Atorvastatin and Amlodipine

Hypolipidaemic/Anti-atheroma · Calcium antagonist/HMG-CoA reductase inhibitor

Indications

Patients at increased CV risk due to the presence of 2 modifiable risk factors hypertension & dyslipidaemia; and/or chronic stable angina. Prevention of CV complications.

Dosage

Adults: Dosage range of amlodipine/atorvastatin; 5 mg/10 mg to a max dose of 10 mg/80 mg once daily. Children: Not recommended.

Adverse Effects

Amlodipine: Flushing, fatigue, oedema, dizziness, headache, abdominal pain, nausea, palpitations, somnolence. Atorvastatin: Insomnia, headache, GI disturbances, myalgia, asthaenia.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Active liver disease or unexplained persistent elevations of serum transaminases >3x the upper limit of normal. Women of childbearing potential who are not using adequate contraceptive measures. Precautions: Heart failure, impaired hepatic function. Perform liver function tests before initiating treatment & periodically thereafter. Patient who consume substantial quantities of alcohol and/or have a history of liver disease. Discontinue drug if markedly elevated CPK levels occur or myopathy is diagnosed or suspected. Acute, serious condition suggestive of myopathy or risk factor predisposing to development or renal failure secondary to rhabdomyolysis.

Interactions

Cyclosporin, fibric acid derivative, erythromycin, clarithromycin, azole antifungals, niacin, oral antacid suspension containing magnesium hydroxide, aluminium hydroxide, colestipol, digoxin, norethindrone and ethinyloestradiol.

Advice to Patient

Take with or without meals. Do not break tablet. Contact prescriber if there is any allergic reaction (rash, hives, itching, difficulty in breathing, swelling on face/lips/tongue/throat), severe drowsiness, chest pain, muscle stiffness, abnormal muscle movements, nausea, sweating, upper abdominal pain, loss of appetite, dark urine, dark-coloured stool, yellowing of the skin or white part of eyes. Change position slowly from sitting or lying to standing. Avoid alcohol, grapefruit products and red yeast rice products during treatment. Avoid meals with high-fat content.

Pharmacokinetics

ATORVASTATIN: Onset of action: Initial changes: 3-5 days. Maximal reduction in plasma cholesterol and triglycerides: 2-4 wks. LDL reduction: 10 mg/day: 39%. Absorption: Oral: Rapidly absorbed; extensive first-pass metabolism in GI mucosa and liver. Metabolism: Hepatic. Bioavailability: Parent drug: Approx. 14%. Parent drug and equipotent metabolites: Approx. 30%. Half-life elimination: Parent drug: Approx. 14 hrs. Equipotent metabolites: 20-30 hrs. Time to peak, serum: 1-2 hrs. Excretion: Bile. Urine. AMLODIPINE: Onset of action: Antihypertensive effect: Significant reductions in blood pressure at 24-48 hrs after first dose. Duration: Antihypertensive effect: At least 24 hrs. Discontinuation after 6-7 wks of treatment: Duration extends to at least 72 hrs. Absorption: Well absorbed. Metabolism: Hepatic. Bioavailability: 64%-90%. Half-life elimination: Terminal (biphasic): 30-50 hrs. Time…

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.