Standard Dosing for Atorvastatin
Atorvastatin (brand name Lipitor) is typically dosed once daily, with or without food, at 10-80 mg for adults to lower LDL cholesterol and reduce cardiovascular risk. Start at 10-20 mg for most patients; increase based on response and tolerance after 2-4 weeks. Maximum is 80 mg daily.[1]
Dosing by Condition
- Primary hyperlipidemia or mixed dyslipidemia: 10-20 mg once daily; up to 40 mg if needed.
- Heterozygous familial hypercholesterolemia: 10-20 mg initially; up to 80 mg.
- Homozygous familial hypercholesterolemia: 10-80 mg once daily, often combined with other treatments.
- Prevention of cardiovascular events: 10-80 mg once daily, tailored to risk level.[1][2]
Dosing in Special Populations
- Elderly (65+): Start at 10 mg; no routine adjustment needed unless renal/hepatic issues.
- Renal impairment: No adjustment for mild-moderate; use caution or lower dose in severe cases.
- Hepatic impairment: Avoid in active liver disease; start low (10 mg) if mild.
- Pediatric (10-17 years, heterozygous familial hypercholesterolemia): 10-20 mg once daily.[1][2]
How to Take It and Missed Doses
Swallow whole; evening dosing may help due to cholesterol synthesis peak. For missed dose, take as soon as remembered unless near next dose—skip and resume schedule. Never double up.[1]
Common Adjustments and Monitoring
Titrate every 2-4 weeks based on lipid levels. Check liver enzymes before starting, at 12 weeks, then periodically. Asian patients may need lower starting dose (5 mg) due to higher drug exposure.[1][2]
Potential Interactions Affecting Dose
Reduce dose with CYP3A4 inhibitors like itraconazole or clarithromycin (max 20 mg). No adjustment with most statins, but monitor with fibrates or niacin.[2]
[1]: Lipitor Prescribing Information (Pfizer)
[2]: Drugs.com - Atorvastatin Dosage