Buy Atorvastatin pills 10 mg 30 pcs
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Clinical Pharmacology

Atorvastatin is a lipid-lowering agent from the group of statins. The main mechanism of action of atorvastatin is the inhibition of the activity of HMG-CoA reductase, an enzyme catalyzing the conversion of HMG-CoA to mevalonic acid. This transformation is one of the early stages in the chain of cholesterol synthesis (cholesterol) in the body. Atorvastatin suppression of cholesterol synthesis leads to increased reactivity of LDL receptors in the liver, as well as in extrahepatic tissues. These receptors bind the LDL particles and remove them from the blood plasma, which leads to a decrease in the concentration of LDL-C in the blood.

The anti-atherosclerotic effect of atorvastatin is a consequence of its effect on the walls of blood vessels and blood components. Atorvastatin inhibits the synthesis of isoprenoids, which are growth factors for the cells of the inner lining of blood vessels. Under the influence of atorvastatin, endothelium-dependent dilation of blood vessels is improved, the concentration of cholesterol-LDL, apolipoprotein B, triglycerides (TG) is reduced, the concentration of cholesterol-HDL cholesterol and apolipoprotein A.

Atorvastatin reduces the viscosity of blood plasma and the activity of some coagulation factors and platelet aggregation. Due to this, it improves hemodynamics and normalizes the state of the coagulation system. HMG-CoA reductase inhibitors also have an effect on the metabolism of macrophages, block their activation and prevent atherosclerotic plaque rupture.

As a rule, the therapeutic effect of atorvastatin develops after 2 weeks of use of the drug Atoris®, and the maximum effect is achieved after 4 weeks.

Significantly reduces the risk of ischemic complications (including death from myocardial infarction) by 16%, the risk of re-hospitalization for angina accompanied by signs of myocardial ischemia, by 26%.



  • Decreased total cholesterol, LDL, apolipoprotein B and serum triglycerides in patients with primary hyperlipidemia (Fredrickson types IIa and IIb), including polygenic hypercholesterolemia, familial heterozygous hypercholesterolemia and mixed hyperlipidemia.
  • Reduction of elevated concentrations of total cholesterol, cholesterol-LDL and apolipoprotein B in patients with homozygous familial hypercholesterolemia.
  • The drug Atoris® increases the concentration of cholesterol-HDL in serum and reduces the ratio of cholesterol-LDL / cholesterol-HDL.
  • It is used in case of insufficient effectiveness of diet therapy and other non-pharmacological treatment methods.

Prevention of cardiovascular diseases:

  • Primary prevention of cardiovascular complications in patients without clinical signs of coronary heart disease, but with several risk factors for its development: age over 55 years old, nicotine dependence, arterial hypertension, diabetes mellitus, low plasma HDL-C, genetic predisposition, including against dyslipidemia.
  • Secondary prevention of cardiovascular complications in patients with coronary heart disease in order to reduce the total mortality rate, myocardial infarction, stroke, re-hospitalization for angina and the need for revascularization.


1 tablet contains:

Active substance: atorvastatin calcium 10.36 mg, (equivalent to 10 mg atorvastatin, respectively).

Excipients: Povidone - 5.8 mg; sodium lauryl sulfate - 2.9 mg; calcium carbonate - 31.84 mg; MCC - 29 mg; lactose monohydrate - 57.125 mg; croscarmellose sodium - 7.25 mg; magnesium stearate - 0.725 mg.

Shell film: Opadry II HP 85F28751 white (polyvinyl alcohol, titanium dioxide (E171), macrogol 3000, talc) - 4.35 mg.

Atorvastatin is marketed under different brands and generic names, and comes in different dosage forms:

Brand nameManufacturerCountryDosage form
Atorvastatin Vertex Russia pills
Atorvastatin Izvarino Pharma Russia pills
Atorvastatin-SZ North Star Russia pills
Atorvastatin Canonpharma Russia pills
Liprimar Pfizer USA pills
Atoris Krka dd Novo mesto AO Slovenia pills
Tulip Sandoz Switzerland pills
Torvacard Zentiva KS Czech pills
Atorvastatin-Teva Teva Israel pills

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Dosage and Administration

Before prescribing Atorvastatin, the patient should be advised to recommend a standard lipid-lowering diet, which he must continue to follow throughout the entire period of therapy.

The drug is taken orally, at any time of the day with food, or regardless of meal times.

The dose is selected based on baseline levels of cholesterol / LDL, goals of therapy and individual effect. The initial dose is an average of 10 mg 1 time / day. The dose varies from 10 to 80 mg 1 time / day.

At the beginning of treatment and / or during the dose increase of the drug Atorvastatin, it is necessary every 2-4 weeks to control the content of lipids in the blood plasma and adjust the dose accordingly.

In case of primary hypercholesterolemia and mixed hyperlipidemia, as well as Fredrickson type III and IV hyperlipidemia, in most cases it is enough to administer the drug in a dose of 10 mg 1 time / day. A significant therapeutic effect is observed, as a rule, after 2 weeks; The maximum therapeutic effect is usually observed after 4 weeks. With long-term treatment, this effect persists.

With homozygous familial hypercholesterolemia, the drug is prescribed in a dose of 80 mg (4 tab. 20 mg) 1 time / day.

The use of the drug in patients with renal insufficiency and kidney disease does not affect the level of atorvastatin in the blood plasma or the degree of cholesterol / LDL cholesterol in its use, therefore, changing the dose of the drug is not required.

With hepatic insufficiency, the dose must be reduced.

When using the drug in elderly patients, there were no differences in safety, efficacy, or achievement of lipid-lowering therapy goals in comparison with the general population.

Adverse reactions

On the part of the nervous system: most often 2% - insomnia, dizziness; less than 2% - headache, asthenia, malaise, drowsiness, nightmares, paresthesias, peripheral neuropathy, amnesia, emotional lability, ataxia, facial paralysis, hyperkinesis, migraine, depression, hypoesthesia, loss of consciousness.

On the part of the senses: less often 2% - amblyopia, tinnitus, dry conjunctiva, accommodation disturbance, hemorrhage into the retina, deafness, glaucoma, parosmia, loss of taste, taste perversion.

Since the cardiovascular system: usually 2% - chest pain; less than 2% - palpitations, vasodilation symptoms, orthostatic hypotension, increased blood pressure, phlebitis, arrhythmia, angina pectoris.

From the hematopoietic system: less often 2% - anemia, lymphadenopathy, thrombocytopenia.

On the part of the respiratory system: more often 2% - bronchitis, rhinitis; less often 2% - pneumonia, dyspnea, exacerbation of bronchial asthma, nasal bleeding.

On the part of the digestive system: usually 2% - nausea; less 2% - heartburn, constipation or diarrhea, flatulence, gastralgia, abdominal pain, decreased or increased appetite, dry mouth, belching, dysphagia, vomiting, stomatitis, esophagitis, glossitis, erosive and ulcerative lesions of the oral mucosa, gastroenteritis, hepatitis, biliary colic, cheilitis, duodenal ulcer, pancreatitis, cholestatic jaundice, abnormal liver function, rectal bleeding, melena, gingival bleeding, tenesmus.

From the musculoskeletal system: usually 2% - arthritis; less often 2% - leg muscle spasms, bursitis, tendosynovitis, myositis, myopathy, arthralgia, myalgia, rhabdomyolysis, torticollis, muscle hypertonia, joint contractures.

On the part of the urinary system: usually 2% - peripheral edema; less often 2% - dysuria (including pollakiuria, nocturia, urinary incontinence or urinary retention, imperative urination to urinate, nephritis, hematuria, nephrorolithiasis.

On the part of the genital organs and the mammary gland: most often 2% are urogenital infections; less than 2% - vaginal bleeding, metrorrhagia, epididymitis, decreased libido, impotence, impaired ejaculation, gynecomastia, mastodynia.

On the part of the skin and subcutaneous tissues: more often 2% - alopecia, xerodermia, increased sweating, eczema, seborrhea, ecchymosis, petechiae.

Allergic reactions: less than 2% - pruritus, skin rash, contact dermatitis "rarely - urticaria, angioedema, swelling of the face, photosensitization, anaphylaxis, erythema multiforme exudative (includingStevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

On the part of laboratory parameters: less often 2% - hyperglycemia, hypoglycemia, increased serum CPK, albuminuria.

Other: less than 2% - weight gain, exacerbation of gout.


- active liver disease or increased activity of liver enzymes of unclear genesis (more than 3 times compared with VGN);

- liver failure (severity according to the Child-Pugh A and B classification);

- pregnancy;

- lactation period;

- age up to 18 years (efficacy and safety have not been established);

- Hypersensitivity to the drug.

Precautions should be prescribed for alcohol abuse, history of liver diseases, severe electrolyte imbalance, endocrine and metabolic disorders, hypotension, severe acute infections (sepsis), uncontrolled epilepsy, extensive surgical interventions, injuries, and skeletal muscle diseases.

Drug interactions

The risk of myopathy during treatment with other drugs of this class increases with the simultaneous use of cyclosporine, fibrates, erythromycin, antifungal agents related to azoles, and nicotinic acid.

With simultaneous use of the drug inside atorvastatin and a suspension containing magnesium and aluminum hydroxide, plasma concentrations of atorvastatin decreased by about 35%, but the degree of decrease in the concentration of cholesterol / LDL did not change.

With simultaneous use of atorvastatin does not affect the pharmacokinetics of antipyrine (phenazone), therefore, interaction with other drugs metabolized by the same cytochrome isoenzymes is not expected.

With simultaneous use of colestipol, the concentration of atorvastatin in the blood plasma decreased by approximately 25%. However, the lipid-lowering effect of the combination of atorvastatin and colestipol was superior to that of each drug separately.

With repeated administration of digoxin and atorvastatin in a dose of 10 mg Css of digoxin in the blood plasma did not change. However, when using digoxin in combination with atorvastatin at a dose of 80 mg / day, the concentration of digoxin increased by about 20%. Patients receiving digoxin in combination with atorvastatin should be monitored.

With simultaneous use of atorvastatin and erythromycin (500 mg 4 times / day) or clarithromycin (500 mg 2 times / day), which inhibit cytochrome CYP3A4, an increase in plasma concentration of atorvastatin was observed.

With simultaneous use of atorvastatin (10 mg 1 time / day) and azithromycin (500 mg 1 time / day), the concentration of atorvastatin in the blood plasma did not change.

Atorvastatin did not have a clinically significant effect on the concentration of terfenadine in the blood plasma, which is metabolized mainly by cytochrome CYP3A4; therefore, it seems unlikely that atorvastatin can significantly affect the pharmacokinetic parameters of other CYP3A4 substrates.

With simultaneous use of atorvastatin and a oral contraceptive containing norethindrone and ethinyl estradiol, there was a significant increase in the norethindrone and ethinyl estradiol AUC by about 30% and 20%, respectively. This effect should be considered when choosing an oral contraceptive for a woman receiving atorvastatin.

Simultaneous use with drugs that reduce the concentration of endogenous steroid hormones (including cimetidine, ketoconazole, spironolactone) increases the risk of reducing endogenous steroid horomones (caution should be exercised).

When studying the interaction of atorvastatin with warfarin and cimetidine signs of clinically significant interaction was not found.

With simultaneous use of atorvastatin 80 mg and amlodipine 10 mg, the pharmacokinetics of atorvastatin in an equilibrium state did not change.

No clinically significant undesirable interaction of atorvastatin and antihypertensive agents was noted.

The simultaneous use of atorvastatin with protease inhibitors, known as CYP3A4 inhibitors, was accompanied by an increase in plasma atorvastatin concentrations.

Pharmaceutical incompatibility is unknown.

Pregnancy and Lactation

Atorvastatin is contraindicated for use during pregnancy and lactation (breastfeeding).

It is not known whether atorvastatin is excreted in breast milk. Given the possibility of adverse events in infants, if necessary, use of the drug during lactation should decide on the termination of breastfeeding.

Women of reproductive age during treatment should use adequate methods of contraception. Atorvastatin can be prescribed to women of reproductive age only if the probability of pregnancy is very low and the patient is informed about the possible risk to the fetus during therapy.

Special instructions

Before starting treatment with atorvastatin, the patient should be prescribed a standard hypocholesterol diet, which he must follow during the entire period of treatment. The use of HMG-CoA reductase inhibitors to reduce the concentration of lipids in the blood can lead to changes in biochemical parameters reflecting the function of the liver. Liver function should be monitored before starting therapy, 6 weeks, 12 weeks after the start of atorvastatin use and after each dose increase, as well as periodically, for example, every 6 months. An increase in the activity of liver enzymes in the serum can be observed during therapy with atorvastatin. Patients who have increased enzyme activity should be monitored until they return to normal values. In the event that the values ​​of ALT or ACT are more than 3 times higher than VGN, it is recommended to reduce the dose of atorvastatin or discontinue treatment.

Atorvastatin should be used with caution in patients who abuse alcohol and / or have liver disease. Active liver disease or a persistent increase in the activity of aminotransferases of unclear genesis serve as contraindications to the administration of atorvastatin.

Treatment with atorvastatin can cause myopathy. The diagnosis of myopathy (pain and weakness in the muscles in combination with an increase in the activity of CPK more than 10 times compared to VGN) should be discussed in patients with common myalgias, muscle soreness or weakness and / or a pronounced increase in the activity of CPK. Patients should be warned that they should immediately inform the doctor about the appearance of unexplained pain or weakness in the muscles, if they are accompanied by indisposition or fever. Atorvastatin therapy should be discontinued in the case of a pronounced increase in the activity of CPK or in the presence of confirmed or suspected myopathy. The risk of myopathy in the treatment of other drugs of this class increased with the simultaneous use of cyclosporine, fibrates, erythromycin, nicotinic acid or antifungal agents from the group of azoles. Many of these drugs inhibit CYP3A4-mediated metabolism and / or drug transport. Atorvastatin is biotransformed by CYP3A4. When prescribing atorvastatin in combination with fibrates, erythromycin, immunosuppressive agents, antifungals from the azoles group or nicotinic acid in lipid-lowering doses, the expected benefit and risk of treatment should be carefully weighed and regularly monitored by patients to detect pain or weakness in muscles, especially during the first months treatment and during periods of increasing the dose of any drug. In such situations, periodic determination of CPK activity can be recommended, although such monitoring does not prevent the development of severe myopathy.

When using the drug Atorvastatin, as well as other drugs of this class, cases of rhabdomyolysis with acute renal failure caused by myoglobinuria are described.Atorvastatin therapy should be temporarily stopped or completely canceled if there are signs of possible myopathy or the presence of risk factors for the development of renal failure in the presence of rhabdomyolysis (for example, severe acute infection, hypotension, serious surgery, trauma, severe metabolic, endocrine and electrolyte disturbances and uncontrolled seizures) .

Before initiating therapy with atorvastatin, it is necessary to try to achieve control of hypercholesterolemia by adequate diet therapy, increasing physical activity, reducing body weight in patients with obesity, and treating other conditions.

Patients should be warned that they should immediately see a doctor if they develop unexplained pains or weakness in the muscles, especially if they are accompanied by indisposition or fever.

Influence on ability to drive motor transport and control mechanisms

The adverse effect of the drug Atorvastatin on the ability to drive and work with mechanisms was not reported.


Treatment: there is no specific antidote; Symptomatic therapy is indicated. Hemodialysis is ineffective.

  • Brand name: Atenolol
  • Active ingredient: Atenolol
  • Dosage form: pills white or white with a grayish or creamy shade of color; light marbling is allowed.
  • Manufacturer: PFK Obnovlenie
  • Country of Origin: Russia

Studies and clinical trials of Atorvastatin (Click to expand)
  1. Quantitation of the acid and lactone forms of atorvastatin and its biotransformation products in human serum by high-performance liquid chromatography with electrospray tandem mass spectrometry
  2. Atorvastatin, an HMG-COA reductase inhibitor and effective lipid-regulating agent. Part II. Synthesis of side-chain-labeled [14C]atorvastatin
  3. Atorvastatin, an HMG-COA reductase inhibitor and effective lipid-regulating agent. Part III. Syntheses of [2H5]-, [13C8], and [13C7,15N]atorvastatin and their application in metabolic and pharmacokinetic studies
  4. Synthesis of deuterium-labeled atorvastatin and its metabolites for use as internal standards in a LC/MS/MS method developed for quantitation of the drug and its metabolites in human serum
  5. Effects of atorvastatin on serum lipids, lipoproteins, and hemostasis
  6. Increase in circulating endothelial precursors by atorvastatin in patients with systemic sclerosis
  7. Failure of oral atorvastatin to modulate a murine model of systemic lupus erythematosus
  8. Use of atorvastatin in systemic lupus erythematosus in children and adolescents
  9. Effect of atorvastatin on the intravenous and oral pharmacokinetics of verapamil in rats
  10. Atorvastatin Therapy: Effects on Reduction Of Macrophage Activity (ATHEROMA). Evaluation using USPIO-enhanced magnetic resonance imaging in carotid disease
  11. Simultaneous determination of atorvastatin, amlodipine, ramipril and benazepril in human plasma by LC-MS/MS and its application to a human pharmacokinetic study
  12. Analysis of five HMG-CoA reductase inhibitors— atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin: pharmacological, pharmacokinetic and analytical overview and development of a new method for use in pharmaceutical formulations analysis and in vitro metabolism studies
  13. Simultaneous quantification of atorvastatin and active metabolites in human plasma by liquid chromatography–tandem mass spectrometry using rosuvastatin as internal standard
  14. Atorvastatin has cardiac safety at intensive cholesterol-reducing protocols for long term, yet its cancer-treatment doses with chemotherapy may cause cardiomyopathy even under coenzyme-Q10 protection
  15. New Crystalline Solvates of Atorvastatin Calcium
  16. A New Way to tert-Butyl [(4,6R)-6-Aminoethyl-2,2-dimethyl-1,3-dioxan-4-yl]acetate, a Key Intermediate of Atorvastatin Synthesis.
  17. ChemInform Abstract: A Simplified Catalytic System for Direct Catalytic Asymmetric Aldol Reaction of Thioamides; Application to an Enantioselective Synthesis of Atorvastatin.
  18. Validated Method for the Simultaneous Determination of Lisinopril, Pravastatin, Atorvastatin and Rosuvastatin in API, Formulations and Human Serum by RP-HPLC
  19. Diabetes reduces bone marrow and circulating porcine endothelial progenitor cells, an effect ameliorated by atorvastatin and independent of cholesterol
  20. Improved in vitro dissolution parameters and in vivo hypolipidemic efficiency of atorvastatin calcium through the formation of hydrophilic inclusion complex with cyclodextrins
  21. Metformin and atorvastatin combination further protect the liver in type 2 diabetes with hyperlipidaemia
  22. Effects of Atorvastatin on LDL sub-fractions and peroxidation in type 1 diabetic patients: a randomised double-blind placebo-controlled study
  23. Rapid analysis of atorvastatin calcium using capillary electrophoresis and microchip electrophoresis
  24. Atorvastatin does not exhibit antiviral activity against HCV at conventional doses: A pilot clinical trial

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