- What is Lipitor (atorvastatin)? How does it work (mechanism of action)?
- What are the uses for Lipitor (atorvastatin)?
- What are the side effects of Lipitor (atorvastatin)?
- What is the dosage for Lipitor (atorvastatin)? How should it be taken?
- Which drugs or supplements interact with Lipitor (atorvastatin)?
- Is Lipitor (atorvastatin) safe to use during pregnancy or while breastfeeding?
- What else should I know about Lipitor (atorvastatin)?
What is Lipitor (atorvastatin)? How does it work (mechanism of action)?
Lipitor (atorvastatin) is type of statin that lowers the level of cholesterol in the blood. All statins, including atorvastatin, prevent the production of cholesterol in the liver by blocking HMG-CoA reductase, an enzyme that makes cholesterol. Statins reduce total cholesterol as well as LDL cholesterol in blood. LDL cholesterol is believed to be the "bad" cholesterol that is primarily responsible for the development of coronary artery disease. Reducing LDL cholesterol levels retards progression and may even reverse coronary artery disease. Atorvastatin also raises the concentrations of HDL ("good") cholesterol that protects against coronary artery disease and reduces the concentration of triglycerides in the blood. (High blood concentrations of triglycerides also have been associated with coronary artery disease.)
Examples of other statins include:
- lovastatin (Mevacor - brand name discontinued),
- simvastatin, (Zocor),
- fluvastatin (Lescol, Lescol XL),
- pravastatin (Livalo, Zypitamg), and
- rosuvastatin (Crestor)
The FDA approved atorvastatin in December 1996.
What are the uses for Lipitor (atorvastatin)?
- Lipitor is used for the treatment of elevated total cholesterol, LDL, and triglycerides, and to elevate HDL cholesterol. The effectiveness of Lipitor in lowering cholesterol is dose-related, meaning that higher doses reduce cholesterol more.
- In individuals with coronary artery disease Lipitor prevents:
- Lipitor reduces the risk of heart attack, stroke, angina, and revascularization procedures in adults without evidence of coronary heart disease, but with multiple risk factors for coronary artery disease, for example:
- Family history of coronary heart disease
- Lipitor also prevents heart attacks and strokes in patients with type 2 diabetes without evidence of heart disease, but with multiple risk factors for coronary artery disease.
What are the side effects of Lipitor (atorvastatin)?
Lipitor is generally well tolerated. Minor side effects include:
Other commonly reported side effects include:
Lipitor may cause liver and muscle damage. Serious liver damage caused by statins is rare. Liver tests should be performed at the beginning of treatment then as needed thereafter.
Inflammation of the muscles caused by statins can lead to serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood, and myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolysis in less than one percent of patients. To prevent the development of serious rhabdomyolysis, patients taking atorvastatin should contact their health-care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.
Statins have been associated with increases in HbA1c and fasting serum glucose levels as seen in diabetes.
Post-marketing reports for atorvastatin of adverse events include:
Symptoms may start one day to years after starting treatment and resolve within a median of three weeks after stopping the statin.
What is the dosage for Lipitor (atorvastatin)? How should it be taken?
- Lipitor is prescribed once daily.
- The usual starting dose for adults is 10-20 mg per day, and the maximum dose is 80 mg per day. Adults who need more than a 45% reduction in LDL cholesterol may be started at 40 mg daily.
- Pediatric patients should receive 10 mg once daily up to a maximum dose of 20 mg daily.
- Lipitor may be taken with or without food and at any time of day.
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Which drugs or supplements interact with Lipitor (atorvastatin)?
Decreased elimination of Lipitor could increase levels of Lipitor in the body and increase the risk of muscle toxicity from Lipitor. Therefore, Lipitor should not be combined with drugs that decrease its elimination. Examples of such drugs includes:
- erythromycin (E-Mycin),
- ketoconazole (Nizoral),
- itraconazole (Sporanox),
- clarithromycin (Biaxin),
- telithromycin (Ketek),
- cyclosporine (Sandimmune),
- nefazodone (Serzone), and
- HIV protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir).
Large quantities of grape fruit juice (>1.2 liters daily) also will increase blood levels of Lipitor and should not be taken.
The following drugs also may increase the risk of muscle toxicity when combined with Lipitor.
- amiodarone (Cordarone)
- verapamil (Calan Verelan, Isoptin)
- cyclosporine (Sandimmune)
- niacin (Niacor, Niaspan, Slo-Niacin)
- gemfibrozil (Lopid)
- fenofibrate (Tricor)
Lipitor increases the effect of warfarin (Coumadin) and the concentration in blood of digoxin (Lanoxin). Patients taking Lipitor and warfarin or digoxin should be monitored carefully. Cholestyramine (Questran) decreases the absorption of Lipitor. Lipitor should be given at least two hours before and at least four hours after cholestyramine.
Rifampin increases breakdown of Lipitor. To reduce the likelihood of this interaction both drugs should be given at the same time. Lipitor should not be given after rifampin.
Is Lipitor (atorvastatin) safe to use during pregnancy or while breastfeeding?
- Lipitor should not be taken during pregnancy because the developing fetus requires cholesterol for development, and Lipitor reduces the production of cholesterol. Lipitor should only be administered to women of childbearing age if they are not likely to become pregnant.
- It is not known if Lipitor is secreted in breast milk. Because of the potential risk of adverse events, breastfeeding mothers should not use Lipitor.
What else should I know about Lipitor (atorvastatin)?
What preparations of Lipitor (atorvastatin) are available?
- Tablets of 10, 20, 40, and 80 mg
How should atorvastatin be stored?
- Tablets should be stored at room temperature, 20 C to 25 C (68 F to 77 F).
Atorvastatin is available in generic form. You need a prescription for atorvastatin from your doctor.
Lipitor (atorvastatin) is a drug in the statin drug classed prescribed to patients to lower blood cholesterol, LDL, and triglycerides, elevate HDL cholesterol, to prevent angina, stroke, heart attack, congestive heart failure, revascularization procedures in heart disease, and prevent heart attacks, and strokes in patients with type 2 diabetes. Side effects of Lipitor include headache, urinary tract infections (UTIs), joint pain, common cold, intestinal gas (flatulence), diarrhea, constipation, and heartburn.
Drug interactions, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
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Related Disease Conditions
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Cholesterol (Lowering Your Cholesterol)
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.
A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Fatty Liver (NASH)
Nonalcoholic fatty liver disease or NASH occurs due to the accumulation of abnormal amounts of fat within the liver. Fatty liver most likely caused by obesity and diabetes. Symptoms of fatty liver disease are primarily the complications of cirrhosis of the liver; and may include mental changes, liver cancer, the accumulation of fluid in the body (ascites, edema), and gastrointestinal bleeding. Treatment for fatty liver includes avoiding certain foods and alcohol. Exercise, weight loss, bariatric surgery, and liver transplantation are treatments for fatty liver disease.
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Omega-3 fatty acids are essential fats that help decrease one's cholesterol and triglyceride levels as well as reduce the risk of coronary artery disease. Omega-3s are found in salmon, sardines, walnuts, and canola oil. These fats may help reduce the risk of ventricular fibrillation and sudden cardiac death.
High Cholesterol: Frequently Asked Questions
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Heart Attack Treatment
A heart attack involves damage or death of part of the heart muscle due to a blood clot. The aim of heart attack treatment is to prevent or stop this damage to the heart muscle. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury.
Low Cholesterol Diet
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Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
Heart Attacks in Women
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Heart Attack Pathology: Photo Essay
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay includes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack. A coronary artery occlusion may be fatal, but most patients survive it. Death can occur when the occlusion leads to an abnormal heartbeat (severe arrhythmia) or death of heart muscle (extensive myocardial infarction).
Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience: Extreme fatigue Pain in the upper abdomen Dizziness Fainting Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
Vitamins & Exercise: Heart Attack Prevention Series
Vitamins and exercise can lower your risk for heart attack and heart disease. Folic acid, vitamins, and homocysteine levels are interconnected and affect your risk for heart disease or heart attack. For better heart health, avoid the following: fried foods, hard margarine, commercial baked goods, most packaged and processed snack foods, high fat dairy, and processed meats such as bacon, sausage, and deli meats. Antioxidants and exercise also play a key role in heart attack and heart disease prevention. Lower your risk factors for heart disease and heart attack by: lowering cholesterol, lowering blood pressure, diabetes prevention, and smoking cesssation. Here are a few things you can do to prevent heart attacks: Eat whole, natural, fresh foods, eat five to 10 servings of fruits and vegetables daily, eat more omega-3 fatty acids, drink water, tea, non-fat dairy and red wine, eat lean proteins, limit glycemic foods, and exercise daily.
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