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What is Atorvastatin?

If you’ve been told you have high cholesterol, you’re certainly not alone. Thanks to our high-fat western diets and the sedentary lifestyles of many Americans, high cholesterol is an epidemic in the United States. The Center for Disease Control and Prevention (CDC) estimates that 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). Having high cholesterol increases the likelihood of plaque building up on the inside of the blood vessels, causing a narrowing that can eventually lead to a heart attack. While lifestyle changes are a major component of any cholesterol control plan, some people will also need medication to help keep their cholesterol levels in check. Atorvastatin is a common prescription drug that can help lower cholesterol levels.

What Is Atorvastatin?

Atorvastatin, manufactured under the brand name Lipitor, belongs to a class of drugs called HMG CoA reductase inhibitors (more commonly referred to as “statins”). Atorvastatin was patented in 1986 and was first approved for medical use in the United States by the Food and Drug Administration (FDA) in 1996 when it was released as Lipitor. Today, atorvastatin is available by prescription in both brand name and generic forms in the United States. 

What Is Atorvastatin Used to Treat?

Atorvastatin is primarily used to treat high cholesterol by lowering the blood levels of “bad” cholesterol and increasing the levels of “good” cholesterol in conjunction with lifestyle changes. Atorvastatin also helps to lower triglyceride levels, which measure a type of fat found in the blood. By treating high cholesterol and triglyceride levels, atorvastatin reduces the risk of stroke, heart attack, and other complications in people with type 2 diabetes, coronary heart disease, and other risk factors.

Our bodies have two types of cholesterol: LDL, or low-density lipoprotein, which is referred to as “bad” cholesterol, and HDL, or high-density lipoprotein, which is referred to as “good” cholesterol. LDL makes up the majority of the body’s cholesterol, and when present in large quantities, it can build up as plaque on the walls of the blood vessels, causing an increased risk of heart disease, heart attack, and stroke. The narrowed blood vessels block the flow of blood from the heart and other organs. On the other hand, HDL helps to absorb cholesterol and carry it back to the liver, where it is flushed from the body. People with high levels of HDL are at a lower risk for heart disease and stroke. To calculate your total cholesterol level, the HDL and LDL numbers are added together and combined with 20 percent of your triglyceride level. Doctors use total cholesterol levels, along with the specific measurements of HDL, LDL, and triglycerides in the body, to help determine a treatment plan to lower your cholesterol.

How Does Atorvastatin Work?

Like other medications in its class, atorvastatin works by slowing the production of cholesterol in the liver, which manufactures cholesterol. Lowering the production of cholesterol in the liver helps to decrease the amount of cholesterol that builds up as plaque on the walls of the arteries and blocks blood flow to the heart, brain, organs, and extremities. 

What Are the Benefits of Atorvastatin?

Atorvastatin has been around since the 1990s, and statins like it are among the most commonly prescribed drugs in the United States today. Use of Atorvastatin has several benefits:

  • Atorvastatin effectively lowers cholesterol levels and is safe for most people.
  • Atorvastatin can be used to safely treat high cholesterol levels in children at least 10 years of age and older.
  • Statins like atorvastatin help to lower C-reactive protein levels in the coronary arteries, which helps reduce the risk of heart attacks and strokes.
  • Atorvastatin helps to 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. 
  • Atorvastatin is available in a generic form and is highly affordable and accessible for most patients.

Are There Any Risks 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. Your doctor may want to run tests to check liver function regardless of whether or not you have had liver problems or liver damage in the past.
  • Women who are pregnant or planning to become pregnant should not take atorvastatin, as it can harm the fetus.
  • Women who breast-feed should not take atorvastatin.
  • Atorvastatin can potentially interact with the hormones in birth control pills so make sure that your doctor is aware of any hormonal medications that you are taking. 
  • Alcohol can increase the risk of serious side effects when consumed with atorvastatin. 
  • Make sure to tell your doctor if you are taking atorvastatin and are planning on having surgery.

What Dose of Atorvastatin Should I Take?

The recommended dosage for atorvastatin will depend on the condition being treated, the age of the patient, and several other factors. Atorvastatin is offered in 10 mg, 20 mg, 40 mg, and 80 mg strengths. In general, patients being treated for high cholesterol that requires a low to moderate reduction in LDL levels will initially take a dose of 10 to 20 mg once daily. Patients requiring a higher LDL reduction may take 40 mg per day initially. The maintenance dose is somewhere between 10 and 80 mg per day, taken once per day. Patients being treated for high triglyceride levels 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.  Overall, be sure to follow the medical advice of your doctor and drug information including avoiding missed doses and storing the medication at room temperature. 

What Are the Side Effects of Atorvastatin?

Side effects associated with atorvastatin are categorized as either common or uncommon. Common side effects associated with atorvastatin that usually do not need medical attention include:

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

As long as these common side effects are mild and do not linger for more than a few days or weeks, they do not require medical attention. If side effects persist or allergic reactions occur, talk to your doctor.
Some adverse effects of atorvastatin 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
  • Weakness
  • Loss of appetite
  • Flu-like symptoms
  • Yellowing of the skin or eyes
  • Hives
  • Difficulty breathing or swallowing
  • Hoarseness
  • Lack of energy
  • Chest pain
  • Extreme tiredness
  • Unusual bleeding or bruising
  • Pain in the upper right part of the stomach
  • Dark-colored urine
  • Rash
  • Itching
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

Is Atorvastatin Safe for Women Who Are Pregnant or Breastfeeding?

Atorvastatin is not considered safe for pregnant or breastfeeding women. Congenital abnormalities have been reported following pregnancies in women who have taken statins, and the medication is transferred through breast milk to the fetus. Doctors and researchers note that while high cholesterol is a risk factor for disease, it is not a disease in itself, and 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 with liver disease
  • Women who are pregnant, planning to become pregnant, or are breastfeeding
  • 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 who drink more than two alcoholic beverages per day
  • 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

What Else Should I Know About Lowering My Cholesterol?

While medications like atorvastatin are important tools in the fight to lower cholesterol, they are intended to be paired with lifestyle changes in order to be effective. Patients prescribed atorvastatin should work on eating a healthy, balanced diet, weight loss goals, incorporating regular exercise, and living a healthy lifestyle. People taking atorvastatin should avoid eating foods that are high in fat or cholesterol, as the medication is not as effective if not used in conjunction with a low-cholesterol diet. Cholesterol does not improve overnight, and it may take several weeks before you notice an improvement in your symptoms. Your doctor may order regular blood work in order to check your cholesterol levels. If your cholesterol levels improve while taking atorvastatin and your doctor says you no longer need to take the medication, make sure you continue your healthy lifestyle to keep your levels in check.

Published May 8th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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