Atorvastatin Side Effects: What Are They?

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According to the Center for Disease Control and Prevention (CDC), about 95 million American adults have total cholesterol levels higher than 200 mg/dL (high), while 29 million have total cholesterol levels higher than 240 mg/dL (very high).

High cholesterol levels are caused by a number of factors, some of which can be genetic, but mostly, our sedentary lifestyles and high-fat western diets are to blame.

High cholesterol levels can cause plaque to build up on the inside of the blood vessels, which can cause the blood vessels to narrow.

Over time, this narrowing prevents blood from reaching the heart, organs, and extremities and can cause a heart attack.

Although lifestyle changes make a big difference in the fight to keep cholesterol levels down, some people will also need medication to help keep their cholesterol levels in check.

Atorvastatin is one of the most frequently prescribed drugs in the United States, and it can help keep cholesterol levels down in people with high cholesterol.

What Is Atorvastatin?

Atorvastatin was first manufactured under the brand name Lipitor and was patented in 1986.

The medication, which belongs to a class of drugs called HMG CoA reductase inhibitors (more commonly referred to as “statins”), was approved by the Food and Drug Administration (FDA) in 1996 when it was released as Lipitor.

Atorvastatin is a prescription drug available in both brand names and generic forms. 

What Conditions Does Atorvastatin Treat?

Atorvastatin, like other drugs in its class, primarily treats high cholesterol by lowering the blood levels of “bad” cholesterol and increasing the levels of “good” cholesterol in conjunction with lifestyle changes.

The medication is also used to lower triglyceride levels; triglycerides are a type of fat found in the blood. Atorvastatin helps to reduce the risk of heart attack, stroke, and other complications in people with type 2 diabetes, coronary heart disease, and other risk factors.

If you’re confused by the differences between the types of cholesterol and triglycerides, you’re not alone.

The first thing to understand is that we have two types of cholesterol: LDL, or low-density lipoprotein, which is considered “bad” cholesterol, and HDL, or high-density lipoprotein, which is considered “good” cholesterol.

Most of the cholesterol in the body is LDL, and when present in excessive quantities, LDL can build up as plaque on the walls of the blood vessels.

Over time, this plaque causes the blood vessels to narrow, blocking the flow of blood from the heart and other organs and increasing the risk of heart disease, heart attack, and stroke.

Our “good” cholesterol, or HDL, helps to absorb LDL and carry it back to the liver, where it is flushed from the body. Unlike LDL levels, which you want to keep as low as possible, higher levels of HDL are associated with a lower risk for heart disease and stroke.

Doctors calculate your total cholesterol level by adding together the HDL and LDL numbers and combining them with 20 percent of your triglyceride level.

Total cholesterol numbers, levels, along with the specific measurements of HDL, LDL, and triglycerides in the body, are used by doctors to decide which treatment plan will be most successful in helping to lower your amount of cholesterol.

Atorvastatin Side Effects: What Are They?

Both common and uncommon side effects are associated with atorvastatin. Common side effects associated with atorvastatin that usually do not need medical attention include:

  • Diarrhea
  • Joint pain
  • Confusion
  • Gas
  • Forgetfulness or memory loss
  • Heartburn

The above side effects are generally mild and do not linger for more than a few days or weeks, so they do not require medical attention. However, if these common side effects persist or you have an allergic reaction, talk to your doctor.

Other adverse effects of atorvastatin are more serious and do require medical attention. Check with your health care provider immediately if you experience any of the following uncommon but serious side effects while taking atorvastatin:

  • Muscle pain, tenderness, or weakness
  • Fever
  • Nausea
  • Extreme tiredness
  • Unusual bleeding or bruising
  • Pain in the upper right part of the stomach
  • Dark-colored urine
  • Weakness
  • Loss of appetite
  • Flu-like symptoms
  • Lack of energy
  • Chest pain
  • Rash
  • Itching
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Yellowing of the skin or eyes
  • Hives
  • Difficulty breathing or swallowing
  • Hoarseness

How Does Atorvastatin Lower Cholesterol Levels?

Like other statins, atorvastatin slows the production of cholesterol in the liver, which manufactures cholesterol.

As the production of cholesterol in the liver decreases, plaque is less likely to build up on the walls of the arteries and block blood flow to the heart, brain, organs, and extremities.

This results in lower cholesterol levels and a reduced risk of heart attack and stroke.

What Benefits Are Associated With Atorvastatin?

Because atorvastatin is one of the most commonly prescribed drugs in America and has been around for decades, the effects and benefits of the medication are well documented.

Benefits associated with atorvastatin include:

  • The medication is well-tolerated and safe for most people and reduces cholesterol levels effectively when combined with lifestyle changes.
  • Atorvastatin can be used to safely treat high cholesterol levels in children 10 years of age and older.
  • The medication helps reduce the risk of heart attacks and strokes by lowering the level of C-reactive protein (CRP) in the coronary arteries. 
  • Some people experience slightly lower blood pressure as an added benefit of taking the medication.
  • Patients taking statins prior to heart surgery have a lower risk of atrial fibrillation during and after surgery. 
  • The drug is available in a generic form, making it highly affordable and accessible for most patients.

What Risks Are Associated With Atorvastatin?

Although there are many benefits associated with atorvastatin, as listed above, taking the medication also poses some risks. Risks associated with atorvastatin include:

  • Because atorvastatin works primarily on the liver, patients with liver disease may not be able to take atorvastatin safely. Even people with no history of liver problems or liver damage should have their liver function checked prior to taking atorvastatin and throughout the course of treatment
  • Statins like atorvastatin should not be taken by women who are pregnant or breastfeeding due to the risk of congenital birth defects and other harmful effects of the medication.
  • Alcohol can increase the risk of serious side effects when consumed with atorvastatin, especially for people who drink two or more alcoholic beverages per day. 
  • Make sure to tell your doctor if you are taking atorvastatin and are planning on having surgery.

What Is the Recommended Dosage of Atorvastatin?

High cholesterol and triglyceride levels can occur in a variety of combinations, each of which is treated differently. Therefore, the recommended dosage for atorvastatin will depend on the condition being treated, the age of the patient, and several other factors.

The medication is offered in 10 mg, 20 mg, 40 mg, and 80 mg strengths. Most patients being treated for high cholesterol that requires a low to moderate reduction in LDL levels will start with a dose of 10 to 20 mg taken once daily.

Patients requiring a higher LDL reduction may need to take 40 mg per day initially before switching to a maintenance dose.

The maintenance dose for most patients seeking an LDL reduction is somewhere between 10 and 80 mg per day, taken once per day.

When taken for high triglyceride levels, patients are likely to start at a dose of 10 mg taken once per day, with a maintenance dose of 10 to 80 mg taken once per day.

Dosage indications are similar for the prevention of cardiovascular disease.

Be sure to follow the medical advice of your doctor and drug information including avoiding missed doses, noting any potential drug interactions, and storing the medication at room temperature.

What Should Women Who Are Pregnant or Breastfeeding Know About Atorvastatin?

Women who are pregnant or breastfeeding should not take atorvastatin.

Statins like atorvastatin are not considered safe for pregnant or breastfeeding women due to the risk of congenital abnormalities in the fetus.

Additionally,  the medication is transferred through breast milk to the infant.

Because high cholesterol is a risk factor for disease and is not a disease in itself, there is no reason to take statins for the relatively short duration of pregnancy and breastfeeding, as the risks associated with taking the medication outweigh the benefits.

Who Should Not Take Atorvastatin?

Atorvastatin should not be taken by people who are allergic to it or to other statins. People who meet some or all of the following criteria should not take atorvastatin:

  • People who have had any of the following conditions should exercise caution:
    • Muscle pain, muscle aches, muscle problems, or weakness
    • Kidney disease or kidney problems
    • Diabetes
    • Thyroid disorder
  • People experiencing any of the following conditions may need to stop taking atorvastatin for a short time:
    • Uncontrolled seizures
    • Severely low blood pressure
    • Surgery or medical emergency
    • Electrolyte imbalance, such as high or low levels of potassium
    • Severe infection of illness
  • People with liver disease
  • Women who are pregnant or planning to become pregnant.
  • Women who breast-feed should not take atorvastatin.
  • Women taking birth control pills should talk to their doctors about hormone interactions. 
  • People who drink more than two alcoholic beverages per day

What Else Should I Know About Lowering My Cholesterol?

Atorvastatin is most effective when paired with lifestyle changes in order to be effective.

Patients prescribed atorvastatin should work on eating a healthy, balanced diet, weight loss, incorporating regular exercise, and living a healthy lifestyle.

It may take several weeks to notice a change in your cholesterol levels.

References, Studies and Sources:

medically reviewed and fact checked
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