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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 pregnant or breast-feeding, or if you have liver disease.

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

Serious drug interactions can occur when certain medicines are used together with atorvastatin. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

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.

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

You should not use atorvastatin if you are allergic to it, or if you have:

  • liver disease; or

  • if you are pregnant or breast-feeding.

To make sure atorvastatin is safe for you, tell your doctor if you have:

  • muscle pain or weakness;

  • history of liver disease;

  • history of kidney disease;

  • history of stroke (including TIA or "mini-stroke");

  • a thyroid disorder; or

  • if you drink more than 2 alcoholic beverages daily.

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).

This medicine can harm an unborn baby or cause birth defects. Do not use if you are pregnant. Stop taking atorvastatin and tell your doctor right away if you become pregnant Use effective birth control to prevent pregnancy while you are taking this medicine.

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

Atorvastatin is not approved for use by anyone younger than 10 years old.

How should I take atorvastatin?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Atorvastatin is usually taken once a day, with or without food. Take the medicine at the same time each day.

Do not break an atorvastatin tablet before taking it.

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.

While using atorvastatin, you may need frequent blood tests.

Atorvastatin is only part of a complete treatment program that may also include diet, exercise, and weight control. Follow your doctor's instructions very closely.

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 signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

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.

Also call your doctor at once if you have:

  • kidney problems--little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

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

  • signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

Common side effects may include:

  • muscle or joint pain;

  • diarrhea; or

  • upset stomach.

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 or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses:
-In patients without clinically evident coronary heart disease (CHD), but with multiple risk factors for CHD such as age, smoking, hypertension, low HDL-C, or a family history of early CHD, to reduce the risk of myocardial infarction and stroke, and to reduce the risk for revascularization procedures and angina

-In patients with type 2 diabetes, and without clinically evident CHD, but with multiple risk factors for CHD such as retinopathy, albuminuria, smoking, or hypertension, to reduce the risk for myocardial infarction and stroke

-In patients with clinically evident CHD, to reduce the risk of nonfatal myocardial infarction and fatal and nonfatal stroke; to reduce the risk for revascularization procedures; to reduce the risk of hospitalization for CHF; and to reduce the risk of angina

Usual Adult Dose for Homozygous Familial Hypercholesterolemia:

10 mg to 80 mg orally once a day

Uses: To reduce total-C and LDL-C in patients with homozygous familial hypercholesterolemia, as an adjunct to other lipid lowering treatment (e.g., LDL apheresis) or if such treatments are unavailable

Usual Adult Dose for Hyperlipidemia:

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL):

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL):

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type III (Elevated beta-VLDL + IDL):

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type IV (Elevated VLDL):

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hypertriglyceridemia:

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Heterozygous Familial Hypercholesterolemia:

-Initial dose: 10 mg or 20 mg orally once a day; an initial dose of 40 mg may be used in patients who require a reduction in low density lipoprotein (LDL-C) of more than 45%
-Maintenance dose: 10 mg to 80 mg orally once a day

Comments:
-Following initiation and/or upon titration, lipid levels should be evaluated within 2 to 4 weeks and dosages adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), LDL-C, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Pediatric Dose for Heterozygous Familial Hypercholesterolemia:

10 to 17 years: 10 mg orally once a day
-Maximum dose: 20 mg/day

Comments:
-Doses greater than 20 mg/day have not been studied in this patient population.
-Dose adjustments should be made at intervals of 4 weeks or more.

Use: As an adjunct to diet to reduce total-C, LDL-C, and apo B levels in boys and postmenarchal girls, 10 to 17 years of age, with heterozygous familial hypercholesterolemia if after an adequate trial of diet therapy the following findings are present: LDL-C remains 190 mg/dL or greater, or LDL-C remains 160 mg/dL or greater and there is a positive family history of premature cardiovascular disease (CVD) or 2 or more other CVD risk factors are present in the pediatric patient

What other drugs will affect atorvastatin?

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. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • antibiotic or antifungal medicine;

  • birth control pills;

  • cholesterol-lowering medication;

  • heart medication; or

  • medicine to treat HIV or AIDS.

This list is not complete. Other drugs may interact with atorvastatin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

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: 18.03. Revision Date: 2015-06-29, 1:16:44 PM.

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