4/26/2021 Lipitor (atorvastatin) dosing, indications, interactions, adverse effects, and more
This site is intended for healthcare professionals
atorvastatin (Rx)
Brand and Other Names: Lipitor
Classes: Lipid-Lowering Agents, Statins;
HMG-CoA Reductase Inhibitors
Dosing & Uses
Adult Pediatric
Dosage Forms & Strengths
tablet
10mg
20mg
40mg
80mg
Hyperlipidemia
Primary hypercholesterolemia and mixed dyslipidemia
Indicated as an adjunct to diet for treatment of elevated total-C, Apo B, and TG levels and to
increase HDL-C in patients with primary hypercholesterolemia (heterozygous familial and
nonfamilial) and mixed dyslipidemia (Fredrickson type IIa and IIb)
10-20 mg PO qDay initially
Starting dose in patients requiring larger LDL-C reduction (ie, >45%): 40 mg PO qDay
Maintenance: 10-80 mg PO qDay
After initiation and/or upon dose titration, check lipid levels after 2-4 weeks and adjust dose
accordingly
Hypertriglyceridemia
Adjunct to diet for elevated TG levels (Fredrickson type IV)
10 mg PO qDay initially
Maintenance: 10-80 mg PO qDay maintenance
After initiation and/or upon dose titration, check lipid levels after 2-4 weeks and adjust dose
accordingly
Primary dysbetalipoproteinemia
Dysbetalipoproteinemia (Fredrickson type III) in patient with inadequate response to diet
Maintenance: 10-80 mg PO qDay
After initiation and/or upon dose titration, check lipid levels after 2-4 weeks and adjust dose
accordingly
Homozygous familial hypercholesterolemia
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4/26/2021 Lipitor (atorvastatin) dosing, indications, interactions, adverse effects, and more
Reduction of total-C and LDL-C in HoFH as an adjunct to other lip-lowering treatments (eg,
LDL apheresis) or if such treatments are unavailable
10-80 mg PO qDay
Cardiovascular Disease Prevention
10-80 mg PO qDay
Indications
Reduction of risk of stroke and heart attack in type 2 diabetes patients without evidence of
heart disease but with other CV risk factors
Reduction of risk of stroke, heart attack, and revascularization procedures in patients without
evidence of coronary heart disease (CHD) but with multiple risk factors other than diabetes
(eg, smoking, HTN, low HDL-C, family history of early CHD)
Patients with CHD, to reduce risks of MI, stroke, revascularization procedures, hospitalization
for CHF, and angina
Dosage Modifications
Coadministration with other drugs
Bile acid sequestrant: Administer atorvastatin/ezetimibe ≥2 hr before or ≥4 hr after
administering bile acid sequestrant
Cyclosporine, tipranavir plus ritonavir, gemfibrozil: Avoid coadministration with atorvastatin
(increased risk of rhabdomyolysis)
Lopinavir plus ritonavir: Use lowest dose of atorvastatin necessary
Clarithromycin, itraconazole, saquinavir plus ritonavir, darunavir plus ritonavir, fosamprenavir:
Do not exceed atorvastatin dose of 20 mg/day
Nelfinavir: Do not exceed atorvastatin dose of 40 mg/day
Dosing Considerations
Overdose management
Generally considered safe in acute overdose, although not formally studied
Adverse drug reactions from overdose may include peripheral neuropathy, diarrhea,
increased K+, myopathy, rhabdomyolysis, acute renal failure, elevated LFTs, eye lens
opacities
Treatment is supportive
Dosage Forms & Strengths
tablet
10mg
20mg
40mg
80mg
Heterozygous Familial Hypercholesterolemia
Indicated as an adjunct to diet to reduce total-C, LDL-C, and apo B levels in boys and
postmenarchal girls aged 10-17 years with HeFH who have an inadequate response to diet alone
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4/26/2021 Lipitor (atorvastatin) dosing, indications, interactions, adverse effects, and more
(ie, LDL-C remains ≥190 mg/dL or LDL-C remains ≥160 mg/dL and there is positive family history
or early CV disease or 2 or more other CVD risk factors present)
<10 years: Safety and efficacy not established
≥10 years: Initially, 10 mg PO qDay; titrate at 4-week intervals; not to exceed 20 mg PO qDay
Homozygous Familial Hypercholesterolemia (Off-label)
<10 years: Safety and efficacy not established
≥10 years: 10-40 mg PO qDay
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