Atorvastatin Dosage

Medically reviewed by Drugs.com. Last updated on Jun 22, 2023.

Usual Adult Dose for Prevention of Cardiovascular Disease

Starting dose: 10 to 20 mg orally once a day
Maintenance dose: 10 to 80 mg orally once a day

Uses: To reduce the risk of:

• Myocardial infarction (MI), stroke, revascularization procedures, and angina in patients with multiple risk factors for coronary heart disease (CHD) but without clinically evident CHD
• MI and stroke in patients with type 2 diabetes mellitus with multiple risk factors for CHD but without clinically evident CHD
• Nonfatal MI, fatal and nonfatal stroke, revascularization procedures, hospitalization for CHF, and angina in patients with clinically evident CHD

Usual Adult Dose for Homozygous Familial Hypercholesterolemia

Starting dose: 10 to 20 mg orally once a day
Maintenance dose: 10 to 80 mg orally once a day

Comments:

• Patients who require reduction in low-density lipoprotein cholesterol (LDL-C) greater than 45% may start at 40 mg orally once a day.

Use: As an adjunct to other LDL-C-lowering therapies, or alone if such treatments are unavailable, to reduce LDL-C in patients with homozygous familial hypercholesterolemia (HoFH)

Usual Adult Dose for Hyperlipidemia

Starting dose: 10 to 20 mg orally once a day
Maintenance dose: 10 to 80 mg orally once a day

Comments:

• Patients who require reduction in low-density lipoprotein cholesterol (LDL-C) greater than 45% may start at 40 mg orally once a day.

Uses: As an adjunct to diet:

• To reduce LDL-C in patients with primary hyperlipidemia
• To reduce LDL-C in patients with heterozygous familial hypercholesterolemia (HeFH)
• For the treatment of patients with primary dysbetalipoproteinemia
• For the treatment of patients with hypertriglyceridemia

Usual Adult Dose for Hyperlipoproteinemia Type III (Elevated beta-VLDL + IDL)

Starting dose: 10 to 20 mg orally once a day
Maintenance dose: 10 to 80 mg orally once a day

Comments:

• Patients who require reduction in low-density lipoprotein cholesterol (LDL-C) greater than 45% may start at 40 mg orally once a day.

Uses: As an adjunct to diet:

• To reduce LDL-C in patients with primary hyperlipidemia
• To reduce LDL-C in patients with heterozygous familial hypercholesterolemia (HeFH)
• For the treatment of patients with primary dysbetalipoproteinemia
• For the treatment of patients with hypertriglyceridemia

Usual Adult Dose for Hypertriglyceridemia

Starting dose: 10 to 20 mg orally once a day
Maintenance dose: 10 to 80 mg orally once a day

Comments:

• Patients who require reduction in low-density lipoprotein cholesterol (LDL-C) greater than 45% may start at 40 mg orally once a day.

Uses: As an adjunct to diet:

• To reduce LDL-C in patients with primary hyperlipidemia
• To reduce LDL-C in patients with heterozygous familial hypercholesterolemia (HeFH)
• For the treatment of patients with primary dysbetalipoproteinemia
• For the treatment of patients with hypertriglyceridemia

Usual Adult Dose for Heterozygous Familial Hypercholesterolemia

Starting dose: 10 to 20 mg orally once a day
Maintenance dose: 10 to 80 mg orally once a day

Comments:

• Patients who require reduction in low-density lipoprotein cholesterol (LDL-C) greater than 45% may start at 40 mg orally once a day.

Uses: As an adjunct to diet:

• To reduce LDL-C in patients with primary hyperlipidemia
• To reduce LDL-C in patients with heterozygous familial hypercholesterolemia (HeFH)
• For the treatment of patients with primary dysbetalipoproteinemia
• For the treatment of patients with hypertriglyceridemia

Usual Pediatric Dose for Heterozygous Familial Hypercholesterolemia

10 years and older:

• Starting dose: 10 mg orally once a day
• Maintenance dose: 10 to 20 mg orally once a day

Use: As an adjunct to diet to reduce LDL-C in patients with HeFH

Usual Pediatric Dose for Homozygous Familial Hypercholesterolemia

10 years and older:

• Starting dose: 10 to 20 mg orally once a day
• Maintenance dose: 10 to 80 mg orally once a day

Use: As an adjunct to other LDL-C-lowering therapies, or alone if such treatments are unavailable, to reduce LDL-C in patients with HoFH

Renal Dose Adjustments

Renal dysfunction: No adjustment recommended

Comments:

• All patients with renal dysfunction should be monitored for development of myopathy.

Liver Dose Adjustments

Acute liver failure or decompensated cirrhosis: Contraindicated

Dose Adjustments

Assess LDL-C when clinically appropriate (as early as 4 weeks after starting this drug) and adjust the dosage if needed.

Coadministration with the following drugs requires dosage modification of this drug:

• Clarithromycin, darunavir plus ritonavir, elbasvir-grazoprevir, fosamprenavir, fosamprenavir plus ritonavir, itraconazole, letermovir, or saquinavir plus ritonavir: Do not exceed atorvastatin 20 mg orally once a day.
• Nelfinavir: Do not exceed atorvastatin 40 mg orally once a day.

The manufacturer product information should be consulted for additional recommendations regarding coadministration of this drug with other antiviral agents, azole antifungals, or macrolide antibiotics.

Precautions

CONTRAINDICATIONS:

• Acute liver failure or decompensated cirrhosis
• Hypersensitivity to the active component or any of the ingredients

Safety and efficacy have not been established in patients younger than 10 years with HeFH or HoFH.

• Safety and efficacy have not been established in patients younger than 18 years with other types of hyperlipidemia (other than HeFH or HoFH).

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Comments:

• Hemodialysis is not expected to significantly enhance drug clearance due to extensive plasma protein binding.

Other Comments

Administration advice:

• Administer once a day at any time of the day.
• Oral suspension:
• Administer only on an empty stomach (1 hour before or 2 hours after a meal).
• Measure the dose using a calibrated oral syringe or other oral dosing device with only metric graduations (e.g., mL).
• Administer a missed dose as soon as possible; if the dose was missed by more than 12 hours, skip the missed dose and resume with the next scheduled dose.
• Tablets:
• Administer with or without food.
• If a dose is missed, skip the missed dose and resume with the next scheduled dose.

Storage requirements:

• Oral suspension:
• Store at 20C to 25C (68C to 77F); excursions permitted to 15C to 30C (59F to 86F).
• Store and dispense in original bottle; use within 60 days of first opening the bottle, then discard any remainder.
• Tablets:
• Store at 20C to 25C (68C to 77F).

General:

• Hypersensitivity reactions (including anaphylaxis, angioneurotic edema, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis) have been reported.

Monitoring:

• Hepatic: Liver enzymes (before starting therapy and as clinically indicated thereafter)
• Investigations: LDL-C (when clinically appropriate)

Patient advice:

• Read the US FDA-approved patient labeling (Patient Information).
• This drug may cause myopathy and rhabdomyolysis; promptly report any unexplained muscle pain, tenderness, or weakness, especially if accompanied by malaise or fever.
• Do not consume large quantities (more than 1.5 L/day) of grapefruit juice.
• This drug may cause elevated liver enzymes and possibly liver failure; promptly report fatigue, anorexia, right upper abdominal discomfort, dark urine, or jaundice.
• Increases in hemoglobin A1c and fasting serum glucose levels may occur with this drug; optimize lifestyle measures, including regular exercise, maintaining healthy body weight, and making healthy food choices.
• Inform your health care provider of a known/suspected pregnancy.
• Do not breastfeed during therapy.
• Oral suspension: Use an oral dosing syringe or oral dosing cup to correctly measure the prescribed amount of medication; oral dosing syringes and cups may be obtained from your pharmacy.

Frequently asked questions

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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