Atorvastatin

BN: Lipitor
Classification: Pharmacotherapeutic: Hy-droxymethylglutaryl CoA (HMG-CoA) reductase
inhibitor.
Mode of Action: Inhibits HMG-CoA reductase, the enzyme
that catalyzes the early step in cholesterol synthesis. Results in an increase of
ex-pression in LDL receptors on hepatocyte membranes and a stimulation of LDL
catabolism.

Suggested dose:

Indications & contraindications:

Indications

Lipitor is used for the 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

Contraindications:
Hypersensitivity to atorvastatin

Active liver disease or unexplained transaminase elevation

Your doctor should not prescribe this medication if you are a patient with liver
problems

Women who are pregnant or breastfeeding should not take atorvastatin

Side effects & Adverse effects

SIDE EFFECTS
Common: Atorvastatin is generally well
tolerated. Side effects are usually mild
and transient. Frequent (16%): Headache.

Occasional (5%–2%): Myalgia, rash, pru-

ritus, allergy. Rare (less than 2%–1%):

Flatulence, dyspepsia, depression.

ADVERSE EFFECTS/TOXIC
REACTIONS
Potential for cataracts, photosensitivity,
myalgia, rhabdomyolysis.

Drug interactions:

Clarithromycin & Atorvastatin

Combining these medications may significantly increase the blood levels of
atorvastatin. This can increase the risk of side effects such as liver damage and a
rare but serious condition called rhabdomyolysis that involves the breakdown of
skeletal muscle tissue.

erythromycin & atorvastatin

Atorvastatin and erythromycin may be used together with caution. It may be prudent
to withhold atorvastatin if erythromycin treatment is required to avoid any
potential adverse effects.

itraconazole and atorvastatin

Combining these medications may significantly increase the blood levels of

atorvastatin. This can increase the risk of side effects such as liver damage and a
rare but serious condition called rhabdomyolysis that involves the breakdown of
skeletal muscle tissue.

Using atorvastatin together with niacin may increase the risk of a rare but serious
condition called rhabdomyolysis that involves the breakdown of skeletal muscle
tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. The
risk is greatest if you are elderly or have preexisting kidney disease.

Taking rifampin with atorvastatin may lower the amount of atorvastatin in your
body. This means that the atorvastatin may not work as well.

Nursing Responsibilities (10):

Determine the goal of therapy in starting atorvastatin

Monitor serum lipid levels regularly
Evaluate the patient’s response to atorvastatin
For muscle pain, administer pain medications as ordered
Implement safety and fall precautions as atorvastatin may affect concentration,
alertness, and vision
Immediately report EKG changes, yellowish discoloration to the skin, muscle
weakness, or unusual bleeding
Administer at bedtim

References:

Comerford, K. C., & Durkin, M. T. (2021). Nursing 2021 drug handbook. 41st edition.
Philadelphia, Wolters Kluwer.

Cunha, J. (2022, June 20). Atorvastatin: Cholesterol, Uses, Side Effects, Dosages,
Interactions & Warnings. RxList; RxList.
https://www.rxlist.com/atorvastatin/generic-drug.htm

Salvador, K. (2022, September 25). Atorvastatin Nursing Considerations & Patient

Teachings. NurseTogether. https://www.nursetogether.com/atorvastatin-nursing-
considerations/

‌
University of Illinois. (2018, July 5). Atorvastatin, oral tablet.
Medicalnewstoday.com; Medical News Today.
https://www.medicalnewstoday.com/articles/atorvastatin-oral-tablet#alternatives

‌
Wayne, G. (2023, January 16). Atorvastatin (Lipitor) Nursing Considerations and
Patient Teaching [Drug Guide]. Nurseslabs. https://nurseslabs.com/atorvastatin-
nursing-considerations-and-patient-teaching-drug-guide/