atorvastatin
Atorvastatin (Lipitor) is a statin that helps lower cholesterol. As a moderate-to-high-intensity statin, it can lower cholesterol by a greater amount than many other statins. It can also help protect your heart health. The dosage is taken by mouth once a day. Atorvastatin tablets are available as brand-name Lipitor and a generic. There's also a liquid form that only comes as brand name Atorvaliq. It's possible to have side effects like muscle pain, joint pain, and stomach upset. Most times, atorvastatin (Lipitor) is taken along with a heart-healthy diet to get the most benefits from treatment.
What is Atorvastatin (Lipitor)?
What is Atorvastatin (Lipitor) used for?
- High cholesterol in adults
- High triglycerides in adults
- Homozygous familial hypercholesterolemia (HoFH) in people ages 10 years and older
- Heterozygous familial hypercholesterolemia (HeFH) in people ages 10 years and older
- Lowering the risk of heart or blood vessel problems (e.g., heart attack, stroke) in adults at high risk
How Atorvastatin (Lipitor) works
Atorvastatin (Lipitor) is a statin. The main way it works is by blocking a protein in your liver that makes cholesterol. By blocking this protein, the medication affects different types of cholesterol and fats in the body.
- It lessens the amount of "bad" cholesterol in the blood. "Bad" cholesterol is also called low-density lipoprotein, or LDL.
- It also lowers the amount of a type of fat in the blood called triglyceride.
- It helps raise the amount of "good" cholesterol by a little. "Good" cholesterol is also called high-density lipoprotein, or HDL.
Drug facts
More on Atorvastatin (Lipitor) essentials
Side effects of Atorvastatin (Lipitor)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Common cold symptoms (8%)
- Joint pain (7%)
- Diarrhea (7%)
- Pain in arms or legs (6%)
- Urinary tract infection (UTI; 6%)
- Indigestion (5%)
Less Common Side Effects
- Nausea
- Muscle pain
- Muscle spasms
- Trouble sleeping
- Throat pain
Atorvastatin (Lipitor) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe muscle damage (rhabdomyolysis): severe muscle weakness or pain, fever, tiredness, dark urine
- Liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
More on Atorvastatin (Lipitor) side effects
The following Atorvastatin (Lipitor) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common or rare
difficulty with swallowing
dizziness
fast heartbeat
muscle cramps, pain, stiffness, swelling, or weakness
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
tightness in the chest
unusual tiredness or weakness
Incidence not known
Blistering, peeling, or loosening of the skin
chills
dark-colored urine
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
red skin lesions, often with a purple center sore
red, irritated eyes
sores, ulcers, or white spots in the mouth or on the lips
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
hoarseness
lower back or side pain
pain or tenderness around the eyes and cheekbones
painful or difficult urination
stuffy or runny nose
Less common
Back pain
belching or excessive gas
general feeling of discomfort or illness
heartburn, indigestion, or stomach discomfort
lack or loss of strength
loss of appetite
shivering
stomach pain
sweating
trouble sleeping
vomiting
Incidence not known
Appetite increased
black, tarry stools
bloody nose
bloody or cloudy urine
blurred vision
continuing ringing or buzzing or other unexplained noise in the ears
difficult, burning, or painful urination
difficulty seeing at night
excessive muscle tone or tension
fruit-like breath odor
groin or scrotum pain
inability to have or keep an erection
increased body movements
increased sensitivity of the eyes to light
increased sensitivity to touch or pain
increased thirst
increased urination
loss of bladder control
loss of sexual ability, drive, or desire
menstrual bleeding occurring earlier or lasting longer than usual
mental depression
nervousness
nightmares
pale skin
paranoia
pinpoint red spots on the skin
slurred speech
swollen or tender lymph glands in the neck, armpit, or groin
unable to move or feel face
unusual bleeding or bruising
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Atorvastatin (Lipitor)
Pros
- Can lower cholesterol by more than 50% at higher doses
- Taken just once a day
- Approved for children as young as 10 years old with genetic cholesterol problems
- Also available as a liquid (Atorvaliq) for those who have trouble swallowing pills
Cons
- Can't take if you have liver problems
- Higher risk of side effects for some people, like older adults and people who drink alcohol daily
- Risk of a serious muscle problem called rhabdomyolysis
- Not recommended while pregnant or breastfeeding
Pharmacist tips for Atorvastatin (Lipitor)
- You can take atorvastatin (Lipitor) at any time of the day. Once you find a time that works for you, it's best to stick to that time every day. This helps the medication work in a consistent way.
- Remember to take atorvastatin (Lipitor) every day so it keeps working for you. Cholesterol medications like atorvastatin (Lipitor) can start lowering cholesterol in a few weeks. But you likely won't physically notice a difference. Try to take it at around the same time each day or set a reminder on your phone to help you remember.
- If you miss a dose of atorvastatin (Lipitor), take it as soon as you remember. But if it's been more than 12 hours since you usually take it, then skip the missed dose. Wait to take your next dose at the next usual time. Don't take 2 doses at the same time to make up for a missed dose because it can raise your risk of side effects.
- Tell your care team if you have muscle pain, soreness, or weakness while taking atorvastatin (Lipitor). This can be a side effect of the medication. But get help right away if the pain is severe, you have a fever, feel very tired, or have dark urine. These can be signs of a serious muscle problem.
- Don't eat grapefruit or drink grapefruit juice while taking atorvastatin (Lipitor). Grapefruit can raise the medication levels in your body. This can raise your risk of side effects.
- Limit the amount of alcohol you drink while taking atorvastatin (Lipitor). Drinking a lot of alcohol can raise your risk of serious liver problems. This statin also has a similar risk on its own. Talk to your prescriber about how much, if any, is safe for you to drink while taking this medication.
- Tell your prescriber and pharmacist about all the medications, vitamins, and supplements you take or plan to take. They can check for drug interactions and make sure your medications are safe to take together. For example, azole antifungals and colchicine can raise the level of atorvastatin (Lipitor) in your body. This can raise your risk of side effects, like muscle damage. You might need a dose adjustment or you might need to switch to a different medication to stay safe.
- Mark your calendar for your blood test appointments while taking atorvastatin (Lipitor). Your prescriber will check your cholesterol levels to see how well the medication is working and if your dose needs to be adjusted. They might also order lab tests to check your liver to make sure the medication is still safe for you to take.
Tips for the atorvastatin (Lipitor) tablet:
- You can take the tablet with or without food. Try taking it with food next time if the medication ends up hurting your stomach. This might help calm your stomach.
- Swallow the tablet whole. If you have trouble swallowing the tablet, talk to your prescriber about your options.
Tips for Atorvaliq, the liquid form of atorvastatin:
- Take the liquid on an empty stomach, 1 hour before or 2 hours after a meal. Studies show that taking it with food might make less of the medication get absorbed into the body.
- Shake the bottle of Atorvaliq well before you measure out the liquid. This makes sure the medication is properly mixed so you get the correct dose.
- Only use a medication dose cup or oral syringe to measure out your dose of Atorvaliq. Ask the pharmacy for extras. Don't use kitchen spoons because they aren't accurate and might cause you to take the wrong dose.
- Store the Atorvaliq liquid at room temperature (up to 77ºF) for up to 2 months. Keep the medication in its original bottle. After 2 months, throw it away, even if there's still some medication left.
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Risks and warnings for Atorvastatin (Lipitor)
Atorvastatin (Lipitor) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe muscle pain and damage
- Risk factors: Ages 65 years and older | Hypothyroidism that's not well-controlled | Kidney problems | Taking a higher dose of atorvastatin (Lipitor) | Taking other medications that can also cause muscle problems | Taking medications that can interact with atorvastatin (Lipitor)
Atorvastatin (Lipitor) can sometimes cause muscle pain or weakness. The risk is higher if you take other medications that cause muscle damage or interact with atorvastatin.
Rarely, atorvastatin (Lipitor) can cause a serious and life-threatening muscle problem called rhabdomyolysis. This can break down muscle tissue and lead to kidney damage. In rare cases, statins like atorvastatin (Lipitor) can also cause immune-mediated necrotizing myopathy (IMNM). This is an autoimmune condition that causes muscle inflammation and muscle weakness. This muscle problem might last even after you stop taking the statin.
Tell your care team if you have unusual muscle pain, soreness, or weakness so they can help you manage this side effect. But get medical care right away if the muscle pain is severe and you're unusually tired or have dark urine. These can be signs of a serious muscle problem like rhabdomyolysis. Depending on your symptoms, you might need to stop taking atorvastatin (Lipitor) and get treated for the muscle problem.
Liver problems
- Risk factors: History of liver problems | Drinking large amounts of alcohol
Some people who took atorvastatin (Lipitor) had higher liver enzyme levels. This can sometimes suggest liver problems. Most of the time, these changes are usually temporary and don't cause physical symptoms. But in some rare cases, serious liver problems leading to liver failure have happened.
Before starting atorvastatin (Lipitor), let your prescriber know if you have any liver problems. They might also ask for you to get a blood test done to check your liver health. People with serious liver problems shouldn't take this medication.
During your treatment with atorvastatin (Lipitor), your prescriber might ask for more blood tests to keep an eye on your liver. Watch for signs of liver damage and get medical help right away if you notice them. They can include yellow skin or eyes, stomach pain or swelling, nausea, vomiting, dark urine, or dark or bloody stools. You might need to stop taking atorvastatin (Lipitor) to prevent further liver damage.
Higher blood sugar levels
- Risk factors: High blood sugar
Some research suggests that statins like atorvastatin (Lipitor) might raise blood sugar levels a little. This can sometimes raise your A1C, which is your average blood sugar over about 3 months. But still, healthcare professionals believe the benefits of statins are greater than this small risk.
Tell your prescriber if you have diabetes or high blood sugar. They might want you to check your blood sugar more often while you take atorvastatin (Lipitor). Eating nutritious foods and staying active can help keep both your cholesterol and blood sugar under control.
Possible higher risk of brain bleed in certain people taking the 80 mg dose
- Risk factors: Stroke or "ministroke" in the past 6 months
Some studies suggest that people who recently had a stroke or a transient ischemic attack (TIA, or "ministroke") might have a higher risk of brain bleeding when taking the highest dose of atorvastatin (Lipitor), which is 80 mg. But other studies didn't find any evidence of this risk.
If you've had a stroke or "ministroke" in the past 6 months, let your prescriber know. They can talk with you about the risks and benefits of taking atorvastatin (Lipitor). If it's a safe choice for you, they can help choose a safe dose for you to take.
Possible risk of harm when taken while pregnant or breastfeeding
If you become pregnant, stop taking atorvastatin (Lipitor) and tell your prescriber right away. This medication isn't recommended during pregnancy unless the benefits are greater than the risks. Statins might harm an unborn baby. Talk to your prescriber about the safest treatment options for you if you're pregnant or planning to become pregnant.
Breastfeeding is also not recommended while you're taking atorvastatin (Lipitor). Some statins can pass into breast milk and might harm your baby. Talk to your prescriber or a lactation expert about safe ways to feed your baby.
Atorvastatin (Lipitor) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 90 tablets | $13.32 | $0.15 |
| 20mg | 90 tablets | $10.29 | $0.11 |
| 40mg | 30 tablets | $10.54 | $0.35 |
| 80mg | 90 tablets | $17.49 | $0.19 |
Typical dosage for Atorvastatin (Lipitor)
-
Adults: The typical starting dose ranges from 10 mg to 20 mg by mouth once daily. Your prescriber will adjust the dose depending on your cholesterol levels. The typical maintenance dose ranges between 10 mg and 80 mg once daily.
-
Children 10 years and older with HeFH: The typical starting dose is 10 mg by mouth once daily. The prescriber will adjust the dose depending on your child's cholesterol levels. The typical maintenance dose ranges between 10 mg and 20 mg once daily.
-
Children 10 years and older with HoFH: The typical starting dose ranges from 10 mg to 20 mg by mouth once daily. The prescriber will adjust the dose depending on your child's cholesterol levels. The typical maintenance dose ranges between 10 mg and 80 mg once daily.
Your dose might be also be adjusted if you have bothersome or serious side effects or if you take certain medications that interact with atorvastatin (Lipitor).
More on Atorvastatin (Lipitor) dosage
Interactions between Atorvastatin (Lipitor) and other drugs
More on Atorvastatin (Lipitor) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Atazanavir
- Bezafibrate
- Ceritinib
- Ciprofibrate
- Clarithromycin
- Clofibrate
- Colchicine
- Conivaptan
- Cyclosporine
- Dalfopristin
- Danazol
- Daptomycin
- Darolutamide
- Darunavir
- Digoxin
- Diltiazem
- Elbasvir
- Enasidenib
- Erythromycin
- Fenofibrate
- Fenofibric Acid
- Fluconazole
- Fosamprenavir
- Fosnetupitant
- Fusidic Acid
- Gemfibrozil
- Glecaprevir
- Grazoprevir
- Indinavir
- Isavuconazonium Sulfate
- Itraconazole
- Ketoconazole
- Ledipasvir
- Leflunomide
- Letermovir
- Lopinavir
- Mibefradil
- Nefazodone
- Nelfinavir
- Netupitant
- Niacin
- Palbociclib
- Pibrentasvir
- Piperaquine
- Quinupristin
- Saquinavir
- Simeprevir
- Telaprevir
- Telithromycin
- Teriflunomide
- Tipranavir
- Troleandomycin
- Verapamil
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amiodarone
- Amprenavir
- Azithromycin
- Bexarotene
- Black Cohosh
- Boceprevir
- Bosentan
- Clopidogrel
- Cobicistat
- Efavirenz
- Eltrombopag
- Etravirine
- Fosphenytoin
- Fostemsavir
- Interferon Beta
- Oat Bran
- Pectin
- Phenytoin
- Pioglitazone
- Quinine
- Rifampin
- St John's Wort
- Voriconazole
How much does Atorvastatin (Lipitor) cost?
Atorvastatin (Lipitor) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Atorvastatin (Lipitor) will not be safe for you to take.
- Liver problems
What are alternatives to Atorvastatin (Lipitor)?
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