Atorvastatin (Lipitor): Top 12 Drug Facts You Need to Know

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 4, 2024.

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

1. What is atorvastatin (Lipitor)?

Atorvastatin calcium (brand name: Lipitor) is a medicine in a class of drugs called HMG CoA reductase inhibitors, also referred to as "statins." Pfizer’s Lipitor was first approved in 1996 and is considered one of the most successful selling drugs of all time. In 2006, Lipitor had the top U.S. drug sales of over $13 billion. Even today, after its patent loss in 2011, atorvastatin is still one of the most prescribed medications in the U.S.

Statins are usually the first drug used to treat people with high cholesterol levels (high LDL) or heart disease. If you have coronary heart disease (CHD) or risk multiple factors for heart disease (CHD), stains can help reduce the risk of stroke and heart attacks, heart surgery, or chest pain (angina), or hospitalization for congestive heart failure. If you have high cholesterol plus diabetes, high blood pressure, obesity, or a history of smoking, statins may be especially helpful for you.

A doctor might prescribe this drug for you if you are not able to lower your cholesterol after following a low-fat diet and a program of regular exercise. Atorvastatin can be used in adults and children over the age of 10 years along with a healthy diet, weight loss, and exercise.

Atorvastatin is considered a moderate- or high-intensity statin depending upon the dose:

• A dose of 10 to 20 mg per day is considered moderate-intensity therapy with an expected LDL (low density lipoprotein) reduction of 30% to 50%.
• A dose of 40 to 80 mg per day is considered high-intensity therapy with an expected LDL reduction of 50% or greater.

Atorvastatin is one of the many statin drugs on the market. If you and your doctor decide you should start a cholesterol-lowering medication, the choice of drug and your dose is based on many factors, like:

• your risk factors for heart disease, or if you currently have ongoing heart disease
• your cholesterol levels
• your previous treatments for high cholesterol, if any
• your family history for heart disease
• if you have diabetes
• other prescription drugs or medications you take
• cost

2. What does atorvastatin do to the body?

Atorvastatin works by reducing your "bad" cholesterol (low density lipoprotein, or LDL cholesterol) and triglycerides in the blood, while increasing levels of “good" cholesterol (high density lipoprotein, or HDL cholesterol). It can lower the build-up of cholesterol plaque in your blood vessels and arteries that could lead to a heart attack.

• It does this by blocking an enzyme known as 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase in the liver.
• Blocking this enzyme helps to lower the production and increase the removal of bad cholesterol from your body.

Statins typically start to lower your cholesterol levels in about 2 weeks. Roughly 1 to 2 months after you start statin therapy your doctor will check your cholesterol levels with a simple blood test to see how well the drug is working for you.

3. How does atorvastatin come at the pharmacy?

Atorvastatin is an oral tablet you take by mouth once a day to help lower your cholesterol. It is a prescription drug and comes as a generic and brand name (Lipitor) product. Tablets come in strengths of 10 mg, 20 mg, 40 mg, and 80 mg.

Table 1. List of Brand and Generic Statins in the U.S.

Generic name	Brand name(s)	Generics Available?
atorvastatin	Lipitor	yes
fluvastatin	Lescol XL	yes
lovastatin	not available	yes
lovastatin ER (extended-release form)	Altoprev	no
pitavastatin calcium	Livalo	yes
pitavastatin magnesium	Zypitamag	no
pravastatin	not available	yes
rosuvastatin calcium	Crestor	yes
simvastatin	Zocor	yes
simvastatin (oral suspension)	FloLipid	no

What do atorvastatin tablets look like?

• There are many different generic manufacturers and tablets may look different: different shapes, colors or numbers on the pill.
• The best way to see a picture of an atorvastatin tablet is to look at the atorvastatin images in the Pill Identifier Wizard. Here you can search for any drug image by entering the drug name, the imprint code, the pill color, or the pill shape.
• You can also view an image of the brand name product Lipitor, or other statins.

Is atorvastatin combined with any medicines?

Atorvastatin can be found in two combination drugs: Caduet (amlodipine and atorvastatin) and Lypqozet (ezetimibe and atorvastatin).

• • Caduet is a channel blocker and statin drug used to help lower blood pressure and cholesterol in the same pill. It's used to treat high blood pressure or chest pain (angina), and to lower the risk of stroke, heart attack, and other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors. It is available as a generic and brand name drug.
  • Lypqozet is a cholesterol absorption inhibitor and statin drug used to lower cholesterol, LDL cholesterol and other lipids in patients with primary hyperlipidemia and mixed hyperlipidemia. In patients with homozygous familial hypercholesterolemia (HoFH), it is used in addition to other lipid lowering agents.

4. How much does atorvastatin cost?

Most of the drugs in the statin class are now available generically and are much more affordable. While prices differ between cities and pharmacies, atorvastatin usually costs about $10 to $20 for a month supply using an online coupon. Insurance will most likely pay for atorvastatin, after your copay.

Learn more: See the Drugs.com Price Guide for atorvastatin to review prices, coupons and manufacturer's assistance.

Your cost may even be cheaper if you pay with cash and a coupon instead of using an insurance copay, so check with your pharmacist.

If you find you cannot afford your medication, talk to your doctor or pharmacist about ways you may be able to lower your costs. These medications can be life-saving and it is important that you take your medication as prescribed.

5. Should I take atorvastatin at night?

You can take atorvastatin at any time of the day because the amount of time the drug is active (known as the half-life) is long. This drug inhibits the HMG-CoA reductase enzyme for about 20 to 30 hours. This means you can take it at any time during the day or night, but you should take your dose at the same time each day, just to get in the habit.

Some statins should be taken only at night, so be sure to follow the directions on your prescription bottle.

6. Does atorvastatin cause muscle pain?

Yes, muscle pain and weakness is one of the most common complaints with statins. The muscle pain can occur in several different ways.

• Mild to moderate muscle pain (myalgia) is the most commonly reported side effect with statins, and 1% to 10% (1 to 10 out of every 100 people) may report this effect.
• Myositis is a less common inflammation of your muscles that may be accompanied by an elevation in your creatine kinase (CK) which can be determined from a blood test.
• Rhabdomyolysis is a very rare but serious form of muscle pain, occurring in less than 0.1% of people. Severe effect leads to a rapid breakdown of muscle tissue, high elevation of creatine kinase (over 10 times higher), and possible kidney damage or kidney failure.
• Severe muscle breakdown and kidney damage occurs more often in women, in older patients, those with ongoing kidney disease or an underactive thyroid (hypothyroidism).

Drug interactions can also lead to muscle pain. Use of higher doses of atorvastatin with certain medications, such as cyclosporine, clarithromycin, itraconazole, and some HIV and hepatitis drugs can increase the risk of muscle pain. Always have your pharmacist run a drug interaction screen any time to start or stop a new medication.

If you notice symptoms of muscle toxicity or rhabdomyolysis such as fatigue, malaise, pain, tenderness, stiffness, cramping, weakness, bruising, low urine output, fever, or brown-colored urine you should call your doctor immediately. Your medication may need to be stopped, your dose adjusted or your treatment changed completely. 

Learn More: Common Drug Interactions with Atorvastatin (Lipitor)

7. How does atorvastatin cause type 2 diabetes?

The use of statins may lead to a small increased risk of high blood sugar (glucose) levels and type 2 diabetes. In general, most doctors agree that the benefits of statins in lowering your heart risk clearly outweigh any risk from the development of diabetes.

A large review of 13 studies (called a meta-analysis) with over 90,000 patients found that use of statins does lead to a small but statistically significant increased risk of developing diabetes (9%). Statins appear to elevate diabetes risk by impairing insulin sensitivity and insulin secretion, although the exact causes are not fully known. One study suggested an immune response may stop insulin from doing its job properly.

Studies seems to suggest that pravastatin is the statin with the lowest risk of causing diabetes, and high-intensity therapy, such as atorvastatin, rosuvastatin or simvastatin may lead to a greater risk. A review from Lancet estimated that if 10,000 patients were treated for 5 years with atorvastatin 40 mg per day (high-intensity therapy), 50 to 100 new cases of type 2 diabetes might occur.

8. Will atorvastatin make me drowsy?

While atorvastatin won’t cause you to be drowsy or sleepy right after you take it, some people do experience a level of lower energy and tiredness (fatigue) throughout the day. Higher doses may worsen this effect, and women seem to be especially at risk. Fatigue or weakness may also be a sign of more serious effects, such as muscle problems or liver toxicity.

Research published in the journal Archives of Internal Medicine evaluated the side effect of fatigue with statins. Researchers looked at the effect of two other statins, pravastatin and simvastatin, compared to a placebo (sugar pill) in 1016 people. Forty percent, or about 4 out of 10 women reported fatigue and loss of energy after exertion. Older people between 70 and 75 years of age also experienced this effect.

9. Does atorvastatin cause liver problems?

Atorvastatin can cause liver damage. In clinical trials, liver toxicity was reported in less than 1% (1 out of 100) of patients overall, but was more common with higher doses. Statins are extensively metabolized (broken down) by the liver. Your doctor will check your liver enzymes with a simple blood test before you start treatment with statins.

Liver problems might first be noticed on a blood test ordered by your doctor or you might have symptoms of liver disease. Enzyme blood levels (known as transaminases, or AST and ALT) may be high in your lab report. If these levels get to be about 3 times higher than normal, your doctor may decide to stop your medication, lower your dose, or change your medication to a different class.

If you notice symptoms of liver disease, such as severe fatigue or weakness along with loss of appetite, stomach pain, dark-colored urine or yellowing of skin or eyes (jaundice), contact your doctor for medical advice immediately.

Other common side effects of atorvastatin

Statins are usually well-tolerated. If a side effect does occur, your doctor might lower your dose to see if the side effect will subside, or switch you to another statin.

In addition to muscle or joint pain, other common side effects include:

• diarrhea
• upset stomach
• tiredness
• memory loss
• confusion.

These are not all the side effects that may occur with the use of atorvastatin. Ask your doctor or pharmacist for a complete list or view more atorvastatin side effects here.

Do not use atorvastatin if:

• you have previously had a serious allergic reaction to Lipitor, atorvastatin calcium or any inactive ingredient in the medication.
• you have acute liver failure or cirrhosis.

If you become pregnant while taking atorvastatin, call your doctor to discuss if you should continue taking this medicine. Breastfeeding is not recommended during treatment with atorvastatin

10. Why does atorvastatin have a drug interaction with grapefruit juice?

Drinking grapefruit juice or eating grapefruit while taking atorvastatin (Lipitor) can increase the risk of some side effects, such as liver disease or muscle damage. Blood levels of the drug may increase leading to side effects.

Drug levels rise because grapefruit compounds block enzymes involved in the breakdown of atorvastatin (known as cytochrome P450 3A4 [CYP3A4] enzymes). These enzymes are involved in the metabolism of more than 50% of all drugs, and are needed to help eliminate drugs from the body. Some interactions are theoretical, based on their CYP3A4 enzymes, but a warning is still important.

Lovastatin and simvastatin also have drug interactions with grapefruit juice, and you should not drink grapefruit juice at all with these medications.

The drug maker of atorvastatin suggests that people taking this drug avoid large quantities of grapefruit juice (more than 1 quart per day). Always follow the directions on your prescription label.

If you drink grapefruit juice on a daily basis, tell your doctor. They may decide to change your statin to one that does not interact with grapefruit juice (such as pravastatin, fluvastatin, rosuvastatin, or pitavastatin).

Learn More: Common Grapefruit Juice Drug Interactions

11. Can I drink alcohol while taking atorvastatin?

There is no specific drug interaction between alcohol and atorvastatin; but you may consider limiting your alcohol intake because statins plus excessive alcohol may raise your triglyceride levels and possibly lead to liver toxicity.

If you drink more than 2 glasses of alcohol per day, discuss this with your doctor. High cholesterol and alcohol use can be linked if alcohol is consumed chronically and excessively.

Learn More: Cholesterol Medications and Alcohol Interactions

12. Can I stop taking atorvastatin?

Do not stop taking any medication unless you have discussed this with your doctor. If your doctor has recommended that you take a statin drug, it is important that you continue this medication long-term to help protect you from a heart attack or stroke.

Most people continue taking their statins as a lifelong medication. Some people who adhere to a strict diet and exercise routine may be able to stop their statin, but this is not the norm.

Related: How long does atorvastatin stay in my system after I stop it?

If you need to stop your atorvastatin because of a side effect, drug interaction, or other medical issue, your doctor will either choose another stain to use or prescribe another class of cholesterol-lowering medication. Be sure to contact your healthcare provider to discuss your options.

Additional Resources

• Medications for High Cholesterol
• Side-by-Side Comparisons of Statins

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer