Atorvastatin side affects YOU need to KNOW!

We are going to look at the TEN MOST COMMON questions regarding Atorvastatin, including the drug’s most common side effects.

What is Atorvastatin?

Atorvastatin is a lipid lowering drug to lower your cholesterol. Your body makes wax like fat like substance called cholesterol in your liver.  Triglycerides another fat is also made in your liver. They are also found in foods. You need some cholesterol for good health, but too much is not good for you. Cholesterol and triglycerides can clog your blood vessels and make it hard for blood to get to your heart. It is especially important to lower your cholesterol if you have heart disease or diabetes.

Atorvastatin is used together with diet to lower blood levels of “bad” cholesterol(also called LDL ), to increase levels of “good” cholesterol (also called HDL), and to lower triglycerides (a type of fat in the blood).

Why is my Doctor recommending Atorvastatin?

Atorvastatin is used to treat high cholesterol, and to lower the risk of stroke, heart attack, or other heart complications in people with type 2  diabetes or coronary disease. It is also used to slow the progression of heart disease as well as renal disease. Atorvastatin takes a couple of weeks to take effect.

How does it work?

Atorvastatin belongs to family of medications called as Statins. They are also called HMGCoA reductase inhibitors. They  work by blocking  the production of cholesterol in the liver by the enzyme HMGCoA reductase.

How should I take Atorvastatin?

Atorvastatin comes as a tablet to take by mouth. It comes in the following doses 10mg, 20mg, 40mg, and 80mg. It is usually taken once a day with or without food. Take Atorvastatin at around the same time every day. The reason Atorvastatin is usually given at nighttime is because the cholesterol-making enzyme is more active at night. Also, the half-life, or the amount of time it takes for half the dose to leave your body, of some Statins is short. If you are unable to take the dose at nighttime stick to taking the medicine daily at the SAME time.

What happens if I miss a dose?

Use the drug as soon as you can. However, if you are more than 12 hours late for the dose skip the dose and go back to the normal time you take the drug. Do not use two doses at one time.

What should I AVOID while taking Atorvastatin?

Avoid eating foods high in fat or cholesterol, or Atorvastatin will not be as effective.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

Grapefruit may interact with Atorvastatin and lead to unwanted side effects. Grapefruit contains a chemical that interferes with your body’s ability to break down or metabolize certain Statin medications. When Statin takers eat large amounts of grapefruit, the level of statins in their blood can increase, raising the possibility of side effects.

What other drugs can affect Atorvastatin?

The following drugs can interact with Atorvastatin. However, this list is not exhaustive, so please talk to your doctor or pharmacist to see what the right choice FOR you is!

  • Diltiazem (a heart medication)
  • Gemfibrozil(Lopid), fenofibric acid (Fibricor, Trilipix), or fenofibrate (Tricor, Triglide)
  • Antibiotics such as Clarithromycin or Erythromycin
  • Antifungal medications such as Fluconazole (Diflucan)
  • HIV medications
  • Medicines that contain Niacin
  • Drugs that weaken your immune system, such as steroids, cancer medicine, or medicines used to prevent organ transplant rejection, such as Cyclosporine
  • Oral contraceptives
  • Antacids
  • Supplements such as St. John’s Wort or Red yeast rice

Who should absolutely NOT take this medicine?

You should not use Atorvastatin if you are allergic to it, or if you have:

  • liver disease; or
  • if you are pregnant or breastfeeding.

This medicine can cause birth defects or harm the unborn baby. Do not use if you are pregnant. Stop taking Atorvastatin and tell your doctor right away if you become pregnant.

What are serious side effects caused by Atorvastatin?

  • side effects on notepad

    pills and medication side effects

    Although rare some people may have very bad side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash, hives; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking, swelling of the mouth, face, lips, tongue, or throat.
  • Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine.
  • Feeling very tired or weak.
  • Feeling confused.
  • Memory problems or loss.
  • This drug may cause muscle pain, tenderness, or weakness. Sometimes, a very bad muscle problem may happen that may lead to kidney problems. This is a medical condition called Rhabdomyolysis which can, if left untreated lead to death. Call your doctor right away if you have muscle pain, tenderness, or weakness that is not normal.
  • Sometimes, deadly liver problems have happened with this drug. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

What are COMMON side effects?

woman holding calf and man holding left shoulder in pain.

muscle pain

  • All drugs may cause side effects. Talk to your doctor or provider if you have the following side effects or any other side effects that bother you or do not go away.Do not suddenly STOP the medication without talking to your health care provider.
  • Diarrhea.
  • Joint pain, muscle tenderness
  • Upset stomach.
  • Nose or throat irritation.
  • Trouble sleeping.

With my patients we usually reduce the dose and monitor symptoms for the next couple of weeks to ascertain if the symptoms are dose related. If very severe we stop the drug to see if the symptoms resolve. Another strategy used is dosing every other day. Every-other-day regimens, and even once-weekly regimens, have also been evaluated as strategies for improving tolerability

Can Atorvastatin be used in older adults?

asian couple smiling

happy couple

There is benefit from Statin therapy  to healthy individuals 75 years of age or older.  Statin therapy for these individuals with established cardiovascular disease. (That is they have had a stroke, mini-stroke -also known as TIA, or heart attack).In my older patients, I start at a lower dose and titrate up carefully monitoring for side effects.

However, the decision whether to treat high cholesterol in an older individual should be individualized, based on both chronological and biological age. For older people, there is no clear evidence that high cholesterol leads to heart disease or death. In fact, some studies show the opposite—that older people with the lowest cholesterol levels actually have the highest risk of death. (Source choosing wisely).

Moreover, older adults with a limited life span, multiple comorbidities affecting overall function and cognition, multiple prescription drugs with the potential for drug-drug interactions are probably not good candidates for drug therapy. Ultimately, the decision to initiate or discontinue a Statin in an older adult must be an individualized decision considering patient preferences and benefits vs risks for that individual patient.

BONUS SECTION:(Three BONUS FACTS)

  • How long after stopping Atorvastatin will the muscle pains tend to cease? About 4 weeks
  • Cognitive impairment is listed a potential side effect, and as a Doctor who specializes in older adults esp. with the lack of RCT I do take this listed side effect seriously when reported by my older patients.
  • Can Atorvastatin cause increased blood sugar levels?
  • Multiple trials were suggestive of the increased blood glucose levels after long-term Statin use. This has prompted the Food and Drug Administration to include the risk of DM in the product label of statins. Talk to your doctor about whether a Statin is the right choice for given your other medical problems.

 

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