TOVAST 10/MG FC TAB 30/FC TAB

Indications

Off-Label Uses

No specific off-label uses should be asserted for this product; atorvastatin has been studied off-label in conditions such as NAFLD/NASH and contrast-associated AKI prevention, but these are not established indications.

Dosage & Administration

Initial Dose

10-20mg once daily. [6, 18, 20]

Dose Adjustment Notes

Titrate based on LDL-C response at intervals of about 2-4 weeks; no renal dose adjustment; avoid in active liver disease and use caution/monitor in hepatic impairment; with strong CYP3A4 inhibitors or cyclosporine, avoid or use the lowest necessary dose with close monitoring (some labels recommend not exceeding 10 mg/day with cyclosporine).

Side Effects

Common Side Effects

Nasopharyngitis, arthralgia, diarrhea, pain in extremity, urinary tract infection, dyspepsia, nausea, insomnia, muscle spasms. [1, 6, 22]

Safety & Warnings

Warnings & Precautions

Muscle toxicity: counsel to report unexplained muscle pain/weakness; check CK when clinically indicated and stop if myopathy/rhabdomyolysis suspected; risk increases with interacting drugs (CYP3A4 inhibitors, cyclosporine), high dose, older age, hypothyroidism, renal impairment, and fibrates/niacin/colchicine. Hepatic effects: obtain baseline LFTs and repeat if symptoms/signs of hepatotoxicity occur; avoid in active liver disease and use caution with heavy alcohol use/history of liver disease. Metabolic: may increase glucose/HbA1c-monitor in patients at risk for diabetes.

Age Restriction

Not approved for children under 10 years of age.

Driving Warning

Safe

Drug Interactions

Drug Interactions

Major interactions: strong CYP3A4 inhibitors (e.g., clarithromycin/erythromycin, azole antifungals, HIV protease inhibitors/cobicistat, nefazodone) and grapefruit juice (large amounts) ↑ atorvastatin exposure; cyclosporine ↑ exposure (avoid or use very low dose with close monitoring); hepatitis C antivirals (e.g., glecaprevir/pibrentasvir-contraindicated; some others require limits); fibrates (especially gemfibrozil) and niacin (lipid-lowering doses) ↑ myopathy/rhabdomyolysis risk; colchicine ↑ myopathy risk; warfarin-monitor INR when starting/stopping; digoxin-may ↑ digoxin levels; antacids may slightly ↓ atorvastatin levels (usually not clinically significant).

Food Interaction

May be taken with or without food; avoid large quantities of grapefruit juice (clinically, avoid excessive intake-commonly cited as >1 quart/≈1 liter daily).

Special Populations

Elderly

Standard adult dosing; elderly patients (≥65 years) may be at higher risk for myopathy - monitor closely and use lowest effective dose

Storage & Patient Advice

Stopping the Medicine

Do not stop atorvastatin without consulting the prescriber; if discontinued, LDL-C will rise again and cardiovascular risk reduction is lost.

Pharmacology

Mechanism of Action

Selective, competitive inhibition of HMG-CoA reductase, decreasing hepatic cholesterol synthesis and upregulating LDL receptors to increase LDL clearance.

Duration of Effect

Per dose: ~24 hours (supports once-daily dosing). Lipid-lowering effect: begins within ~2 weeks and reaches near-maximal effect by ~4 weeks with continuous daily therapy.

Product Information

Available Dosage Forms

Film-coated tablet (oral).

OTC Alternatives

No OTC alternative

Lipid Target

Both

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