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What is Lipitor (atorvastatin)?

Lipitor (atorvas­tatin) belongs to a class of drugs called HMG-CoA reductase inhibitors or statins.

Lipitor and a healthy diet lower your "bad" cholesterol (LDL), increase "good" cholesterol (HDL), and lower your triglycerides, a type of fat in the blood.

Lipitor treats:

  • High cholesterol

  • Low-density lipoprotein

  • Triglycerides

  • Apolipoprotein B

High bad cholesterol and triglyceride levels can lead to heart issues, including coronary artery disease or heart blockages. Because of this link, doctors often use cholesterol-lowering medications such as Lipitor to reduce the risk of heart attacks and strokes in people with abnormal cholesterol levels. Doctors also use Lipitor in people with multiple risk factors for developing heart disease, such as diabetes.

Lipitor is FDA-approved for adults and children aged ten and up. You or your child should only take statins under the direction of a physician.

Off-label uses

Doctors sometimes prescribe statins like Lipitor to stop the progress of autoimmune or chronic inflammatory diseases, such as secondary-progressive multiple sclerosis (SPMS).

That's because Lipitor and other statins may have some novel effects, such as:

  • Influencing immune responses

  • Enhancing the body's anti-inflammatory processes

  • Altering different signaling pathways

Doctors also often use statins off-label for neurological diseases, such as Alzheimer's disease or Parkinson's disease. High blood cholesterol is associated with the progression of these diseases. Patients with HIV or bacterial infections, such as tuberculosis (TB), may benefit from these drugs.

How do you take Lipitor?

Take this medicine exactly as prescribed by your doctor. Don't take more of it, don't use it more often or for longer than you're told to by your doctor.

Your doctor may also prescribe additional medicines to control your blood sugar levels if they are high. Follow your doctor's instructions carefully about any particular diet.

Take this medicine at the same time each day. Swallow the pill whole, don't break, crush, or chew it. You can take this medicine after meals or prior, but this medication is most effective at bedtime.

Minimize your alcohol consumption while taking atorvastatin. It could cause serious liver problems.

If you regularly drink grapefruit juice, tell your doctor. Drinking large amounts of grapefruit juice (more than 1 liter each day) while taking this medicine may increase your risks of muscle injury and lead to kidney problems.

Dosages of atorvastatin

Tablets

  • 10mg

  • 20mg

  • 40mg

  • 80mg

Daily doses

Your doctor will prescribe the correct dosage for your circumstances. Follow your doctor's instructions or the directions on the medication label. If your dosage differs from what we’ve listed here, do not adjust it unless your doctor tells you to.

The amount of medicine you take depends on:

  • The medication strength

  • The medical condition for which you're taking the drug

  • The number of doses per day

  • The time allowed in between doses

  • The duration of time you take the medication

Adults: Take 10 or 20mg once a day. Some people may need to start at 40mg per day. Your doctor may increase your dosage to a maximum of 80mg per day if necessary.

Children 10-17 years old: Initially, start with 10mg once daily. Their doctor may adjust the dose as necessary. However, the amount is usually no more than 20mg per day.

Seeing results

You should see noticeable improvements in your cholesterol levels within four weeks if you take your medication as directed.

Potential side effects of Lipitor

Statins can cause side effects like all medicines.

Common side effects

These reactions occur in more than 1 in every 100 people. Side effects may improve after the initial few days as your body adjusts to the medicine.

Continue taking Lipitor, but speak to your doctor or pharmacist if these common side effects bother you or don't disappear:

  • Headaches

  • Diarrhea

  • Mild backaches, muscle aches, or joint pain

  • Feeling sick (nausea)

  • Sore throat

  • Cold-like symptoms

  • Stuffy nose

  • Constipation

  • Intestinal gas

  • Loss of appetite

  • Urinary tract infection

Less common side effects

  • Severe muscle aches or pain

  • Generalized weakness

  • Dark urine

Serious side effects

Rare side effects occur in fewer than one in 1,000 people who take atorvastatin.

Call a doctor if you experience any of these symptoms:

  • Severe stomach pain

  • Yellow skin or eyes (jaundice)

  • A skin rash with pink-red blotches

  • Severe muscle pain, tenderness, or cramping

  • Severe joint pain

  • A cough, feeling short of breath, and weight loss

  • Cognitive impairment such as memory loss or confusion

Long-term use of Lipitor

Lipitor can have long-term side effects. However, this is uncommon.

For example, abnormal liver function is a serious but rare side effect of Lipitor. It’s possible to reverse liver damage caused by the drug if your doctor catches it early and stops your medication.

Another infrequent side effect of Lipitor is immune-mediated necrosis of muscle (IMNM). This is a condition when your immune system mistakenly attacks your muscles.

Studies have shown that sometimes IMNM due to statins can be successfully treated with long-term medication. However, this may not be suitable for everyone.

If you have any concerns or questions about the long-­term side effects of Lipitor, ask your doctor or pharmacist for advice.

Missed doses

If you miss a dose of this medicine, take it as soon as possible and wait at least 12 hours before taking the second dose. However, if it's almost time for your next scheduled dose, skip the missed one and resume your regular dosing schedule. Don't double up on doses.

Overdoses

High doses of Lipitor can increase the risk of statin toxicity, leading to serious side effects. You may experience symptoms including:

  • Muscle pain, weakness, and inflammation

  • Elevated creatine kinase (CK) levels in the blood

If muscles are damaged, the cells leak creatine kinase (CK) and myoglobin protein into the bloodstream. The substances released from the dying muscle cells can harm the kidneys if muscle damage is severe.

Statin overdoses can be a concern. If you're taking several other medications or have any other health conditions, you might forget to take your dose correctly. For example, you may fail to take your medication one day and take too much of it another day. To prevent overdosing, medication reminders such as alarm clocks and pill boxes can be helpful.

If you think you’ve overdosed, seek immediate medical assistance or call United States Poison Control at 1-800-222-1222.

Tell your doctor if you experience unusual muscle pain or weakness while taking Lipitor. Muscle pain and muscle weaknesses are possible symptoms of statin toxicity.

What to discuss with your doctor before taking Lipitor

  • If you have any allergies, including to atorvastatin

  • If you have any medical conditions or a family history of heart disease

  • If you have liver disease, kidney disease, or alcoholism

  • All prescription medications, over-the-counter drugs, and supplements you’re taking

  • If you’re pregnant, breastfeeding, or planning on getting pregnant. Statins can harm an unborn baby. Ask your doctor about reliable birth control methods.

Drinking alcohol daily may increase your risk for liver problems, especially when combined with statins. Ask your doctor or pharmacy for more information.

Discuss with your doctor if you have any other kinds of allergies, such as an allergy to foods, dyes or preservatives, or animals, too. Read the labels or package ingredients carefully for nonprescription products.

Older adults may be more sensitive to some of the side effects of this medication, especially muscle problems.

Stopping Lipitor

Some people can stop taking statins without adverse cardiac effects, but it can be hazardous for others. Don't stop taking these drugs if you have a heart attack or stroke history. You're more likely to experience a recurrence when you stop taking statins.

However, if you haven't had a history of heart attacks or strokes and want to stop using statins, speak to your doctor. They can help you determine which risk factors you have and whether stopping statins is right for you.

If your doctor thinks you can safely stop taking your statins, they can recommend a plan. This may involve completely stopping statins or lowering your statin use. One of these options may help you if taking statins causes you any problems.

Changing medications

Your doctor might recommend changing from one kind of cholesterol medication to another.

For example, the American Heart Association recommends these options for people with high blood cholesterol who cannot take statin drugs:

  • Ezetimibe

  • A fibric acid supplement (fenofibric acid)

  • A slow-release niacin supplement

Starting an exercise program

Your healthcare provider might suggest lifestyle changes before stopping the medication. These may include adopting an exercise program or modifying your diet.

Remember, these lifestyle changes may not work as quickly or as well as a statin in reducing your cholesterol. A wholesome diet and regular exercise program can have many health benefits, but they may not lower cholesterol enough to replace statins.

You and your healthcare provider should closely monitor your cholesterol level to ensure your lifestyle changes have the desired effect on your cholesterol.

Limit statin use

Instead of completely stopping your statin medication, your doctor may suggest reducing your dose. This could mean fewer side effects, and the drug may still work well enough to control your cholesterol levels.

Your doctor may recommend reducing your statin dose while adding another type of cholesterol medication.

Adding other cholesterol drugs

Your healthcare provider might be able to reduce your statin dose by adding ezetimibe (Zetia), bile acid sequestrants (cholestyramine), or niacin (Niaspan). These medications can control your cholesterol levels while you're taking the lower dose of statins.

Add on L-carnitine supplements

Carnitine supplements are another option, especially for people with diabetes. Carnitine is an amino compound made by your body. Preliminary studies have found that taking L-carnitine twice a day may improve the effectiveness of statins.

Taking CoQ10 supplements

Some studies have shown that CoQ10 supplements lower the risk of muscle aches from statin use.

Lipitor and pregnancy

There is limited data on the use of statins during pregnancy to determine if they cause congenital disabilities or miscarriages.

This drug may cause congenital disabilities when used by pregnant women because it decreases cholesterol synthesis and possibly the production of other substances derived from cholesterol. It is unknown whether this effect occurs in humans.

If you become pregnant while taking this medication, contact your doctor immediately.

Interactions with other drugs

If your doctor has told you to take this medicine, your doctor may already know about any possible drug interactions and may be monitoring you carefully for them. You can avoid these interactions by telling your doctor about all the drugs and supplements you’re taking.

Lipitor may interact (cause an adverse reaction) with several other drugs, including:

CYP3A4 inhibitors

CYP3A is an enzyme that helps your body break down certain drugs. If you take Lipitor with potent CY3A4 inhibitors, your levels of Lipitor may increase. As a result, your risk for side effects may be higher.

Examples of CY3A4 solid inhibitors include drugs such as:

  • Clarithromycin and erythromycin

  • Ketoconazole and itraconazole (Sporanox)

  • Saquinavir and tipranavir

Your doctor may prescribe a different drug regimen to avoid this interaction.

Letermovir or Cyclosporine

When taking Lipitor, don't take cyclosporine (Gengraf, Sandimmune) or letermovir (Prevymis). Doing so may increase your risk of muscle pain or weakness. In addition, these drugs may slow down the protein that transports medications in your body. They may also affect how your body processes Lipitor.

If you're taking letermovir or cyclosporine, you should discuss it with your physician before taking Lipitor. They'll select the best medications to treat your condition.

Other fibrates and gemfibrozil

You shouldn't take Lipitor while taking gemfibrozil (Lopid). Fibrates are drugs that lower levels of triglycerides in your blood. They can cause muscle pain as a side effect.

Like cyclosporine and letermovir, gemfibrozil slows down the protein that transports drugs like Lipitor in our bodies. As a result, combining gemfibrozil and Lipitor increases the risk of developing muscle pain.

Before taking Lipitor, you should also tell your physician if you're taking another fibrate, such as fenofibrate. Lipitor can still be used with these medications, but not as effectively as with gemfibrozil.

If your doctor suggests that you should take Lipitor together with a fibrate drug, they may decide to lower your Lipitor or fibrate dosage.

Other drugs that escalate muscle pain

Other than the drugs described above, other medications may increase your risk of muscle pain or weakness if taken with Lipitor.

These medications include:

  • Niacin

  • Some medicines used for hepatitis C: Glecaprevir/pibrentasvir and elbasvir/grazoprevir 

  • Colchicine

Before taking Lipitor, talk with your doctor if you're using any of these medications: Your doctor may decide you need a smaller dose of Lipitor. They may prescribe you a different drug instead of Lipitor.

Lipitor and herbs and supplements

There haven't been any reports of herbs or supplements interacting with Lipitor. However, you should check with your doctor or pharmacist before using supplements while taking Lipitor.

Allergy information

Tell your doctor if you've ever had an unusual or allergic reaction to any medicines.

Symptoms of an allergic reaction can range from mild to life-threatening. If you have a severe reaction, seek immediate medical attention.

Signs of an allergic reaction include:

  • Hives

  • Swelling of your face, lips, tongue, or throat

  • Difficulty breathing

Clinical trial history

Pfizer’s Lipitor was FDA-approved in 1997.

The first Phase III trial (ASCOT)¹ had 10,305 participants. It evaluated the effectiveness of Lipitor on coronary heart diseases. The study demonstrated that Lipitor significantly reduced fatal coronary heart disease and non-fatal myocardial infarction (MI) events. It also decreased revascularization procedures (surgery to restore blood flow to clogged arteries) by 42%.

Another study² with 2,838 participants reported a decrease in the risk of stroke by 48%.

Statins continue to be a cornerstone medication for lowering the risk of heart attacks and strokes in patients at increased risk for these conditions.

Tips and advice for taking Lipitor

  • Take one tablet per day. Taking it at the same time may make it easier to remember.

  • Initially, your doctor will recommend starting at 10-20mg/day and increasing it according to your body’s response.

  • Follow the directions for Lipitor precisely as prescribed by your doctor. Do not increase or reduce the dosage without their advice.

  • Don't drink large quantities of grapefruit juices or eat grapefruit while taking Lipitor.

  • While you're taking Lipitor, limit your alcohol intake to no more than two drinks per day.

  • If you're experiencing acute muscle pain or other conditions that could increase your risk of severe injury or kidney failure, stop taking Lipitor and seek urgent medical attention.

  • Follow a low-fat diet while taking Lipitor.

  • Exercise regularly.

  • Quit smoking if you smoke. Avoid second-hand smoke.

  • See your doctor immediately if you notice any yellowing or discoloration of your skin or short­ness of breath, unexplained cough, or general tiredness.

  • Do not take Lipitor during pregnancy or when breastfeeding. Make sure you use effective contraception while taking Lipitor and talk to your doctor before you conceive.

Have you considered clinical trials?

Access the latest treatments and medications. unavailable elsewhere - entirely free of charge. We make it easy to take part.

Joining community groups and exercise programs for my condition made me feel empowered – but I want to be part of finding a cure.
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Disclaimer

Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.

However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.

It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.

Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.

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