- 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.
Quick GuideLower Your Cholesterol, Save Your Heart
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.
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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- Diet & Nutrition FAQs
- Sugar FAQs
- Heart Disease FAQs
- Diabetes FAQs
- Stroke FAQs
- Salt FAQs
- High Cholesterol (Hyperlipidemia) FAQs
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- What are Cholesterol-Lowering Statins?
- Does Nizoral Shampoo Interfere with Statins?
- What Are the Risks and Side Effects of Zocor?
- Grapefruit Juice and Drug Interactions
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- atorvastatin (Lipitor) vs. simvastatin (Zocor)
- rosuvastatin, Crestor
- Zocor (simvastatin)
- pravastatin, Pravigard PAC (discontinued)
- lovastatin, Mevacor, Altoprev
- ezetimibe and simvastatin, Vytorin
- fluvastatin, Lescol, Lescol XL
- cerivastatin, Baycol
- lovastatin vs. simvastatin
Prevention & Wellness
- Health Tip: Grapefruit May Interact With Medication
- Whether Statins Cut Alzheimer's Risk May Depend on Gender, Race
- Coming Soon: Lower Cholesterol From a Twice-a-Year Shot?
- High-Dose Statins Boost Survival: Study
- Are There Alternatives to Statins?
- Just a Little of Statins' Effect Enough to Help Heart: Study
- Statins May Reduce Heart Risks Linked to Sleep Apnea: Study
- Prescription Drug Use on the Rise in U.S.
- Prescription Meds: Too Common in Pregnancy?
- Statins Might Reduce Complications After Major Lung Surgery
- Statins Linked to Raised Risk of Type 2 Diabetes
- Experimental Cholesterol-Lowering Drug Effective, Study Reports
- New Drug Lowers Cholesterol Beyond What Statins Can Do, Study Finds
- Merck Recalls Cholesterol Drug Liptruzet
- Cholesterol Drugs May Boost Your Gums' Health, Too
- Statin Use May Reduce Parkinson's Risk, Study Says
- Most Statin Users Won't Have Major Side Effects
- Statins Plus Certain Antibiotics May Set Off Toxic Reaction: Study
- Cholesterol Drugs Linked to Muscle, Joint Problems: Study
- Could Statins Raise Diabetes Risk?
- Statin Side Effects Often Manageable: Study
- Shopping Around Brings Steep Prescription Drug Savings, Report Finds
- High-Dose Statins Linked to Acute Kidney Damage
- Firm Stops Making Generic Lipitor After Recall
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- Generic Lipitor Recall
- Health Highlights: Nov. 26, 2012
- More New Drugs a Bad Fit With Grapefruit, Study Finds
- New Drug to Lower 'Bad' Cholesterol Shows Promise
- Statins Tied to Reduced Glaucoma Risk
- Statins Won't Hurt, Might Even Help, Your Pancreas: Study
- Statins May Help Prevent Irregular Heartbeat in Elderly
- Rheumatoid Arthritis Patients Who Quit Statins May Face Raised Death Risk
- New Injection Might Lower Tough-to-Treat Cholesterol
- Statin Alternative Looks Promising in Early Trials
- Health Highlights: March 7, 2012
- Health Highlights: March 6, 2012
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- New Warnings on Cholesterol-Lowering Statins
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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Cholesterol TestA cholesterol blood test measures the amount of cholesterol in the body. There are two types of cholesterol; the "good" cholesterol or HDL, and the "bad" cholesterol or LDL. High cholesterol levels in the blood can lead to heart attack, stroke, and peripheral vascular disease. Learn more about cholesterol tests and how to interpret them.
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HDL vs. LDL Cholesterol Differences
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Triglycerides are found in body fat and from the fats you eat. Triglycerides levels in the blood reflect what you have eaten recently. HDL and LDL cholesterol levels show what you have been eating over a long period of time. If you eat a fatty meal your triglyceride levels will be elevated for a short period of time. If you continue to eat a diet high in fat your triglyceride levels will continue to rise. The liver transfers the triglycerides into body fat, or cholesterol, which raises LDL and lowers HDL levels in the blood.
Healthy (normal) total blood cholesterol levels are determined by the levels of HDL, LDL, and triglycerides in the blood. Talk with your doctor or other health care professional if you are concerned about your cholesterol levels, which can easily be determined with a simple blood test.
VLDL, or very-low- lipoproteins, is a third type of cholesterol. VLDL is another type of "bad" cholesterol that the liver produces, which contains a high amount of triglycerides.
REFERENCE: American Heart Association. "HDL (Good), LDL (Bad) Cholesterol and Triglycerides." Updated: Jul 05, 2017.
Heart Disease (Coronary Artery Disease)
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:
- High blood pressure
- High cholesterol
- Family history
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.
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Stroke Symptoms and Treatment
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:
- double vision or vision loss,
- 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.
Triglyceride TestTriglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.