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CARDIOVASCULAR SYSTEM › LIPID MODIFYING AGENTS › LIPID MODIFYING AGENTS, COMBINATIONS › Lipid modifying agents in combination with other drugs
atorvastatin and perindopril
C10BX15
Forms & Strengths
- Atorvastatin/Perindopril arginine combination tablets
- Available strengths: 10 mg/5 mg, 10 mg/10 mg, 20 mg/5 mg, 20 mg/10 mg, 40 mg/5 mg, 40 mg/10 mg
Adult Dosing
- Hypertension and dyslipidemia: One tablet once daily, titrated based on component response
- Maximum daily dose: 80 mg atorvastatin / 10 mg perindopril
- Renal impairment adjustment required if CrCl < 60 mL/min
Pediatric Dosing
- Not recommended for pediatric use due to lack of safety and efficacy data for the fixed combination
Indications
- Management of hypertension in patients with concomitant hypercholesterolemia or mixed dyslipidemia
- Reduction of cardiovascular events in patients with coronary artery disease and risk factors
Mechanism of Action
- Atorvastatin: Competitive inhibitor of HMG-CoA reductase, reducing hepatic cholesterol synthesis and increasing LDL receptors
- Perindopril: Angiotensin-converting enzyme (ACE) inhibitor, preventing the conversion of angiotensin I to angiotensin II, leading to vasodilation
Contraindications
- Hypersensitivity to atorvastatin, perindopril, or other ACE inhibitors
- Active liver disease or unexplained persistent elevations of serum transaminases
- Pregnancy and lactation
- History of angioedema related to previous ACE inhibitor therapy
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Adverse Reactions
- Myalgia, arthralgia, and increased creatine kinase
- Persistent dry cough related to the ACE inhibitor component
- Dizziness, headache, and fatigue
- Gastrointestinal disturbances (diarrhea, dyspepsia, nausea)
- Hyperkalemia and elevated liver function tests
- Rare: Angioedema, rhabdomyolysis, acute renal failure
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) increase atorvastatin exposure and myopathy risk
- Potassium-sparing diuretics, potassium supplements, and ARBs increase the risk of hyperkalemia
- Lithium: Concomitant use with ACE inhibitors may lead to lithium toxicity
- NSAIDs may reduce the antihypertensive effect of perindopril and increase renal impairment risk
Curated Content: Needs Vetting Before Put to Clinical Use