What is the dosing for atorvastatin?

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