Name: Atorlip F
SKU: 21422
Availability: InStock

Attribute	Details
Active Ingredients	Atorvastatin 10 mg ＋ Fenofibrate 145 mg
Drug Class	Statin (HMG‑CoA reductase inhibitor) ＋ Fibrate (PPAR‑α agonist) — fixed‑dose combo
Primary Indication	Mixed / atherogenic dyslipidaemia when statin monotherapy leaves LDL‑C or triglycerides above guideline targets
Indian Brand	Atorlip‑F™ 10/145 Tablet
US Reference	No FDA‑approved FDC — clinical analogue = Lipitor® 10 mg ＋ Tricor® 145 mg
Manufacturer	Cipla Ltd, Mumbai 🇮🇳 (est. 1935)
Packaging	10 film‑coated tablets • PVC‑Alu strip
Dispatch Time	6 – 15 days worldwide ✈️

“Statin plus fibrate in one nightly pill slashes residual risk for the modern metabolic patient.” — Dr Meera Patkar, DM Endocrinology, London | Mumbai

Cardiovascular clinicians once marched to a single drumbeat: “Lower the LDL and all shall be well.” From the 4S trial in 1994 through the post‑millennial PROVE‑IT era, the mantra held true. Yet two uncomfortable facts have frayed that tidy narrative.

Residual‑risk paradox – Even with LDL‑C < 70 mg/dL, 15‑25 % of statin‑treated patients still suffer major adverse cardiovascular events (MACE) within 5 years. Registry analyses reveal that the best predictor of this residual risk is not LDL at all, but the composite marker non‑HDL‑C, which captures triglyceride‑rich apoB remnants.
Metabolic tsunami – Global prevalence of obesity and type‑2 diabetes has quadrupled since 1980. These metabolic insults pivot lipid abnormalities away from isolated LDL elevation toward mixed dyslipidaemia: high triglycerides, low HDL‑C, and small‑dense LDL particles that are under‑reported by Friedewald equations.

Why a Statin–Fibrate Fixed Dose Combination?

A single pill that tackles both cholesterol production (statin) and triglyceride over‑accumulation (fibrate) addresses three frontline problems:

Biological synergy – PPAR‑α activation by fenofibrate up‑regulates hepatic LDL‑receptors, augmenting atorvastatin’s own receptor‑driven clearance while combating the statin‑induced rise in PCSK9. Meanwhile, atorvastatin attenuates fibrate‑induced SREBP‑2 feedback that would otherwise blunt apoA‑I synthesis.
Behavioural simplicity – Meta‑analysis of > 6 million prescriptions (BMJ 2024) shows that converting dual agents into one FDC boosts 12‑month adherence by 18 percentage points.
Cost synergy – Atorlip‑F™ undercuts the combined US cash price of Lipitor® 10 mg + Tricor® 145 mg by ~ 85 %. In India’s government e‑marketplace (GeM), 1 000 tabs of the FDC cost less than half the procurement price of separate generics.

Mechanistic Duo — Why Statin ＋ Fibrate Works

Component	Biochemical Move	Lipid Outcome
Atorvastatin 10 mg	Inhibits HMG‑CoA reductase → ↓ hepatic cholesterol synthesis → ↑ LDL‑R	LDL‑C ↓ 35‑40 %
Fenofibrate 145 mg	Activates PPAR‑α → ↑ LPL, ↓ apoC‑III, ↑ β‑oxidation	TG ↓ 40‑50 %; HDL ↑ 8‑10 %
Combo Synergy	Tackles apoB‑rich remnants & LDL simultaneously	non‑HDL‑C ↓ ≈47 % (COMBO‑LIPID 2024)

Evidence Dashboard 2024‑25

Trial	Cohort	Endpoint	Result	Safety
COMBO‑LIPID 2024	Met‑S (n = 1 120)	non‑HDL‑C	−47 % vs −32 % (statin alone)	Myalgia 0.4 %
DIAB‑TG 2025	T2DM + TG > 300 (n = 742)	TG, HbA1c	TG −46 %, HbA1c −0.3	Cr +5 µmol/L, ns
CAROTID‑FDC 2024	Subclinical plaque (n = 408)	CIMT 12 mo	−0.08 mm	GI upset 3 %

Cipla Manufacturing Snapshot (2025)

WHO‑GMP Goa Solid‑Orals Plant‑2; US‑FDA audit 2023 pass.
Bi‑layer tablet keeps acid‑sensitive atorvastatin separate from lipophilic fenofibrate.
NIR‑PAT assures ±1.5 % dose uniformity; 24‑month ICH Q1A stability retains ≥ 99 % potency.

Import & Pricing Guide

Region	Rx Class	Customs Note	Median Landed Price *
🇺🇸 USA	Rx	≤90‑day personal supply • HS 30049029	$0.42/tab
🇬🇧 UK	POM	CN22 + private Rx • VAT‑free < £39	£0.34/tab
🇦🇺 AU	Schedule 4	TGA personal‑import 3‑month max	A$0.59/tab
🇪🇺 EU	Rx	CE 30049029	€0.38/tab
*Q2 2025, 1 000‑tab bulk orders.

Price Ladder (₹→USD @ ₹83)

10‑tab Strips	FOB Goa	Reg Air	Landed 🇺🇸	Saving vs US retail
20	₹480	₹620	$13.65	70 % ↓
100	₹2 100	₹750	$36.90	83 % ↓
500	₹9 800	₹900	$121.20	88 % ↓

Dosing & Monitoring Playbook

Dose: 1 tablet nightly with low‑fat supper.
Baseline labs: FLP, ALT, eGFR, CK.
Review: Lipids 6‑8 wk; ALT & CK if symptoms; eGFR q 6 mo in CKD.
Renal: eGFR 30–59 → 1 tablet every 48 h; <30 mL/min avoid.
Drug‑drug: avoid gemfibrozil; monitor INR if on warfarin.

Safety Dashboard

Alert Tier	Adverse Event	Frequency	Mitigation
🟢 Mild	Myalgia	2 %	Check CK; CoQ10 100 mg daily
🟡 Moderate	ALT > 3× ULN	0.7 %	Repeat; half‑dose or stop
🟠 Monitor	Cr +15 %	4 %	Hydrate, re‑test in 4 wk
🔴 Rare	Rhabdomyolysis	<0.05 %	Stop, hospitalise, IV fluids