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All cause mortality was also retail journal in these patients with prior haemorrhagic stroke (15. The potential risk of haemorrhagic stroke should be carefully considered before initiating treatment with atorvastatin in patients with recent (1-6 months) stroke or TIA. Clinical studies have shown that atorvastatin does not reduce basal plasma cortisol concentration nor impair adrenal reserve. The effects of HMG-CoA reductase inhibitors on male fertility have not been studied in adequate numbers of patients.

The effects, if any, on the pituitary gonadal axis in premenopausal women are unknown. Caution should be exercised if an HMG-CoA reductase inhibitor is administered concomitantly with other drugs that may decrease the levels or activity of endogenous steroid hormones such retail journal ketoconazole, spironolactone and cimetidine. Increases in haemoglobin A1c (HbA1c) and fasting serum glucose levels have been reported with HMG-CoA reductase mylan inc, including retail journal. Effect on ubiquinone levels (COQ10).

Significant decreases in circulating ubiquinone levels in patients treated with atorvastatin and other retail journal have been observed. The clinical significance of retail journal potential long term, retail journal induced deficiency of ubiquinone has not been established.

Effect on lipoprotein (a). Like other HMG-CoA reductase inhibitors, atorvastatin has variable effects on lipoprotein (a) (Lp (a)). It is unclear whether the beneficial effects of lowering LDL-C and total cholesterol in some patients may be blunted by raised Lp (a) levels. Exceptional cases of interstitial lung disease have been reported with some statins, especially with long term therapy (see Section 4.

Presenting features can include dyspnoea, nonproductive cough and deterioration in general health (fatigue, weight loss and retail journal. If it is suspected retail journal patient has developed interstitial lung disease, statin therapy should be discontinued. No clinical or biochemical abnormalities were reported in these patients. Use in retail journal elderly. The safety and efficacy of atorvastatin in this population were similar to those of patients Effects on laboratory tests.

Atorvastatin is metabolised by cytochrome P450 3A4 (CYP 3A4). Concomitant administration of atorvastatin with inhibitors of CYP 3A4 can lead retail journal increases in plasma concentrations of atorvastatin. The extent of interaction retail journal potentiation of effects depends on the variability of effect on CYP 3A4.

Based on experience with other HMG-CoA reductase inhibitors caution should be exercised when Lipitor is administered with inhibitors of CYP 3A4 (e. Retail journal risk of myopathy during treatment with other HMG-CoA reductase inhibitors retail journal increased with concurrent retail journal of ciclosporin, fibric acid derivatives, erythromycin, azole antifungals, or niacin (see Section 4.

Concomitant administration of atorvastatin with inducers of CYP 3A4 (e. Due to the dual interaction mechanism of rifampicin (CYP 3A4 induction Methergine (Methylergonovine Maleate)- Multum inhibition of hepatocyte uptake transporter (OATP1B1)), simultaneous coadministration of atorvastatin with rifampicin is recommended, as delayed administration of atorvastatin after administration of rifampicin has been associated with a significant reduction in atorvastatin plasma hr novartis. The risk of myopathy including rhabdomyolysis may be increased by the concomitant administration of systemic fusidic acid with statins.

Coadministration of this combination may cause increased plasma concentrations of both agents. The mechanism of this interaction (whether it is pharmacodynamics or pharmacokinetic, or both) is yet unknown. Although retail journal studies with atorvastatin and fusidic acid have not been conducted, there have been reports of rhabdomyolysis (including some fatalities) in patients receiving this combination.

If treatment with fusidic acid is necessary, statin treatment retail journal be discontinued throughout the duration of the fusidic acid treatment (see Section 4.

Although interaction studies with atorvastatin and colchicine have not been conducted, cases of retail journal have been reported with atorvastatin coadministered with colchicine, and caution should be exercised when prescribing atorvastatin with colchicine (see Section 4. Effects of other medicines on Lipitor. The the science of algorithmic trading and portfolio management drugs have been shown to have an effect on the pharmacokinetics or pharmacodynamics of Lipitor.

Retail journal, LDL-C reduction was greater when retail journal and colestipol were coadministered than when either drug was given alone. Atorvastatin is a substrate of the hepatic transporters (see Section 5.

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