Atorvastatin side effects

Atorvastatin 1 0, 20, 40, 80 mg tablets 1 0 to 80 mg once daily (at any time of day) Most frequent side effects are constipation, abdominal pain, diarrhea, dyspepsia, and nausea. Statins... 

As indicated in Table 1, statins, which block cholesterol biosynthesis by inhibition of hepatic HMGCoA reductase, have been used extensively to reduce LDL-C levels. At most therapeutic doses, statins marginally increase HDL levels by 5-10% [3,16]. The HDL elevation observed with statins has been highly variable and not easily extrapolated from the effects on LDL. A recent study (STELLAR) demonstrated increased HDL elevation with the use of rosuvastatin compared to simvastatin, pravastatin or atorvastatin (10% vs. 2-6%) [16,24], Although the mechanism of HDL elevation by statins is not clearly understood, it is proposed that statins enhance hepatic apoA-I synthesis [25] and decrease apoB-containing lipoproteins [26]. A number of clinical trials have demonstrated that statins reduce the risk of major coronary events. However, it is not clear if the statin-induced rise in HDL levels is an independent contributor to the reduced risk of coronary events. The observed small increase in HDL and adverse side effect profile related to liver function abnormalities and muscle toxicity limits the use of statins as monotherapy for HDL elevation [27],... 

Atorvastatin is generally well tolerated. Side effects are usually mild and transient. Frequent (16%)... 

Myotoxic side effects, including myopathy or rhabdomyolysis, have been observed with the usage of atorvastatin calcium. Painful myalgia with a significant creatine kinase release (> 2000IU/1) is also associated with the use of atorvastatin [35]. 

Pelli N, Setti M, Ceppa P, Toncini C, Indiveri F (2003) Autoimmune hepatitis revealed by atorvastatin. Eur J Gastroenterol Hepatol 15 921-924. Sniderman AD (2004) Is there value in liver function test and creatine phosphokinase monitoring with statin use Am J Cardiol 94 30F-4F. Dujovne CA (2002) Side effects of statins hepatitis versus ransaminitis myositis versus CPKitis . Am J Cardiol 89 1411-1413. 

CALCIUM CHANNEL BLOCKERS STATINS t plasma levels of atorvastatin, lovastatin and simvastatin case reports of myopathy when atorvastatin and simvastatin are co-administered with diltiazem or verapamil Uncertain, but postulated to be due to inhibition of CYP3A4-mediated metabolism of statins in the intestinal wall. Also, diltiazem and verapamil inhibit intestinal P-gp, which may t the bioavailability of statins Watch for side-effects of statins. It has been suggested that the dose of simvastatin should not exceed 20 mg when given with verapamil, and 40 mg when given with diltiazem... 

The complementary shape and pattern of hydrogen bonding ensure that atorvastatin binds to HMG-CoA reductase and inhibits its ability to catalyze the formation of mevalonate. The hallmark of this and other effective dmgs is their ability to bind strongly with their intended target molecules, while at the same time not interacting with other molecules that could lead to unwanted side effects. 

Exercise There is moxmting evidence that exercise might exacerbate statin-related side effects such as myopathy [50]. The randomised, controlled trial with 37 subjects (exercise plus simvastatin n= 18 exercise only n= 19) showed that simvastatin attenuates increases in cardiorespiratory fitness and skeletal muscle mitochondrial content when combined with exercise training in patients at risk of the metabolic syndrome [51]. The short-term administration of high-dose atorvastatin did not result in altered muscle function despite mild increases in creatine kinase levels [52]. 

Background It is well known that hypercholesterolemia is a major risk factor in the progression of atherosclerosis, the major cause of cardiovascular diseases. Statins are widely used to treat hypercholesterolemia. The mechanism of action of these drugs is to reduce the endogenous production of cholesterol by inhibiting 3-hydroxy-3-methylglutaryl coenzyme (HMG-CoA) reductase. Atorvastatin (ATV, Lipitor) is one of the top-selling prescribed oral medications. The only known adverse effect is skeletal muscle toxicity (myopathy) that may be related to the formation of the lactone of the acidic side chain on the molecule. 

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