n and 9.5% of the patients on placebo discontinued due to adverse reactions regardless of causality.
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 4 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.
Table 4: Clinical Adverse Reactions Occurring in > 2% in Patents Treated with any dose of Atorvastatin and at an Incidence Greater than Placebo Regardless of Causality (% of patients). Adverse Reaction * Any dosen=8755 Atorvastatin10 mgn=3908 Atorvastatin20 mgn=188 Atorvastatin40 mgn=604 Atorvastatin80 mgn=4055 Placebon=7311
* Adverse Reaction >2% in any dose greater than placebo
Nasopharyngitis 8.3 12.9 5.3 7.0 4.2 8.2
Arthralgia 6.9 8.9 11.7 10.6 4.3 6.5
Diarrhea 6.8 7.3 6.4 14.1 5.2 6.3
Pain in extremity 6.0 8.5 3.7 9.3 3.1 5.9
Urinary tract infection 5.7 6.9 6.4 8.0 4.1 5.6
Dyspepsia 4.7 5.9 3.2 6.0 3.3 4.3
Nausea 4.0 3.7 3.7 7.1 3.8 3.5
Musculoskeletal pain 3.8 5.2 3.2 5.1 2.3 3.6
Muscle spasms 3.6 4.6 4.8 5.1 2.4 3.0
Myalgia 3.5 3.6 5.9 8.4 2.7 3.1
Insomnia 3.0 2.8 1.1 5.3 2.8 2.9
Pharyngolaryngeal pain 2.3 3.9 1.6 2.8 0.7
Adverse Reaction >2% in any dose greater than placebo
6.2 Postmarketing ExperienceBecause the reactions below are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
The additional events described below have been identified during post-approval use of ezetimibe and/or atorvastatin.
Blood and lymphatic system disorders: thrombocytopenia
Nervous system disorders: headache; paresthesia; peripheral neuropathy
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).
Gastrointestinal disorders: pancreatitis
Skin and subcutaneous tissue disorders: angioedema; bullous rashes (including erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis); rash; urticaria
Musculoskeletal and connective tissue disorders: myopathy/rhabdomyolysis [see Warnings and Precautions (5.1)]
There have been rare reports of immune-mediated necrotizing myopathy associated with statin use [see Warnings and Precautions (5.1)].
Injury, poisoning and procedural complications: tendon rupture
Immune system disorders: anaphylaxis; hypersensitivity reactions
Hepatobiliary disorders: hepatitis; cholelithiasis; cholecystitis; fatal and nonfatal hepatic failure
Psychiatric disorders: depression
Laboratory abnormalities: elevated creatine phosphokinase
7 DRUG INTERACTIONS[See Clinical Pharmacology (12.3).]
LIPTRUZET
The risk of myopath