Page 9 - P4403.59-V45_Numark Magazine November 23.

Think the No.1 statin* in a licensed liquid format
Supporting

Patients with

Medicines:

UK Pharmacy

Contracts

Atorvastatin 4mg/ml Oral Suspension
Introducing the first licensed liquid Atorvastatin

In the ever changing and often challenging landscape of
healthcare, pharmacists play a vital role in supporting
patient health. Although for those working in the industry
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Scan the QR c
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Scan the QR code below for more information or go to www.lipidsreduction.com *The No.1 dispensed statin in England 2020 1
this has been clear, since the COVID-19 pandemic,
Abbreviated prescribing information. See SmPC for full details (www.medicines.org.uk). Name of the medicinal Cholesterol Levels (SPARCL) In a post-hoc analysis of stroke subtypes in patients without coronary heart disease (CHD) who had a recent stroke or
product: Atorvastatin 4mg/ml Oral Suspension. Qualitative and quantitative composition: Each 1 ml contains 4mg of transient ischemic attack (TIA) there was a higher incidence of haemorrhagic stroke in patients initiated on atorvastatin 80 mg compared to placebo. patients are realising that their local community
Atorvastatin (as 4.14 mg atorvastatin calcium trihydrate). Pharmaceutical form: Oral Suspension. White to brownish Skeletal muscle effects Atorvastatin, like other HMG-CoA reductase inhibitors, may in rare occasions affect the skeletal muscle and cause myalgia,
white Suspension. Therapeutic indications: Hypercholesterolaemia Atorvastatin Oral Suspension is indicated as an myositis, and myopathy that may progress to rhabdomyolysis, a potentially life-threatening condition characterised by markedly elevated creatine
adjunct to diet for reduction of elevated total cholesterol (total-C), LDL-cholesterol (LDL-C), apolipoprotein B, and kinase (CK) levels (> 10 times ULN), myoglobinaemia and myoglobinuria which may lead to renal failure. Before treatment Atorvastatin should pharmacy is the key stone to receiving not only their
triglycerides in adults, adolescents and children aged 10 years or older with primary hypercholesterolaemia including be prescribed with caution in patients with pre-disposing factors for rhabdomyolysis. A CK level should be measured before starting statin treatment
familial hypercholesterolaemia (heterozygous variant) or combined (mixed) hyperlipidaemia (Corresponding to Types in the following situations: renal impairment; hypothyroidism; personal or familial history of hereditary muscular disorders; previous history of monthly prescriptions, but also advice and services.
IIa and IIb of the Fredrickson classification) when response to diet and other nonpharmacological measures is muscular toxicity with a statin or fibrate; previous history of liver disease and/or where substantial quantities of alcohol are consumed; in elderly (age
Scan here to inadequate. Atorvastatin Oral Suspension is also indicated to reduce total-C and LDL-C in adults with homozygous > 70 years), the necessity of such measurement should be considered, according to the presence of other predisposing factors for rhabdomyolysis,
visit website familial hypercholesterolaemia as an adjunct to other lipid-lowering treatments (e.g. LDL apheresis) or if such situations where an increase in plasma levels may occur, such as interactions and special populations including genetic subpopulations. In such
treatments are unavailable. Prevention of cardiovascular disease Prevention of cardiovascular events in adult patients situations, the risk of treatment should be considered in relation to possible benefit, and clinical monitoring is recommended. If CK levels are In the UK, the pharmacy contract forms the backbone of
estimated to have a high risk for a first cardiovascular event, as an adjunct to correction of other risk factors. Posology and method of administration: significantly elevated (> 5 times ULN) at baseline, treatment should not be started. Concomitant treatment with other medicinal products Risk of
Posology The patient should be placed on a standard cholesterol-lowering diet before receiving Atorvastatin Oral Suspension and should continue rhabdomyolysis is increased when atorvastatin is administered concomitantly with certain medicinal products that may increase the plasma professional engagement within the healthcare system, outlining
on this diet during treatment with Atorvastatin Oral Suspension. The dose should be individualised according to baseline LDL-C levels, the goal of concentration of atorvastatin such as potent inhibitors of CYP3A4 or transport proteins (e.g. ciclosporin, telithromycin, clarithromycin, delavirdine,
therapy and patient response. The usual starting dose is 10 mg (2.5 ml) once a day. Adjustment of dose should be made at intervals of 4 weeks or stiripentol, ketoconazole, voriconazole, itraconazole, posaconazole, letermovir and HIV protease inhibitors including ritonavir, lopinavir, atazanavir, the terms and conditions under which they provide their
more. The maximum dose is 80 mg (20 ml) once a day. Primary hypercholesterolaemia and combined (mixed) hyperlipidaemia. The majority of indinavir, darunavir, tipranavir/ritonavir etc). The risk of myopathy may also be increased with the concomitant use of gemfibrozil and other fibric
patients are controlled with Atorvastatin Oral Suspension 10 mg (2.5 ml) once a day. A therapeutic response is evident within 2 weeks, and the acid derivates, antivirals for the treatment of hepatitis C (HCV) (boceprevir, telaprevir, elbasvir/grazoprevir), erythromycin, niacin or ezetimibe. If indispensable services. However, within the UK, each of the four
maximum therapeutic response is usually achieved within 4 weeks. The response is maintained during chronic therapy. Heterozygous familial possible, alternative (non-interacting) therapies should be considered instead of these medicinal products. In cases where co-administration of these
hypercholesterolaemia. Patients should be started with Atorvastatin Oral Suspension 10 mg (2.5 ml) daily. Doses should be individualised and medicinal products with atorvastatin is necessary, the benefit and the risk of concurrent treatment should be carefully considered. When patients are nations, hold distinct variations within the pharmacy contract,
adjusted every 4 weeks to 40 mg (10 ml) daily. Thereafter, either the dose may be increased to a maximum of 80 mg (20 ml) daily or a bile acid receiving medicinal products that increase the plasma concentration of atorvastatin, a lower maximum dose of atorvastatin is recommended. In
sequestrant may be combined with 40 mg (10 ml) atorvastatin once daily. Homozygous familial hypercholesterolaemia. Only limited data are addition, in the case of potent CYP3A4 inhibitors, a lower starting dose of atorvastatin should be considered and appropriate clinical monitoring of and as your trusted membership organisation. Numark are here
available. The dose of atorvastatin in patients with homozygous familial hypercholesterolemia is 10 to 80 mg (2.5 to 20 ml) daily. Atorvastatin these patients is recommended. Atorvastatin must not be co-administered with systemic formulations of fusidic acid or within 7 days of stopping
should be used as an adjunct to other lipid-lowering treatments (e.g. LDL apheresis) in these patients or if such treatments are unavailable. fusidic acid treatment. In patients where the use of systemic fusidic acid is considered essential, statin treatment should be discontinued throughout to ensure you remain informed and supported when navigating
Prevention of cardiovascular disease. In the primary prevention trials the dose was 10 mg/day (2.5 ml/day). Higher doses may be necessary in order the duration of fusidic acid treatment. There have been reports of rhabdomyolysis (including some fatalities) in patients receiving fusidic acid and
to attain (LDL-) cholesterol levels according to current guidelines. Renal impairment No adjustment of dose is required. Hepatic impairment statins in combination. The patient should be advised to seek medical advice immediately if they experience any symptoms of muscle weakness, through the different areas of the contract.
Atorvastatin Oral Suspension should be used with caution in patients with hepatic impairment. Atorvastatin Oral Suspension is contraindicated in pain or tenderness. Statin therapy may be re-introduced seven days after the last dose of fusidic acid. In exceptional circumstances, where prolonged
patients with active liver disease. Co-administration with other medicines. In patients taking the hepatitis C antiviral agents elbasvir/grazoprevir or systemic fusidic acid is needed, e.g., for the treatment of severe infections, the need for co-administration of atorvastatin and fusidic acid should only
letermovir for cytomegalovirus infection prophylaxis concomitantly with atorvastatin, the dose of atorvastatin should not exceed 20 mg/day (5 ml). be considered on a case-by-case basis and under close medical supervision. Paediatric population No clinically significant effect on growth and
Use of atorvastatin is not recommended in patients taking letermovir co-administered with ciclosporin. Elderly Efficacy and safety in patients older sexual maturation was observed in a 3- year study based on the assessment of overall maturation and development, assessment of Tanner Stage, In terms of providing services, you will be aware that depending on
than 70 using recommended doses are similar to those seen in the general population. Paediatric population Hypercholesterolaemia Paediatric use and measurement of height and weight. Interstitial lung disease. Exceptional cases of interstitial lung disease have been reported with some statins,
should only be carried out by physicians experienced in the treatment of paediatric hyperlipidaemia and patients should be re-evaluated on a regular especially with long term therapy. Presenting features can include dyspnoea, non-productive cough and deterioration in general health (fatigue, which country you are in, there are different variations of the same
basis to assess progress. For patients with Heterozygous Familial Hypercholesterolemia aged 10 years and above, the recommended starting dose weight loss and fever). If it is suspected a patient has developed interstitial lung disease, statin therapy should be discontinued. Diabetes Mellitus.
of atorvastatin is 10 mg (2.5 ml) per day. The dose may be increased to 80 mg (20 ml) daily, according to the response and tolerability. Doses Some evidence suggests that statins as a class raise blood glucose and in some patients, at high risk of future diabetes, may produce a level of or similar service you will need to administer to meet the pharmacy
should be individualised according to the recommended goal of therapy. Adjustments should be made at intervals of 4 weeks or more. The dose hyperglycaemia where formal diabetes care is appropriate. This risk, however, is outweighed by the reduction in vascular risk with statins and
titration to 80 mg (20 ml) daily is supported by study data in adults and by limited clinical data from studies in children with Heterozygous Familial therefore should not be a reason for stopping statin treatment. Patients at risk (fasting glucose 5.6 to 6.9 mmol/L, BMI>30kg/m , raised contract, and in some instances where it is possible to claim.
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Hypercholesterolemia. There are limited safety and efficacy data available in children with Heterozygous Familial Hypercholesterolemia between 6 triglycerides, hypertension) should be monitored both clinically and biochemically according to national guidelines. Undesirable effects (summary
to 10 years of age derived from open-label studies. Atorvastatin is not indicated in the treatment of patients below the age of 10 years. Currently only, see SmPC for full details): The following undesirable effects are common (≥1/100, < 1/10): nasopharyngitis, allergic reactions,
available data are described in the SmPC but no recommendation on posology can be made. Other pharmaceutical forms/strengths may be more hyperglycaemia, headache, pharyngo-laryngeal pain, epistaxis, constipation, flatulence, dyspepsia, nausea, diarrhoea, myalgia, arthralgia, pain in
appropriate for this population. Method of administration: Atorvastatin Oral Suspension is for oral use only. Each daily dose of atorvastatin is given extremity, muscle spasms, joint swelling, back pain, liver function test abnormal, blood creatine kinase increased. The following undesirable effects Pharmacy’s bread and butter is supporting patients with their
all at once and may be given at any time of day with or without food. Shake well before use. For instructions for use of the medicinal product before are considered serious: thrombocytopenia, peripheral neuropathy, hearing loss, pancreatitis, hepatitis, hepatic failure, cholestasis, angioneurotic
administration, see section 6.6 of the SmPC. Contraindications: Atorvastatin Oral Suspension is contraindicated in patients: with hypersensitivity to oedema, Stevens Johnson syndrome, toxic epidermal necrolysis, myopathy, myositis, rhabdomyolysis, muscle rupture, tendinopathy (including medicines and as part of each country's pharmacy contract there

the active substance or to any of the excipients listed in section 6.1 of the SmPC; with active liver disease or unexplained persistent elevations of rupture), lupus-like syndrome, immune-mediated necrotizing myopathy. Legal classification: POM (Prescription Only Medicine). Marketing
serum transaminases exceeding 3 times the upper limit of normal; during pregnancy, while breast-feeding and in women of child-bearing potential authorisation holder: Rosemont Pharmaceuticals Ltd, Yorkdale Industrial Park, Braithwaite Street, Leeds, LS11 9XE, UK. Marketing authorisation are numerous services that will involve this...
not using appropriate contraceptive measures; treated with the hepatitis C antivirals glecaprevir/pibrentasvir. Special warnings and precautions for number: PL 00427/0256. Date of text: January 2022. Cost: £198.76.
use: Liver effects Liver function tests should be performed before the initiation of treatment and periodically thereafter. Patients who develop any
signs or symptoms suggestive of liver injury should have liver function tests performed. Atorvastatin Oral Suspension should be used with caution in Reference: 1. Statista. Leading chemical substances dispensed in England in 2020. Available at: https://www.statista.com/statistics/378445/
patients who consume substantial quantities of alcohol and/or have a history of liver disease. Stroke Prevention by Aggressive Reduction in prescription-cost-analysis-top-twenty-chemicals-by-items-in-england/ Accessed 28 February 2022.
Rosemont Pharmaceuticals Ltd. Rosemont House, Yorkdale Industrial Park, Braithwaite Street, Leeds LS11 9XE T +44 (0)113 244 1400 F +44 (0)113 245 3567
E infodesk@rosemontpharma.com Sales/Customer Service: T +44 (0)113 244 1999 F +44 (0)113 246 0738 W www.rosemontpharma.com
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Rosemont Pharmaceuticals Ltd on 0113 244 1400
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