Lipitor: Advanced Lipid Management for Cardiovascular Risk Reduction
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Lipitor (atorvastatin calcium) is a prescription medication classified as a statin, or HMG-CoA reductase inhibitor, designed to manage elevated cholesterol levels and reduce the risk of cardiovascular events. It functions by inhibiting the enzyme responsible for cholesterol production in the liver, thereby lowering low-density lipoprotein (LDL) cholesterol and triglycerides while increasing high-density lipoprotein (HDL) cholesterol. Clinically proven in extensive trials, Lipitor is indicated for primary and secondary prevention of cardiovascular disease, including myocardial infarction and stroke, in appropriate patient populations. Its efficacy and safety profile have been established across diverse demographics, making it a cornerstone in modern lipid-lowering therapy under physician supervision.
Features
- Contains atorvastatin calcium as the active pharmaceutical ingredient
- Available in multiple strengths: 10 mg, 20 mg, 40 mg, and 80 mg tablets
- Film-coated, oval-shaped tablets imprinted with specific codes for strength identification
- Formulated for once-daily oral administration, with or without food
- Manufactured under strict pharmaceutical quality control standards
- Stable chemical composition with a shelf life of 24 months when stored properly
- Bioequivalent across all manufacturing sources approved by regulatory authorities
Benefits
- Significantly reduces LDL cholesterol levels by 39-60% depending on dosage
- Lowers triglyceride levels by 19-37% through consistent therapy
- Moderately increases HDL cholesterol by 5-9% to support reverse cholesterol transport
- Reduces risk of myocardial infarction by up to 36% in high-risk populations
- Decreases stroke incidence by approximately 48% in patients with existing cardiovascular disease
- Slows progression of coronary atherosclerosis as demonstrated in intravascular ultrasound studies
Common use
Lipitor is primarily prescribed for the management of dyslipidemia, including primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia. It is indicated for patients who require substantial LDL cholesterol reduction beyond what can be achieved through dietary modification alone. Additionally, Lipitor is used for cardiovascular risk reduction in adults with multiple risk factors for coronary heart disease, those with established cardiovascular disease, and patients with type 2 diabetes who demonstrate additional risk factors. The medication may be prescribed as monotherapy or in combination with other lipid-lowering agents when clinically appropriate, though combination therapy requires careful monitoring for potential interactions.
Dosage and direction
The recommended starting dosage for most patients is 10 mg or 20 mg once daily. For patients requiring more aggressive LDL cholesterol reduction (greater than 45%), an initial dose of 40 mg may be appropriate. The maximum recommended dose is 80 mg daily. Dosage should be individualized based on baseline LDL cholesterol levels, the goal of therapy, and patient response. Lipitor may be administered at any time of day, with or without food, though consistency in administration time is recommended. Liver function tests should be performed before initiating therapy and periodically thereafter. Dose adjustments may be necessary based on efficacy and tolerance, particularly in patients taking concomitant medications that affect atorvastatin metabolism.
Precautions
Patients should be advised to report any unexplained muscle pain, tenderness, or weakness promptly, particularly if accompanied by fever or malaise. Regular monitoring of liver enzymes is recommended before treatment initiation and as clinically indicated thereafter. Lipitor should be used with caution in patients who consume substantial quantities of alcohol or have a history of liver disease. Blood glucose levels should be monitored in patients with diabetes or risk factors for diabetes, as statins may increase hemoglobin A1c and fasting serum glucose levels. Patients should be informed that Lipitor is not a substitute for dietary management of hyperlipidemia and that they should maintain appropriate exercise and dietary regimens during treatment.
Contraindications
Lipitor is contraindicated in patients with active liver disease or unexplained persistent elevations of hepatic transaminases. It should not be used during pregnancy or breastfeeding, as cholesterol synthesis is essential for fetal development and statins may cause fetal harm. The medication is contraindicated in patients with hypersensitivity to any component of the formulation. Concomitant use with strong CYP3A4 inhibitors such as itraconazole, ketoconazole, posaconazole, voriconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin, nefazodone, and cobicistat-containing products is contraindicated due to significantly increased atorvastatin exposure.
Possible side effect
The most common adverse reactions (≥2% and greater than placebo) include nasopharyngitis, arthralgia, diarrhea, pain in extremity, and urinary tract infection. Musculoskeletal side effects may include myalgia (1.4-3.6%), arthralgia (2.2-3.1%), and muscle spasms (1.0-1.5%). Serious but rare side effects include rhabdomyolysis with acute renal failure, hepatotoxicity, and immune-mediated necrotizing myopathy. Other reported adverse reactions include constipation, dyspepsia, nausea, insomnia, and elevations in liver enzymes. Approximately 1.5% of patients discontinue therapy due to adverse effects in clinical trials, with the most common reasons being digestive system disorders and musculoskeletal pain.
Drug interaction
Lipitor is metabolized primarily by cytochrome P450 3A4, resulting in several clinically significant interactions. Concomitant administration with strong CYP3A4 inhibitors increases atorvastatin exposure approximately 3- to 4-fold and is contraindicated. Moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil, amiodarone) may increase atorvastatin exposure by approximately 2- to 3-fold, requiring dose limitations. Gemfibrozil and other fibrates may increase the risk of myopathy and should be used with caution. Cyclosporine, tipranavir/ritonavir, and glecaprevir/pibrentasvir significantly increase atorvastatin exposure and require dose limitations. Antacids containing magnesium and aluminum hydroxide may decrease atorvastatin concentrations approximately 35%; administration should be separated by at least 2 hours.
Missed dose
If a dose is missed, patients should take it as soon as they remember, unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistency in daily administration is important for maintaining stable lipid-lowering effects, though occasional missed doses are unlikely to significantly impact long-term efficacy. Patients should be educated about the importance of adherence to prescribed therapy for optimal cardiovascular protection.
Overdose
There is no specific antidote for atorvastatin overdose. In the event of overdose, symptomatic and supportive measures should be implemented. The patient should receive appropriate supportive treatment as required. Due to extensive protein binding, hemodialysis is not expected to significantly enhance atorvastatin clearance. Liver function and CPK levels should be monitored, and the patient observed for signs of myopathy or renal failure. In cases of massive overdose, gastric lavage may be considered if performed soon after ingestion. Medical toxicology consultation is recommended for significant overdoses.
Storage
Store Lipitor tablets at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep the medication in its original container with the lid tightly closed to protect from moisture and light. Do not store in bathrooms or other areas with high humidity. Keep out of reach of children and pets. Do not use tablets that are discolored, damaged, or beyond the expiration date printed on the packaging. Proper disposal of unused medication should follow local regulations for pharmaceutical waste.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Lipitor is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary based on patient-specific factors including genetics, concomitant medications, and underlying health conditions. Patients should not initiate, discontinue, or modify their dosage without consulting their prescribing physician. The full prescribing information contains complete details regarding indications, contraindications, warnings, and precautions.
Reviews
Clinical trials involving over 80,000 patients have demonstrated Lipitor’s efficacy in reducing cardiovascular events. The ASCOT-LLA study showed 36% reduction in non-fatal myocardial infarction and fatal coronary heart disease in hypertensive patients with additional risk factors. The SPARCL trial demonstrated 16% relative risk reduction in fatal or non-fatal stroke among patients with recent stroke or TIA. Real-world evidence studies have confirmed these benefits in diverse populations, with meta-analyses showing consistent reduction in major vascular events per 1 mmol/L LDL cholesterol reduction. Patient satisfaction surveys indicate high adherence rates relative to other statins, attributed to once-daily dosing and generally favorable tolerability profile.