Orvatin 40 mg Tablet

Statin medicine that lowers cholesterol:

• High LDL ("bad") cholesterol and triglycerides (with diet)
• Prevention of heart attack and stroke in people at high cardiovascular risk (diabetes, high blood pressure, smokers, family history)
• After a heart attack, stroke or with established heart disease (secondary prevention)
• Familial hypercholesterolaemia (children 10 years and over, on specialist advice)

Adults: 10–20 mg once daily to start; high-intensity 40–80 mg once daily after heart attack or stroke. Maximum 80 mg/day.

Children (10–17 years, familial hypercholesterolaemia): start 10 mg once daily; up to 20 mg.

• Can be taken at any time of day, with or without food, but at the same time each day.
• Cholesterol is usually checked after 4–12 weeks.

• Allergy to atorvastatin
• Active liver disease or unexplained persistently raised liver enzymes
• Pregnancy and breastfeeding; women who may become pregnant without contraception
• Use with glecaprevir/pibrentasvir (hepatitis C)

Common: muscle aches, joint pain, headache, nausea, constipation or diarrhoea, indigestion, nosebleed, sore throat, raised blood sugar.

Less common: raised liver enzymes, tiredness, sleep problems.

Rare but serious: muscle damage (myopathy, rhabdomyolysis — unexplained muscle pain, weakness, dark urine), liver inflammation, tendon problems, severe skin reactions, new diabetes in at-risk people.

• Report unexplained muscle pain, tenderness or weakness, especially with fever.
• Liver tests before starting and if symptoms appear.
• Higher muscle risk: age over 70, kidney disease, hypothyroidism, heavy alcohol use, interacting drugs.
• Avoid large amounts of grapefruit juice.

Contraindicated in pregnancy and breastfeeding; stop if pregnancy is planned or confirmed.

• Clarithromycin, erythromycin, itraconazole, ketoconazole, HIV/HCV protease inhibitors, ciclosporin (higher muscle risk — avoid or limit dose)
• Gemfibrozil, fenofibrate, niacin, colchicine (muscle risk)
• Fusidic acid (avoid together — serious muscle damage)
• Grapefruit juice (large amounts)
• Warfarin, digoxin (monitor)

No specific treatment; supportive care, check liver and muscle enzymes.

Store below 30°C, in the original pack.