Atorvastatin
| Drug monograph · NCLEX study reference | |
| Trade names | Lipitor |
|---|---|
| Therapeutic class | Antihyperlipidemic |
| Pharmacologic class | HMG-CoA reductase inhibitor (statin) |
| Onset / peak / duration | Lipid effect onset about 2 weeks; maximal effect 4 to 6 weeks; duration sustained with daily dosing. |
| Half-life / level | Half-life about 14 hours (active metabolites 20 to 30 hours); no routine serum level. |
| Routes | PO (oral) |
| High-alert (ISMP) | No |
| Black box warning | None |
| Antidote / reversal | None; discontinue and provide supportive care for rhabdomyolysis. |
| Pregnancy / lactation | Contraindicated; cholesterol is needed for fetal development. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Atorvastatin (brand name Lipitor) — Antihyperlipidemic; HMG-CoA reductase inhibitor (statin).
Identification
- Therapeutic class: Antihyperlipidemic.
- Pharmacologic class: HMG-CoA reductase inhibitor (statin).
Pharmacology
- Mechanism of action: Inhibits HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis, which upregulates LDL receptors and lowers serum LDL and triglycerides while modestly raising HDL.
- Onset / peak / duration: Lipid effect onset about 2 weeks; maximal effect 4 to 6 weeks; duration sustained with daily dosing.
- Half-life / therapeutic level: Half-life about 14 hours (active metabolites 20 to 30 hours); no routine serum level.
Clinical use
- Indications: Hyperlipidemia, mixed dyslipidemia, primary and secondary prevention of cardiovascular events.
- Usual dose, route, frequency: 10 to 80 mg PO once daily, any time of day.
- Maximum dose / adjustments: Max 80 mg/day. No renal adjustment; use caution and lower doses in hepatic impairment; limit dose with strong CYP3A4 inhibitors.
Safety
- Contraindications: Active liver disease, unexplained persistent transaminase elevation, pregnancy and breastfeeding.
- Black box warning: None.
- Interactions: CYP3A4 inhibitors (clarithromycin, azole antifungals, grapefruit juice) raise levels and myopathy risk; fibrates and niacin increase rhabdomyolysis risk; cyclosporine; red yeast rice (herbal) duplicates statin effect.
- Pregnancy / lactation: Contraindicated; cholesterol is needed for fetal development.
- High-alert: No.
Adverse effects
- Common side effects: Myalgia, headache, GI upset, elevated transaminases.
- Serious effects to report: Rhabdomyolysis (muscle pain with dark urine), hepatotoxicity, new diabetes.
- Antidote / reversal: None; discontinue and provide supportive care for rhabdomyolysis.
Nursing process
- Assessment before administration: Baseline lipid panel, liver function tests (LFTs), pregnancy status, alcohol use, history of muscle disease.
- Interventions during therapy: Give without regard to meals; reinforce diet and exercise; hold and report unexplained muscle pain.
- Monitor: Lipid panel at 4 to 12 weeks then periodically; LFTs if symptomatic; creatine kinase (CK) if muscle symptoms.
- Evaluation / expected outcome: LDL reduction toward goal without muscle or hepatic injury.
Patient teaching
- Patient teaching: Continue lifestyle changes; statins are long-term therapy.
- Notify provider if: Unexplained muscle pain or weakness, dark urine, yellowing of skin or eyes, pregnancy.
- Administration tips: Take any time daily; avoid large amounts of grapefruit juice; do not stop without provider guidance.