Xelpid 20 mg

Description

Indications Xelpid is prescribed as an adjunct to dietary management for reducing elevated total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B (Apo-B), and triglyceride levels in conditions where diet and other non-pharmacological interventions are insufficient.

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

Pharmacology Atorvastatin, the active ingredient in Xelpid, selectively inhibits HMG-CoA reductase, an enzyme crucial for cholesterol biosynthesis. By blocking this enzyme, Atorvastatin reduces plasma cholesterol levels and enhances hepatic LDL receptor activity, promoting LDL uptake and breakdown.

• Absorption: Rapidly absorbed after oral administration, reaching peak plasma concentrations within 1 to 2 hours. The bioavailability of the parent drug is about 14%, while systemic availability of HMG-CoA reductase inhibitory activity is approximately 30%.
• Distribution: The mean volume of distribution is about 381 liters, with approximately 98% binding to plasma proteins.
• Metabolism: Extensively metabolized to ortho- and parahydroxylated derivatives and beta-oxidation products, primarily by cytochrome P450 3A4.
• Excretion: Eliminated mainly through bile after hepatic metabolism. The plasma elimination half-life is about 14 hours, with the inhibitory effect lasting 20-30 hours. Less than 2% is excreted via urine.

Dosage & Administration

• Primary Hypercholesterolemia & Combined Hyperlipidemia:
  • Adults: 10 mg once daily, increasing if necessary at 4-week intervals to a maximum of 80 mg per day.
  • Children (10-18 years): Initially 10 mg once daily, with a maximum dose of 20 mg per day.
• Familial Hypercholesterolemia:
  • Adults: Start with 10 mg daily, increasing up to 40 mg daily. If required, the dose can be raised to 80 mg daily or combined with an anion-exchange resin.
  • Children (10-18 years): Begin with 10 mg once daily, increasing as needed up to 80 mg per day.
• Cardiovascular Event Prevention:
  • Adults: Start with 10 mg daily and adjust based on response.

Patients should follow a cholesterol-lowering diet before and throughout treatment with Xelpid. Lipid levels should be monitored every 2 to 4 weeks, and the dose adjusted accordingly.

Drug Interactions

• Increased Myopathy Risk: With concurrent use of cyclosporine, fibric acid derivatives, niacin, erythromycin, and azole antifungals.
• Antacids: Reduce plasma levels of atorvastatin by approximately 35%, but LDL-C reduction remains unchanged.
• Colestipol: Lowers atorvastatin plasma concentrations by 25%; however, LDL-C reduction is more significant when used together.
• Digoxin: Increases digoxin levels by approximately 20%; monitoring is recommended.
• Erythromycin: Raises atorvastatin plasma concentrations by about 40%.
• Oral Contraceptives: Increases AUC values of norethindrone and ethinyl estradiol.
• Warfarin: No significant effect on prothrombin time.

Contraindications

• Hypersensitivity to any component of Xelpid.
• Active liver disease or unexplained elevated serum transaminases.
• History of serious adverse reactions to HMG-CoA reductase inhibitors.

Side Effects Xelpid is generally well-tolerated. Common side effects include:

• Digestive issues: Constipation, flatulence, dyspepsia, abdominal pain.
• General symptoms: Infection, headache, back pain, rash, fatigue, joint pain, and muscle pain.

Pregnancy & Lactation

• Pregnancy: Atorvastatin is contraindicated during pregnancy due to potential risks to fetal development.
• Lactation: Not known whether atorvastatin is excreted in human milk; therefore, breastfeeding is not recommended while using Xelpid.

Precautions & Warnings

• Liver Function: Liver enzyme tests should be conducted before initiating therapy and periodically thereafter. Discontinue use if significant elevation occurs.
• Muscle Effects: Patients should report unexplained muscle pain, tenderness, or weakness.
• Alcohol Consumption: Use with caution in patients who consume excessive alcohol or have a history of liver disease.

Use in Special Populations

• Elderly: Plasma concentrations are approximately 40% higher than in younger adults.
• Pediatrics: Pharmacokinetic data in children are limited; used with caution.
• Renal Impairment: No dose adjustment is necessary.
• Hepatic Impairment: Plasma concentrations are significantly increased in patients with chronic alcoholic liver disease.

Overdose Management There is no specific treatment for Xelpid overdose. Management includes symptomatic and supportive care, with monitoring of liver function and creatine kinase levels. Hemodialysis is unlikely to enhance drug clearance.

Therapeutic Class

• Statins, Anti-anginal & Anti-ischemic drugs.

Storage Conditions

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

Common Questions

• What is Xelpid used for?
  • It is a statin medication used to lower cholesterol and triglycerides and reduce the risk of cardiovascular diseases.
• How should Xelpid be taken?
  • Take once daily, at the same time each day, with or without food.
• Does Xelpid cause weight loss?
  • Weight loss is not a reported side effect.
• Can it be prescribed to children?
  • Yes, for children aged 10 years and above under medical supervision.
• Can I stop taking Xelpid?
  • Do not discontinue use without consulting your doctor.

Quick Tips

• If you experience stomach upset, take Xelpid with food.
• Report any muscle weakness or pain to your doctor.
• Regularly monitor liver function during treatment.
• Diabetic patients should check blood sugar levels frequently.
• Do not take Xelpid during pregnancy or while breastfeeding.