Divastin 10 mg

Description

Indications

Divastin is prescribed as a supplement to a cholesterol-lowering diet for reducing elevated levels of total cholesterol, LDL cholesterol, apolipoprotein B (Apo-B), and triglycerides. This is recommended when diet and other non-pharmacological treatments are insufficient. Divastin is indicated for:

• Heterozygous and homozygous familial hypercholesterolemia to lower total cholesterol and LDL cholesterol.
• Mixed dyslipidemia (Fredrickson Type Ia and Ib) to reduce elevated cholesterol and triglyceride levels.
• Hypertriglyceridemia (Fredrickson Type IV) to treat high serum triglycerides.
• Dysbetalipoproteinaemia (Fredrickson Type III) to manage elevated lipid levels.
• Coronary artery disease: To reduce the risk of cardiac ischemic events in individuals with mild to moderate symptomatic coronary artery disease and elevated LDL cholesterol.
• Hypercholesterolemia associated with diabetes or renal transplantation: To decrease total and LDL cholesterol levels in patients whose condition is worsened by these factors.

Follow the recommendations of a registered healthcare provider for appropriate medication use.

Pharmacology

Atorvastatin, the active ingredient in Divastin, is a potent selective inhibitor of HMG-CoA reductase, an enzyme responsible for converting HMG-CoA to mevalonate, a cholesterol precursor. By inhibiting this enzyme, atorvastatin reduces cholesterol synthesis in the liver and increases the uptake of LDL cholesterol through enhanced receptor activity.

Absorption: After oral administration, atorvastatin is rapidly absorbed, with peak plasma concentrations occurring within 1 to 2 hours. The absorption increases proportionally with dose. The absolute bioavailability of atorvastatin is about 14%, while the bioavailability of its cholesterol-lowering activity is approximately 30%.

Distribution: Atorvastatin has a mean volume of distribution of approximately 381 liters and binds 98% to plasma proteins. It shows poor penetration into red blood cells. Atorvastatin is likely to be secreted into human milk, based on animal data.

Metabolism: Atorvastatin undergoes extensive metabolism, producing active ortho- and parahydroxylated metabolites, contributing to approximately 70% of the drug’s inhibitory effect on HMG-CoA reductase. The metabolism occurs mainly through cytochrome P450 3A4.

Excretion: Atorvastatin and its metabolites are primarily excreted in bile. The plasma elimination half-life is about 14 hours, while the half-life of its inhibitory effect is 20 to 30 hours due to the active metabolites. Only a small amount (less than 2%) is excreted in urine.

Dosage & Administration

For Primary Hypercholesterolemia and Combined Hyperlipidemia:

• Adults: Start with 10 mg once daily, increasing at 4-week intervals if necessary, up to a maximum of 80 mg daily.
• Children (10-18 years): Start with 10 mg daily, with a maximum dose of 20 mg per day after 4 weeks if required.

For Familial Hypercholesterolemia:

• Adults: Start with 10 mg daily, gradually increasing to 40 mg, with possible further increases to 80 mg.
• Children (10-18 years): Start with 10 mg daily, with a maximum dose of 80 mg daily after 4 weeks if necessary.

For Prevention of Cardiovascular Events:

• Adults: Start with 10 mg daily, with adjustments based on response.

It is advised that the patient follows a standard cholesterol-lowering diet before starting Divastin and continues it throughout treatment. Lipid levels should be checked 2 to 4 weeks after starting treatment to assess the need for dosage adjustment.

Interaction

Divastin may interact with several other medications, which can increase the risk of side effects, including:

• Cyclosporine, fibric acid derivatives, niacin (nicotinic acid), and erythromycin: Can increase the risk of myopathy.
• Antacids: Decreases plasma concentrations of atorvastatin by 35%, but does not affect LDL-C reduction.
• Colestipol: Increases LDL-C reduction when coadministered with atorvastatin, though plasma concentrations of atorvastatin decrease by about 25%.
• Warfarin: No significant effect on prothrombin time when used with atorvastatin.

Other interactions include increased plasma concentrations of atorvastatin when used with erythromycin, digoxin, and oral contraceptives. Caution is advised when combining atorvastatin with these drugs.

Contraindications

Divastin should not be used in individuals with:

• Hypersensitivity to atorvastatin or any of its components.
• Active liver disease or unexplained persistent elevations in serum transaminases.
• History of severe adverse reactions to HMG-CoA reductase inhibitors.

Side Effects

Most patients tolerate Divastin well. However, possible side effects include:

• Common: Constipation, flatulence, dyspepsia, abdominal pain.
• Less common: Infection, headache, back pain, rash, fatigue, joint pain, muscle aches.

Pregnancy & Lactation

• Pregnancy: Atorvastatin is contraindicated during pregnancy due to potential risks to the fetus. It should be discontinued if pregnancy is confirmed.
• Lactation: Atorvastatin should not be used while breastfeeding, as it may be excreted in breast milk and could harm the infant.

Precautions & Warnings

• Liver function: Liver function should be monitored before and during treatment, especially in individuals with a history of liver disease or alcohol consumption.
• Myopathy: If muscle pain, weakness, or marked elevations in CPK levels occur, discontinue the medication.

Storage

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

Common Questions about Divastin 10 mg Tablet

• What is Divastin 10 mg Tablet?
  It is a statin used to lower cholesterol and prevent heart-related conditions.

• How should I take it?
  Take one tablet daily, at the same time each day, with or without food.

• What if I miss a dose?
  If you miss a dose, take it as soon as you remember unless it’s almost time for the next dose. Do not take two doses at once.

• Is it safe for long-term use?
  Yes, as long as it is taken as prescribed, Divastin is safe for long-term use.