Atorvastatin

💊 What is Atorvastatin used for?

• •To reduce the risk of heart attack, stroke, certain heart procedures, and angina in adults with several risk factors for coronary heart disease (CHD) but without clinically evident CHD
• •To reduce the risk of heart attack and stroke in adults with type 2 diabetes who have several risk factors for CHD but no clinically evident CHD
• •To reduce the risk of non-fatal heart attack, fatal and non-fatal stroke, certain heart procedures, hospital stays for congestive heart failure, and angina in adults with clinically evident CHD
• •As an add-on to diet to lower LDL-C in adults with primary hyperlipidemia
• •As an add-on to diet to lower LDL-C in adults and children aged 10 years and older with heterozygous familial hypercholesterolemia (HeFH)
• •To lower LDL-C in adults and children aged 10 years and older with homozygous familial hypercholesterolemia (HoFH), together with other LDL-C-lowering treatments, or alone if those treatments are unavailable
• •As an add-on to diet for adults with primary dysbetalipoproteinemia or hypertriglyceridemia

How it works

The label describes atorvastatin as an HMG-CoA reductase inhibitor (a statin). It decreases the body's making of cholesterol, which lowers LDL-C levels.

How it is usually taken

• •The label says to take it by mouth once a day, at any time of the day, with or without food. It is used along with diet as stated in the label. Follow the instructions from your prescriber or pharmacist.

Comes as

• •20 mg tablets: white, elliptical, film-coated tablets marked "20" on one side and "ATS" on the other

⚠️ Atorvastatin side effects

🛑 Who should not take Atorvastatin, and who should be careful

The label says not to take it if

• 🚨You have acute liver failure or decompensated cirrhosis (the label lists these as contraindications).
• 🚨You have had an allergy or hypersensitivity to atorvastatin or any of its ingredients. The label notes that serious allergic reactions have been reported.

Tell your doctor before taking it if

• •The label lists these risk factors for muscle problems: age 65 or older, uncontrolled hypothyroidism, kidney problems, use with certain other drugs, and a higher dose.
• •The label says your liver may be tested before starting and as needed after that.
• •The label notes that rising HbA1c and fasting blood sugar levels may happen with this medicine. It encourages regular exercise, a healthy weight, and healthy food choices.
• •The label says the medicine can affect a pregnancy and is not recommended during breastfeeding (see the pregnancy and breastfeeding sections).
• •The label says immune-mediated necrotizing myopathy (an autoimmune muscle disease) has been rarely reported with statins. The label says to stop the medicine if it is suspected.
• •The label says to tell your healthcare provider about all medicines you take, both prescription and over the counter.

🔀 Atorvastatin with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Cyclosporine and gemfibrozil: the label says concomitant use is not recommended.
• •Tipranavir plus ritonavir, and glecaprevir plus pibrentasvir: the label says concomitant use is not recommended.
• •Certain anti-viral medicines, azole antifungals, and macrolide antibiotics: the label says dose adjustments are recommended.
• •Niacin (at lipid-modifying doses above 1 gram per day), fibrates, colchicine, and ledipasvir plus sofosbuvir: the label says these have been linked to muscle problems, and the benefit should be weighed against the increased risk.
• •Large amounts of grapefruit juice (more than 1.2 liters daily): the label says this is not recommended.
• •Rifampin: the label says it may reduce atorvastatin levels, and it is to be given at the same time as atorvastatin.
• •Oral contraceptives: the label says atorvastatin may increase norethindrone and ethinyl estradiol levels, which should be considered when choosing a contraceptive.
• •Digoxin: the label says atorvastatin may increase digoxin levels, and patients should be monitored.

Alcohol and food

The label says atorvastatin can be taken with or without food. It says large amounts of grapefruit juice (more than 1.2 liters daily) are not recommended because they can raise the risk of muscle problems. The label does not give alcohol guidance.

🤰 Atorvastatin in pregnancy and breastfeeding

Pregnancy

The label says to discontinue atorvastatin when pregnancy is recognized, or to consider the ongoing needs of the individual patient. It says atorvastatin may cause fetal harm based on how it works. The label also says treatment of high cholesterol is not generally necessary during pregnancy. Data from statin use in pregnant women have not identified a drug-associated risk of major birth defects, but data are insufficient to determine a risk of miscarriage. The label advises pregnant patients and patients who can become pregnant to know about the potential risk to a fetus.

Breastfeeding

The label says breastfeeding is not recommended during treatment with atorvastatin.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20° to 25°C (68° to 77°F), which is controlled room temperature.

If a dose is missed

The label says that if a dose is missed, do not take the missed dose. Resume with the next scheduled dose.

If too much is taken

The label says there are no specific antidotes known. Contact Poison Control at 1-800-222-1222 for the latest recommendations. The label says hemodialysis is not expected to significantly increase how fast atorvastatin is cleared from the body.

🗒️ Questions to ask about Atorvastatin

• Why was atorvastatin chosen for me instead of another cholesterol medicine?
• Do I need blood tests for liver function or cholesterol before and during treatment?
• What muscle symptoms should make me call you right away?
• Does this medicine affect my blood sugar or HbA1c, and what can I do about it?
• Which of my current medicines, supplements, or foods could interact with atorvastatin?
• What should I do if I might be pregnant or am planning a pregnancy?
• How will we know if the medicine is working for my cholesterol?

❓ Atorvastatin: frequently asked questions