Atorvastatin Dosage

Applies to the following strength(s): 10 mg ; 20 mg ; 40 mg ; 80 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your
doctor or pharmacist.

Usual Adult Dose for:

Prevention of Cardiovascular Disease

Homozygous Familial Hypercholesterolemia

Hyperlipidemia

Hyperlipoproteinemia Type IIa (Elevated LDL)

Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL)

Hyperlipoproteinemia Type III (Elevated beta-VLDL + IDL)

Hyperlipoproteinemia Type IV (Elevated VLDL)

Hypertriglyceridemia

Heterozygous Familial Hypercholesterolemia

Usual Pediatric Dose for:

Heterozygous Familial Hypercholesterolemia

Additional dosage information:

Renal Dose Adjustments

Liver Dose Adjustments

Dose Adjustments

Precautions

Dialysis

Other Comments

Usual Adult Dose for Prevention of Cardiovascular

Disease
-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)

of more than 45%

-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses:
-In patients without clinically evident coronary heart disease (CHD), but with
multiple risk factors for CHD such as age, smoking, hypertension, low HDL-C,
or a family history of early CHD, to reduce the risk of myocardial infarction
and stroke, and to reduce the risk for revascularization procedures and
angina
-In patients with type 2 diabetes, and without clinically evident CHD, but with
multiple risk factors for CHD such as retinopathy, albuminuria, smoking, or
hypertension, to reduce the risk for myocardial infarction and stroke
-In patients with clinically evident CHD, to reduce the risk of nonfatal
myocardial infarction and fatal and nonfatal stroke; to reduce the risk for
revascularization procedures; to reduce the risk of hospitalization for CHF;
and to reduce the risk of angina

Usual Adult Dose for Homozygous Familial

Hypercholesterolemia
10 mg to 80 mg orally once a day
Uses: To reduce total-C and LDL-C in patients with homozygous familial
hypercholesterolemia, as an adjunct to other lipid lowering treatment (e.g.,
LDL apheresis) or if such treatments are unavailable

Usual Adult Dose for Hyperlipidemia

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)
of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary
dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond
adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type

IIa (Elevated LDL)
-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)
of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary
dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond
adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type

IIb (Elevated LDL + VLDL)
-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)

of more than 45%

-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary
dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond
adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type

III (Elevated beta-VLDL + IDL)
-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)
of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary
dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond
adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type

IV (Elevated VLDL)
-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)
of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary
dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond
adequately to diet

Usual Adult Dose for Hypertriglyceridemia

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)
of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary

dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond

adequately to diet

Usual Adult Dose for Heterozygous Familial

Hypercholesterolemia
-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may
be used in patients who require a reduction in low density lipoprotein (LDL-C)
of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day
Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated
within 2 to 4 weeks and dosages adjusted accordingly.
Uses: As an adjunct to diet in the following conditions: to reduced total
cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG)
levels, and to increase high density lipoprotein (HDL-C) in patients with
primary hypercholesterolemia (heterozygous familial and nonfamilial) and
mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of
elevated TG levels (Fredrickson Type IV); and for the treatment of primary
dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond
adequately to diet

Usual Pediatric Dose for Heterozygous Familial

Hypercholesterolemia
10 to 17 years: 10 mg orally once a day
-Maximum dose: 20 mg/day
Comments:
-Doses greater than 20 mg/day have not been studied in this patient
population.
-Dose adjustments should be made at intervals of 4 weeks or more.
Use: As an adjunct to diet to reduce total-C, LDL-C, and apo B levels in boys
and postmenarchal girls, 10 to 17 years of age, with heterozygous familial
hypercholesterolemia if after an adequate trial of diet therapy the following
findings are present: LDL-C remains 190 mg/dL or greater, or LDL-C remains

160 mg/dL or greater and there is a positive family history of premature

cardiovascular disease (CVD) or 2 or more other CVD risk factors are present
in the pediatric patient

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Active liver disease (including unexplained persistent elevations in hepatic
transaminase levels): Contraindicated

Dose Adjustments
Concomitant lipid lowering therapy:
-This drug may be used with bile acid resins; the combination of HMG-CoA
reductase inhibitors (statins) and fibrates should be used with caution.
In patients taking cyclosporine or HIV protease inhibitors (tipranavir
plus ritonavir) or the hepatitis C protease inhibitor (telaprevir):
-Avoid use with atorvastatin
In patients with HIV taking lopinavir plus ritonavir:
-Use with caution; lowest effective dose of atorvastatin should be used
Concomitant therapy with clarithromycin, itraconazole, or in
patients with HIV taking a combination of saquinavir plus ritonavir,
darunavir plus ritonavir, fosamprenavir, or fosamprenavir plus
ritonavir:
-Maximum dose: 20 mg/day; appropriate clinical assessment is
recommended to ensure the lowest effective dose is employed
Concomitant therapy with the HIV protease inhibitor nelfinavir or
the hepatitis C protease inhibitor boceprevir:
-Maximum dose: 40 mg/day; appropriate clinical assessment is
recommended to ensure the lowest effective dose is employed

Precautions
Safety and efficacy have not been established in pre-pubertal patients or
patients younger than 10 years.
Consult WARNINGS section for additional precautions.

Dialysis
Data not available

Other Comments
Administration advice:
-May be taken orally once a day at any time, with or without food
General:
-This drug has not been studied in conditions where the major lipoprotein
abnormality is elevation of chylomicrons (Fredrickson Types I and V).
-Dosages should be individualized according to patient characteristics,
including goals of therapy and response to therapy.
-Drug therapy should only be one component of multiple risk factor
intervention in individuals at significantly increased risk for atherosclerotic
vascular disease due to hypercholesterolemia; patients should be placed on
this drug only when a diet restricted in saturated fat and cholesterol and
other nonpharmacologic measures have proven inadequate.
-Patients with CHD or multiple risk factors for CHD may start this drug
simultaneously with diet.
Monitoring:
-Hepatic: Measure liver enzyme tests prior to initiating therapy, if
signs/symptoms of liver injury occur, and as clinically indicated throughout
therapy
-Metabolic: Following initiation or upon titration if this drug, lipid levels
should be analyzed within 2 to 4 weeks and the dosage adjusted accordingly;
periodic testing of lipid levels should be performed to determine goal
attainment
Patient advice:

-Advise patients to report immediately any unexplained muscle pain,

tenderness, or weakness, especially if accompanied by malaise or fever, or if
muscle signs/symptoms persist after discontinuing therapy.
-Patients should talk to their health care provider if they are pregnant,
planning to become pregnant, or breastfeeding; this drug is not
recommended for use during pregnancy or lactation.
-Counsel patients on the importance of contraceptive methods while taking
this drug.
-Patients should be aware that there are a number of potential drug
interactions with this drug and they should speak with a healthcare
professional before starting any new medications including over the counter
medications.