Avamax Special Precautions

Liver Dysfunction: Usage of HMG-CoA reductase inhibitors eg, administration of some other lipid-lowering agents, has been associated with biochemical abnormalities of liver function.
It is recommended that liver function tests be performed prior to treatment and after 12 weeks following the initiation of therapy or at any elevation of dose and periodically, eg, semi-annually, thereafter.
Changes of liver enzymes generally occur in the first 3 months of treatment with atorvastatin. Patients who develop increased transaminase levels should be monitored until the abnormalities resolve. Should an increase in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) value exceed 3 times the upper limit value, reduction of dose or discontinuation of atorvastatin treatment is recommended. Atorvastatin should be used with great caution in patients who consume substantial quantities of alcohol and/or have a history of liver disease. Use of atorvastatin in patients with active liver disease or unexplained persistent transaminase elevations is contraindicated.
Skeletal Muscles: The possibility of myopathy [muscle aches or muscle weakness in conjunction with increases in creatine phosphokinase (CPK) values >10 times the upper limit value] should be considered in any patient with diffuse myalgia, muscle tenderness or weakness, and/or marked elevation of CPK. The risk of myopathy in patients taking statins is increased with concurrent administration of cyclosporine, fibric acid derivatives, erythromycin, immunosuppressive drugs, azole antifungals or lipid-lowering doses of niacin should carefully weigh the potential benefits and risks, and should carefully monitor all patients who develop the signs or symptoms of muscle pain, tenderness or weakness, particularly during the initial months of therapy and during any periods of upward dosage titration of either medicinal product.
Atorvastatin therapy should be temporarily withheld or discontinued in any patient with an acute, serious condition which might result from a myopathy and in those having a risk factor predisposing to the development of renal failure secondary to rhabdomyolysis (eg, severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine and electrolyte disorders and uncontrolled seizures).
Effects on the Ability to Drive or Operate Machinery: Atorvastatin does not affect the ability to drive motor vehicles and use machines.