Substance from the group of statins.
Principle of action: competitive, reversible inhibition of HMG-CoA reductase (rate-determining key enzyme in cholesterol synthesis; reduction of endogenous cholesterol synthesis and lowering of total cholesterol and LDL cholesterol levels.
Treatment on the basis of and in combination with lifestyle changes (dietary changes, exercise, smoking cessation if necessary) in accordance with guidelines (Mach F. et al 2020).
Hypercholesterolemia, dyslipidemia
Primary prevention: in case of increased risk of cardiovascular disease (≥10% SCORE2/SCORE2-OP).
Secondary prevention: if cardiovascular disease is already present or there is a history of a serious event.
homozygous and heterozygous FH (from 10 years of age).
In children, observe age-dependent maximum doses, treatment and monitoring only by a specialist (guideline).
Dosage in accordance with guidelines according to target value with lowest necessary dose, if necessary dose increases at 4 - 6 week intervals; avoid high dosages , if necessary combination therapy (ezetimibe) at an early stage, take individual patient factors into account.
Doubling the dose brings only approx. 6% additional LDL-C reduction , but higher risk of side effects as side effects are dose-dependent!
Administration: orally as a tablet, once daily, independent of food.
Preferably taken in the evening, improved efficacy, as cholesterol synthesis depends on the time of day with the highest cholesterol synthesis at night or early in the morning. Atorvastatin can be taken at any other time of day due to its long half-life
Important: daily intake time should always be maintained in order to avoid fluctuations in potency.
Adherence to therapy is important and should be discussed with the patient !
Expert information Red List Atorvastatin
Mach F et al (2020). 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) European Heart Journal 41;1:111-188 https://doi.org/10.1093/eurheartj/ehz455