Atorvastatin (Oral)

Atorvastatin can reduce the possibility of stroke and heart attack when combined with exercise, weight loss, and a nutritious diet.

Overview

Atorvastatin is a powerful prescription drug that can lower the chance of stroke and heart attack. It must be combined with exercise, weight loss, and a nutritious diet in order to be effective. Atorvastatin stops cholesterol from collecting in the arteries. When congested, the arteries can stop blood from properly flowing to the brain and heart.

This medication can also lower the chance that people with heart disease will need heart surgery or may develop heart disease. Atorvastatin can lower the volume of fatty substances in the blood, including triglycerides and low-density lipoprotein cholesterol (negative type of cholesterol). Atorvastatin can also increase the positive kind of cholesterol, high-density lipoprotein cholesterol. Atorvastatin is manufactured under the US brand name Lipitor, but is also obtainable as a generic medication. Generic medications are usually cheaper but can vary in form or potency from the brand name Lipitor.

People between 10 to 17 years old with hereditary heterozygous hypercholesterolemia could benefit from taking atorvastatin. This is a familial condition in which the body cannot remove cholesterol from itself. Atorvastatin can reduce the manufacture of cholesterol in the body to lower how much cholesterol can be built up on artery walls; this, in turn, causes blood flow to the brain, heart, and other body parts to be blocked.

When the arteries experience a build-up of fats and cholesterol (the activity is known as atherosclerosis), blood flow is reduced and this causes the oxygen supply to your brain, heart, and other body parts to also decrease. Heart attacks, strokes, angina (chest pain), and heart disease have been shown to be prevented by first lowering the blood level of fats and cholesterol.

This medication can lower triglyceride (fat) and cholesterol concentrations in the blood. Taking atorvastatin can possibly prevent medical issues such as stroke, chest pain, or heart attack initiated by fat obstruction in the blood vessels.

Atorvastatin can also counteract specific kinds of blood vessel and/or heart issues for patients who have a higher chance of developing a heart problem.

This medication is only available with a prescription from a physician. It is available in tablet dosage form.

Atorvastatin works by counteracting an enzyme that manufactures cholesterol within the body, lowering the total amount of cholesterol in the blood.

After taking atorvastatin orally, the medication should be fully absorbed with top plasma strengths reached in one to two hours.

Conditions treated

  • High cholesterol
  • Triglyceride concentrations in blood
  • Heart attack
  • Stroke
  • Chest pain

Type of medicine

  • HMG-CoA reductase inhibitors (statins)

Side Effects

While Atorvastatin is typically well tolerated, it can cause severe side effects. Seek emergency help right away if any of the following side effects occur:

  • Weakness
  • Urine discoloration (dark-colored)
  • Unusual bleeding or bruising
  • Tiredness (extreme)
  • Swelling of the lower legs, ankles, feet, hands, eyes, lips, tongue, throat, or face
  • Swallowing difficulty
  • Stomach pain (upper right portion)
  • Skin/eye yellowing
  • Rash
  • Nausea
  • Muscle weakness, tenderness, or pain
  • Memory loss/forgetfulness
  • Loss of appetite
  • Lack of energy
  • Joint pain
  • Itching
  • Hoarseness
  • Hives
  • Heartburn
  • Gas
  • Flu-like signs
  • Fever
  • Diarrhea
  • Confusion
  • Chest pain
  • Breathing difficulty

Other side effects can occur while taking atorvastatin. Consult your physician if the patient has any unusual issues or difficulties while on atorvastatin.

If severe side effects occur, you or your doctor should alert the FDA. A report can be sent to the MedWatch Adverse Event Reporting initiative online or by phone at 1-800-FDA-1088.

Dosage

Different individuals may receive different prescriptions as the medication varies depending on patient and illness characteristics. Only take this medication according to the physician's directions or the instructions on the label. The information below gives only average doses of atorvastatin. Do not change your dose unless your physician instructs you to adjust it.

The strength of the medication determines the total quantity of atorvastatin needed. Additionally, the medical problem and the total dose count each day, how spaced out the doses are, and the time it takes to take the medication will determine how the medication is prescribed.

Atorvastatin is available in tablet form and should be taken orally (by mouth). It is typically prescribed once daily, either on its own or with food. It is important to take this medication at approximately the same time daily. Ask your pharmacist or doctor for further explanation on any part of the directions that you do not completely understand.

A patient may be started on a small dose of atorvastatin, which can be increased gradually. The dose should not be increased quicker than once every two to four weeks.

As with most prescriptions, Atorvastatin should stay part of your medication regime even if the negative effects of the illness have ended. The entire prescription must be taken. Be sure your doctor is aware if you need to stop taking atorvastatin and ensure the physician approves.

The atorvastatin tablets must be swallowed whole. Do not chew, crush, or break the tablet.

Oral Dosage Instructions (Tablets)

Adults with high cholesterol: Take 10 to 20 milligrams (mg) once daily. Certain patients may need to begin with 40 mg daily. Your physician may decide to increase your doses as your body reacts, or does not react, to the medication. Typically, 80 mg per day is the highest that a doctor will prescribe.

Children between 10 and 17: Take 10 mg once daily. Your physician may decide to increase your doses as your body reacts, or does not react to the medication. Typically, 20 mg per day is the maximum dosage to be prescribed for children.

Children under 10: Physician must determine dose.

Missed Dose

This dose should be taken immediately once the patient discovers it has been missed, unless the time is closer to the next scheduled dose. If it is almost time for the next dose, the skipped dose should remain missed and the patient should return to the normal dosing schedule. Keep in mind that two doses should not be taken in a 12-hour time period. Never double doses of atorvastatin.

Directions and Unpackaging

Follow the instructions on the medication packages to determine how to take atorvastatin. Never take a dose that is greater or less than the prescribed amount. Never take a dose that is more or less frequent than the prescribed schedule. Taking a dose that is different from what the doctor has intended can greatly increase the likelihood of negative side effects.

A set of patient directions or medication guide will be part of the atorvastatin prescription package. Carefully read and be sure to understand all medication information before taking atorvastatin.

Interactions

Drug Interactions

Occasionally, particular medications can be used at the same time despite the chances of interaction; in other instances, medications should never be used together. Consult your physician to determine whether or not additional medications are safe to take with atorvastatin. Under circumstances where your physician may prescribe more than one medication, they may adjust the dosage or take additional precautions.

Be sure to inform your medical professional if you are already taking of any of the following medications. The following interactions are significant, however the list is not completely all-inclusive:

  • Posaconazole

It is typically not recommended to use atorvastatin with any of the subsequent medications, but certain cases may require the combination. In rare cases that require both medications to be prescribed at the same time, the physician may adjust the dose or frequency of dose for one or both medications:

  • Verapamil
  • Troleandomycin
  • Tipranavir
  • Telithromycin
  • Telaprevir
  • Simeprevir
  • Saquinavir
  • Quinupristin
  • Piperaquine
  • Niacin
  • Nelfinavir
  • Nefazodone
  • Mibefradil
  • Lopinavir
  • Ketoconazole
  • Itraconazole
  • Isavuconazonium Sulfate
  • Indinavir
  • Idelalisib
  • Grazoprevir
  • Gemfibrozil
  • Fusidic Acid
  • Fosamprenavir
  • Fluconazole
  • Fenofibric Acid
  • Fenofibrate
  • Erythromycin
  • Eliglustat
  • Elbasvir
  • Domperidone
  • Diltiazem
  • Digoxin
  • Darunavir
  • Daptomycin
  • Danazol
  • Dalfopristin
  • Cyclosporine
  • Conivaptan
  • Colchicine
  • Clofibrate
  • Clarithromycin
  • Ciprofibrate
  • Ceritinib
  • Bezafibrate
  • Atazanavir

An increased possibility of side effects can be caused when atorvastatin is used with any of the following medications, but the combination could prove to be the most optimal form of treatment. In rare cases that require both medications to be prescribed at the same time, the physician may adjust the dose or frequency of dose for one or both medications:

  • Voriconazole
  • St John's Wort
  • Rifampin
  • Quinine
  • Pioglitazone
  • Phenytoin
  • Pectin
  • Oat Bran
  • Interferon Beta
  • Fosphenytoin
  • Etravirine
  • Eltrombopag
  • Efavirenz
  • Clopidogrel
  • Bosentan
  • Boceprevir
  • Black Cohosh
  • Bexarotene
  • Azithromycin
  • Amprenavir
  • Amiodarone

Interactions can also occur if the patient eats or drinks certain types of food around the time they are taking the medication. The use of tobacco or alcohol can also trigger interaction onset. The significance of the following interactions has determined their inclusion on this list.

Side effects can be increased if patients take atorvastatin while consuming the following food. Some cases may not allow patients to avoid this food, but your physician may adjust the dose or frequency of the dose when it must be combined.

  • Grapefruit Juice

Warnings

Be sure to inform your physician and pharmacist if the patient has any allergies to atorvastatin, the ingredients in atorvastatin, or any other prescription drugs. Your pharmacist can provide you with a list of ingredients for any drug.

Patients with diabetes should take extra caution when taking atorvastatin. This medication can increase total blood sugar. Be sure to observe and keep your blood sugar levels regulated while on this prescription.

If you have liver disease, be sure your doctor is aware of this. Atorvastatin could cause liver damage. Your physician could possibly request additional laboratory tests to monitor the working state of your liver, even if it is suspected that you do not have a liver illness. It is smart to test the liver when treatment begins, and then to have additional tests as needed. A physician will typically not recommend for a patient to take atorvastatin if they have had liver disease or if the results from the lab test reveal that liver disease could be developing. Severe liver damage instigated by statins is not common.

Severe failure of muscular cells can occur if the muscles become inflamed. This is called rhabdomyolysis. Rhabdomyolysis triggers myoglobin (muscle protein) to be released into the blood. Myoglobin can trigger the failure of the kidneys and possibly death. Rhabdomyolysis is caused by statins (when taken alone) in fewer than one percent of patients. Patients who experience weakness, muscle tenderness, or muscle pain that cannot be explained should consult their physician right away, as severe rhabdomyolysis can be developed.

Inform your doctor if: you drink more than two alcoholic drinks per day; you are older than 65; you have had liver issues previously; you currently have or have had diabetes, low blood pressure, seizures, kidney disease, thyroid disease, or muscle aches.

Women should not breastfeed while taking atorvastatin.

Consult your physician regarding safe amounts for consumption of alcoholic drinks while on atorvastatin. Alcohol greatly increases the possibility of severe side effects.

If you are currently pregnant or plan to conceive, you should not take atorvastatin. Women should not become pregnant while taking this medication. Discuss birth control options with your physician that can be utilized during treatment. Atorvastatin should be avoided while pregnant as it can hurt the fetus. If you are already taking atorvastatin and become pregnant, you should immediately stop using this medication and contact your physician right away.

Patients who are planning to have surgery (dental surgery included) should inform the physician or the dentist of the atorvastatin use. Patients who become hospitalized because of severe infections or injury should tell the emergency personnel of the atorvastatin use as well.

Special Dietary Instructions

Patients should follow a low-fat, low-cholesterol diet while taking atorvastatin as much as possible, however it is important that drastic changes in nutritional habits should be avoided. Follow dietary and exercise advice given by your dietitian or doctor. Grapefruit juice should be avoided during atorvastatin prescription, at least in large quantities (over 1 quart per day).

Other Medical Problems

Preexisting medical issues can impact the effectiveness of atorvastatin. Inform your physician of other medical issues, particularly:

  • Transient ischemic attack (TIA) (recent) this medication can raise the possibility of stroke for individuals with these ailments
  • Stroke (recent)
  • Sepsis (severe infection) – take caution as kidney or muscle issues could develop
  • Seizures (convulsions) not well managed
  • Metabolic conditions (severe)
  • Low blood pressure (hypotension)
  • Liver enzymes (elevated) patients with these ailments should avoid this medication
  • Liver disease (history of) take caution as side effects can be intensified
  • Liver disease (active)
  • Kidney disease (severe)
  • Hypothyroidism (underactive)
  • Endocrine disorders (severe)
  • Electrolyte disorders (severe)
  • Diabetes
  • Alcohol abuse, or history of

Specific Demographic Use

Pediatric

There have not been any current pediatric-specific issues that would reduce the effectiveness of atorvastatin for children ages 10 to 17. However, take caution, as the medication has not been tested effective for children under 10.

Geriatric

There have not been any current geriatric-specific issues that would reduce the effectiveness of atorvastatin for the elderly. Elderly patients tend to have more frequent muscle issues that are age-related, and these necessitate extra caution from the patient.

Breastfeeding

There have been dangerous effects to the infant when studying the impacts of atorvastatin on women who breastfeed. This medication should be stopped while breastfeeding, or the physician may need to find an alternate prescription.

Storage

This medication must be stored out of the reach of children. Keep the medicine in the original package, and ensure it stays closed tightly. Store the prescription at room temperature in a place that is away from excess moisture and heat. Consult your doctor to determine how to properly dispose of unneeded or unused medication so that children, pets, or other people do not use it. It is important not to retain medication past the date that it expired.

Summary

Atorvastatin can lower the bad cholesterol and triglycerides in a patient's blood and can increase the good cholesterol. This medication must be used with a proper exercise and healthy diet to work effectively. The type of medication that atorvastatin belongs to is referred to as ‘satins'.

Lowering the number of negative triglycerides and cholesterol produced by the liver and increasing the positive cholesterol lowers the chance of developing heart disease, stroke, angina, and revascularization actions in heart disease. It also helps to reduce the chance of getting a heart attack or stroke for patients who have type 2 diabetes.

Patients should ensure they are eating a nutritious diet; a low-fat/low-cholesterol diet is ideal. Patients should be participating in additional lifestyle activities to improve the effects of this prescription. The most common side effects include heartburn, constipation, diarrhea, intestinal gas, common cold, joint pain, urinary tract infections (UTIs), and headaches. Quitting smoking, losing weight if overweight and exercising can improve the effectiveness of atorvastatin. Breastfeeding/pregnancy safety, dosing, and drug interactions should be evaluated prior to having this medicine. Your physician can give you more information regarding this medication if desired.

Resources
Last Reviewed:
December 22, 2017
Last Updated:
April 04, 2018