Atorvastatin

Atorvastatin is a prescription medicine used to treat high cholesterol levels and to prevent heart disease. Atorvastatin belongs to a group of drugs called HMG-CoA reductase inhibitors, also known as statins. These drugs block an enzyme in the body called HMG-CoA reductase. This is a major enzyme involved in making cholesterol in the body. 

Atorvastatin is a prescription medicine used to treat adults and children at least 10 years of age with high cholesterol that cannot be controlled by exercise and a low-fat diet alone. Atorvastatin is also used to prevent heart disease.

Atorvastatin may be found in some form under the following brand names:

• Caduet

• Lipitor

• Liptruzet

Atorvastatin can cause serious side effects. These side effects have happened only to a small number of people. Your doctor can monitor you for them. These side effects usually go away if your dose is lowered or atorvastatin is stopped. These serious side effects include:

• Muscle problems. Atorvastatin can cause serious muscle problems that can lead to kidney problems, including kidney failure. You have a higher chance for muscle problems if you are taking certain other medicines with atorvastatin.
• Liver problems. Your doctor should do blood tests to check your liver before you start taking atorvastatin and if you have symptoms of liver problems while you take atorvastatin. Call your doctor right away if you have the following symptoms of liver problems:
  • feel tired or weak
  • loss of appetite
  • upper belly pain
  • dark amber colored urine
  • yellowing of your skin or the whites of your eyes

Call your doctor right away if you have:

• muscle problems like weakness, tenderness, or pain that happen without a good reason, especially if you also have a fever or feel more tired than usual.
• allergic reactions including swelling of the face, lips, tongue, and/or throat that may cause difficulty in breathing or swallowing which may require treatment right away.
• nausea and vomiting.
• passing brown or dark-colored urine.
• you feel more tired than usual
• your skin and whites of your eyes get yellow.
• stomach pain.
• allergic skin reactions.

In clinical studies, patients reported the following common side effects while taking atorvastatin: the common cold (known as nasopharyngitis), joint pain, diarrhea, pain in extremeties, and urinary tract infections.

The following additional side effects have been reported with atorvastatin:

• general feeling of discomfort (malaise)
• fever
• neck pain
• joint swelling
• hives

Talk to your doctor or pharmacist if you have side effects that bother you or that will not go away.

These are not all the side effects of atorvastatin. Ask your doctor or pharmacist for a complete list.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• antifungal medications such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• cimetidine (Tagamet)
• clarithromycin (Biaxin)
• colchicine (Colcrys)
• digoxin (Lanoxin)
• diltiazem (Cardizem, Cartia, Taztia, Tiazac)
• erythromycin (E.E.S., E-Mycin, Erythrocin)
• efavirenz (Sustiva, in Atripla)
• oral contraceptives (birth control pills)
• other cholesterol-lowering medications such as fenofibrate (Tricor), gemfibrozil (Lopid), and niacin (nicotinic acid, Niacor, Niaspan)
• certain HIV protease inhibitors such as darunavir (Prezista), fosamprenavir (Lexiva), lopinavir (in Kaletra), nelfinavir (Viracept), saquinavir (Invirase), ritonavir (Norvir, in Kaletra) and tipranavir (Aptivus)
• medications that suppress the immune system such as cyclosporine (Neoral, Sandimmune)
• rifampin (Rifadin, Rimactane)
• spironolactone (Aldactone)
• telaprevir (Incivek)

This is not a complete list of atorvastatin drug interactions. Ask your doctor or pharmacist for more information.

Statin medications, including atorvastatin, carry a rare but serious risk of:

• liver damage
• memory loss or confusion
• increase in blood sugar levels (hyperglycemia)
• type 2 diabetes
• immune-mediated muscle breakdown

Certain statins can increase risk of muscle weakness as well.  It is important to consult your physician to discuss the benefits and risks associated with using this medication.

Do not take atorvastatin if you:

• are pregnant or think you may be pregnant, or are planning to become pregnant. Atorvastatin may harm your unborn baby. If you get pregnant, stop taking atorvastatin and call your doctor right away.
• are breastfeeding. Atorvastatin can pass into your breast milk and may harm your baby.
• have liver problems.
• are allergic to atorvastatin or any of its ingredients. 

Atorvastatin has not been studied in children under 10 years of age.

• Talk to your doctor before you start any new medicines. This includes prescription and non-prescription medicines, vitamins, and herbal supplements. atorvastatin and certain other medicines can interact causing serious side effects.
• Do not get pregnant. If you get pregnant, stop taking atorvastatin right away and call your doctor.

Grapefruit and grapefruit juice may interact with atorvastatin and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Tell your doctor if you:

• have muscle aches or weakness
• drink more than 2 glasses of alcohol daily
• have diabetes
• have a thyroid problem
• have kidney problems

Some medicines should not be taken with atorvastatin. Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Atorvastatin and certain other medicines can interact causing serious side effects. Especially tell your doctor if you take medicines for:

• your immune system
• cholesterol
• infections
• birth control
• heart failure
• HIV or AIDS

Tell your doctor if you are pregnant or think you may be pregnant, or are planning to become pregnant. Atorvastatin may harm your unborn baby. If you get pregnant, stop taking atorvastatin and call your doctor right away.

Tell your doctor if you are breastfeeding. Atorvastatin can pass into your breast milk and may harm your baby.

• Take atorvastatin exactly as prescribed by your doctor. Do not change your dose or stop atorvastatin without talking to your doctor. Your doctor may do blood tests to check your cholesterol levels during your treatment with atorvastatin. Your dose of atorvastatin may be changed based on these blood test results.
• Take atorvastatin each day at any time of day at about the same time each day. Atorvastatin can be taken with or without food. Don't break atorvastatin tablets before taking.
• Your doctor should start you on a low-fat diet before giving you atorvastatin. Stay on this low-fat diet when you take atorvastatin.
• If you miss a dose of atorvastatin, take it as soon as you remember. Do not take atorvastatin if it has been more than 12 hours since you missed your last dose. Wait and take the next dose at your regular time. Do not take 2 doses of atorvastatin at the same time.

The atorvastatin dose your doctor recommends will depend on several factors including your age, the medical condition being treated, other medical conditions you have, and the medications you are taking.

The recommended starting atorvastatin dose is 10 or 20 mg once daily. For some people with extremely high cholesterol, the starting atorvastatin dose may be as high as 40 mg.

After several weeks the atorvastatin dose may be increased as necessary to achieve the desired cholesterol levels. If you are experiencing side effects, your doctor may reduce your atorvastatin dose. The recommended dosage range of atorvastatin is 10 to 80 mg once daily.

For children (ages 10 to 17), the maximum recommended daily atorvastatin dose is 20 mg.

If you take too much atorvastatin or overdose, call your doctor or Poison Control Center right away. Or go to the nearest emergency room.

• Store atorvastatin at room temperature, 68 to 77°F (20 to 25°C).
• Do not keep medicine that is out of date or that you no longer need.
• Keep atorvastatin and all medicines out of the reach of children. Be sure that if you throw medicine away, it is out of the reach of children.