Atorvastatin food interactions
Pro Research Analysisby 
Searched over 200M research papers
Atorvastatin Food Interactions: Impact on Bioavailability and Absorption
Introduction to Atorvastatin and Food Interactions
Atorvastatin, a widely used HMG-CoA reductase inhibitor, is prescribed to lower cholesterol levels and reduce the risk of cardiovascular disease. Understanding how food intake affects the absorption and bioavailability of atorvastatin is crucial for optimizing its therapeutic efficacy.
Effect of Food on Atorvastatin Absorption
Decreased Absorption Rate with Food
Research indicates that food intake significantly impacts the pharmacokinetics of atorvastatin. A study involving 16 healthy volunteers demonstrated that consuming a medium-fat breakfast reduced the mean maximum plasma concentration (Cmax) of atorvastatin by 47.9% and the area under the concentration-time curve (AUC) by 12.7% compared to fasting conditions 1. This suggests that food decreases the rate of atorvastatin absorption, although the extent of absorption remains relatively unaffected.
Delayed Time to Maximum Concentration
Further studies corroborate these findings, showing that food delays the time to reach maximum concentration (tmax) of atorvastatin. In a study with 27 healthy subjects, food intake delayed tmax and decreased Cmax by 32% 2. Despite these changes, the overall impact on the drug's lipid-lowering efficacy is minimal, as the extent of absorption (AUC) is not significantly altered.
Clinical Implications of Food-Drug Interactions
Minimal Clinical Impact on Lipid-Lowering Effects
Although food intake alters the pharmacokinetic profile of atorvastatin, these changes are not expected to have a clinically significant effect on its lipid-lowering properties. Multiple-dose clinical studies have shown that the therapeutic outcomes of atorvastatin are more closely related to the dose rather than the plasma concentration profiles 1. Therefore, patients can take atorvastatin with or without food without compromising its efficacy.
Considerations for Fixed-Dose Combinations
When atorvastatin is administered in combination with other drugs, such as metformin, food interactions remain consistent with those observed for the individual drugs. A study on the fixed-dose combination (FDC) of atorvastatin and metformin extended release (XR) found that food delayed tmax and decreased Cmax for atorvastatin, while increasing the AUC for metformin 2. These alterations align with the known effects of food on the individual drugs, suggesting that the FDC formulation does not introduce new food-drug interaction concerns.
Conclusion
In summary, food intake affects the absorption rate and peak plasma concentration of atorvastatin, but these changes do not significantly impact its clinical efficacy in lowering cholesterol levels. Patients can take atorvastatin with or without food, and similar considerations apply when it is part of a fixed-dose combination with other medications like metformin. Understanding these interactions helps in optimizing atorvastatin therapy for better patient outcomes.
Sources and full results
Most relevant research papers on this topic
Effect of Food on the Bioavailability of Atorvastatin, an HMG‐CoA Reductase Inhibitor
A medium-fat breakfast significantly decreased the rate of atorvastatin absorption, but had little impact on the extent of drug absorption.
RCTPharmacokinetics of fixed-dose combination of atorvastatin and metformin compared with individual tablets
No clinically relevant pharmacokinetic interaction was observed when atorvastatin was co-administered with metformin, but food may affect the absorption of both drugs from an FDC formulation.
RCT
Rigorous JournalPharmacokinetic Interaction between Atorvastatin and Omega-3 Fatty Acid in Healthy Volunteers
Atorvastatin and omega-3 fatty acids show a pharmacokinetic interaction in healthy volunteers, with 90% CIs for primary endpoints outside typical bioequivalence ranges.
Non-RCTAbsence of a significant pharmacokinetic interaction between atorvastatin and fenofibrate: a randomized, crossover, study of a fixed-dose formulation in healthy Mexican subjects
Aatorvastatin and fenofibrate have no significant pharmacokinetic interaction in healthy Mexican volunteers.
RCTAtorvastatin: safety and tolerability
Atorvastatin is generally well tolerated across its therapeutic dosage range, with rare adverse events (liver function abnormalities and muscle-related side effects) occurring in specific populations.
Systematic ReviewEffects of atorvastatin and/or probucol on recovery of atherosclerosis in high-fat-diet-fed apolipoprotein E-deficient mice.
Atorvastatin and/or probucol can help recover atherosclerosis in high-fat-diet-fed apolipoprotein E-deficient mice by suppressing ER stress and increasing TLR-4 levels.
RCT
Animal StudyRigorous JournalReduction of LDL cholesterol by 25% to 60% in patients with primary hypercholesterolemia by atorvastatin, a new HMG-CoA reductase inhibitor.
Atorvastatin effectively reduces LDL cholesterol by 25% to 60% in patients with primary hypercholesterolemia, providing a greater reduction than other HMG-CoA reductase inhibitors.
RCT
Highly CitedClinical Pharmacokinetics of Atorvastatin
Atorvastatin effectively lowers LDL cholesterol levels, but its pharmacokinetics may be affected by factors such as food, drug interactions, and dietary factors.
Highly CitedPhysiologically based pharmacokinetic modeling of disposition and drug-drug interactions for atorvastatin and its metabolites.
The developed PBPK model accurately predicts atorvastatin's pharmacokinetic profiles and drug-drug interactions, aiding in assessing its safety and efficacy in the clinic.
In Vitro StudyComparison of efficacy and safety of atorvastatin (80 mg) to simvastatin (20 to 40 mg) in patients aged <65 versus >or=65 years with coronary heart disease (from the Incremental DEcrease through Aggressive Lipid Lowering [IDEAL] study).
Atorvastatin (80 mg) is more effective in reducing cardiovascular events in patients aged 65 years compared to simvastatin (20 to 40 mg) in both 65 and >65 years with stable coronary disease.
RCT
Large Human Trial