Atorvastatin, sold under the brand name Lipitor, is used to treat high cholesterol. It can also be used to prevent heart disease, heart attacks, and strokes. It is commonly prescribed if you have a family history of heart disease or if you have a long-term health condition like arthritis or diabetes.

Atorvastatin (Lipitor) is available only by prescription in tablet form. However, there is a chewable variant available for those who have trouble swallowing. On this page, we'll be breaking down the top questions that patients typically have about atorvastatin (Lipitor) such as how it works, drug and food interactions, and when to take it.

What is atorvastatin?

Atorvastatin is a prescription medication delivered in a tablet form taken orally. It is available both as the brand-name drug Lipitor and in generic form. It works by blocking HMG-CoA reductase, an enzyme necessary for cholesterol production statins. By blocking HMG-CoA reductase, atorvastatin lowers your low-density lipoprotein or “bad” cholesterol. Additionally, atorvastatin improves your body's natural ability to get rid of low-density lipoprotein via your liver and raises your high-density lipoprotein or "good" cholesterol.

What is atorvastatin used for?

Atorvastatin is used to reduce cholesterol levels—including total cholesterol, LDL, apolipoprotein B, and triglycerides—in people whose levels are too high. It is also used to reduce the risk of heart attack and stroke. For it to be most effective, it is recommended to combine atorvastatin with a healthy diet and exercise. One of the primary benefits of atorvastatin is reduced cholesterol buildup in arteries, which in turn ensures proper blood flow to the heart and brain. It is also common to use atorvastatin as one part of combination therapy, meaning it is used together with another drug. The other medications involved in the regimen can include bile acid resins or other cholesterol-lowering drugs.

When to take atorvastatin, morning or night?

It does not matter what time of day you choose to take atorvastatin. However, it is important that whatever time you choose is the time you take it every day. Some doctors have recommended taking it in the evening due to your body’s increased cholesterol production at night. Furthermore, atorvastatin is gentle on the stomach, so it is not important to take it with food.

What foods should I avoid while taking atorvastatin?

Generally, you should try not to eat fatty or high cholesterol foods as they can reduce the effectiveness of atorvastatin. Grapefruit can also lead to unwanted side effects when it interacts with atorvastatin and should not be consumed in excess. You can learn more here.

What drugs should I not take with atorvastatin?

There are many potential drug interactions for atorvastatin as well as other statins. We have listed below some of the most common, but this is not a complete list and you should ask your doctor about any medication you are taking if you plan to add atorvastatin to your regimen.

Common severe interactions:

• Cyclosporine
• Pazopanib
• Tipranavir
• Telaprevir
• Gemfibrozil

Common moderate to mild interactions:

• Alvimopan
• Armodafinil
• Coenzyme q10
• Colestipol
• Fexofenadine
• Fluvoxamine
• Isradipine
• Loratadine
• Orlistat
• Ruxolitinib
• Trazodone

What are the side effects of atorvastatin?

Just like any other medicine, atorvastatin produces a range of possible side effects. We have listed below common side effects, which are experienced by at least one in one hundred people. The more serious side effects are rare and experienced by around one in one thousand patients.

Common side effects:

• Diarrhea
• Nausea
• Headaches
• Joint and backaches
• Pain in arms or legs
• Muscle pain
• Nosebleeds
• Sore throat
• Runny or stuffy nose
• Constipation

It is important to note that even if you are experiencing side effects that are common, you should speak to your doctor if they are severe, bothering you, persistent, or worsening.

Severe side effects:

• Intense muscle pain, cramps or weakness
• Yellowing skin or eyes
• Darkened urine
• Severe stomach pain
• Shortness of breath and coughing
• Unintended weight loss

If you experience any of these symptoms, talk to your doctor.

Allergic reaction – In some rare cases, patients can experience allergic reactions. Seek emergency medical care if you experience any of the following symptoms after taking atorvastatin.

• Skin rash
• Wheezing
• Tightness in the throat or chest
• Difficulty talking or breathing
• Swelling of the face, lips, tongue or throat

What caused the 2018 atorvastatin recall?

If you are thinking about taking atorvastatin, you may have heard that in 2018 there was a major recall of more than 200,000 bottles. Understandably, you may want to know what happened. In late May 2018, a firm responsible for producing atorvastatin voluntarily recalled bottles when it was reported that a foreign object had been found embedded in a tablet. It is worth noting, however, that the classification of the recall suggests that the use of the affected tablets would have likely been harmless.

Is atorvastatin bad for your kidneys?

Recent studies have shown that high doses of powerful cholesterol-lowering drugs, such as atorvastatin 20 mg or higher, have the potential to damage the kidneys. One study found a 34% higher risk of being hospitalized for acute kidney injury in patients taking powerful cholesterol-lowering drugs compared to patients taking lower-potency cholesterol drugs. It is worth noting that the risk to individual patients is still very low, although the total number of affected patients could still be quite high. This is simply because millions of people take drugs like these worldwide.

Atorvastatin vs simvastatin

A question that patients often have is about the differences between atorvastatin and simvastatin and which is a better option for them. Both medications are in the same class, known as HMG-coA reductase inhibitors. They both function the same way, inhibiting HMG-coA reductase and in turn reducing cholesterol. Both have similar side effect profiles, though simvastatin may cause muscle pain more often. One of the key differences that some people are interested in is the average cash price. While it is hard to give one answer to this question as insurance will play a huge role in the cost of this treatment atorvastatin’s average price per 30 tablets is $519 and simvastatin averages $28 per 30 tablets.

You can learn more about the similarities and differences between different statins here: You Most Common Questions About Statins Answered

Does atorvastatin cause weight gain?

While atorvastatin and other statins are not known to directly cause weight gain, some of their side effects can potentially lead to weight gain. While taking atorvastatin, it is not uncommon to experience mild muscle aches and weakness, which can make physical activity more difficult. A lack of physical activity has the potential to lead to weight gain. The second factor that often contributes to weight gain among patients taking atorvastatin is a false sense of security. It is possible to assume that taking a cholesterol-lowering drug makes it okay to make poor dietary choices and that simply is not true. Over time, these choices can lead to weight gain.

Does atorvastatin cause sleep problems?

If you are beginning treatment with atorvastatin, you will be relieved to know that research has found no link between any statins and sleep problems of any kind. Furthermore, a Lancet study in 2018 found that patients taking statins slept better, in terms of ability to fall asleep, amount of times they woke throughout the night, and in the overall quality of the sleep. That said, many doctors do receive complaints about sleep problems among patients taking statins. A generally accepted explanation for this is an opposite placebo effect. This means that patients are experiencing the negative side effects of drugs simply because they are expecting to, not because the drug is causing them. It is, however, possible that some patients may experience sleep disturbances due to joint pain, muscle pain, or other potential side effects.

What if I miss a day of atorvastatin?

If you forget to take a dose occasionally you have no reason to worry, just take your next dose the next day at the usual time. Never take an extra dose for any reason. It is also important to note that you should never take two doses within twelve hours of one another.

Is it okay to drink alcohol while taking atorvastatin?

It is okay to drink alcohol while taking atorvastatin. That said, drinking a lot of alcohol increases your chances of muscle and liver problems. To be safe, avoid drinking more than 14 units of alcohol per week. For reference, a pint of beer is roughly two to three units of alcohol.

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