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Atorvastatin belongs to the group of medications known as HMG CoA reductase inhibitors ("statins"). It is used to treat people who have high cholesterol levels, including those people who have certain inherited cholesterol disorders. When you use this medication, you also need to make lifestyle changes, including switching to a diet low in fat and cholesterol, quitting smoking, and increasing the amount of exercise you do.
Atorvastatin works by blocking an enzyme that is used to make cholesterol in the liver. When that enzyme is blocked, less cholesterol is produced and the amount of cholesterol in the blood decreases. Atorvastatin lowers the level of total cholesterol and low density lipoprotein (LDL, or "bad" cholesterol), and raises high density lipoprotein (HDL, or "good" cholesterol) levels. Reduction of cholesterol levels in the blood has been shown to reduce the risks associated with heart disease, such as heart attack.
Atorvastatin is used to reduce the risk of heart attack in people experiencing symptoms associated with heart disease.
Atorvastatin is also used to reduce the risk of heart attack in people with high blood pressure who have at least 3 additional risk factors for heart disease but not experiencing symptoms associated with heart disease. The risk factors of heart disease for these individuals include:
- being male
- being 55 years old or older
- enlarged heart ventricles
- family history of heart disease
- smoking
- specific abnormalities on an ECG
- the total cholesterol to HDL-cholesterol ratio that is greater than or equal to 6
- type 2 diabetes
Atorvastatin is also used to reduce the risk of heart attack and stroke in people with high blood pressure and type 2 diabetes who have other risk factors for heart disease but not experiencing symptoms associated with heart disease. The risk factors of heart disease for these individuals include:
- a specific type of protein in the urine
- being 55 years old or older
- disease of the retina
- smoking
The medication usually takes about 2 to 4 weeks to have a significant effect on the cholesterol level in your blood. After this time, your doctor will likely send you for a blood test to check for changes in your cholesterol levels.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
10 mg Each white, elliptical, film coated tablet, embossed with "10" on one side and "PD 155" on the other, contains atorvastatin 10 mg. Nonmedicinal ingredients: calcium carbonate, candelilla wax, croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, talc, titanium dioxide, polysorbate 80, and simethicone emulsion.
20 mg Each white, elliptical, film coated tablet, embossed with "20" on one side and "PD 156" on the other, contains atorvastatin 20 mg. Nonmedicinal ingredients: calcium carbonate, candelilla wax, croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, talc, titanium dioxide, polysorbate 80, and simethicone emulsion.
40 mg Each white, elliptical, film coated tablet, embossed with "40" on one side and "PD 157" on the other, contains atorvastatin 40 mg. Nonmedicinal ingredients: calcium carbonate, candelilla wax, croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, talc, titanium dioxide, polysorbate 80, and simethicone emulsion.
80 mg Each white, elliptical, film coated tablet, embossed with "80" on one side and "PD 158" on the other, contains atorvastatin 80 mg. Nonmedicinal ingredients: calcium carbonate, croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, talc, titanium dioxide, polysorbate 80, and simethicone emulsion.
Atorvastatin should not be taken by anyone who:
- is allergic to atorvastatin or to any of the ingredients of the medication
- is pregnant or plans on becoming pregnant
- is breast-feeding
- has active liver disease or unexplained increases in liver function tests
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- constipation
- diarrhea
- gas
- headache
- heartburn
- nausea
- rash
- stomach upset
- vomiting
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- symptoms of liver damage (such as yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of muscle damage (unexplained muscle pain, tenderness or weakness, or brown or discoloured urine - especially if you also have a fever or a general feeling of being unwell)
- severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
- symptoms of a serious allergic reaction such as swelling of the face or throat, hives, or difficulty breathing
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
There may be an interaction between atorvastatin and any of the following:
- amiodarone
- antacids
- antifungal medications (e.g., itraconazole, ketoconazole)
- birth control pills
- cholestyramine
- cimetidine
- colestipol
- corticosteroids (i.e., prednisone, prednisolone, etc.)
- cyclosporine
- digoxin
- diltiazem
- efavirenz
- fibrates (e.g., bezafibrate, gemfibrozil, fenofibrate)
- grapefruit juice
- macrolide antibiotics (e.g., azithromycin, erythromycin, clarithromycin)
- nefazodone
- niacin (nicotinic acid)
- protease inhibitors (e.g., nelfinavir, ritonavir, saquinavir)
- rifampin
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (nonprescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Alcohol: People who drink large quantities of alcohol should be closely monitored by their doctor while they are taking this medication.
Cardiovascular: Caution should be exercised when initiating therapy with atorvastatin within 6 months of having a stroke or transient ischemic attack (TIA) due to an increased risk of hemorrhagic stroke.
Kidney function: People with decreased kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Your doctor will perform regular tests to check your liver function. This medication should not be used by people with active liver disease or by people whose liver function tests are higher than normal. People with a history of liver disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Muscle effects: In rare cases, serious muscle pain, cramps, and weakness have been associated with the use of statin medications (i.e., cholesterol-lowering medications whose names end in "-statin," such as atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin), especially at higher doses. Before taking this medication, tell your doctor or pharmacist if you:
- have kidney or liver problems
- are taking niacin or a fibrate medication (such as gemfibrozil, fenofibrate)
- have an underactive thyroid gland (hypothyroidism)
- regularly drink more than 3 alcoholic drinks per day
- have had any past problems with muscles (pain, tenderness) after taking a statin such as atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin
- have a personal or family history of inherited muscle problems
- are more than 70 years old
- have undergone surgery or suffered any traumatic injury
- are frail
- do excessive physical exercise
- have diabetes
Report any unexplained muscle pain, tenderness, weakness, or cramps, or any brown or discoloured urine to your doctor immediately, particularly if you are also experiencing malaise (a general feeling of being unwell) or fever.
Pregnancy: Atorvastatin should not be taken by pregnant women. If you become pregnant while taking this medication, stop taking it immediately and call your doctor.
Breast-feeding: It is not known if atorvastatin passes into breast milk. Women taking atorvastatin should not breast-feed.
Children: There is limited experience with the use of this medication by children. Atorvastatin has only been studied for use by children aged 10 to 17 years who have inherited cholesterol disorders (also known as familial hypercholesterolemia).
Seniors: If you are more than 70 years old, you may experience more side effects. Your doctor will monitor you closely while you are taking this medication.
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