Atorvastatin + Ezetimibe

Indications

Atorvastatin + Ezetimibe is used for: Hypercholesterolaemia, Primary Hyperlipidemia

Adult Dose

Oral Hypercholesterolaemia Adult: Per tablet contains atorvastatin 10 mg and ezetimibe 10 mg: Usual starting: 1 tablet once daily.

Child Dose

Safety and efficacy not established

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity; active liver disease or unexplained persistent elevated liver function tests. Pregnancy and lactation.

Precautions

Hepatic impairment; patients consuming substantial quantities of alcohol with a history of liver disease. Not recommended for use in children <10 yr. Lactation: Because of the potential for adverse reactions in nursing infants, women taking this drug should not breast feed. Contraindicated in breastfeeding women.

Pregnancy-Lactation

Pregnancy Category: X Lactation: Because of the potential for adverse reactions in nursing infants, women taking this drug should not breast feed. Contraindicated in breastfeeding women.

Interactions

Atorvastatin: Increases digoxin levels; increases anticoagulant effect of warfarin. Avoid the combination of HMG-CoA reductase inhibitors and fibrates. Ezetimibe: Cholestyramine decreases AUC of ezetimibe by approx 55%; ciclosporin may increase ezetimibe levels. Potentially Fatal: Antacids decrease atorvastatin levels; colestipol decreases atorvastatin plasma levels; propranolol decreases antihyperlipidaemic activity of atorvastatin.

Adverse Effects

Side effects of Atorvastatin + Ezetimibe : 1-10% Increased ALT (5%), Increased AST (4%), Musculoskeletal pain (4%), Abdominal pain (3%), Nausea (3%), Arthralgias (3%), Muscle weakness (2%), Dizziness (2%), Hyperkalemia (2%), Hot flushes (2%), Coughing (2%), Bronchitis (2%), Sinusitis (2%)

Mechanism of Action

Atorvastatin competitively inhibits HMG-CoA reductase, the enzyme that catalyses the conversion of HMG-CoA to mevalonate which is an early rate-limiting step in cholesterol biosynthesis. Ezetimibe inhibits the absorption of cholesterol from the intestine, thus decreasing the delivery of intestinal cholesterol to the liver.