Avas 10 mg

Description

Indications Avas is prescribed as an adjunct to diet to lower elevated total cholesterol, LDL cholesterol, apolipoprotein B (Apo-B), and triglyceride levels in cases where dietary adjustments and other non-pharmacological measures prove insufficient.

• Helps reduce total cholesterol and LDL cholesterol in individuals with heterozygous and homozygous familial hypercholesterolemia.
• Manages elevated cholesterol and triglycerides in patients with mixed dyslipidemia (Fredrickson Type Ia and Ib).
• Treats elevated serum triglyceride levels in hypertriglyceridemia (Fredrickson Type IV).
• Used for dysbetalipoproteinemia management (Fredrickson Type III).
• Reduces cardiac ischemic events in individuals with asymptomatic or mild to moderate symptomatic coronary artery disease with high LDL-cholesterol levels.
• Lowers total and LDL cholesterol levels in cases of hypercholesterolemia linked to diabetes mellitus or renal transplantation.

Take this medication only as advised by a registered physician.

Pharmacology Avas contains atorvastatin, a selective inhibitor of HMG-CoA reductase, the enzyme responsible for converting HMG-CoA to mevalonate, a precursor of sterols such as cholesterol. Atorvastatin works by reducing cholesterol production in the liver while enhancing hepatic LDL receptor activity, which promotes LDL uptake and breakdown.

• Absorption: Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours. Bioavailability is approximately 14%, with systemic availability of HMG-CoA reductase inhibitory activity at around 30%.
• Distribution: Has an approximate volume of distribution of 381 liters and is 98% bound to plasma proteins. Minimal penetration into red blood cells occurs. Likely secreted into human milk based on animal studies.
• Metabolism: Extensively metabolized into ortho- and parahydroxylated derivatives, along with beta-oxidation products. These metabolites contribute significantly to HMG-CoA reductase inhibition. Metabolized primarily via cytochrome P450 3A4.
• Excretion: Eliminated primarily through bile after hepatic and extra-hepatic metabolism. The elimination half-life is about 14 hours, with active metabolites extending the inhibitory activity to 20-30 hours. Less than 2% of the drug is excreted through urine.

Dosage & Administration

• Primary Hypercholesterolemia & Mixed Dyslipidemia:
  • Adults: Initial dose of 10 mg once daily, with a maximum dose of 80 mg daily. Adjustments can be made at 4-week intervals.
  • Children (10-18 years): Starting dose of 10 mg once daily, with a maximum of 20 mg daily.
• Familial Hypercholesterolemia:
  • Adults: Initial dose of 10 mg daily, increased in 4-week intervals up to 40 mg daily. If necessary, may be further increased to 80 mg daily or combined with anion-exchange resin.
  • Children (10-18 years): Initial dose of 10 mg once daily, increasing as needed up to a maximum of 80 mg daily.
• Prevention of Cardiovascular Events:
  • Adults: Start with 10 mg once daily, adjusted based on response.

Patients should follow a cholesterol-lowering diet before and during treatment. Lipid levels should be monitored within 2-4 weeks of starting therapy, and dosage should be adjusted accordingly.

Interactions

• Increased Risk of Myopathy: When used with cyclosporine, fibric acid derivatives, niacin, erythromycin, or azole antifungals.
• Antacids: May reduce atorvastatin plasma concentrations by approximately 35% but do not significantly impact LDL-C reduction.
• Colestipol: Co-administration decreases atorvastatin plasma concentrations by 25%, but combined therapy results in better LDL-C reduction.
• Digoxin: Increases plasma digoxin concentrations by about 20%.
• Erythromycin: May increase atorvastatin plasma concentrations by 40%.
• Oral Contraceptives: Increases norethindrone and ethinyl estradiol exposure.
• Warfarin: No significant effect on prothrombin time.

Contraindications

• Hypersensitivity to atorvastatin or any excipient.
• Active liver disease or unexplained persistent elevations in liver enzymes.
• History of serious adverse reactions to HMG-CoA reductase inhibitors.

Side Effects Avas is generally well-tolerated, though some patients may experience:

• Common: Constipation, flatulence, indigestion, abdominal pain.
• Others: Infection, headache, back pain, rash, weakness, joint pain, or muscle pain.

Pregnancy & Lactation

• Pregnancy: Contraindicated. Atorvastatin may cause fetal harm and should not be used during pregnancy.
• Lactation: Not recommended due to unknown excretion in human milk and potential adverse effects on the infant.

Precautions & Warnings

• Liver Function: Liver enzyme tests should be conducted before and during treatment. Discontinue use if significant liver dysfunction occurs.
• Alcohol Consumption & Liver Disease: Use with caution in those with liver disease or heavy alcohol use.
• Muscle Effects: Discontinue use if unexplained muscle pain, tenderness, or weakness occurs.

Use in Special Populations

• Elderly: Plasma atorvastatin concentrations are higher in elderly patients, potentially enhancing LDL-lowering effects.
• Children: Limited pharmacokinetic data are available.
• Renal Impairment: No dose adjustment required.
• Hepatic Impairment: Increased plasma concentrations observed in patients with liver disease.
• Hemodialysis: Not expected to significantly clear atorvastatin due to extensive protein binding.

Overdose Effects No specific treatment is available. Symptomatic and supportive care should be provided. Liver function and CK levels should be monitored. Hemodialysis is not expected to be effective in clearing atorvastatin.

Therapeutic Class

• Statins
• Anti-anginal & Anti-ischemic agents

Storage Conditions

• Store in a cool, dry place away from direct light and heat.
• Keep out of reach of children.

Common Questions

• What is Avas used for?
  • Avas lowers cholesterol levels and prevents cardiovascular diseases such as heart attacks.
• How should I take Avas?
  • Take once daily, at the same time each day, with or without food.
• Can Avas cause diabetes?
  • A slight increase in blood sugar levels may occur. Regular monitoring is advised for diabetic patients.
• Is Avas safe for long-term use?
  • Yes, if taken as prescribed by a doctor.
• Can I stop taking Avas suddenly?
  • No, stopping abruptly may worsen your condition. Consult your doctor before discontinuing.
• Does Avas cause memory loss?
  • Memory loss is a rare side effect. Consult your doctor if you experience it.
• Can children take Avas?
  • Yes, but only for children aged 10 years and above, under medical supervision.
• Does Avas act as a blood thinner?
  • No, it is not a blood thinner but lowers cholesterol to reduce stroke and heart attack risk.