title: [Atorvastatin (Lipitor)].
abstract: Atorvastatin is a second generation synthetic statin, introduced in Belgium in May 1998. Its mechanism of action is similar to that of the other statins, i.e. the inhibition of HMG Co-A reductase, the key enzyme in cholesterol synthesis, which leads to the increase of LDL receptors. The prolonged half-life (20-30 H) of atorvastatin and its active metabolites, induces a prolonged inhibition of HMG Co-A reductase and a reduction of hepatitic apo B production. The biological efficacy of atorvastatin is high: 41 to 61% lowering of LDL depending of the dose. Atorvastatin is indicated in primary hypercholesterolemia, mixed hyperlipidemia and homozygous familial hypercholesterolemia. If necessary, a resin or even a fibrate may be added. The safety profile is good. The most common adverse effects are gastro-intestinal and transient. Liver tests or muscle enzymes are rarely modified. If clinical proof of reduction of CV morbidity and mortality in primary and secondary prevention is obtained, atorvastatin shall represent a major step forward in the treatment of hypercholesterolemia.
authors.affiliation: Centre d'Etudes et de Traitement des maladies cardio-vasculaires, Hôpital Erasme.
authors.forename: Y
authors.initials: Y
authors.lastname: Carpentier
authors.forename: J
authors.initials: J
authors.lastname: Ducobu
authors.forename: J
authors.initials: J
authors.lastname: Sternon
mesh_terms: D000924:Anticholesteremic Agents / Q000191:economics / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D000069059:Atorvastatin; D001530:Belgium; D016527:Drug Costs; D006538:Heptanoic Acids / Q000191:economics / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods; D011758:Pyrroles / Q000191:economics / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin
vernacular_title: Atorvastatine (Lipitor).