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What is Atorvastatin used for?

We’ve all heard that high cholesterol can increase your risk of heart attack, but how many people actually know their cholesterol numbers? According to the Center for Disease Control and Prevention (CDC), more of us should, because it is estimated 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). This is due in large part to our western diets, which are high in fat, and the sedentary lifestyles that many people live. High cholesterol levels in the blood can cause plaque to build up inside the blood vessels, causing a narrowing that can eventually lead to a heart attack. There’s no question that the first step towards lowering your cholesterol levels is making lifestyle changes to make sure you’re eating a healthy, well-balanced diet and getting plenty of exercise, but due to genetics or extremely high cholesterol levels, some people will also need medication to help keep their cholesterol levels in check. Atorvastatin, marketed under the brand name Lipitor,  is one of the most popular cholesterol medications on the market today. 

What Is Atorvastatin?

Atorvastatin is part of a class of drugs called HMG CoA reductase inhibitors (more commonly referred to as “statins”), which are commonly used to treat high cholesterol levels in the blood. 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. The medication is a prescription drug and is available in both brand name and generic forms. 

What Is Atorvastatin Used For?

Statins like atorvastatin are commonly used to treat high cholesterol levels in the blood. Statins work by lowering the blood levels of “bad” cholesterol and increasing the levels of “good” cholesterol in conjunction with lifestyle changes. The medication can also help to lower triglyceride levels; triglycerides are a type of fat found in the blood. By lowering cholesterol and triglyceride levels, statins like atorvastatin reduce the risk of stroke, heart attack, and other complications in people with type 2 diabetes, coronary heart disease, and other risk factors.
When doctors talk about cholesterol, they generally refer to two different types: LDL, or low-density lipoprotein, which is often called “bad” cholesterol, and HDL, or high-density lipoprotein, which is often called “good” cholesterol. Most of the cholesterol in our bodies is LDL, and when present in large quantities, it can build up as plaque on the walls of the blood vessels, blocking the flow of blood from the heart and other organs and causing an increased risk of heart disease, heart attack, and stroke. Good cholesterol, or HDL, is responsible for absorbing cholesterol and carrying it back to the liver, where it is flushed from the body. It is ideal to have a low LDL number and a higher HDL number because 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. Your treatment plan will be decided based on your total cholesterol level, the proportion of LDL to HDL, and the amount of triglycerides in the body. 

How Do Statins Like Atorvastatin Work?

Statins work by slowing the production of cholesterol in the liver, which is responsible for manufacturing cholesterol. When the production of cholesterol is lowered, this decreases 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, thereby reducing the risk of heart attack and stroke.

What Are the Benefits of Atorvastatin?

Because of the high cholesterol levels found in so many American adults and the rising incidence of cardiovascular disease, statins like atorvastatin are among the most commonly prescribed drugs in the United States today. Statins have been studied extensively, and atorvastatin has been in use since the 1990s. Use of atorvastatin has several benefits:

  • Atorvastatin effectively lowers cholesterol levels and is safe for most people.
  • Children aged 10 and older can safely use atorvastatin to treat high cholesterol levels. 
  • Atorvastatin helps to reduce C-reactive protein (CRP) levels in the coronary arteries, decreasing the likelihood of heart attacks and strokes.
  • Some people experience slightly lower blood pressure while taking atorvastatin.
  • When taken prior to heart surgery, patients using atorvastatin have a lower risk of atrial fibrillation. 
  • The medication is available in a generic form and is 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:

  • Patients with liver disease or liver function issues may not be able to use atorvastatin because the medication acts primarily on the liver. Even if you have never had liver problems or liver damage, your doctor may want to conduct blood work to check for liver function prior to taking atorvastatin and throughout the course of treatment. 
  • Statins like atorvastatin should not be taken during pregnancy, as they can harm the fetus.
  • Breastfeeding women should not take atorvastatin.
  • Using alcohol, especially drinking more than two drinks per day, can increase the risk of serious side effects when consumed with 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.
  • Make sure to tell your doctor if you are taking atorvastatin and are planning on having surgery.

What Dose of Atorvastatin Should I Take?

There are many different iterations of high cholesterol levels, and which one a specific patient has will impact the recommended dosage for atorvastatin. 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 requiring a low to moderate reduction in LDL levels will start with a dose of 10 to 20 mg taken once daily. Patients with more critical LDL levels may take 40 mg per day initially. The maintenance dose is somewhere between 10 and 80 mg per day, taken once per day, which will vary depending on the patient. When used to treat high triglyceride levels, most patients 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
  • Heartburn
  • Joint pain
  • Gas
  • Forgetfulness or memory loss
  • Confusion

Most side effects listed above are mild and last for only a few days or weeks as your body adjusts to atorvastatin. If side effects persist or an allergic reaction develops, 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:

  • Weakness
  • Loss of appetite
  • Flu-like symptoms
  • 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
  • Yellowing of the skin or eyes
  • Hives
  • Difficulty breathing or swallowing
  • Hoarseness
  • Lack of energy
  • Chest pain
  • Rash
  • Itching
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

Can Women Who Are Pregnant or Breastfeeding Take Atorvastatin?

Women who are pregnant or breastfeeding should not take atorvastatin. Some pregnant women who have taken statins during pregnancy have reported congenital abnormalities in their babies, and the medication is transferred through breast milk to the fetus. Because high cholesterol is a risk factor for disease, and not a disease in itself, doctors advise that 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
  • People who drink more than two alcoholic beverages per day
  • Women who are pregnant or are planning to become pregnant.
  • Women who breast-feed 
  • 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 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

What Else Should I Know About Lowering My Cholesterol?

Atorvastatin is an effective treatment for high cholesterol, but it is meant to be used in conjunction with lifestyle changes. Patients prescribed atorvastatin should work on eating a healthy, low-cholesterol diet, weight loss, incorporating regular exercise, and living a healthy lifestyle. It may take several weeks before seeing an improvement in your cholesterol levels. 

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

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