Atorvastatin

IUPAC: (3R, 5R ) -7 - [2 - ( 4-fluorophenyl )-5 -isopropyl -3-phenyl -4-( phenylcarbamoyl ) pyrrol- 1-yl] - 3,5- dihydroxyheptanoic acid

C10AA05

Statins

HMG-CoA reductase inhibitor

Insoluble in water ( 1.12 mg · l-1 at 25 ° C)

> 5000 mg · kg -1 ( LD50, Rat, oral, calcium salt)

Template: Infobox chemical / molecular formula search available

Atorvastatin, a drug from the group of statins, used for the treatment of hypercholesterolemia. In German-speaking countries it is also distributed under the name Lipitor ® and Atorvalan ® as well as in many other countries as Lipitor ®. It was first brought in 1997 by Warner -Lambert in the trade, but today it is marketed by Pfizer. Since May 2012, the drug is first available as a generic in Germany.

Mechanism of Action

Atorvastatin is a competitive HMG -CoA reductase inhibitors. The HMG -CoA reductase acts as a catalyst in the reduction of 3-hydroxy -3-methylglutaryl -coenzyme A (HMG -CoA) to mevalonate, which is a limiting step in hepatic cholesterol synthesis.

By lowering the cholesterol synthesis, the liver cells increase the number of LDL - receptors on the cell surface, so that the increased LDL uptake into the liver cell and thus reduce the LDL levels in the blood.

Potency

Atorvastatin was until the beginning of 2009 than in the dosages used most powerful statin on the German market and is about two to three times as strong as simvastatin ( 10 mg of atorvastatin correspond to about 20-30 mg of simvastatin ). Stronger than atorvastatin which is available on the German market since January 2009, rosuvastatin. From 8 May 2012, the potencies are offered 30 and 60 mg of generic drug companies in addition, they allow an individual therapy setting for each patient so that the risk of possible side effects can be minimized.

Side effects

Atorvastatin may cause inter alia disorders of the gastrointestinal tract ( diarrhea, constipation, bloating ), fatigue, muscle pain, headache and joint pain. The serious, albeit rare, side effects include toxic myopathies, which can be fatal. Recent studies show an increased diabetes risk by statins, although the risk-benefit ratio is clearly favorable.

Market significance / Therapy Benefits

World market

Atorvastatin had 2008 on the global statin market with a market share of about 40-50%. 2008, provided Pfizer revenue of 12.4 billion dollars. 2011 atorvastatin No. 1 on the world's top-selling drug, with sales of $ 12.264 billion.

Germany

On the German market, the market share at the end of 2003 about 50%. In early 2004 joined a health care reform into force, setting out a fixed amount for all statins. The Pfizer decided not to adjust prices for Lipitor to the fixed amounts, so since when prescribing Lipitor ® a higher co-payment for patients of loss. Justified this measure was part of the manufacturer with economic reasons in the international context. As a result of this action fell by cash to the market share of prescribed by the statutory health insurance Lipitor packs in Germany in 2005 to less than 5 percent. The market share of private health insurance the same period was about 50 percent. On May 7, 2012, the patent for atorvastatin ran out; since 8 May 2012, the active ingredient is thus free for generics supplier. Since according to the study have more than 50 % of patients already, for example, are in therapy with simvastatin, a not sufficiently lowered LDL and total cholesterol, atorvastatin for cash patients with greater efficacy at a similar price is an alternative.

Trade names

Lipitor (D, A, CH), Atoris (D ) and other generics (D, A, CH)

Caduet (A, CH ) and other generics (D, A, CH)