Indications Atorvastatin (Orva 10mg) is used as an adjunct to diet and lifestyle changes to lower elevated total cholesterol, LDL cholesterol, apolipoprotein B (Apo‑B), and triglycerides. It is indicated for patients with familial hypercholesterolemia (heterozygous or homozygous), mixed dyslipidemia (Fredrickson Type IIa and IIb), hypertriglyceridemia (Type IV), and dysbetalipoproteinemia (Type III). It also helps prevent cardiovascular events in patients with coronary artery disease, diabetes, or high LDL cholesterol levels.

Pharmacology Atorvastatin selectively inhibits HMG‑CoA reductase, the enzyme responsible for converting HMG‑CoA to mevalonate, a precursor of cholesterol. This inhibition reduces cholesterol synthesis in the liver and increases LDL receptor numbers, enhancing LDL clearance. Absorption: Rapid after oral administration; peak plasma concentration within 1–2 hours. Distribution: Volume of distribution ≈ 381 L; about 98% protein bound. Metabolism: Extensively metabolized by CYP3A4 to active hydroxy metabolites. Excretion: Primarily via bile; less than 2% excreted in urine. Half‑life ≈ 14 hours (pharmacologic activity up to 30 hours).

Dosage & Administration Adults: Start with 10 mg once daily; adjust every 4 weeks or more; maximum 80 mg daily. Children (10–17 years): Start with 10 mg daily; maximum 20 mg daily. Familial hypercholesterolemia: Adults 10–40 mg daily, may increase to 80 mg; children 10–20 mg daily. Prevention of cardiovascular events: Start 10–20 mg daily; may increase to 40 mg if LDL reduction >45% required. Can be taken any time of day, with or without food.

Drug Interactions Risk of myopathy increases with cyclosporine, fibrates, niacin, erythromycin, and azole antifungals. Antacids reduce atorvastatin plasma levels (~35%) but not LDL reduction. Colestipol decreases atorvastatin levels (~25%) but enhances LDL reduction. Digoxin levels may increase (~20%). Oral contraceptives increase norethindrone and ethinyl estradiol levels (~30% and 20%). Warfarin shows no significant interaction.

Contraindications Contraindicated in patients with hypersensitivity to any component, active liver disease, unexplained persistent elevation of transaminases, or history of serious adverse reaction to HMG‑CoA reductase inhibitors.

Side Effects Generally well tolerated. Common side effects include constipation, flatulence, dyspepsia, abdominal pain, headache, back pain, rash, arthralgia, and myalgia. Rarely, liver enzyme elevation or muscle-related symptoms may occur.