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CARDIOVASCULAR SYSTEM › LIPID MODIFYING AGENTS › LIPID MODIFYING AGENTS, COMBINATIONS › Lipid modifying agents in combination with other drugs
atorvastatin, amlodipine and candesartan
C10BX19
Forms & Strengths
- Fixed-dose combination capsule/tablet
- Atorvastatin 10 mg / Amlodipine 5 mg / Candesartan 8 mg
- Atorvastatin 10 mg / Amlodipine 5 mg / Candesartan 16 mg
- Atorvastatin 20 mg / Amlodipine 5 mg / Candesartan 8 mg
- Atorvastatin 20 mg / Amlodipine 5 mg / Candesartan 16 mg
- Atorvastatin 20 mg / Amlodipine 10 mg / Candesartan 16 mg
Adult Dosing
- One capsule/tablet daily, titrated based on individual component responses
- Maximum recommended dose typically limited by individual component maximums (Atorvastatin 80 mg, Amlodipine 10 mg, Candesartan 32 mg daily)
Pediatric Dosing
- Safety and efficacy not established in pediatric patients; combination not recommended
Indications
- Management of hypertension and dyslipidemia simultaneously in patients already stabilized on the individual components
- Reduction of cardiovascular risk in appropriate adult patients
Mechanism of Action
- Atorvastatin: Inhibits HMG-CoA reductase, decreasing hepatic cholesterol synthesis and increasing LDL receptors
- Amlodipine: Inhibits calcium ion influx across cardiac and vascular smooth muscle membranes, causing peripheral vasodilation
- Candesartan: Blocks angiotensin II AT1 receptors, leading to vasodilation and decreased aldosterone secretion
Contraindications
- Hypersensitivity to atorvastatin, amlodipine, candesartan, dihydropyridines, or any component
- Active liver disease or unexplained persistent elevations of serum transaminases
- Pregnancy (second and third trimesters) due to risk of fetal injury and death
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment
Adverse Reactions
- Peripheral edema
- Dizziness
- Headache
- Nasopharyngitis
- Myalgia
- Elevated liver transaminases
- Hypotension
- Hyperkalemia
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) increase atorvastatin and amlodipine exposure
- CYP3A4 inducers (e.g., rifampin, St. John's wort) decrease atorvastatin and amlodipine concentrations
- Dual blockade of the renin-angiotensin system (ACE inhibitors, aliskiren) increases risk of hypotension, hyperkalemia, and renal impairment
- Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium increase hyperkalemia risk with candesartan
- Lithium: decreased renal clearance of lithium leading to potential toxicity with candesartan
Curated Content: Needs Vetting Before Put to Clinical Use