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It is inhibitor of 3hydroxy-3methylglutaryl co-enzyme A (HMG-CoA) reductase, a rate-limiting enzyme in cholesterol biosynthesis. It reduces hepatic LDL receptors. Thereby decreasing LDL particles, with homozygous and heterozygous familial hypercholesterolemia, non-familial forms of hypercholesterolemia and mixed dyslipidemia, who rarely respond to other drugs. It also decreases VLDL-C and triglycerides, increases HDL-C and apolipoprotein A-1.

INDICATIONS: Primary hypercholesterolemia (heterozygous familial and non familial), mixed (combined) dyslipidemia and homozygous hypercholesterolemia in patients who have not responded adequately to diet and other appropriate measures.

CONTRAINDICATIONS: Active liver diseases or increased serum transaminases, hypersensitivity to any component, pregnancy, lactation. Use with caution in alcoholics or in patients with prior history of liver diseases. Liver function tests are recommended prior to and at 12 weeks following initation of the therapy.

ADVERSE EFFECTS: Constipation, diarrhea, dyspepsia, flatulence, abdominal pain, chest pain, bronchitis, sinusitis, rhinitis insomnia, dizziness, arthralgia, urinary tract infection, myalgia, peripheral edema, pruritus, rash flu like syndrome. Rare cases of rhabdomyolysis with acute renal failure are reported.

DRUG INTERACTION: Increased myopathy with concomitant use of - cyclosporine, fibric acid derivatives, niacin, erythromycin, azoleantifungals. Decreased concentration of atorvastatin with antacids. Increased concentration of atorvastatin with erythromycin.

DOSAGE: Primary hyperchloesterolaemia and combined hyperlipidaemia : 10 mg once daily.

Familial hypercholesterolaemia: initial dose-100 mg OD.Lipid levels are done after 2-4 weeks of initiation and dose adjustment accordingly (dose range 10-80 mg OD). No relation to meals.