, and what is the optimal dose?
The recommended starting dose of atorvastatin is 10 mg once a day (QD). The maximum tolerated dose (MTD) for atorvastatin is 100mg QD. When treating patients with cardiovascular disease, there are no definitive clinical guidelines on when to initiate therapy or how often to do so; however, it appears that most patients can tolerate 40-80mg QD as their first therapeutic drug. Most physicians will start patients at 20 -40mg QD daily until they reach an acceptable degree of LDL cholesterol reduction and then increase the dosage by 5 –10mg/day every 2 –3 days until the patient reaches his/her target serum LDL cholesterol level. At this time, additional lifestyle changes should be made such as: diet modification and exercise regimen. Patients who have not achieved adequate control on initial therapy within 3 months may benefit from increasing doses of dosages more frequently than once daily but not more often than every 3 days. For example, if a patient has an effective serum LDL cholesterol level of <100 mg/dL after 8 weeks on 40 mg of atorvastatin daily, he/she might be started on 80 mg BID instead. If this does not achieve levels in line with treatment goals within 6 months then 60 mg BID would be initiated next week followed by 50 mg BID in subsequent weeks. Since it takes approximately 4 weeks to attain saturation point for each stat