Atorvastatin

August 4, 2018

About atorvastatin

Atorvastatin belongs to a group of medicines called statins. It's used to lower cholesterol.

It's also taken to prevent heart disease, heart attack and stroke.

The medicine is available on prescription. It comes as tablets, including chewable tablets, for people who have difficulty swallowing.

Key facts

It's usual to take atorvastatin once a day.
The most common side effects are headaches, feeling sick, diarrhoea and cold-like symptoms.
Don't take atorvastatin if you're pregnant or think you could be pregnant. This medicine can harm an unborn baby.
Keep taking atorvastatin even if you feel well, as you will still be getting the benefits. Most people with high cholesterol don't have any symptoms.
Atorvastatin is also called by the brand name Lipitor.

Who can and can't take atorvastatin

Atorvastatin can be taken by adults and children over the age of 10 years.

Atorvastatin isn't suitable for some people. Tell your doctor if you:

have had an allergic reaction to atorvastatin or any other medicines in the past
have liver or kidney problems
are trying to get pregnant, think you might be pregnant, you're already pregnant, or you're breastfeeding
have severe lung disease
have previously had a stroke caused by bleeding into the brain
drink large amounts of alcohol
have an underactive thyroid
have had muscular side effects when taking a statin in the past
have had, or have, a muscle disorder

Lipitor chewable tablets contain a substance called aspartame - check with your doctor before taking these if you have phenylketonuria (an inherited disorder of protein metabolism).

How and when to take it

Take atorvastatin once a day. You can choose to take it at any time, as long as you stick to the same time every day.

Atorvastatin doesn't upset the stomach, so you can take it with or without food.

How much will I take?

The usual dose for adults is between 10mg and 80mg a day.

In children, the usual dose is 10mg to 20mg once a day. Sometimes higher doses are used - your doctor will work out the amount of atorvastatin that's right for your child.

Your dose depends on the reason for taking it, your cholesterol levels, and what other medicines you're taking.

Swallow atorvastatin tablets whole with a glass of water. If you've been given chewable tablets, you can chew them or swallow them whole with a glass of water.

What if I forget to take it?

If you occasionally forget to take a dose, take your next dose the next day at the usual time. Never take 2 doses at the same time. Never take extra doses.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking an extra dose of atorvastatin by accident is unlikely to harm you.

Talk to your pharmacist or doctor if you're worried or take more than 1 extra dose.

Side effects

Like all medicines, atorvastatin can cause side effects in some people.

One rare but serious side effect is unexplained muscle pain, tenderness or weakness.

Common side effects

These common side effects of atorvastatin happen in more than 1 in 100 people.

Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away:

feeling sick
headache
pain in the back and joints
nosebleeds
sore throat
cold-like symptoms, such as a runny nose, blocked nose or sneezing
constipation, wind, indigestion or diarrhoea

Report any unexplained muscle pain, tenderness or weakness to a doctor straight away.

Serious side effects

Serious side effects when taking atorvastatin are rare and happen in less than 1 in 1,000 people.

Stop taking atorvastatin and tell a doctor if you get:

muscle pain, tenderness, weakness or cramps - these can be signs of muscle breakdown and kidney damage
yellow skin or eyes - this can be a sign of liver problems
a skin rash with pink-red blotches, especially on the palms of the hands or soles of the feet
severe tummy pain - this can be a sign of pancreas problems
a cough, feeling short of breath, and weight loss - this can be a sign of lung disease

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction to atorvastatin.

A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

The warning signs of a serious allergic reaction are:

getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
wheezing
tightness in the chest or throat
having trouble breathing or talking
swelling of the mouth, face, lips, tongue, or throat

These are not all the side effects of atorvastatin. For a full list see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

How to cope with side effects

What to do about:

feeling sick - stick to simple meals and don't eat rich or spicy food. It might help to take your atorvastatin after a meal or snack.
headaches - make sure you rest and drink plenty of fluids. Don't drink too much alcohol
diarrhoea - drink plenty of water or other fluids. It may also help to take oral rehydration solutions, which you can buy from a pharmacy or supermarket to prevent dehydration.

Pregnancy and breastfeeding

Atorvastatin isn't recommended during pregnancy or breastfeeding, as there's no firm evidence it's safe.

Talk to your doctor if you want to get pregnant. It's best to stop taking atorvastatin at least 3 months before you start trying for a baby.

If you become pregnant while taking atorvastatin, stop taking the medicine and tell your doctor.

Atorvastatin and breastfeeding

It's not known if atorvastatin gets into breast milk, but it may cause problems for your baby. You may be able to stop atorvastatin while you breastfeed.

Tell your doctor if you're trying to get pregnant, become pregnant, or if you're breastfeeding.

Cautions with other medicines

Some medicines affect the way atorvastatin works and can increase the risk of serious side effects.

Medicines that may not mix well with atorvastatin include:

some antibiotics and antifungals
some HIV medicines
some hepatitis C medicines
warfarin (stops blood clotting)
ciclosporin (treats psoriasis and rheumatoid arthritis)
colchicine (a medicine for gout)
contraceptive pills
verapamil, diltiazem, amlodipine (for high blood pressure and heart problems)
amiodarone (makes your heart stable)

If you're taking atorvastatin and need to take one of these medicines, your doctor may:

prescribe a lower dose of atorvastatin
prescribe a different statin medicine
recommend that you stop taking atorvastatin for a while

Mixing atorvastatin with herbal remedies and supplements

St John's wort, a herbal medicine taken for depression, reduces the amount of atorvastatin in your blood, so it doesn't work as well.

Talk to your doctor if you're thinking about starting St John's wort, as it will change how well atorvastatin works.

Tell your doctor and pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

Common questions

How does atorvastatin work?

Atorvastatin acts on the liver to stop it making cholesterol. This lowers your blood cholesterol level.

How long will I take atorvastatin for?

Usually, treatment with a statin such as atorvastatin is for life.

Are statins safe?

You may have read negative stories about statins, but they're thought to be very safe, effective medicines with very few side effects. Sometimes the side effects reported are unrelated to the medicine.

If you're concerned about the safety of statins, talk to your doctor.

Is atorvastatin addictive?

No, there's no evidence that atorvastatin is addictive.

What will happen if I come off it?

The benefits of atorvastatin will only continue for as long as you take it. If you stop taking atorvastatin without starting a different cholesterol-lowering treatment, your cholesterol level may rise again.

Talk to your doctor if you want to stop taking the medicine. It's important to find another way to lower your cholesterol. Lowering the dose of atorvastatin may be an option too.

Can I drive or ride a bike?

Yes, you can drive or cycle while taking atorvastatin.

Will it reduce my fertility?

Atorvastatin doesn't reduce male or female fertility.

Are there other cholesterol-lowering medicines?

There are several other statin medicines, including:

fluvastatin
pravastatin
rosuvastatin
simvastatin

Statins all work in the same way, but they differ in how well they lower cholesterol.

If you have a side effect with one statin, it may not happen with another. Some medicines don't mix well with one statin, but you can take them with a different one.

Your doctor will find the right statin and dose for you, depending on your medical history, cholesterol level and the other medicines you take.

Will it stop my contraception working?

Atorvastatin may slightly increase the hormones released into your system from some contraceptive pills. You will still be protected from pregnancy, but this could increase your chances of side effects from contraceptive pills.

If you have any side effects, talk to your doctor or pharmacist.

Can I drink alcohol with it?

Yes, you can drink alcohol while taking atorvastatin.

However, drinking a lot of alcohol may mean you're more likely to get muscle and liver side effects. Try not to drink more than 14 units of alcohol a week.

Is there any food or drink I need to avoid?

Drinking lots of grapefruit juice (more than about a litre a day) can interfere with the way atorvastatin works.

Can lifestyle changes help?

Reducing your cholesterol may mean you don't need to be prescribed a statin medicine. There are lifestyle changes you can make that will help lower your cholesterol:

lose excess weight
eat healthy foods by decreasing saturated fat and increasing fibre, fruits, vegetables, wholegrains and fish
stop smoking
cut down on alcohol
try to exercise every day

As part of a healthy diet, it can also help to include foods fortified with plant sterols and stanols. These are proven to help lower cholesterol. You can buy spreads, cheese, cereals, granola bars, orange juice, wholemeal bread and yoghurt-style drinks that have been fortified with plant sterols and stanols from most supermarkets.