Components:
Medically reviewed by Fedorchenko Olga Valeryevna, PharmD. Last updated on 28.05.2022
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Top 20 medicines with the same components:
Prevention of Cardiovascular Disease: Encourage aspirin use in men (45-79 years) and women (55-79 years) when potential benefit (ie, prevention of myocardial infarction in men and prevention of ischemic stroke in women) outweighs potential harm of gastrointestinal hemorrhage.
Primary Prevention of Thromboembolic Disorders and Cardiovascular Events: Ischemic stroke; transient ischemic attack (TIA); prevention of recurrent myocardial infarction (MI); unstable angina pectoris; chronic stable angina pectoris.
Secondary Prevention of Cardiovascular Disease in Persons with Diabetes Mellitus Especially in the Following Subgroups: History of MI, vascular bypass procedure, stroke or transient ischemic attack and angina. Persons with additional risk factors: Hypertension, smoking, dyslipidemia and family history of cardiovascular disease.
Revascularization Procedures: Patients who have undergone revascularization procedures eg, coronary artery bypass graft (CABG), percutaneous transluminal coronary angioplasty (PTCA) and carotid endarterectomy when there is a preexisting condition for which aspirin is already indicated.
Pregnancy-Induced Hypertension: Primary prevention of pregnancy-induced hypertension, preeclampsia and intrauterine growth retardation particularly in pregnant women with preexisting chronic hypertension, auto-immune disorders like systemic lupus erythematosus (SLE), positive cardiolipin antibody test, history of recurring toxemia in successive pregnancies, and hypotension developing before the 20th week of gestation.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Hypertension
Atenolol is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including atenolol.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than 1 drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent ardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (eg, on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
Atenolol may be administered with other antihypertensive agents.
Angina Pectoris Due To Coronary Atherosclerosis
Atenolol is indicated for the long-term management of patients with angina pectoris.
Acute Myocardial Infarction
Atenolol is indicated in the management of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality. Treatment can be initiated as soon as the patient's clinical condition allows. In general, there is no basis for treating patients like those who were excluded from the ISIS-1 trial (blood pressure less than 100 mm Hg systolic, heart rate less than 50 bpm) or have other reasons to avoid beta blockade. As noted above, some subgroups (eg, elderly patients with systolic blood pressure below 120 mm Hg) seemed less likely to benefit.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Atorvastatin is indicated as an adjunct to diet for the treatment of patients with elevated total cholesterol (total-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein B (apo B), and triglycerides (TG) and to increase high density lipoprotein cholesterol (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and non-familial hypercholesterolemia), combined (mixed) hyperlipidemia (Fredrickson Types IIa and IIb), elevated serum TGlevels (Fredrickson Type IV), and for patients with dysbetalipoproteinemia (Fredrickson Type III) who do not respond adequately to diet.
Atorvastatin is also indicated for the reduction of total-C and LDL-C in patients with homozygous familial hypercholesterolemia.
Prevention of Cardiovascular Complications: In patients without clinically evident cardiovascular disease (CVD), and with or without dyslipidemia, but with multiple risk factors for coronary heart disease (CHD), such as smoking, hypertension, diabetes, low HDL-C, or a family history of early CHD, atorvastatin is indicated to: Reduce the risk of fatal CHD and non-fatal myocardial infarction (MI); reduce the risk of stroke; reduce the risk of revascularization procedures and angina pectoris.
In patients with clinically evident CHD, atorvastatin is indicated to: Reduce the risk of non-fatal MI; reduce the risk of fatal and non-fatal stroke; reduce the risk for revascularization procedures; reduce the risk of hospitalization for congestive heart failure (CHF); reduce the risk of angina.
As adjunct to lifestyle changes, such as proper diet and exercise, intensive atorvastatin treatment has been shown to halt the progression of atherosclerosis (total atheroma or plaque volume) in patients with coronary artery disease and other individuals who are at high risk for cardiovascular disease.
Chronic Kidney Disease: In patients with diabetes with moderately decreased eGFR, Atorvastatin is indicated to reduce the risk for cardiovascular disease.
In patients with clinically evident coronary heart disease and CKD not requiring dialysis, atorvastatin is indicated to reduce the risk of major cardiovascular events including stroke.
In patients with clinically evident coronary heart disease and/or diabetes with microalbuminuria, atorvastatin is indicated to reduce the rate of GFR decline and progression of CKD.
Pediatric Patients (10-17 Years of Age): Atorvastatin is indicated as an adjunct to diet to reduce total-C, LDL-C, and apo B levels in boys and post-menarchal girls, 10 to 17 years of age, with heterozygous familial hyperchlolesterolemia if, after an adequate trial of diet therapy, the following findings are present: LDL-C remains ≥190 mg/dL or, LDL-C remains ≥160 mg/dL and there is a positive family history of premature CVD or, two or more other CVD risk factors are present in the pediatric patient.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Losartan potassium is used to treat high blood pressure (hypertension). High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.
Losartan potassium works by blocking the action of a substance in the body that causes blood vessels to tighten. As a result, Losartan potassium relaxes blood vessels. This lowers blood pressure.
Losartan potassium is also used to decrease the risk of stroke in patients with high blood pressure and a condition called left ventricular hypertrophy (LVH). LVH is an enlargement of the left pumping chamber of the heart and can cause problems with the way the heart pumps blood.
Losartan potassium is also used to treat a condition called diabetic nephropathy. Diabetic nephropathy is a complication of type 2 diabetes which causes the kidneys to not work properly.
Aspirin may also be used to lessen the chance of heart attack, stroke, or other problems that may occur when a blood vessel is blocked by blood clots. Aspirin helps prevent dangerous blood clots from forming. However, this effect of aspirin may increase the chance of serious bleeding in some people. Therefore, aspirin should be used for this purpose only when your doctor decides, after studying your medical condition and history, that the danger of blood clots is greater than the risk of bleeding. Do not take aspirin to prevent blood clots or a heart attack unless it has been ordered by your doctor.
Salicylates may also be used for other conditions as determined by your doctor.
The caffeine present in some of these products may provide additional relief of headache pain or faster pain relief.
Some salicylates are available only with your medical doctor's or dentist's prescription. Others are available without a prescription; however, your medical doctor or dentist may have special instructions on the proper dose of these medicines for your medical condition.
Atenolol is used alone or together with other medicines (such as hydrochlorothiazide) to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.
Atenolol is also used to help prevent chest pain and to decrease the severity of heart attacks.
atenolol is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.
atenolol is available only with your doctor's prescription.
Atorvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." Atorvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).
Atorvastatin is used to treat high cholesterol, and to lower the risk of stroke, heart attack, or other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors.
Atorvastatin is used in adults and children who are at least 10 years old.
Atorvastatin may also be used for purposes not listed in this medication guide.
Losartan potassium is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure may reduce the risk of strokes and heart attacks.
Losartan potassium is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. As a result, Losartan potassium relaxes the blood vessels. A lower blood pressure will increase the supply of the blood and oxygen to the heart.
Losartan potassium is also used to decrease the risk of stroke in patients with high blood pressure and enlargement of the heart. It is also used to treat kidney problems in patients with type 2 diabetes and a history of hypertension.
Losartan potassium is available only with your doctor's prescription.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Caplet, oral: 500 mg
Bayer Aspirin Extra Strength: 500 mg
Bayer Genuine Aspirin: 325 mg
Bayer Women's Low Dose Aspirin: 81 mg [contains elemental calcium 300 mg]
Caplet, oral [buffered]:
Ascriptin Maximum Strength: 500 mg [contains aluminum hydroxide, calcium carbonate, magnesium hydroxide] [DSC]
Bayer Plus Extra Strength: 500 mg [contains calcium carbonate]
Caplet, enteric coated, oral:
Bayer Aspirin Regimen Regular Strength: 325 mg
Capsule Extended Release, oral:
Aspirin: 162.5 mg
Suppository, rectal: 300 mg (12s); 600 mg (12s)
Tablet, oral: 325 mg
Aspercin: 325 mg
Aspirtab: 325 mg
Bayer Genuine Aspirin: 325 mg
Tablet, oral [buffered]: 325 mg
Ascriptin Regular Strength: 325 mg [contains aluminum hydroxide, calcium carbonate, magnesium hydroxide]
Buffasal: 325 mg [contains magnesium oxide]
Bufferin: 325 mg [contains calcium carbonate, magnesium carbonate, magnesium oxide]
Bufferin Extra Strength: 500 mg [contains calcium carbonate, magnesium carbonate, magnesium oxide]
Buffinol: 324 mg [sugar free; contains magnesium oxide]
Tri-Buffered Aspirin: 325 mg [contains calcium carbonate, magnesium carbonate, magnesium oxide]
Tablet, chewable, oral: 81 mg
Bayer Aspirin Regimen Children's: 81 mg [cherry flavor]
Bayer Aspirin Regimen Children's: 81 mg [orange flavor]
St Joseph Adult Aspirin: 81 mg
Tablet, delayed release, oral: 81 mg, 325 mg
Aspirin Adult Low Dose: 81 mg
Aspirin Adult Low Strength: 81 mg
Aspirin EC Low Strength: 81 mg
Bayer Aspirin: 325 mg
Bayer Aspirin EC Low Dose: 81 mg
GoodSense Low Dose: 81 mg
Tablet, enteric coated, oral: 81 mg, 325 mg, 650 mg
Aspir-low: 81 mg
Bayer Aspirin Regimen Adult Low Strength: 81 mg
Aspirin: 325 mg
Aspirin Arthritis Strength: 500 mg
Aspirin Low Strength: 81 mg
Halfprin: 81 mg [DSC]
St Joseph Adult Aspirin: 81 mg
Dosing: Adult
Note: Ibuprofen, naproxen, and possibly other nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the cardioprotective effects of aspirin (Capone 2005; Catella-Lawson 2001; MacDonald 2003). Avoid regular or frequent use of NSAIDs in patients receiving aspirin for cardiovascular protection. An ER formulation exists (162.5 mg capsule); however, it should not be used in situations when a rapid onset of action is necessary (eg, ST-elevation myocardial infarction [MI]); dosing information provided is based on the IR formulations.
Analgesic and antipyretic: Immediate release:
Oral: 325 mg to 1 g every 4 to 6 hours as needed; usual maximum daily dose: 4 g/day (Abramson 2019). Note: If patient cannot take orally, rectal suppositories (300 or 600 mg) are available.
Anti-inflammatory for arthritis associated with rheumatic disease: Immediate release:
Oral: 4 to 8 g/day in 4 to 5 divided doses as needed; titrate dose based on response and tolerability. Continue treatment until symptoms resolve (typically 1 to 2 weeks, but potentially up to 8 weeks). Use of aspirin at these high doses (4 to 8 g/day) may be limited by adverse effects (tinnitus, diminished auditory acuity, GI intolerance) (Abramson 2019; Carapetis 2012; Steer 2019).
Atherosclerotic cardiovascular disease:
Acute coronary syndrome: Note: For rapid onset, non-enteric-coated IR tablet(s) should be chewed and swallowed upon identification of clinical and ECG findings suggesting an acute coronary syndrome. Enteric-coated aspirin is not preferred since onset of action may be delayed. If it is the only product available, enteric-coated IR tablet(s) may be chewed and swallowed (ACCP [Eikelboom 2012]; Sai 2011). For maintenance therapy, any oral formulation is acceptable for use.
Non–ST-elevation acute coronary syndromes or ST-elevation myocardial infarction: Note: For initial therapy, administer aspirin in combination with an IV anticoagulant and a P2Y12 inhibitor (ACC/AHA [Amsterdam 2014]; ACCF/AHA [O'Gara 2013]).
Initial:
Immediate release (non-enteric-coated):
Oral: 162 to 325 mg administered once (chew and swallow) at the time of diagnosis (ACC/AHA [Amsterdam 2014]; ACCF/AHA [O'Gara 2013]).
Rectal (alternative route): 600 mg administered once at the time of diagnosis if an IR oral formulation is unavailable or oral route is not feasible (Maalouf 2009).
Maintenance (secondary prevention): Immediate release:
Oral: 75 to 100 mg once daily (ACC/AHA [Levine 2016]; Hennekens 2019; Mehta 2001).
Duration of therapy: Aspirin plus a P2Y12 inhibitor (dual antiplatelet therapy [DAPT]) should be continued for ≥12 months unless bleeding risk is a concern. If there have been no major bleeding complications after 12 months, continuation of DAPT may be considered. Re-evaluate the need for DAPT at regular intervals based on bleeding and thrombotic risks. When DAPT is complete, discontinue the P2Y12 inhibitor and continue aspirin indefinitely (ACC/AHA [Levine 2016]; Bonaca 2015; Cutlip 2019a; Lincoff 2019; Mauri 2014; Mehta 2001; Wallentin 2009; Wiviott 2007; Yusuf 2001).
Percutaneous coronary intervention for stable ischemic heart disease (off-label use):
Initial: Note: For initial therapy, non-enteric-coated IR tablet(s) should be administered. Enteric-coated aspirin is not preferred since onset of action is delayed. For patients who receive a coronary stent during percutaneous coronary intervention, administer aspirin in combination with an IV anticoagulant and clopidogrel (ACCF/AHA/SCAI [Levine 2011]).
Patients chronically taking aspirin ≥325 mg/day prior to percutaneous coronary intervention: Immediate release (non-enteric-coated):
Oral: 75 to 100 mg prior to the procedure (Cutlip 2020); some experts recommend doses up to 325 mg (ACCF/AHA/SCAI [Levine 2011]).
Patients not chronically taking aspirin or chronically taking aspirin <325 mg/day prior to percutaneous coronary intervention: Immediate release (non-enteric-coated):
Oral: 300 to 325 mg given ≥2 hours (preferably 24 hours) before the procedure (ACCF/AHA/SCAI [Levine 2011]; Cutlip 2020).
Maintenance: Immediate release:
Oral: 75 to 100 mg once daily in combination with clopidogrel (DAPT); upon completion of the recommended duration of DAPT, continue aspirin indefinitely (ACC/AHA [Levine 2016]; Cutlip 2019c). Refer to Clopidogrel monograph for information on duration of DAPT.
Atherosclerotic cardiovascular disease, primary prevention (off-label use): Note: Use should be a shared decision between health care professionals and patients after weighing the cardiovascular disease risk versus benefits (ACC/AHA [Arnett 2019]).
Immediate release:
Oral: 75 to 100 mg once daily (ACC/AHA [Arnett 2019]).
Atherosclerotic cardiovascular disease, secondary prevention:
Carotid artery atherosclerosis, asymptomatic or symptomatic (off-label use): Immediate release:
Oral: 75 to 325 mg once daily (ACCP [Alonso-Coello 2012]; Walker 1995).
Coronary artery bypass graft surgery: Immediate release:
Oral: 75 to 81 mg once daily beginning preoperatively; continue indefinitely following surgery (AHA [Kulik 2015]; Aranki 2019).
Off-pump coronary artery bypass graft surgery: Following surgery, consider adding clopidogrel in combination with aspirin for 12 months then discontinue clopidogrel and continue aspirin indefinitely (AHA [Kulik 2015]).
Patients with acute coronary syndrome followed by coronary artery bypass graft surgery: Administer aspirin in combination with a P2Y12 inhibitor for 12 months then continue aspirin indefinitely (AHA [Kulik 2015]). Some experts do not use P2Y12 inhibitors postoperatively in these patients (Aranki 2019).
Ischemic stroke/Transient ischemic attack:
Cardioembolic stroke (alternative agent): Note:
Oral anticoagulation is preferred. For patients who cannot take an oral anticoagulant, may consider aspirin as an alternative (AHA/ASA [Kernan 2014]).
Immediate release:
Oral: 75 to 100 mg once daily (AHA/ASA [Kernan 2014]).
Intracranial atherosclerosis (50% to 99% stenosis of a major intracranial artery), secondary prevention: Immediate release:
Oral: 325 mg once daily; for patients with recent stroke or transient ischemic attack (within 30 days) may consider short-term use of clopidogrel (for 21 or 90 days depending on degree of stenosis) in combination with aspirin (AHA/ASA [Kernan 2014]; Chimowitz 2011) followed by single-agent antiplatelet therapy with aspirin, clopidogrel, or aspirin/ER dipyridamole indefinitely (ACCP [Lansberg 2012]; AHA/ASA [Kernan 2014]; Cucchiara 2019).
Noncardioembolic ischemic stroke/transient ischemic attack: Note: For patients with a minor stroke (National Institutes of Health Stroke Scale score ≤3) or high-risk transient ischemic attack (ABCD/ of 81 mg tablet):
Analgesic:
Oral, rectal:
Note:Infants, Children, and Adolescents weighing <50 kg: Limited data available: 10 to 15 mg/kg/dose every 4 to 6 hours; maximum daily dose: 90 mg/kg/day or 4,000 mg/day whichever is less (APS 2016)
Children ≥12 years and Adolescents weighing ≥50 kg: 325 to 650 mg every 4 to 6 hours; maximum daily dose: 4,000 mg/day
Anti-inflammatory: Limited data available: Infants, Children, and Adolescents:
Oral: Initial: 60 to 90 mg/kg/
dayMaintenance: 80 to 100 mg/kg/day divided every 6 to 8 hours; monitor serum concentrations (Levy 1978)
Antiplatelet effects: Limited data available: Infants, Children, and Adolescents:
Oral: Adequate pediatric studies have not been performed; pediatric dosage is derived from adult studies. Usual adult maximum daily dose for antiplatelet effects is 325 mg/day.
Acute ischemic stroke (AIS):
Noncardioembolic: 1 to 5 mg/kg/dose once daily for ≥2 years; patients with recurrent AIS or TIAs should be transitioned to clopidogrel, LMWH, or warfarin (ACCP [Monagle 2012])
Secondary to Moyamoya and non-Moyamoya vasculopathy: 1 to 5 mg/kg/dose once daily; Note: In non-Moyamoya vasculopathy, continue aspirin for 3 months, with subsequent use guided by repeat cerebrovascular imaging (ACCP [Monagle 2012]).
Prosthetic heart valve:
Bioprosthetic aortic valve (with normal sinus rhythm): 1 to 5 mg/kg/dose once daily for 3 months (AHA [Giglia 2013]; ACCP [Guyatt 2012]; ACCP [Monagle 2012])
Mechanical aortic and/or mitral valve: 1 to 5 mg/kg/dose once daily combined with vitamin K antagonist (eg, warfarin) is recommended as first-line antithrombotic therapy (ACCP [Guyatt 2012]; ACCP [Monagle 2012]). Alternative regimens: 6 to 20 mg/kg/dose once daily in combination with dipyridamole (Bradley 1985; el Makhlouf 1987; LeBlanc 1993; Serra 1987; Solymar 1991)
Shunts: Blalock-Taussig; Glenn; postoperative; primary prophylaxis: 1 to 5 mg/kg/dose once daily (ACCP [Monagle 2012]; AHA [Giglia 2013])
Norwood, Fontan surgery, postoperative; primary prophylaxis: 1 to 5 mg/kg/dose once daily (ACCP [Monagle 2012]; AHA [Giglia 2013])
Transcatheter Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) devices, postprocedure prophylaxis: 1 to 5 mg/kg/dose once daily starting one to several days prior to implantation and continued for at least 6 months. For older children and adolescents, after device closure of ASD, an additional anticoagulant may be given with aspirin for 3 to 6 months, but the aspirin should continue for at least 6 months (AHA [Giglia 2013]).
Ventricular assist device (VAD) placement: 1 to 5 mg/kg/dose once daily initiated within 72 hours of VAD placement; should be used with heparin (initiated between 8 to 48 hours following implantation) and with or without dipyridamole (ACCP [Monagle 2012])
Kawasaki disease: Limited data available; optimal dose not established: Note: Patients with Kawasaki disease and presenting with influenza or viral illness should not receive aspirin; acetaminophen is suggested as an antipyretic in these patients and an alternate antiplatelet agent suggested for a minimum of 2 weeks (AHA [McCrindle 2017]).
Infants, Children, and Adolescents:
Oral:
Initial therapy (acute phase): Recommended dosing regimens vary. Use in combination with IV immune globulin (within first 10 days of symptom onset) and corticosteroids in some cases.
High dose: 80 to 100 mg/kg/day divided every 6 hours for up to 14 days until fever resolves for at least 48 to 72 hours (AAP [Red Book 2015]; ACCP [Monagle 2012]; AHA [Giglia 2013]; AHA [McCrindle 2017])
Moderate dose: 30 to 50 mg/kg/day divided every 6 hours for up to 14 days until fever resolves for at least 48 to 72 hours (AHA [McCrindle 2017])
Subsequent therapy (low-dose; antiplatelet effects): 3 to 5 mg/kg/day once daily; reported dosing range: 1 to 5 mg/kg/day; initiate after fever resolves for at least 48 to 72 hours (or after 14 days). In patients without coronary artery abnormalities, administer the lower dose for 6 to 8 weeks. In patients with coronary artery abnormalities, low-dose aspirin should be continued indefinitely (in addition to therapy with warfarin) (AAP [Red Book 2015]; ACCP [Monagle 2012]; AHA [Giglia 2013]; AHA [McCrindle 2017]).
Rheumatic fever: Limited data available: Infants, Children, and Adolescents:
Oral: Initial: 100 mg/kg/
daydaydayMigratory polyarthritis, with carditis without cardiomegaly or congestive heart failure: Initial: 100 mg/kg/day in 4 divided doses for 3 to 5 days, followed by 75 mg/kg/day in 4 divided doses for 4 weeks
Carditis and cardiomegaly or congestive heart failure: At the beginning of the tapering of the prednisone dose, aspirin should be started at 75 mg/kg/day in 4 divided doses for 6 weeks
Hypertension
The initial dose of Atenolol is 50 mg given as one tablet a day either alone or added to diuretic therapy. The full effect of this dose will usually be seen within one to two weeks. If an optimal response is not achieved, the dosage should be increased to Atenolol 100 mg given as one tablet a day. Increasing the dosage beyond 100 mg a day is unlikely to produce any further benefit.
Atenolol may be used alone or concomitantly with other antihypertensive agents including thiazide-type diuretics, hydralazine, prazosin, and alpha-methyldopa.
Angina Pectoris
The initial dose of Atenolol is 50 mg given as one tablet a day. If an optimal response is not achieved within one week, the dosage should be increased to Atenolol 100 mg given as one tablet a day. Some patients may require a dosage of 200 mg once a day for optimal effect.
Twenty-four hour control with once daily dosing is achieved by giving doses larger than necessary to achieve an immediate maximum effect. The maximum early effect on exercise tolerance occurs with doses of 50 to 100 mg, but at these doses the effect at 24 hours is attenuated, averaging about 50% to 75% of that observed with once a day oral doses of 200 mg.
Acute Myocardial Infarction
In patients with definite or suspected acute myocardial infarction, treatment with Atenolol I.V. Injection should be initiated as soon as possible after the patient's arrival in the hospital and after eligibility is established. Such treatment should be initiated in a coronary care or similar unit immediately after the patient's hemodynamic condition has stabilized. Treatment should begin with the intravenous administration of 5 mg Atenolol over 5 minutes followed by another 5 mg intravenous injection 10 minutes later. Atenolol I.V. Injection should be administered under carefully controlled conditions including monitoring of blood pressure, heart rate, and electrocardiogram. Dilutions of Atenolol I.V. Injection in Dextrose Injection USP, Sodium Chloride Injection USP, or Sodium Chloride and Dextrose Injection may be used. These admixtures are stable for 48 hours if they are not used immediately.
In patients who tolerate the full intravenous dose (10 mg), Atenolol Tablets 50 mg should be initiated 10 minutes after the last intravenous dose followed by another 50 mg oral dose 12 hours later. Thereafter, Atenolol can be given orally either 100 mg once daily or 50 mg twice a day for a further 6-9 days or until discharge from the hospital. If bradycardia or hypotension requiring treatment or any other untoward effects occur, Atenolol should be discontinued.
Data from other beta blocker trials suggest that if there is any question concerning the use of IV beta blocker or clinical estimate that there is a contraindication, the IV beta blocker may be eliminated and patients fulfilling the safety criteria may be given Atenolol Tablets 50 mg twice daily or 100 mg once a day for at least seven days (if the IV dosing is excluded).
Although the demonstration of efficacy of Atenolol is based entirely on data from the first seven postinfarction days, data from other beta blocker trials suggest that treatment with beta blockers that are effective in the postinfarction setting may be continued for one to three years if there are no contraindications.
Atenolol is an additional treatment to standard coronary care unit therapy.
Elderly Patients Or Patients With Renal Impairment
Atenolol is excreted by the kidneys; consequently dosage should be adjusted in cases of severe impairment of renal function. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Evaluation of patients with hypertension or myocardial infarction should always include assessment of renal function. Atenolol excretion would be expected to decrease with advancing age.
No significant accumulation of Atenolol occurs until creatinine clearance falls below 35 mL/min/1.73m². Accumulation of atenolol and prolongation of its half-life were studied in subjects with creatinine clearance between 5 and 105 mL/min. Peak plasma levels were significantly increased in subjects with creatinine clearances below 30 mL/min.
The following maximum oral dosages are recommended for elderly, renally-impaired patients and for patients with renal impairment due to other causes:
Creatinine Clearance (mL/min/1.73m²) | Atenolol Elimination Half-Life (h) | Maximum Dosage |
15-35 | 16-27 | 50 mg daily |
< 15 | > 27 | 25 mg daily |
Some renally-impaired or elderly patients being treated for hypertension may require a lower starting dose of Atenolol: 25 mg given as one tablet a day. If this 25 mg dose is used, assessment of efficacy must be made carefully. This should include measurement of blood pressure just prior to the next dose (“trough” blood pressure) to ensure that the treatment effect is present for a full 24 hours.
Although a similar dosage reduction may be considered for elderly and/or renally-impaired patients being treated for indications other than hypertension, data are not available for these patient populations.
Patients on hemodialysis should be given 25 mg or 50 mg after each dialysis; this should be done under hospital supervision as marked falls in blood pressure can occur.
Cessation Of Therapy In Patients With Angina Pectoris
If withdrawal of Atenolol therapy is planned, it should be achieved gradually and patients should be carefully observed and advised to limit physical activity to a minimum.
How supplied
Atenolol Tablets
Tablets of 25 mg atenolol, NDC 0310-0107 (round, flat, uncoated white tablets identified with “T” debossed on one side and 107 debossed on the other side) are supplied in bottles of 100 tablets.
Tablets of 50 mg atenolol, NDC 0310-0105 (round, flat, uncoated white tablets identified with “Atenolol” debossed on one side and 105 debossed on the other side, bisected) are supplied in bottles of 100 tablets.
Tablets of 100 mg atenolol, NDC 0310-0101 (round, flat, uncoated white tablets identified with “Atenolol” debossed on one side and 101 debossed on the other side) are supplied in bottles of 100 tablets.
Store at controlled room temperature, 20-25°C (68-77°F). Dispense in well-closed, light-resistant containers.
Distributed by: AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850. Revised: Oct 2012
Always take Atorvastatin exactly as prescribed.
The following instructions may apply only if the doctor has not prescribed a different regimen for administering Atorvastatin. Observe the instructions closely, otherwise the medicine cannot be effective.
Before the start of treatment, the physician will prescribe a low-cholesterol diet and should be strictly observe throughout the treatment with Atorvastatin.
Usual Starting Dose: Adults and Children ≥10 years: 10 mg once daily. The physician will determine further doses to achieve the desired blood cholesterol levels. Thereafter, the dose will be adjusted individually every ≤4 weeks frequently. Maximum Daily Dose: 80 mg for adults and 20 mg once daily for children.
Elevated Blood Cholesterol Levels (Hypercholesterolemia) or Concurrent Elevation of Blood Cholesterol and Triglyceride Levels (Mixed Hyperlipidemia): In the majority of patients, the effective daily dose of atorvastatin is 20 mg. The effect of treatment can be seen after 2 weeks; it is usually greatest after 4 weeks. This therapeutic effect is then maintained with long-term administration of Atorvastatin.
Hereditary Increase of Blood Cholesterol Levels (Familial Hypercholesterolemia): Heterozygous Familial Hypercholesterolemia: Starting Dose: 10 mg once daily. The dose should be determined for each individual patient. The physician will increases the dose up to 80 mg daily every 4 weeks.
Homozygous Familial Hypercholesterolemia: Adults: In the majority of patients (taking atorvastatin 80 mg daily), blood cholesterol levels (LDL cholesterol) decreased by 17-31% in clinical trials.
Patients with Renal Insufficiency and the Elderly:
In clinical trials, it was ascertained that no dosage adjustment is necessary in elderly patients.
Administration: Take Atorvastatin with some liquid at any time of the day and regardless of food intake.
Atorvastatin are designated for long-term administration.
Missed Dose: Do not take a double dose, but only the normal dose.
Hypertension
Adult Hypertension
The usual starting dose of Losartan potassium is 50 mg once daily. The dosage can be increased to a maximum dose of 100 mg once daily as needed to control blood pressure. A starting dose of 25 mg is recommended for patients with possible intravascular depletion (e.g., on diuretic therapy).
Pediatric Hypertension
The usual recommended starting dose is 0.7 mg per kg once daily (up to 50 mg total) administered as a tablet or a suspension. Dosage should be adjusted according to blood pressure response. Doses above 1.4 mg per kg (or in excess of 100 mg) daily have not been studied in pediatric patients.
Losartan potassium is not recommended in pediatric patients less than 6 years of age or in pediatric patients with estimated glomerular filtration rate less than 30 mL/min/1.73 m².
Hypertensive Patients With Left Ventricular Hypertrophy
The usual starting dose is 50 mg of Losartan potassium once daily. Hydrochlorothiazide 12.5 mg daily should be added and/or the dose of Losartan potassium should be increased to 100 mg once daily followed by an increase in hydrochlorothiazide to 25 mg once daily based on blood pressure response.
Nephropathy In Type 2 Diabetic Patients
The usual starting dose is 50 mg once daily. The dose should be increased to 100 mg once daily based on blood pressure response.
Dosage Modifications In Patients With Hepatic Impairment
In patients with mild-to-moderate hepatic impairment the recommended starting dose of Losartan potassium is 25 mg once daily. Losartan potassium has not been studied in patients with severe hepatic impairment.
Preparation Of Suspension (for 200 mL of a 2.5 mg/mL suspension)
Add 10 mL of Purified Water USP to an 8 ounce (240 mL) amber polyethylene terephthalate (PET) bottle containing ten 50 mg Losartan potassium tablets. Immediately shake for at least 2 minutes. Let the concentrate stand for 1 hour and then shake for 1 minute to disperse the tablet contents. Separately prepare a 50/50 volumetric mixture of Ora-Plus™ and Ora-Sweet SF™. Add 190 mL of the 50/50 Ora-Plus™/Ora- Sweet SF™ mixture to the tablet and water slurry in the PET bottle and shake for 1 minute to disperse the ingredients. The suspension should be refrigerated at 2-8°C (36-46°F) and can be stored for up to 4 weeks. Shake the suspension prior to each use and return promptly to the refrigerator.
How supplied
Dosage Forms And Strengths
- Losartan potassium, 25 mg, are white, oval, film-coated tablets with code 951 on one side.
- Losartan potassium, 50 mg, are white, oval, film-coated tablets with code 952 on one side and scored on the other.
- Losartan potassium, 100 mg, are white, teardrop-shaped, film-coated tablets with code 960 on one side.
Storage And Handling
Losartan potassium is a white film-coated tablet supplied as follows:
Losartan potassium | Shape | Engraving (reverse) | NDC 0006-xxxx-xx | |
Bottle/30 | Bottle/90 | |||
25 mg | oval | 951 | n/a | 0951-54 |
50 mg | oval | 952 (scored) | 0952-31 | 0952-54 |
100 mg | teardrop | 960 | 0960-31 | 0960-54 |
Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Keep container tightly closed. Protect from light.
Manufactured for: Merck Sharp & Dohme Corp., a subsidiary of MERCK & CO., INC., Whitehouse Station, NJ 08889, USA. Revised: Dec 2015
See also:
What is the most important information I should know about Aspirin?
This medicine is contraindicated in the following situations:
hypersensitivity to acetylsalicylic acid or any of the excipients history of asthma provoked by the administration of salicylates or substances of similar activity, including anti-inflammatory drugs, PUD evolving any constitutional or acquired bleeding disorder, risk of bleeding, severe hepatic, severe renal insufficiency, uncontrolled severe heart failure, pregnancy beyond 24 weeks of gestation (5 months of age) at doses above 100 mg per day: beyond 24 weeks of gestation (5 months old), all inhibitors of prostaglandin synthesis may explain the fetus: a cardiopulmonary toxicity (ductus arteriosus and pulmonary hypertension), renal dysfunction may progress to renal failure associated with oligohydramniosIn late pregnancy, the mother and the newborn may have: a prolonged bleeding time due to an anti-platelet aggregation may occur even after administration of low doses of medication inhibiting uterine contractions leading to a delay term or prolonged laborConsequently, aspirin is not recommended cons beyond 24 weeks of gestation (5 months old), in combination with methotrexate in doses above 20 mg / week, in combination with oral anticoagulants for anti-inflammatory doses of acetylsalicylic acid (> 1 g per dose and / or ? 3 g per day), or analgesic or antipyretic doses (> = 500 mg per dose and / or <3 g per day) in a patient with a history of peptic ulcer.
Due to the presence of lactose, the drug is contraindicated for congenital galactosemia, malabsorption of glucose and galactose deficiency or lactase.
The use of this drug is not recommended during lactation: acetylsalicylic acid passing into breast milk, this medicine is not recommended during breastfeeding.
Concomitant use of acetylsalicylic acid, with anti-inflammatory doses (> 1 g per dose and / or ? 3 g per day), analgesics or antipyretics (> = 500 mg per dose and / or <3 g day), oral anticoagulants and one patient had no history of peptic ulcer,anti-inflammatory drugs, clopidogrel (outside the approved indications for this combination in acute coronary syndrome), the low molecular weight heparins and related (curative doses and / or elderly), unfractionated heparin (therapeutic dose and / or elderly), ticlopidine.
See also:
What is the most important information I should know about Atenolol?
Do not stop taking atenolol without first talking to your doctor. Stopping suddenly may make your condition worse.
If you need to have any type of surgery, you may need to temporarily stop using atenolol. Be sure the surgeon knows ahead of time that you are using atenolol.
Atenolol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking atenolol.
Atenolol is only part of a complete program of treatment for hypertension that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely if you are being treated for hypertension.
If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.
Store atenolol at room temperature away from moisture and heat.
See also:
What is the most important information I should know about Atorvastatin?
Active liver disease, which may include unexplained persistent elevations in Hepatic Transaminase Levels
Hypersensitivity to any Component of this Medication
Pregnancy
Women who are pregnant or may become pregnant. Atorvastatin calcium may cause fetal harm when administered to a pregnant woman. Serum cholesterol and triglycerides increase during normal pregnancy, and cholesterol or cholesterol derivatives are essential for fetal development. Atherosclerosis is a chronic process and discontinuation of lipid-lowering drugs during pregnancy should have little impact on the outcome of long-term therapy of primary hypercholesterolemia. There are no adequate and well-controlled studies of Atorvastatin calcium use during pregnancy; however in rare reports, congenital anomalies were observed following intrauterine exposure to statins. In rat and rabbit animal reproduction studies, Atorvastatin revealed no evidence of teratogenicity. Atorvastatin CALCIUM SHOULD BE ADMINISTERED TO WOMEN OF CHILDBEARING AGE ONLY WHEN SUCH PATIENTS ARE HIGHLY UNLIKELY TO CONCEIVE AND HAVE BEEN INFORMED OF THE POTENTIAL HAZARDS. If the patient becomes pregnant while taking this drug, Atorvastatin calcium should be discontinued immediately and the patient apprised of the potential hazard to the fetus.
Nursing Mothers
It is not known whether Atorvastatin is excreted into human milk; however a small amount of another drug in this class does pass into breast milk. Because statins have the potential for serious adverse reactions in nursing infants, women who require Atorvastatin calcium treatment should not breastfeed their infants.
See also:
What is the most important information I should know about Losartan potassium?
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Losartan potassium, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to Losartan potassium or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Use Aspirin as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take Aspirin by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
- Take Aspirin with a full glass of water (8 oz/240 mL). Do not lie down for 30 minutes after taking Aspirin.
- Swallow Aspirin whole. Do not break, crush, or chew before swallowing.
- Use Aspirin exactly as directed on the package, unless instructed differently by your doctor. If you are taking Aspirin without a prescription, follow any warnings and precautions on the label.
- If you miss a dose of Aspirin and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Aspirin.
Use Atenolol as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Atenolol may be taken with or without food.
- Take Atenolol on a regular schedule to receive the most benefit from it. Taking Atenolol at the same time each day will help you remember to take it.
- Continue to take Atenolol even if you feel well. Do not miss any doses.
- Do not suddenly stop taking Atenolol without first checking with your doctor. Some conditions may become worse if you suddenly stop taking Atenolol.
- If you miss a dose of Atenolol, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Atenolol.
Use atorvastatin as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with atorvastatin. Talk to your pharmacist if you have questions about this information.
- Take atorvastatin by mouth with or without food.
- Swallow atorvastatin whole. Do not break, crush, or chew before swallowing.
- Taking atorvastatin at the same time each day will help you remember to take it.
- Eating grapefruit or drinking grapefruit juice may increase the amount of atorvastatin in your blood, which may increase your risk for serious side effects. The risk may be greater with large amounts of grapefruit or grapefruit juice. Avoid large amounts of grapefruit or grapefruit juice (eg, more than 1 quart daily). Talk with your doctor or pharmacist if you have questions about including grapefruit or grapefruit juice in your diet while you are taking atorvastatin.
- Continue to take atorvastatin even if you feel well. Do not miss any doses.
- If you miss a dose of atorvastatin, take it as soon as possible if you remember within 12 hours of the missed dose. If it is more than 12 hours since the missed dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use atorvastatin.
Use Losartan potassium as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Losartan potassium. Talk to your pharmacist if you have questions about this information.
- Take Losartan potassium by mouth with or without food.
- If you cannot swallow tablets, ask your doctor or pharmacist about preparing a suspension of Losartan potassium.
- Take Losartan potassium on a regular schedule to get the most benefit from it. Taking Losartan potassium at the same time each day will help you remember to take it.
- Continue to take Losartan potassium even if you feel well. Do not miss any doses.
- If you miss a dose of Losartan potassium, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Losartan potassium.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Aspirin is used to reduce fever and relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches. It may also be used to reduce pain and swelling in conditions such as arthritis. Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking a certain natural substance in your body to reduce pain and swelling. Consult your doctor before giving this drug to a child younger than 12 years. It is very important to keep this and all medication out of the reach of children. Aspirin is a common cause of poisoning in children.
Your doctor may direct you to take a low dose of aspirin to prevent blood clots. This effect reduces the risk of stroke and heart attack. If you have recently had surgery on clogged arteries (such as bypass surgery, carotid endarterectomy, coronary stent), your doctor may direct you to use aspirin in low doses as a "blood thinner" to prevent blood clots. Aspirin prevents blood clots by stopping certain blood cells (platelets) from clumping together.
How to use Aspirin
If you are taking this medication for self-treatment, follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist. If your doctor has directed you to take this medication, take it exactly as prescribed.
Chew the tablet thoroughly before swallowing. This medication may also be crushed or swallowed whole. If stomach upset occurs while you are taking this medication, you may take it with food or milk.
The dosage and length of treatment are based on your medical condition and response to treatment. Read the product label to find recommendations on how many tablets you can take in a 24-hour period and how long you may self-treat before seeking medical advice. Do not take more medication or take it for longer than recommended unless directed by your doctor. Use the smallest effective dose. Consult your doctor or pharmacist if you have any questions.
If you are taking this medication for self-treatment of headache, seek immediate medical attention if you also have slurred speech, weakness on one side of the body, or sudden vision changes. Before using this drug, consult a doctor or pharmacist if you have headaches caused by head injury, coughing, or bending, or if you have a headache with persistent/severe vomiting, fever, and stiff neck. These may be signs of serious medical conditions.
If you are taking this medication as needed (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medicine may not work as well.
You should not take this medication for self-treatment of pain for longer than 10 days. You should not use this drug to self-treat a fever that lasts longer than 3 days. In these cases, consult a doctor because you may have a more serious condition. Tell your doctor promptly if you develop ringing in the ears or difficulty hearing.
If your condition persists or worsens (such as new or unusual symptoms, redness/swelling of the painful area, pain/fever that does not go away or gets worse) or if you think you may have a serious medical problem, tell your doctor promptly.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Use: Labeled Indications
Acute MI: Management of hemodynamically stable patients with definite or suspected acute MI to reduce cardiovascular mortality.
Guideline recommendations: According to the American College of Cardiology Foundation/American Heart Association (ACC/AHA) guidelines for the management of ST-elevation myocardial infarction (STEMI) and the ACC/AHA guidelines for the management of non-ST-elevation ACS (NSTE-ACS), oral beta-blockers should be initiated within the first 24 hours unless the patient has signs of heart failure, evidence of a low-output state, an increased risk for cardiogenic shock, or other contraindications. However, recommendations do not specify any particular beta-blocking agent for optimal treatment of NSTE-ACS. Thus, clinicians must use practical experience to determine proper therapy in managing patients (ACC/AHA [Amsterdam 2014]; ACC/AHA [O'Gara 2013]).
Angina pectoris caused by coronary atherosclerosis: Long-term management of patients with angina pectoris.
Hypertension: Management of hypertension. Note: Beta-blockers are not recommended as first-line therapy (ACC/AHA [Whelton 2017]).
Off Label Uses
Atrial fibrillation (rate control)
Based on the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guideline for the management of patients with atrial fibrillation (AF), the use of beta-blockers, including atenolol, for ventricular rate control in patients with paroxysmal, persistent, or permanent AF is effective and recommended for this condition.
Supraventricular tachycardia (AV nodal reentrant tachycardia [AVNRT], AV reentrant tachycardia [AVRT], atrial flutter, focal atrial tachycardia [AT])
Based on the American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines for the management of patients with supraventricular arrhythmias, the use of an oral beta-blocker, including atenolol, is an effective and recommended treatment option for the ongoing management of a variety of symptomatic supraventricular tachycardias (AVNRT, AVRT, focal AT) without pre-excitation in patients who are not candidates for, or prefer not to undergo catheter ablation.
Oral beta-blockers, including atenolol, may also be useful for the ongoing management (acute rate control) in hemodynamically stable patients with atrial flutter.
Thyrotoxicosis
Based on the 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis, beta-blockers, including atenolol, are effective and recommended in the treatment of symptomatic thyrotoxicosis. Beta-blockers should also be considered in asymptomatic patients who are at increased risk of complications due to worsening hyperthyroidism.
Based on the American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guideline for management of patients with ventricular arrhythmias and prevention of sudden cardiac death, beta-blockers are effective for control of ventricular arrhythmias and ventricular premature beats.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Use: Labeled Indications
Heterozygous familial hypercholesterolemia: To reduce elevated total cholesterol (total-C), LDL cholesterol (LDL-C), apolipoprotein B (apo B), and triglyceride levels, and to increase HDL cholesterol in patients with primary hypercholesterolemia.
Heterozygous familial hypercholesterolemia (pediatrics): To reduce total-C, LDL-C, and apo B levels in pediatric patients 10 to 17 years of age with heterozygous familial hypercholesterolemia with LDL-C ≥190 mg/dL, LDL-C ≥160 mg/dL with positive family history of premature cardiovascular disease (CVD), or LDL-C ≥160 mg/dL with 2 or more other CVD risk factors.
Homozygous familial hypercholesterolemia: To reduce total-C and LDL-C in patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) or if such treatments are unavailable.
Prevention of atherosclerotic cardiovascular disease:
Primary prevention of atherosclerotic cardiovascular disease (ASCVD): To reduce the risk of myocardial infarction (MI), stroke, revascularization procedures, and angina in adult patients without a history of coronary heart disease (CHD) but who have multiple CHD risk factors.
Secondary prevention in patients with established ASCVD: To reduce the risk of MI, stroke, revascularization procedures, and angina in patients with a history of CHD.
Off Label Uses
Transplantation, post heart or post kidney
Based on the 2010 International Society of Heart and Lung Transplantation guidelines for the care of heart transplant recipients, atorvastatin is effective and recommended following heart transplant, regardless of cholesterol levels, to reduce cardiac allograft vasculopathy and improve long-term outcomes.
Based on the 2013 Kidney Disease: Improving Global Outcomes clinical practice guideline for lipid management in chronic kidney disease, atorvastatin is suggested following kidney transplant to reduce cardiovascular events (eg, myocardial infarction, stroke, cardiovascular death).
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.
How to use Losartan potassium
Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.
There are many brands and forms of acetaminophen available. Read the dosing instructions carefully for each product because the amount of acetaminophen may be different between products. Do not take more acetaminophen than recommended.
If you are giving acetaminophen to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.
For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.
For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.
Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.
Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.
Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.
Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.
See also:
What other drugs will affect Aspirin?
Alcohol: Do not take Aspirin 2 hours before or 1 hour after consuming alcohol. Alcohol can interfere with the controlled release properties of Aspirin.
Renin-angiotensin system (RAS) inhibitors: In patients who are elderly, volume-depleted (including those on diuretic therapy), or who have compromised renal function, coadministration of NSAIDs, including Aspirin, with RAS inhibitors may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving RAS inhibitors and Aspirin.
NSAIDs, including Aspirin may attenuate the antihypertensive effects of RAS inhibitors.
Anticoagulant and antiplatelets: Increased risk of bleeding
Anticonvulsants: Salicylate can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels.
Methotrexate: Salicylate can inhibit renal clearance of methotrexate, leading to bone marrow toxicity, especially in the elderly or renal impaired.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs): The concurrent use of Aspirin with other NSAIDs increases the risk of bleeding and may result in renal impairment.
Ibuprofen can interfere with the anti-platelet effect of low dose aspirin. Patients who use Aspirin and take a single dose of ibuprofen 400 mg should dose the ibuprofen at least 2-4 hours or longer after ingestion of Aspirin. Wait 8 hours after ibuprofen dosing, before giving aspirin, to avoid significant interference.
Nonselective NSAIDs may interfere with the antiplatelet effect of low-dose aspirin.
See also:
What other drugs will affect Atenolol?
Catecholamine-depleting drugs (eg, reserpine) may have an additive effect when given with beta-blocking agents. Patients treated with Atenolol plus a catecholamine depletory should therefore be closely observed for evidence of hypotension and/or marked bradycardia which may produce vertigo, syncope, or postural hypotension.
Calcium channel blockers may also have an additive effect when given with Atenolol.
Disopyramide is a Type I antiarrhythmic drug with potent negative inotropic and chronotropic effects. Disopyramide has been associated with severe bradycardia, asystole and heart failure when administered with beta blockers.
Amiodarone is an antiarrhythmic agent with negative chronotropic properties that may be additive to those seen with beta blockers.
Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. If the two drugs are coadministered, the beta blocker should be withdrawn several days before the gradual withdrawal of clonidine. If replacing clonidine by beta-blocker therapy, the introduction of beta blockers should be delayed for several days after clonidine administration has stopped.
Concomitant use of prostaglandin synthase inhibiting drugs, eg, indomethacin, may decrease the hypotensive effects of beta blockers.
Information on concurrent usage of atenolol and Atenolol is limited. Data from several studies, ie, TIMI-II, ISIS-2, currently do not suggest any clinical interaction between Atenolol and beta blockers in the acute myocardial infarction setting.
While taking beta blockers, patients with a history of anaphylactic reaction to a variety of allergens may have a more severe reaction on repeated challenge, either accidental, diagnostic or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat the allergic reaction.
Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.
See also:
What other drugs will affect Atorvastatin?
The risk of myopathy during treatment with statins is increased with concurrent administration of fibric acid derivatives, lipid-modifying doses of niacin, cyclosporine, or strong CYP 3A4 inhibitors (e.g., clarithromycin, HIV protease inhibitors, and itraconazole).
Strong Inhibitors of CYP 3A4
Atorvastatin is metabolized by cytochrome P450 3A4. Concomitant administration of Atorvastatin with strong inhibitors of CYP 3A4 can lead to increases in plasma concentrations of atorvastatin. The extent of interaction and potentiation of effects depend on the variability of effect on CYP 3A4.
Clarithromycin
Atorvastatin AUC was significantly increased with concomitant administration of Atorvastatin 80 mg with clarithromycin (500 mg twice daily) compared to that of Atorvastatin alone. Therefore, in patients taking clarithromycin, caution should be used when the Atorvastatin dose exceeds 20 mg.
Combination of Protease Inhibitors
Atorvastatin AUC was significantly increased with concomitant administration of Atorvastatin 40 mg with ritonavir plus saquinavir (400 mg twice daily) or Atorvastatin 20 mg with lopinavir plus ritonavir (400 mg + 100 mg twice daily) compared to that of Atorvastatin alone. Therefore, in patients taking HIV protease inhibitors, caution should be used when the Atorvastatin dose exceeds 20 mg.
Itraconazole
Atorvastatin AUC was significantly increased with concomitant administration of Atorvastatin 40 mg and itraconazole 200 mg. Therefore, in patients taking itraconazole, caution should be used when the Atorvastatin dose exceeds 20 mg.
Grapefruit Juice
Contains one or more components that inhibit CYP 3A4 and can increase plasma concentrations of atorvastatin, especially with excessive grapefruit juice consumption ( > 1.2 liters per day).
Cyclosporine
Atorvastatin and atorvastatin-metabolites are substrates of the OATP1B1 transporter. Inhibitors of the OATP1B1 (e.g., cyclosporine) can increase the bioavailability of atorvastatin. Atorvastatin AUC was significantly increased with concomitant administration of Atorvastatin 10 mg and cyclosporine 5.2 mg/kg/day compared to that of Atorvastatin alone. In cases where co-administration of Atorvastatin with cyclosporine is necessary, the dose of Atorvastatin should not exceed 10 mg.
Rifampin or other Inducers of Cytochrome P450 3A4
Concomitant administration of Atorvastatin with inducers of cytochrome P450 3A4 (e.g., efavirenz, rifampin) can lead to variable reductions in plasma concentrations of atorvastatin. Due to the dual interaction mechanism of rifampin, simultaneous co-administration of Atorvastatin with rifampin is recommended, as delayed administration of Atorvastatin after administration of rifampin has been associated with a significant reduction in atorvastatin plasma concentrations.
Digoxin
When multiple doses of Atorvastatin and digoxin were coadministered, steady state plasma digoxin concentrations increased by approximately 20%. Patients taking digoxin should be monitored appropriately.
Oral Contraceptives
Co-administration of Atorvastatin and an oral contraceptive increased AUC values for norethindrone and ethinyl estradiol. These increases should be considered when selecting an oral contraceptive for a woman taking Atorvastatin.
Warfarin
Atorvastatin had no clinically significant effect on prothrombin time when administered to patients receiving chronic warfarin treatment.
See also:
What other drugs will affect Losartan potassium?
Using Losartan potassium with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Lithium
Using Losartan potassium with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Aceclofenac
Acemetacin
Alclofenac
Apazone
Benoxaprofen
Bromfenac
Bufexamac
Carprofen
Celecoxib
Clometacin
Clonixin
Dexketoprofen
Diclofenac
Diflunisal
Dipyrone
Droxicam
Etodolac
Etofenamate
Felbinac
Fenbufen
Fenoprofen
Fentiazac
Floctafenine
Fluconazole
Flufenamic Acid
Flurbiprofen
Ibuprofen
Indomethacin
Indoprofen
Isoxicam
Ketoprofen
Ketorolac
Lornoxicam
Meclofenamate
Mefenamic Acid
Meloxicam
Nabumetone
Naproxen
Niflumic Acid
Nimesulide
Oxaprozin
Oxyphenbutazone
Phenylbutazone
Pirazolac
Piroxicam
Pirprofen
Propyphenazone
Proquazone
Rifampin
Rofecoxib
Sulindac
Suprofen
Tenidap
Tenoxicam
Tiaprofenic Acid
Tolmetin
Valdecoxib
Zomepirac
See also:
What are the possible side effects of Aspirin?
Adverse Reactions
As with all drugs which may affect hemostasis, bleeding is associated with aspirin. Hemorrhage may occur at virtually any site. Risk is dependent on multiple variables including dosage, concurrent use of multiple agents which alter hemostasis, and patient susceptibility. Many adverse effects of aspirin are dose related, and are rare at low dosages. Other serious reactions are idiosyncratic, related to allergy or individual sensitivity. Accurate estimation of frequencies is not possible. The reactions listed below have been reported for aspirin.
Cardiovascular: Cardiac arrhythmia, edema, hypotension, tachycardia
Central nervous system: Agitation, cerebral edema, coma, confusion, dizziness, fatigue, headache, hyperthermia, insomnia, lethargy, nervousness, Reye's syndrome
Dermatologic: Skin rash, urticaria
Endocrine & metabolic: Acidosis, dehydration, hyperglycemia, hyperkalemia, hypernatremia (buffered forms), hypoglycemia (children)
Gastrointestinal: Gastrointestinal ulcer (6% to 31%), duodenal ulcer, dyspepsia, epigastric distress, gastritis, gastrointestinal erosion, heartburn, nausea, stomach pain, vomiting
Genitourinary: Postpartum hemorrhage, prolonged gestation, prolonged labor, proteinuria, stillborn infant
Hematologic & oncologic: Anemia, blood coagulation disorder, disseminated intravascular coagulation, hemolytic anemia, hemorrhage, iron deficiency anemia, prolonged prothrombin time, thrombocytopenia
Hepatic: Hepatitis (reversible), hepatotoxicity, increased serum transaminases
Hypersensitivity: Anaphylaxis, angioedema
Neuromuscular & skeletal: Acetabular bone destruction, rhabdomyolysis, weakness
Otic: Hearing loss, tinnitus
Renal: Increased blood urea nitrogen, increased serum creatinine, interstitial nephritis, renal failure (including cases caused by rhabdomyolysis), renal insufficiency, renal papillary necrosis
Respiratory: Asthma, bronchospasm, dyspnea, hyperventilation, laryngeal edema, noncardiogenic pulmonary edema, respiratory alkalosis, tachypnea
Miscellaneous: Low birth weight
Postmarketing and/or case reports: Anorectal stenosis (suppository), atrial fibrillation (toxicity), cardiac conduction disturbance (toxicity), cerebral infarction (ischemic), cholestatic jaundice, colitis, colonic ulceration, coronary artery vasospasm, delirium, esophageal obstruction, esophagitis (with esophageal ulcer), hematoma (esophageal), macular degeneration (age-related) (Li 2015), periorbital edema, rhinosinusitis
See also:
What are the possible side effects of Atenolol?
Most adverse effects have been mild and transient.
The frequency estimates in the following table were derived from controlled studies in hypertensive patients in which adverse reactions were either volunteered by the patient (US studies) or elicited, eg, by checklist (foreign studies). The reported frequency of elicited adverse effects was higher for both Atenolol and placebo-treated patients than when these reactions were volunteered. Where frequency of adverse effects of Atenolol and placebo is similar, causal relationship to Atenolol is uncertain.
Volunteered (US Studies) | Total - Volunteered and Elicited (Foreign+US Studies) | |||
Atenolol (n=164) % | Placebo (n=206) % | Atenolol (n=399) % | Placebo (n=407) % | |
CARDIOVASCULAR | ||||
Bradycardia | 3 | 0 | 3 | 0 |
Cold Extremities | 0 | 0.5 | 12 | 5 |
Postural Hypotension | 2 | 1 | 4 | 5 |
Leg Pain | 0 | 0.5 | 3 | 1 |
CENTRAL NERVOUS SYSTEM/ NEUROMUSCULAR | ||||
Dizziness | 4 | 1 | 13 | 6 |
Vertigo | 2 | 0.5 | 2 | 0.2 |
Light-headedness | 1 | 0 | 3 | 0.7 |
Tiredness | 0.6 | 0.5 | 26 | 13 |
Fatigue Lethargy | 3 1 | 1 0 | 6 3 | 5 0.7 |
Drowsiness | 0.6 | 0 | 2 | 0.5 |
Depression | 0.6 | 0.5 | 12 | 9 |
Dreaming | 0 | 0 | 3 | 1 |
GASTROINTESTINAL | ||||
Diarrhea | 2 | 0 | 3 | 2 |
Nausea | 4 | 1 | 3 | 1 |
RESPIRATORY | ||||
Wheeziness | 0 | 0 | 3 | 3 |
Dyspnea | 0.6 | 1 | 6 | 4 |
Acute Myocardial Infarction
In a series of investigations in the treatment of acute myocardial infarction, bradycardia and hypotension occurred more commonly, as expected for any beta blocker, in atenololtreated patients than in control patients. However, these usually responded to atropine and/or to withholding further dosage of atenolol. The incidence of heart failure was not increased by atenolol. Inotropic agents were infrequently used. The reported frequency of these and other events occurring during these investigations is given in the following table. In a study of 477 patients, the following adverse events were reported during either intravenous and/or oral atenolol administration:
Conventional Therapy Plus Atenolol (n=244) | Conventional Therapy Alone (n=233) | |
Bradycardia | 43 (18%) | 24 (10%) |
Hypotension | 60 (25%) | 34 (15%) |
Bronchospasm | 3 (1.2%) | 2 (0.9%) |
Heart Failure | 46 (19%) | 56 (24%) |
Heart Block | 11 (4.5%) | 10 (4.3%) |
BBB + Major | ||
Axis Deviation | 16 (6.6%) | 28 (12%) |
Supraventricular Tachycardia | 28 (11.5%) | 45 (19%) |
Atrial Fibrillation | 12 (5%) | 29 (11%) |
Atrial Flutter | 4 (1.6%) | 7 (3%) |
Ventricular Tachycardia | 39 (16%) | 52 (22%) |
Cardiac Reinfarction | 0 (0%) | 6 (2.6%) |
Total Cardiac Arrests | 4 (1.6%) | 16 (6.9%) |
Nonfatal Cardiac Arrests | 4 (1.6%) | 12 (5.1%) |
Deaths | 7 (2.9%) | 16 (6.9%) |
Cardiogenic Shock | 1 (0.4%) | 4 (1.7%) |
Development of Ventricular | ||
Septal Defect | 0 (0%) | 2 (0.9%) |
Development of Mitral | ||
Regurgitation | 0 (0%) | 2 (0.9%) |
Renal Failure | 1 (0.4%) | 0 (0%) |
Pulmonary Emboli | 3 (1.2%) | 0 (0%) |
In the subsequent International Study of Infarct Survival (ISIS-1) including over 16,000 patients of whom 8,037 were randomized to receive Atenolol treatment, the dosage of intravenous and subsequent oral Atenolol was either discontinued or reduced for the following reasons:
Reasons for Reduced Dosage | ||
IV Atenolol Reduced Dose ( < 5 mg)* | Oral Partial Dose | |
Hypotension/Bradycardia | 105 (1.3%) | 1168 (14.5%) |
Cardiogenic Shock | 4 (.04%) | 35 (.44%) |
Reinfarction | 0 (0%) | 5 (.06%) |
Cardiac Arrest | 5 (.06%) | 28 (.34%) |
Heart Block ( > first degree) | 5 (.06%) | 143 (1.7%) |
Cardiac Failure | 1 (.01%) | 233 (2.9%) |
Arrhythmias | 3 (.04%) | 22 (.27%) |
Bronchospasm | 1 (.01%) | 50 (.62%) |
*Full dosage was 10 mg and some patients received less than 10 mg but more than 5 mg. |
During postmarketing experience with Atenolol, the following have been reported in temporal relationship to the use of the drug: elevated liver enzymes and/or bilirubin, hallucinations, headache, impotence, Peyronie's disease, postural hypotension which may be associated with syncope, psoriasiform rash or exacerbation of psoriasis, psychoses, purpura, reversible alopecia, thrombocytopenia, visual disturbance, sick sinus syndrome, and dry mouth. Atenolol, like other beta blockers, has been associated with the development of antinuclear antibodies (ANA), lupus syndrome, and Raynaud's phenomenon.
Potential Adverse Effects
In addition, a variety of adverse effects have been reported with other beta-adrenergic blocking agents, and may be considered potential adverse effects of Atenolol.
Hematologic: Agranulocytosis.
Allergic: Fever, combined with aching and sore throat, laryngospasm, and respiratory distress.
Central Nervous System: Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation of time and place; short-term memory loss; emotional lability with slightly clouded sensorium; and, decreased performance on neuropsychometrics.
Gastrointestinal: Mesenteric arterial thrombosis, ischemic colitis.
Other: Erythematous rash.
Miscellaneous: There have been reports of skin rashes and/or dry eyes associated with the use of beta-adrenergic blocking drugs. The reported incidence is small, and in most cases, the symptoms have cleared when treatment was withdrawn. Discontinuance of the drug should be considered if any such reaction is not otherwise explicable. Patients should be closely monitored following cessation of therapy.
The oculomucocutaneous syndrome associated with the beta blocker practolol has not been reported with Atenolol. Furthermore, a number of patients who had previously demonstrated established practolol reactions were transferred to Atenolol therapy with subsequent resolution or quiescence of the reaction.
See also:
What are the possible side effects of Atorvastatin?
The following serious adverse reactions are discussed in greater detail in other sections of the label:
Rhabdomyolysis and myopathy
Liver enzyme abnormalities
Clinical Trial Adverse Experiences
Because clinical trials are conducted under widely varying conditions, the adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
In the Atorvastatin placebo-controlled clinical trial database of 16,066 patients (8755 Atorvastatin vs. 7311 placebo; age range 10–93 years, 39% women, 91% Caucasians, 3% Blacks, 2% Asians, 4% other) with a median treatment duration of 53 weeks, 9.7% of patients on Atorvastatin and 9.5% of the patients on placebo discontinued due to adverse reactions regardless of causality. The five most common adverse reactions in patients treated with Atorvastatin that led to treatment discontinuation and occurred at a rate greater than placebo were: myalgia (0.7%), diarrhea (0.5%), nausea (0.4%), alanine aminotransferase increase (0.4%), and hepatic enzyme increase (0.4%).
The most commonly reported adverse reactions (incidence ≥ 2% and greater than placebo) regardless of causality, in patients treated with Atorvastatin in placebo controlled trials (n=8755) were: nasopharyngitis (8.3%), arthralgia (6.9%), diarrhea (6.8%), pain in extremity (6.0%), and urinary tract infection (5.7%).
Table 2 summarizes the frequency of clinical adverse reactions, regardless of causality, reported in ≥ 2% and at a rate greater than placebo in patients treated with Atorvastatin (n=8755), from seventeen placebo-controlled trials.
Other adverse reactions reported in placebo-controlled studies include:
Body as a whole: malaise, pyrexia; Digestive system: abdominal discomfort, eructation, flatulence, hepatitis, cholestasis; Musculoskeletal system: musculoskeletal pain, muscle fatigue, neck pain, joint swelling; Metabolic and nutritional system: transaminases increase, liver function test abnormal, blood alkaline phosphatase increase, creatine phosphokinase increase, hyperglycemia; Nervous system: nightmare; Respiratory system: epistaxis; Skin and appendages: urticaria; Special senses: vision blurred, tinnitus; Urogenital system: white blood cells urine positive.
Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)
In ASCOT involving 10,305 participants (age range 40–80 years, 19% women; 94.6% Caucasians, 2.6% Africans, 1.5% South Asians, 1.3% mixed/other) treated with Atorvastatin 10 mg daily (n=5,168) or placebo (n=5,137), the safety and tolerability profile of the group treated with Atorvastatin was comparable to that of the group treated with placebo during a median of 3.3 years of follow-up.
Collaborative Atorvastatin Diabetes Study (CARDS)
In CARDS involving 2,838 subjects (age range 39–77 years, 32% women; 94.3% Caucasians, 2.4% South Asians, 2.3% Afro-Caribbean, 1.0% other) with type 2 diabetes treated with Atorvastatin 10 mg daily (n=1,428) or placebo (n=1,410), there was no difference in the overall frequency of adverse reactions or serious adverse reactions between the treatment groups during a median follow-up of 3.9 years. No cases of rhabdomyolysis were reported.
Treating to New Targets Study (TNT)
In TNT involving 10,001 subjects (age range 29–78 years, 19% women; 94.1% Caucasians, 2.9% Blacks, 1.0% Asians, 2.0% other) with clinically evident CHD treated with Atorvastatin 10 mg daily (n=5006) or Atorvastatin 80 mg daily (n=4995), there were more serious adverse reactions and discontinuations due to adverse reactions in the high-dose atorvastatin group (92, 1.8%; 497, 9.9%, respectively) as compared to the low-dose group (69, 1.4%; 404, 8.1%, respectively) during a median follow-up of 4.9 years. Persistent transaminase elevations (≥3 × ULN twice within 4–10 days) occurred in 62 (1.3%) individuals with atorvastatin 80 mg and in nine (0.2%) individuals with atorvastatin 10 mg. Elevations of CK (≥ 10 × ULN) were low overall, but were higher in the high-dose atorvastatin treatment group (13, 0.3%) compared to the low-dose atorvastatin group (6, 0.1%).
Incremental Decrease in Endpoints through Aggressive Lipid Lowering Study (IDEAL)
In IDEAL involving 8,888 subjects (age range 26–80 years, 19% women; 99.3% Caucasians, 0.4% Asians, 0.3% Blacks, 0.04% other) treated with Atorvastatin 80 mg/day (n=4439) or simvastatin 20–40 mg daily (n=4449), there was no difference in the overall frequency of adverse reactions or serious adverse reactions between the treatment groups during a median follow-up of 4.8 years.
Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL)
In SPARCL involving 4731 subjects (age range 21–92 years, 40% women; 93.3% Caucasians, 3.0% Blacks, 0.6% Asians, 3.1% other) without clinically evident CHD but with a stroke or transient ischemic attack (TIA) within the previous 6 months treated with Atorvastatin 80 mg (n=2365) or placebo (n=2366) for a median follow-up of 4.9 years, there was a higher incidence of persistent hepatic transaminase elevations (≥ 3 × ULN twice within 4–10 days) in the atorvastatin group (0.9%) compared to placebo (0.1%). Elevations of CK (>10 × ULN) were rare, but were higher in the atorvastatin group (0.1%) compared to placebo (0.0%). Diabetes was reported as an adverse reaction in 144 subjects (6.1%) in the atorvastatin group and 89 subjects (3.8%) in the placebo group.
In a post-hoc analysis, Atorvastatin 80 mg reduced the incidence of ischemic stroke (218/2365, 9.2% vs. 274/2366, 11.6%) and increased the incidence of hemorrhagic stroke (55/2365, 2.3% vs. 33/2366, 1.4%) compared to placebo. The incidence of fatal hemorrhagic stroke was similar between groups (17 Atorvastatin vs. 18 placebo). The incidence of non-fatal hemorrhagic strokes was significantly greater in the atorvastatin group (38 non-fatal hemorrhagic strokes) as compared to the placebo group (16 non-fatal hemorrhagic strokes). Subjects who entered the study with a hemorrhagic stroke appeared to be at increased risk for hemorrhagic stroke [7 (16%) Atorvastatin vs. 2 (4%) placebo].
There were no significant differences between the treatment groups for all-cause mortality: 216 (9.1%) in the Atorvastatin 80 mg/day group vs. 211 (8.9%) in the placebo group. The proportions of subjects who experienced cardiovascular death were numerically smaller in the Atorvastatin 80 mg group (3.3%) than in the placebo group (4.1%). The proportions of subjects who experienced non-cardiovascular death were numerically larger in the Atorvastatin 80 mg group (5.0%) than in the placebo group (4.0%).
Postmarketing Experience
The following adverse reactions have been identified during postapproval use of Atorvastatin. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Adverse reactions associated with Atorvastatin therapy reported since market introduction, that are not listed above, regardless of causality assessment, include the following: anaphylaxis, angioneurotic edema, bullous rashes (including erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis), rhabdomyolysis, myositis, fatigue, tendon rupture, fatal and non-fatal hepatic failure, dizziness, depression, peripheral neuropathy, and pancreatitis.
There have been rare reports of immune-mediated necrotizing myopathy associated with statin use.
There have been rare postmarketing reports of cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin use. These cognitive issues have been reported for all statins. The reports are generally nonserious, and reversible upon statin discontinuation, with variable times to symptom onset (1 day to years) and symptom resolution (median of 3 weeks).
Pediatric Patients (ages 10–17 years)
In a 26-week controlled study in boys and postmenarchal girls (n=140, 31% female; 92% Caucasians, 1.6% Blacks, 1.6% Asians, 4.8% other), the safety and tolerability profile of Atorvastatin 10 to 20 mg daily was generally similar to that of placebo.
See also:
What are the possible side effects of Losartan potassium?
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Hoarseness
swelling of face, mouth, hands, or feet
trouble in swallowing or breathing (sudden)
Incidence not known
Abdominal pain
black, tarry stools
bleeding gums
blood in urine or stools
coma
confusion
convulsions
decreased urine output
difficult breathing
fast or irregular breathing
headache
increased thirst
irregular heartbeat
large, flat, bluish patches on the skin
muscle pain or cramps
nausea or vomiting
painful knees and ankles
pinpoint red spots on skin
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal pain
weakness or heaviness of legs
yellow eyes and skin
Check with your doctor as soon as possible if any of the following side effects occur:
Less common
Cough, fever or sore throat
dizziness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Less common
Back pain
diarrhea
fatigue
nasal congestion
Rare
Cough, dry
leg pain
muscle cramps or pain
sinus problems
trouble in sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
Tablets containing 25 mg, 50 mg or 100 mg Atenolol Ph. Eur.
Injection for intravenous use presented as an isotonic, citrate buffered, aqueous solution, containing 5 mg of Atenolol Ph. Eur. in 10 ml.
Excipients/Inactive Ingredients: Tablets: Gelatin, glycerol, magnesium carbonate, magnesium stearate, maize starch, hypromellose, sodium lauryl sulphate, titanium hydroxide.
100 mg Tablets Only: Macrogol 300, sunset yellow lake. Injection:
Atorvastatin 10: Each tablet contains atorvastatin calcium equivalent to 10 mg atorvastatin.
Atorvastatin 20 mg: Each tablet contains atorvastatin calcium equivalent to 20 mg atorvastatin.
Atorvastatin 40 mg: Each tablet contains atorvastatin calcium equivalent to 40 mg atorvastatin.
Atorvastatin 80 mg: Each tablet contains atorvastin calcium equivalent to 80 mg atorvastatin.
Atorvastatin is a white, elliptical film coated tablet containing atorvastatin calcium. Atorvastatin calcium is a synthetic lipid-lowering agent, which is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. This enzyme catalyzes the conversion of HMG-CoA to mevalonate, an early and rate-limiting step in cholesterol biosynthesis.
The empirical formula of atorvastatin calcium is (C33H34FN2O5)2Ca·3H2O and its molecular weight is 1209.42.
Atorvastatin calcium is a white to off-white crystalline powder, practically insoluble in aqueous solutions of pH 4 and below. It is very slightly soluble in distilled water, pH 7.4 phosphate buffer, and acetonitrile; slightly soluble in ethanol; and freely soluble in methanol.
Losartan potassium POTASSIUM (Losartan potassium), the first of a new class of agents for the treatment of hypertension, is an angiotensin II receptor (type AT1) antagonist. Losartan potassium POTASSIUM (Losartan potassium) also provides a reduction in the combined risk of cardiovascular death, stroke, and myocardial infarction in hypertensive patients with left ventricular hypertrophy and renal protection for type 2 diabetic patients with proteinuria.
Losartan potassium potassium, a non-peptide molecule, is chemically described as 2-butyl-4-chloro-1-[[2'-(1H-tetrazol-5-yl)[1,1'-biphenyl]-4-yl]methyl]-1H-imidazole-5-methanol monopotassium salt.
Its empirical formula is C22H22ClKN6O.
Losartan potassium potassium is a white to off-white free-flowing crystalline powder with a molecular weight of 461.01. It is freely soluble in water, soluble in alcohols, and slightly soluble in common organic solvents, such as acetonitrile and methyl ethyl ketone.
Oxidation of the 5-hydroxymethyl group on the imidazole ring results in the active metabolite of Losartan potassium.