Atorlip 20 is a prescription medication containing atorvastatin calcium, specifically formulated to address elevated levels of low-density lipoprotein (LDL) cholesterol and triglycerides in the blood. As a member of the statin class of drugs, it functions by competitively inhibiting HMG-CoA reductase, the rate-limiting enzyme in the hepatic cholesterol biosynthesis pathway. This targeted mechanism facilitates a significant reduction in cardiovascular risk factors, supporting long-term vascular health. It is indicated for use in conjunction with dietary modifications and is prescribed for adult patients requiring pharmacological intervention for dyslipidemia.

Features

• Active ingredient: Atorvastatin Calcium 20 mg
• Pharmaceutical form: Film-coated tablets
• Mechanism: Selective, competitive inhibition of HMG-CoA reductase
• Bioavailability: Approximately 12%
• Half-life: 14 hours; active metabolites contribute to prolonged pharmacodynamic effect
• Excretion: Primarily via hepatic metabolism and biliary elimination

Benefits

• Significantly reduces LDL cholesterol levels, directly lowering atherogenic risk
• Increases high-density lipoprotein (HDL) cholesterol, supporting reverse cholesterol transport
• Lowers triglyceride concentrations, reducing pancreatitis and cardiovascular risk
• Provides anti-inflammatory and plaque-stabilizing pleiotropic effects within the vascular endothelium
• Contributes to overall reduction in major adverse cardiac events (MACE) in at-risk populations
• Supports long-term management of familial and acquired hypercholesterolemia

Common use

Atorlip 20 is commonly prescribed for the treatment of primary hypercholesterolemia, including heterozygous familial and non-familial forms, as well as mixed dyslipidemia. It is also indicated to reduce the risk of myocardial infarction, stroke, and revascularization procedures in adults with multiple risk factors but without established coronary heart disease. Clinical use extends to patients with type 2 diabetes and hypertension with additional risk factors, where lipid-lowering therapy is warranted for primary prevention of cardiovascular events.

Dosage and direction

The recommended starting dose for most patients is one Atorlip 20 tablet orally once daily, with or without food. Dosage may be adjusted based on lipid-lowering response and therapeutic goals, with a maximum recommended dose of 80 mg daily. Administration timing is flexible but should be consistent. Liver function tests should be performed prior to initiation and periodically thereafter. Dose adjustments are necessary in patients taking certain concomitant medications or with predisposing factors for myopathy.

Precautions

Prior to initiating therapy, secondary causes of hypercholesterolemia should be ruled out. Liver enzyme levels must be measured at baseline and periodically during treatment; discontinuation is advised if transaminase levels persist at >3 times the upper limit of normal. Patients should be advised to report unexplained muscle pain, tenderness, or weakness promptly. Use with caution in patients with a history of hepatic disease, heavy alcohol consumption, or in the elderly. Renal impairment generally does not affect dosing, but caution is advised in severe cases.

Contraindications

Atorlip 20 is contraindicated in patients with active liver disease or unexplained persistent elevations of serum transaminases. It must not be used during pregnancy, in women who may become pregnant, or during breastfeeding due to potential fetal harm and excretion in milk. Concomitant use with strong CYP3A4 inhibitors such as itraconazole, clarithromycin, or HIV protease inhibitors is contraindicated. Hypersensitivity to any component of the formulation also prohibits use.

Possible side effect

Common adverse reactions include headache, myalgia, arthralgia, nausea, and diarrhea. Less frequently, patients may experience elevated liver enzymes, insomnia, or nightmares. Serious but rare side effects include rhabdomyolysis with renal dysfunction, hepatotoxicity, and immune-mediated necrotizing myopathy. Hyperglycemia and increased HbA1c have been reported. Allergic reactions, including rash and angioedema, may occur in susceptible individuals.

Drug interaction

Atorlip 20 is metabolized primarily by CYP3A4; concomitant use with potent inhibitors of this enzyme increases atorvastatin exposure and risk of myopathy. These include cyclosporine, gemfibrozil, and certain antifungal and antiviral agents. Bile acid sequestrants may reduce bioavailability and should be administered at least 2 hours apart. Caution is advised with warfarin, as atorvastatin may potentiate its anticoagulant effect. Interactions with oral contraceptives, digoxin, and colchicine have also been documented.

Missed dose

If a dose is missed, it should be taken as soon as remembered, 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. Doubling the dose to compensate for a missed tablet is not recommended.

Overdose

There is no specific antidote for atorvastatin overdose. Treatment should be supportive and symptomatic. Gastric lavage may be considered if ingestion was recent. Liver function and CPK levels should be monitored. Hemodialysis is not expected to significantly enhance elimination due to high protein binding and extensive hepatic metabolism.

Storage

Store at room temperature (15–30°C) in a dry place, protected from light and moisture. Keep the blister strips in the original packaging until use. Do not use beyond the expiration date printed on the packaging. Keep out of reach of children and pets.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient responses and requirements may vary.

Reviews

Clinical studies and meta-analyses consistently demonstrate the efficacy and safety profile of atorvastatin 20 mg in diverse patient populations. In the ASCOT-LLA trial, atorvastatin 10 mg significantly reduced coronary events in hypertensive patients with additional risk factors. Higher doses, including 20 mg, have shown further LDL reduction and cardiovascular benefit in subsequent studies. Patient tolerance is generally high, with discontinuation rates due to adverse effects comparable to placebo in large randomized trials. Long-term real-world data support its role in primary and secondary prevention strategies.