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atorvastatin

Pronunciation

Generic Name: atorvastatin (a TOR va sta tin)
Brand Name: Lipitor

What is atorvastatin?

Atorvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." Atorvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).

Atorvastatin is used to treat high cholesterol, and to lower the risk of stroke, heart attack, or other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors.

Atorvastatin is used in adults and children who are at least 10 years old.

Atorvastatin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about atorvastatin?

You should not take atorvastatin if you are allergic to it, if you are pregnant or breast-feeding, or if you have liver disease.

Stop taking this medication and tell your doctor right away if you become pregnant.

Before taking atorvastatin, tell your doctor if you have a thyroid disorder, muscle pain or weakness, a history of liver or kidney disease, or if you drink more than 2 alcoholic beverages daily.

In rare cases, atorvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

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Avoid eating foods that are high in fat or cholesterol. Atorvastatin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

There are many other drugs that can increase your risk of serious medical problems if you take them together with atorvastatin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Atorvastatin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

What should I discuss with my healthcare provider before taking atorvastatin?

You should not take atorvastatin if you are allergic to it, if you are pregnant or breast-feeding, or if you have liver disease.

To make sure you can safely take atorvastatin, tell your doctor if you have any of these other conditions:

  • history of liver disease;

  • history of kidney disease;

  • muscle pain or weakness;

  • a thyroid disorder; or

  • if you drink more than 2 alcoholic beverages daily.

In rare cases, atorvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. This condition may be more likely to occur in older adults and in people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid).

Tell your doctor about all other medications you use. Certain other drugs can increase your risk of serious muscle problems, and it is very important that your doctor knows if you are using any of them:

  • diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac);

  • gemfibrozil (Lopid), fenofibric acid (Fibricor, Trilipix), or fenofibrate (Antara, Fenoglide, Lipofen, Lofibra, Tricor, Triglide);

  • telaprevir (Incivek);

  • antibiotics such as clarithromycin (Biaxin) or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole);

  • antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), or voriconazole (Vfend);

  • HIV medications such as darunavir (Prexista), fosamprenavir (Lexiva), ritonavir (Norvir), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), saquinavir (Invirase), or tipranavir (Aptivus);

  • medicines that contain niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others); or

  • drugs that weaken your immune system, such as steroids, cancer medicine, or medicines used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), or tacrolimus (Prograf).

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not take atorvastatin if you are pregnant. Stop taking this medication and tell your doctor right away if you become pregnant. Use effective birth control to avoid pregnancy while you are taking atorvastatin.

Atorvastatin may pass into breast milk and could harm a nursing baby. Do not breast-feed while you are taking atorvastatin.

How should I take atorvastatin?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Do not break an atorvastatin tablet unless your doctor has told you.

Atorvastatin is usually taken once a day, with or without food. Take the medicine at the same time each day. Your doctor may occasionally change your dose to make sure you get the best results.

You may need to stop using atorvastatin for a short time if you have:

  • uncontrolled seizures;

  • an electrolyte imbalance (such as high or low potassium levels in your blood);

  • severely low blood pressure;

  • a severe infection or illness; or

  • surgery or a medical emergency.

To be sure this medicine is helping your condition, your blood will need to be tested often. Visit your doctor regularly.

Atorvastatin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. You may need to take atorvastatin on a long-term basis for the treatment of high cholesterol.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 12 hours away. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking atorvastatin?

Avoid eating foods that are high in fat or cholesterol. Atorvastatin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

Grapefruit and grapefruit juice may interact with atorvastatin and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Atorvastatin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking atorvastatin and call your doctor at once if you have any of these serious side effects:

  • unexplained muscle pain, tenderness, or weakness;

  • confusion, memory problems;

  • fever, unusual tiredness, and dark colored urine;

  • swelling, weight gain, urinating less than usual or not at all;

  • increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • mild muscle pain;

  • diarrhea; or

  • mild nausea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Atorvastatin dosing information

Usual Adult Dose for Prevention of Cardiovascular Disease:

Initial dose: 10 mg to 80 mg orally once a day.

The initial dosage of atorvastatin recommended for this patient in the prevention of cardiovascular disease is 10 mg to 80 mg orally once a day. Atorvastatin may be administered at any time of the day without regard for meals.

Dose adjustments should be made at intervals of 2 to 4 weeks.

Studies have demonstrated that treatment with atorvastatin is associated with significant reductions in the risk of cardiovascular endpoints and stroke in various patient populations for both primary and secondary prevention.

For primary prevention, atorvastatin treatment was effective in hypertensive patients with normal or mildly elevated cholesterol levels as well as in patients with type II diabetes. Patients had relatively low cholesterol levels at baseline in both trials; however, treatment with atorvastatin still resulted in significant reductions in cardiovascular outcomes and stroke.

For secondary prevention, intensive lipid lowering therapy with atorvastatin 80 mg/day was associated with significant incremental clinical benefit beyond therapy with 10 mg/day in patients with stable coronary heart disease. It was also shown to significantly reduce the risk of clinical outcomes in coronary heart disease patients versus usual medical care.

Usual Adult Dose for Hyperlipidemia:

Initial dose: 10, 20 or 40 mg orally once a day. The 40 mg starting dose is recommended for patients who require a reduction in LDL-cholesterol of more than 45%.

Dose adjustments should be made at intervals of 2 to 4 weeks.

Maintenance dose: 10 to 80 mg orally once a day.

Usual Pediatric Dose for Heterozygous Familial Hypercholesterolemia:

10 to 17 years:
10 mg per day (max dose is 20 mg per day). Adjustments should be made at intervals of 4 weeks or more.

What other drugs will affect atorvastatin?

Many drugs can interact with atorvastatin. Below is just a partial list. Tell your doctor if you are using:

  • birth control pills;

  • cimetidine (Tagamet);

  • conivaptan (Vaprisol);

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • spironolactone (Aldactone, Aldactazide);

  • an antibiotic such as dalfopristin/quinupristin (Synercid), rifampin (Rifater, Rifadin, Rifamate), telithromycin (Ketek), and others;

  • an antidepressant such as nefazodone;

  • heart or blood pressure medication such as digoxin (Lanoxin), diltiazem (Cartia, Cardizem), nicardipine (Cardene), quinidine (Quin-G), verapamil (Calan, Covera, Isoptin, Verelan), and others;

  • HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), indinavir (Crixivan), and others; or

  • any other "statin" medication such as amlodipine and atorvastatin (Caduet), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Simcor, Vytorin).

This list is not complete and there are many other drugs that can increase your risk of serious medical problems if you take them together with atorvastatin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about atorvastatin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 18.02. Revision Date: 2012-03-21, 12:00:31 PM.

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