any components of the formulation

Adverse effects

• Muscle pain or weakness (myopathy, rhabdomyolysis)
• Liver enzyme elevation
• Gastrointestinal disturbances (nausea, diarrhea, constipation)
• Headache
• Rash
• Increased blood sugar levels

Interactions

• CYP3A4 inhibitors (e.g., azole antifungals, macrolide antibiotics) may increase atorvastatin levels
• CYP3A4 inducers (e.g., rifampicin, St. John's Wort) may decrease atorvastatin levels
• Fibrates may increase the risk of myopathy
• Warfarin may have its effects altered when used with atorvastatin

Precautions

• Monitor liver function tests before and during therapy
• Caution in patients with a history of liver disease
• Caution in patients with renal impairment
• Assess risk of myopathy, especially in elderly patients or those on concomitant medications

Pregnancy

Atorvastatin is contraindicated in pregnancy due to potential risk to the fetus. It is recommended to discontinue use as soon as pregnancy is detected.

Breast-feeding

Atorvastatin is contraindicated during breastfeeding due to potential secretion in breast milk and possible harm to the infant.

Storage

Atorvastatin should be stored at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Tablets (10 mg, 20 mg, 40 mg, 80 mg)