Lipitor (atorvastatin)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Do I need a prescription for Lipitor (atorvastatin)?

Yes

Why is Lipitor (atorvastatin) prescribed to patients?

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.

There are also post-marketing reports of:

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)?

  • 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:

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.

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 I keep Lipitor (atorvastatin) stored?
  • Tablets should be stored at room temperature, 20 C to 25 C (68 F to 77 F).
How does Lipitor (atorvastatin) work?
  • 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.)
When was Lipitor (atorvastatin) approved by the FDA?
  • The FDA approved atorvastatin in December 1996.

Reference: FDA Prescribing Information

Quick GuideLower Your Cholesterol, Save Your Heart

Lower Your Cholesterol, Save Your Heart

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See more info: atorvastatin on RxList
Reviewed on 11/1/2016
References
Reference: FDA Prescribing Information

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