Atasin 20

Indications

Atasin is a cholesterol-lowering medication prescribed as an adjunct to a healthy diet, specifically aimed at reducing elevated levels of total cholesterol, LDL cholesterol, apolipoprotein B (Apo-B), and triglycerides. It is particularly effective in patients where diet and lifestyle changes have proven insufficient.

Key Indications Include:

• Familial Hypercholesterolemia (Heterozygous and Homozygous): To reduce total cholesterol and LDL cholesterol levels.
• Mixed Dyslipidemia (Fredrickson Type Ia and Ib): To lower elevated cholesterol and triglycerides.
• Hypertriglyceridemia (Fredrickson Type IV): For the treatment of elevated serum triglycerides.
• Dysbetalipoproteinemia (Fredrickson Type III): To manage abnormal lipid profiles.
• Coronary Artery Disease: To reduce the risk of ischemic cardiac events in patients with asymptomatic or mildly symptomatic coronary artery disease and elevated LDL cholesterol.
• Hypercholesterolemia Related to Diabetes or Renal Transplantation: To manage elevated cholesterol in patients with diabetes or post-renal transplantation.

Always follow the guidance of a registered healthcare professional when using this medication.

Pharmacology of Atasin

Atasin contains atorvastatin, a potent selective inhibitor of the enzyme HMG-CoA reductase. This enzyme plays a crucial role in converting HMG-CoA into mevalonate, a precursor for cholesterol production. By inhibiting this enzyme, atorvastatin effectively lowers cholesterol and lipoprotein levels in the bloodstream. Additionally, atorvastatin increases the number of LDL receptors on liver cells, enhancing the removal of LDL cholesterol from circulation.

• Absorption: Atorvastatin is quickly absorbed after oral intake, reaching peak plasma concentrations within 1-2 hours. Its absorption rate increases proportionally with dose, with about 14% bioavailability of the parent drug.
• Distribution: The drug has a volume of distribution of about 381 liters and binds 98% to plasma proteins. It is not significantly absorbed into red blood cells.
• Metabolism: Atorvastatin undergoes extensive liver metabolism, producing active metabolites that contribute to about 70% of the drug’s therapeutic effects.
• Excretion: The drug is primarily eliminated in bile, with a half-life of around 14 hours for the drug and 20-30 hours for its inhibitory effects on HMG-CoA reductase. Less than 2% of the dose is excreted in urine.

Dosage and Administration

For managing Primary Hypercholesterolemia and Combined Hyperlipidemia, the typical starting dose is:

• Adults: 10 mg once daily, with the option to increase up to 80 mg based on patient response, after 4 weeks.
• Children (10-18 years): Start at 10 mg daily, increasing to a maximum of 20 mg daily if needed.

For Familial Hypercholesterolemia, the recommended starting doses are:

• Adults: Begin with 10 mg daily, with increments up to 40 mg after 4 weeks, and a maximum of 80 mg.
• Children (10-18 years): Start at 10 mg daily, with a maximum dose of 80 mg per day.

For Cardiovascular Event Prevention, the initial dose is typically 10 mg daily, adjusted as necessary.

Atorvastatin should be used alongside a cholesterol-lowering diet, and patients should continue following this diet throughout treatment. Regular monitoring of lipid levels is advised, with adjustments made after 2-4 weeks of treatment.

Drug Interactions

Certain medications can affect the efficacy and safety of Atasin:

• Cyclosporine, fibric acid derivatives, niacin, erythromycin, and azole antifungals can increase the risk of myopathy.
• Antacids may reduce atorvastatin plasma levels by approximately 35%.
• Colestipol may decrease atorvastatin plasma levels but enhances LDL-C reduction.
• Digoxin may interact with atorvastatin, increasing plasma digoxin concentrations by 20%.
• Erythromycin can increase atorvastatin levels by 40% due to cytochrome P450 3A4 inhibition.
• Oral Contraceptives can interact with atorvastatin, increasing plasma levels of norethindrone and ethinyl estradiol.
• Warfarin does not show significant interaction with Atasin.

Contraindications

Atasin is contraindicated in patients who have a known hypersensitivity to atorvastatin or any of its components. It should not be used in patients with active liver disease or unexplained persistent elevation of liver enzymes. It is also not recommended for patients with a history of severe adverse reactions to HMG-CoA reductase inhibitors.

Common Side Effects

Atasin is generally well-tolerated, though side effects may include:

• Common: Constipation, flatulence, abdominal pain, and dyspepsia.
• Other Effects: Headache, back pain, rash, fatigue, muscle pain (myalgia), and joint pain (arthralgia).

Pregnancy and Lactation

• Pregnancy: Atasin is contraindicated during pregnancy due to potential risks to the fetus. Women who are pregnant or planning to become pregnant should avoid atorvastatin.
• Lactation: Atorvastatin is not recommended during breastfeeding, as it may be excreted in breast milk and pose risks to the infant.

Precautions and Warnings

Liver function should be monitored before and during treatment with Atasin. It should be used cautiously in patients who consume significant amounts of alcohol or have a history of liver disease. Treatment should be stopped if there is evidence of muscle issues (e.g., elevated CPK levels or suspected myopathy).

Overdose Effects

There is no specific antidote for atorvastatin overdose. Treatment is symptomatic and supportive. Regular liver function and serum CK level monitoring are essential. Hemodialysis is not effective in enhancing atorvastatin clearance due to its strong plasma protein binding.

Therapeutic Class

Atasin is classified under Other Anti-anginal & Anti-ischaemic drugs, Statins, which are used to manage cholesterol levels and reduce cardiovascular risk.

Storage Recommendations

Store Atasin in a cool, dry place, away from heat and light. Keep out of reach of children.