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Atovastatin is xtnsivly mtabolizd totho- and paahydoxylatd divativs and vaious bta-oxidation poducts. In vitinhibition HMG-CoA ductas by otho- and paahydoxylatd mtabolits is quivalnt tthat atovastatin. Appoximatly 70% ciculating inhibitoy activity HMG-CoA ductas is attibutd tactiv mtabolits. In vitstudis suggst th impotanc atovastatin mtabolism by cytochom (CY) P450 3A4, consistnt with incasd plasma concntations atovastatin in humans ollowing co-administation with ythomycin, a known inhibitthis isozym. In animals, th otho-hydoxy mtabolit undgos uth glucuonidation.

Pscibing commndations intacting agnts a summaizd in Tabl 1 blow.

Statins, lik som oth lipid-lowing thapis, hav bn associatd with biochmical abnomalitis liv unction. Psistnt lvations (>3 tims th upp limit nomal occuing on twmoccasions) in sum tansaminass occud in 0.7% patints whcivd atovastatin in clinical tials. Th incidnc ths abnomalitis was 0.2%, 0.2%, 0.6%, and 2.3% 10, 20, 40, and 80 mg, spctivly.

ATOLIP CV should b usd with caution in patints whconsum substantial quantitis alcohol and/hav a past histoy liv disas. Activ liv disas unxplaind psistnt tansaminas lvations a containdications tth us ATOLIP CV .

In a study in halthy mal subjcts whn clopidogl 75 mg p day was givn with a standad bakast, man inhibition ADP-inducd platlt agggation was ducd by lss than 9%. Th activ mtabolit AUC 0-24 was unchangd in th psnc ood, whil th was a 57% dcas in activ mtabolit C max . Simila sults w obsvd whn a clopidogl 300 mg loading dos was administd with a high-at bakast. ATOLIP CV can b administd with without ood.

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