Easy-to-read medicine information about atorvastatin – what is it, how to take atorvastatin safely and possible side effects.
Type of medicine
Also called
Medicine to lower cholesterol (cholesterol is a type of fat in the body)
Belongs to a group of medicines known as statins
Lipitor®
Zarator®
What is atorvastatin?
Atorvastatin is used to lower cholesterol (fat) levels in your blood. When excess cholesterol collects in the walls of your blood vessels, it increases your chance of having a heart attack, or stroke. Lowering cholesterol reduces your risk of heart and blood vessel disease.
Atorvastatin can also reduce your chance of heart disease if you have an increased risk of it, even if your cholesterol levels are normal.
Atorvastatin works by blocking an enzyme that produces cholesterol and in this way slows the production of cholesterol in your body.
A review of scientific studies into the effectiveness of statins (including atorvastatin) found that around 1 in every 50 people treated with a statin for 5 years would avoid a serious event, such as a heart attack or stroke.
Dose
The starting dose of atorvastatin is usually 10 milligrams or 20 milligrams once a day.
Depending on your cholesterol level, your doctor may increase your dose gradually to a maximum of 80 milligrams once a day.
Always take your atorvastatin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much atorvastatin to take, how often to take it, and any special instructions.
How to take atorvastatin
Take atorvastatin once a day, at around the same time each day.
You can take atorvastatin either with or without food.
To reduce your cholesterol, you must keep taking atorvastatin every day.
Do not drink more than one or two small glasses of grapefruit juice a day. This is because grapefruit juice has a chemical that can increase the amount of atorvastatin in your blood, and increases the risk of side effects.
Limit drinking alcohol while your are taking atorvastatin. Alcohol can increase the risk of serious side effects.
If you forget your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
Possible side effects
Like all medicines, atorvastatin can cause unwanted side effects, although not everyone gets them. Often unwanted side effects improve as your body gets used to the new medicine.
Side effects
What should I do?
Diarrhoea (loose stools)
Stomach upset
Bloating or gas in the tummy
Nausea (feeling sick)
Mild joint or muscle pain (especially in the legs or arms)
These are quite common when you first start taking atorvastatin, and usually go away with time
Tell your doctor if troublesome
Signs of problems with your muscles and kidneys such as muscle pain, muscle tenderness or weakness, dark coloured urine, yellowing of the skin or eyes, sharp pain in your stomach area
Tell your doctor immediately or ring HealthLine
Interactions
Atorvastatin may interact with a few medications and herbal supplements, so check with your doctor or pharmacist.
New Zealand Formulary Patient Information: Atorvastatin
Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ
Information for clinicians
Statin evidence review, Sept 2016
SUMMARY: "This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment.
Large-scale evidence from randomised trials shows that statin therapy reduces the risk of major vascular events (ie, coronary deaths or myocardial infarctions, strokes, and coronary revascularisation procedures) by about one-quarter for each mmol/L reduction in LDL cholesterol during each year (after the first) that it continues to be taken.
The absolute benefits of statin therapy depend on an individual's absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. For example,
lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an effective low-cost statin regimen (eg, atorvastatin 40 mg daily, costing about £2 per month) for 5 years in 10 000 patients would typically prevent major vascular events from occurring in about 1000 patients (ie, 10% absolute benefit) with pre-existing occlusive vascular disease (secondary prevention) and
in 500 patients (ie, 5% absolute benefit) who are at increased risk but have not yet had a vascular event (primary prevention).
Statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken, so larger absolute benefits would accrue with more prolonged therapy, and these benefits persist long term.
The only serious adverse events that have been shown to be caused by long-term statin therapy—ie, adverse effects of the statin are: myopathy (defined as muscle pain or weakness combined with large increases in blood concentrations of creatine kinase), new-onset diabetes mellitus, and, probably, haemorrhagic stroke.
Typically, treatment of 10 000 patients for 5 years with an effective regimen (eg, atorvastatin 40 mg daily) would cause about:
5 cases of myopathy (one of which might progress, if the statin therapy is not stopped, to the more severe condition of rhabdomyolysis),
50–100 new cases of diabetes, and
5–10 haemorrhagic strokes.
However, any adverse impact of these side-effects on major vascular events has already been taken into account in the estimates of the absolute benefits.
Statin therapy may cause symptomatic adverse events (eg, muscle pain or weakness) in up to about 50–100 patients (ie, 0·5–1·0% absolute harm) per 10 000 treated for 5 years.
However, placebo-controlled randomised trials have shown definitively that almost all of the symptomatic adverse events that are attributed to statin therapy in routine practice are not actually caused by it (ie, they represent misattribution).
Collins, Rory et al. Interpretation of the evidence for the efficacy and safety of statin therapy The Lancet , Sept 2016, Volume 388 , Issue 10059 , 2532 - 2561. [Full article]
