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| | #REDIRECT [[Atorvastatin calcium#Adult Indications and Dosage]] |
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| ==Indications and Usage for Atorvastatin==
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| <font size="4">[[Atorvastatin indications#Prevention of Cardiovascular Disease|Prevention of Cardiovascular Disease]]</font>
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| <font size="4">[[Atorvastatin indications#Hypercholesterolemia|Hypercholesterolemia]]</font>
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| ----
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| ===Prevention of Cardiovascular Disease===
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| In adult patients without clinically evident [[coronary heart disease]], but with multiple risk factors for [[coronary heart disease]] such as age, [[smoking]], [[hypertension]], [[low HDL-C]], or a [[family history of early coronary heart disease]], Atorvastatin is indicated to:
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| * Reduce the risk of [[myocardial infarction]]
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| * Reduce the risk of [[stroke]]
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| * Reduce the risk for [[revascularization]] procedures and [[angina]]
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| In patients with [[type 2 diabetes]], and '''without clinically evident [[coronary heart disease]]''', but with [[multiple risk factors for coronary heart disease]] such as [[retinopathy]], [[albuminuria]], [[smoking]], or [[hypertension]], [[Atorvastatin]] is indicated to:
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| * Reduce the risk of [[myocardial infarction]]
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| * Reduce the risk of [[stroke]]
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| In patients with '''clinically evident [[coronary heart disease]]''', [[Atorvastatin]] is indicated to:
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| * Reduce the risk of non-fatal [[myocardial infarction]]
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| * Reduce the risk of fatal and non-fatal [[stroke]]
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| * Reduce the risk for [[revascularization]] procedures
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| * Reduce the risk of hospitalization for [[CHF]]
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| * Reduce the risk of [[angina]]
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| ''[[Atorvastatin indications#Indications and Usage for Atorvastatin|Return to top]]''
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| ===Hypercholesterolemia===
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| Atorvastatin is indicated:
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| * as an adjunct to diet to reduce elevated [[total-C]], [[LDL-C]], [[apo B]], and [[TG]] levels and to increase [[HDL-C]] in patients with [[primary hypercholesterolemia]] (heterozygous familial and nonfamilial) and mixed [[dyslipidemia]] (Fredrickson Types IIa and IIb);
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| * as an adjunct to diet for the treatment of patients with elevated serum TG levels(Fredrickson Type IV);
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| * for the treatment of patients with [[primary dysbetalipoproteinemia]] (Fredrickson Type III) who do not respond adequately to diet;
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| * to reduce [[total-C]] and [[LDL-C]] in patients with [[homozygous familial hypercholesterolemia]] as an adjunct to other lipid-lowering treatments (e.g, LDL apheresis) or if such treatments are unavailable;
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| * as an adjunct to diet to reduce [[total-C]], [[LDL-C]], and [[apo B]] levels in boys and postmenarchal girls, 10 to 17 years of age, with [[heterozygous familial hypercholesterolemia]] if after an adequate trial of diet therapy the following findings are present:
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| :* LDL-C remains ≥ 190 mg/dL or
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| :* LDL-C remains ≥ 160 mg/dL and:
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| * there is a positive [[family history of premature cardiovascular disease]] or
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| * two or more other [[CVD risk factors]] are present in the pediatric patient
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| Therapy with lipid-altering agents should be a component of multiple-risk-factor intervention in individuals at increased risk for atherosclerotic vascular disease due to [[hypercholesterolemia]]. Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol only when the response to diet and other nonpharmacological measures has been inadequate (see National Cholesterol Education Program (NCEP) Guidelines, summarized in Table 7).
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| [[Image:Atorvastatin indications table 7.jpg|thumb|left|350px|Table 7]]
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| {{-}}
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| After the LDL-C goal has been achieved, if the TG is still ≥200 mg/dL, non-HDL-C (total-C minus HDL-C) becomes a secondary target of therapy. Non-HDL-C goals are set 30 mg/dL higher than LDL-C goals for each risk category.
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| Prior to initiating therapy with Atorvastatin, secondary causes for hypercholesterolemia (e.g., poorly controlled [[diabetes mellitus]], [[hypothyroidism]], [[nephrotic syndrome]], [[dysproteinemia]]s, obstructive [[liver disease]], other drug therapy, and [[alcoholism]]) should be excluded, and a lipid profile performed to measure [[total-C]], [[LDL-C]], [[HDL-C]], and [[TG]]. For patients with [[TG]] <400 mg/dL (<4.5 mmol/L), [[LDL-C]] can be estimated using the following equation:
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| LDL-C = total-C - (0.20 × [TG] + HDL-C).
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| For TG levels >400 mg/dL (>4.5 mmol/L), this equation is less accurate and [[LDL-C]] concentrations should be determined by ultracentrifugation.
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| [[Atorvastatin]] has not been studied in conditions where the major lipoprotein abnormality is elevation of chylomicrons (Fredrickson Types I and V).
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| The NCEP classification of cholesterol levels in pediatric patients with a familial history of hypercholesterolemia or premature cardiovascular disease is summarized below:
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| [[Image:Atorvastatin indications table 2.jpg|thumb|left|350px]]
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| {{-}}
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| ''[[Atorvastatin indications#Indications and Usage for Atorvastatin|Return to top]]''
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| {{FDA}}
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| [[Category:Drugs]]
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