13 Atorvastatin Side Effects and How to Manage Them
Key takeaways:
Atorvastatin (Lipitor) is a statin medication used to treat high cholesterol. It can also lower the risk of heart attack and stroke in certain people who are at high risk.
Commonly reported atorvastatin side effects include muscle pain, joint pain, and diarrhea. Serious atorvastatin side effects are rare but possible. They include liver, kidney, and severe muscle damage.
Atorvastatin can also cause blood glucose (sugar) levels to rise, increasing the risk of diabetes in certain people. But for most people prescribed atorvastatin, its benefits outweigh this risk.
If you’re unable to tolerate atorvastatin, there are several options your prescriber may recommend to help you stick with treatment. Examples include lowering your dose, taking a temporary break, and switching statins. Don’t stop atorvastatin on your own.
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Table of contents
Atorvastatin (Lipitor) is a statin medication used to treat high cholesterol. It’s also used to lower the risk of heart attack or stroke in certain people who are at high risk. If you’re prescribed atorvastatin, take it at the same time each day and be consistent with treatment. But if you’re experiencing side effects, you may be wondering if there’s anything you can do to find relief.
Some of the most common atorvastatin side effects include muscle pain, joint pain, and diarrhea. But for most people, these side effects may go away over time. If they don’t, there are steps your prescriber can take to find a solution that’s right for you.
Atorvastatin side effects at a glance
Below are both common and rare (but potentially serious) atorvastatin side effects. Keep in mind, everyone responds differently to medication. Let your prescriber know about any side effects you experience while taking atorvastatin.
The most commonly reported atorvastatin side effects include:
Muscle pain
Joint pain
Common cold symptoms
Diarrhea
Urinary tract infection
Upset stomach and nausea
Muscle spasms
Less common atorvastatin side effects include:
Liver damage
Severe muscle damage
Blood glucose (sugar) changes
Kidney damage
Memory problems
Hair loss
Peripheral neuropathy (nerve pain)
Tendon rupture
Chest pain
Loss of appetite
Headache
Let’s look more closely at 13 of these side effects.
1. Muscle pain
Muscle pain is one of the most commonly reported atorvastatin side effects. It seems to happen most often in the calves and thighs. A recent meta-analysis found a small increased risk of muscle pain with statins, usually within the first year. But it also found that most reports of muscle symptoms may not actually be due to the statin.
But if you do experience muscle pain while taking atorvastatin, there’s a good chance it will go away over time. And if it doesn’t or it becomes bothersome, you have a few options. Your prescriber may lower your dose, change your dosing schedule, or have you take a temporary break. In some cases, they may have you try a different statin.
Atorvastatin interactions: Did you know that some medications and substances shouldn’t be taken with atorvastatin? Here’s a list of notable atorvastatin interactions and how to manage them.
Real stories: Three real people describe their experience taking atorvastatin to help lower their cholesterol.
Atorvastatin dosage: The right atorvastatin dosage for you depends on your cholesterol levels, treatment goals, and other factors. Learn more about typical atorvastatin dosages here.
Don’t try stopping atorvastatin or changing your dose without your prescriber’s guidance.
2. Joint pain
Joint pain is another possible atorvastatin side effect. But some people may think atorvastatin is causing their joint pain when it’s actually arthritis. And people already living with arthritis may feel that atorvastatin makes their joint pain worse.
Joint pain from atorvastatin often goes away over time. If it becomes bothersome, your prescriber may suggest an over-the-counter (OTC) pain reliever to help in the meantime. But if your joint pain doesn’t go away or becomes worse, your prescriber may adjust your statin regimen.
3. Common cold symptoms
Some people taking atorvastatin report experiencing common cold symptoms. This might include a runny or stuffy nose, sneezing, or a sore throat.
If you come down with a cold while taking atorvastatin, it should go away on its own. That’s because colds are usually caused by viruses. Antibiotics don’t work against viruses, so they won’t make it go away any faster. In the meantime, your prescriber or pharmacist can recommend OTC cold remedies to manage your symptoms.
Let your prescriber know if your symptoms are severe or if they don’t start getting better within 10 days. They can determine the potential cause and next steps.
4. Diarrhea
Diarrhea is possible with all statins, including atorvastatin. Similar to muscle and joint pain, diarrhea often gets better over time. Avoid fatty and fried foods when taking atorvastatin, it may help lessen diarrhea and provide benefits for your cholesterol at the same time. Be sure to drink plenty of water so you don’t get dehydrated.
Talk to your prescriber if your diarrhea is bothersome, severe, or not going away.
5. Upset stomach (indigestion) and nausea
In addition to diarrhea, stomach-related side effects such as nausea and an upset stomach (indigestion) are possible with atorvastatin. If this happens to you, certain lifestyle changes can help:
Take your dose with food. Atorvastatin can be taken with or without food. But if your stomach is upset after taking your dose, see if taking it with a meal or snack helps.
Avoid spicy or fried foods. These foods can make nausea worse. Instead, temporarily sticking with bland, starchy foods for the time being may be easier on your stomach.
Take your dose before bedtime. Taking atorvastatin at night may keep you from noticing the nausea since you’ll be asleep.
Try an OTC nausea medication. Talk to your pharmacist or prescriber about OTC nausea remedies that can give you some relief. Stronger prescription nausea medications are available too, if needed.
6. Liver damage
While rare, liver damage has been reported in some people taking atorvastatin. Signs and symptoms of liver damage include dark urine, stomach pain, or yellowing of the skin or eyes. Loss of appetite is also possible.
In most cases, liver damage is mild, short-lived, and doesn’t cause noticeable symptoms. But your prescriber might notice a change in your liver tests. So, be sure to keep up with any follow-up appointments during treatment, and let them know if you develop any symptoms.
The risk of liver damage appears to slightly go up with higher atorvastatin doses. And it may be more likely if you drink large amounts of alcohol or have a history of liver problems. If there are any changes in your liver tests, your prescriber may lower your atorvastatin dose.
7. Blood glucose changes
Atorvastatin can cause changes in your blood glucose levels. This can increase the risk of developing Type 2 diabetes, especially in people at higher risk. It may also worsen existing diabetes in people already living with the condition.
Even so, the benefits of atorvastatin often outweigh this risk — especially for people with diabetes. In fact, experts recommend statin therapy for certain people with diabetes to prevent problems down the road, including heart attack or stroke.
If you have diabetes or are at risk of developing diabetes, your prescriber may want to monitor your blood glucose more closely during treatment.
8. Severe muscle damage
While rare, rhabdomyolysis is possible with atorvastatin. This is when damaged muscle breaks down and its byproducts are released into the bloodstream. Symptoms include intense muscle pain, dark or red urine, and feeling weak or tired. Seek medical attention right away if these symptoms develop.
The risk of developing rhabdomyolysis can go up if you take atorvastatin with certain interacting medications. Examples of these include erythromycin (Ery-Tab) and itraconazole (Sporanox). Make sure your healthcare team has your current medication list to check for interactions.
9. Kidney damage
Kidney damage from atorvastatin is also rare. When it happens, it’s most commonly caused by rhabdomyolysis. This is because components from broken down muscle can clog up your kidneys, resulting in kidney failure.
Kidney failure from rhabdomyolysis can happen quickly. And it can be life-threatening if left untreated. So, it’s important to seek immediate medical treatment if symptoms of rhabdomyolysis develop.
10. Memory problems
Some people report experiencing memory problems while taking statins like atorvastatin. However, current evidence doesn’t strongly link statins as the cause. In fact, there’s some evidence suggesting that statins may even lower the risk of dementia.
Even so, it’s important to let your prescriber know if you notice any memory changes while taking atorvastatin. They can help determine the potential cause and work with you to find the best next steps. Thankfully, most reported cases of memory changes have been reversible.
11. Hair loss
While uncommon, there have been some reports of hair loss in people taking atorvastatin. Keep in mind that hair loss can have many causes, including stress, health conditions, older age, and genetics (androgenetic alopecia).
The type of hair loss that may be caused by atorvastatin isn’t usually permanent. In other words, your hair should grow back after stopping the medication. But it’s important to continue taking atorvastatin since its benefits outweigh the risk of this side effect.
If you notice hair thinning or loss while taking atorvastatin, your prescriber can help determine the cause. If needed, they can also suggest ways to lessen or manage hair loss.
12. Chest pain
While muscle pain is most common in the calves and thighs, atorvastatin can cause muscle pain anywhere in the body. While uncommon, there has been at least one reported case of someone taking statins who experienced muscle pain in their chest. In this case, the pain went away after the statin was stopped.
Keep in mind that statins like atorvastatin are often prescribed to lower the risk of major cardiovascular events, such as heart attack. Chest pain from a heart attack often travels down the arms, neck, or jaw. Other symptoms include shortness of breath, sweating, and nausea. Seek immediate medical attention if you think you’re having a heart attack.
If you develop chest pain while taking atorvastatin, it’s best to go to the nearest ER to be safe. That way, you can receive treatment if it’s something serious. If atorvastatin is the cause, your prescriber may lower your dose or have you stop taking it. Don’t try to stop it on your own.
13. Headache
Headache may be possible with statins, including atorvastatin. In one study of older adults, about 1 in 3 people taking either atorvastatin or rosuvastatin got a headache. But another study found that statins might lower your risk for a headache if you have adequate vitamin D levels.
If you’re experiencing headaches after starting atorvastatin, they may get better over time as you adjust to the medication. You can also speak to your pharmacist or prescriber about taking an over-the-counter headache medication. Staying well hydrated, managing stress, and getting enough exercise may help, too.
When should you contact your healthcare team about atorvastatin side effects?
If any side effects you experience while taking atorvastatin start affecting your daily life, reach out to your healthcare team. In some cases, atorvastatin may not actually be the cause. And your prescriber can help determine the culprit as well as how to address it.
While rare, serious atorvastatin side effects are possible. Dark urine, severe muscle pain, and decreased urination are a few side effects that require medical attention. Seek medical attention right away if any of these develop.
If you’re having difficulty tolerating atorvastatin, don’t stop taking it on your own. There are several options your prescriber can recommend to help you stick with treatment. Examples include lowering your dose, changing your dose schedule, and switching statins.
Frequently asked questions
There’s some evidence linking statin therapy to a small amount of weight gain, possibly due to dietary changes. But this doesn’t mean that you’ll gain weight from taking atorvastatin. If you notice any changes in your body weight that are concerning to you, contact your prescriber. They can discuss potential lifestyle changes to help you meet your specific health goals.
Compared to men, women may be more likely to report muscle-related side effects, such as muscle pain, from statins. In fact, the female sex is considered to be a risk factor in this case. Women also seem to be more likely to stop or switch their statin due to muscle-related side effects.
Muscle pain is a commonly reported statin side effect. It seems to be more likely in people with the following risk factors:
Women
Older adults
Taking medications that interact with their statin
Hypothyroidism
Drinking a lot of alcohol
The bottom line
Common atorvastatin side effects include muscle pain, joint pain, and diarrhea. While rare, severe muscle damage, liver damage, and kidney problems are also possible.
Certain atorvastatin side effects may be more likely to happen if you’re taking medications that interact with atorvastatin. Sharing your current medication list can help your healthcare team check for these interactions up front.
Contact your prescriber if you’re experiencing any bothersome atorvastatin side effects. They can determine the cause and potential next steps.
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References
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Padhye, M. R., et al. (2022). Plethora of adverse drug reactions in geriatric population receiving statin therapy for dyslipidaemia. Journal of Family Medicine and Primary Care.
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Segal, A. S. (2002). Alopecia associated with atorvastatin. American Journal of Medicine.
Selva-O’Callaghan, A., et al. (2018). Statin-induced myalgia and myositis: An update on pathogenesis and clinical recommendations. Expert Review of Clinical Immunology.
U.S. Preventive Services Task Force. (2022). Statin use for the primary prevention of cardiovascular disease in adults. Journal of the American Medical Association.
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