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Before instituting therapy with Atorvastatin, an attempt should be made to control hypercholesterolemia with appropriate diet, exercise and weight reduction in obese patients, and to treat the underlying medical problems.
Patient who develop any signs or symptoms suggesting liver injury should have liver function test performed.
Patients who develop increased transaminase levels should be monitored until the abnormality(ies) resolve(s). Should an increase in ALT or AST of greater than three times the upper limit of normal persist, reduction of dose or withdrawal of Atorvastatin is recommended. Atorvastatin can cause an elevation in transaminases.
Atorvastatin should be use with caution in patients who consume substantial quantities of alcohol and/or have a history of liver disease.
Atorvastatin therapy should be discontinued if markedly elevated creatine phosphokinase levels occur.
Myalgia has been reported in Atorvastatin treated patients.
As with other drugs in this class, rare class of rhabdomyolysis with acute renal failure, secondary to myoglobinuria has been reported. Atorvastatin therapy should be temporarily withheld or discontinued in any patient with an acute, serious condition suggestive of myopathy or having a risk factor predisposing to the development of renal failure secondary to rhabdomyolysis (e.g., severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine and electrolyte disorders and uncontrolled seizures).
Patient should be advised to promptly report unexplained muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. Adolescent females and women of childbearing potential should be counseled on appropriate contraceptive methods while on Atorvastatin therapy.
