Atorvastatin... problem with nausea etc - British Heart Fou...

British Heart Foundation

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Atorvastatin... problem with nausea etc

Brown_Rabbit profile image
25 Replies

Hi... I had heart attack thirteen days ago and am now at home with the standard cocktail of five drugs... four I take after breakfast; the fifth is a 80mg Atorvastatin horse pill, which I was instructed to take ‘at night’ (because that is when the liver makes cholesterol). I’ve never had issues with statins before (I have FH) but I believe this one is playing havoc with my digestive system; I can’t just ignore the sleepless nights, filled with wind and nausea. My cholesterol had been well controlled with Simvastatin and Ezetimibe for years and was low when I was admitted to hospital, so presumably this maximum dose is prophylactic.

So... questions... are these GI side effects (?) from Atorvastatin? Are they common? Do they go away after a while? Does anyone take this drug at a different time of day, say with food rather than on an empty stomach? Any observations would be very helpful... Thanks 🙂

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25 Replies
Smellymjk profile image
Smellymjk

I was put on this tablet after my stent was put in and had really bad muscular pain so changed to a different statin. Apparently it’s a cheap statin and can have side Effects. Ask for aReview of medicine. Also the tablets can being on reflux and I had to increase my oMeprazole so I am not surprised if it brings on sickness feelings! Good luck

Jay777 profile image
Jay777

Statins always used to be prescribed at night but the patient information leaflet for Atorvastatin states “at any time of day, with or without food”

The standard dose post HA recommended by NICE is 80mg whereas for high cholesterol it’s 40mg. This is because statins stabilise the plaque in the arteries and therefore can prevent a further HA. If you are having trouble tolerating Atorvastatin there are others and statins have been found to reduce the plaque over time so can be really valuable to anyone with narrowed arteries. Speak to your GP as there are different ones you can try.

Atorvastatin is one of the “modern” statins, mg for mg it’s twice as effective as Simvastatin.

@Smellymjk, drugs become “cheap” once they go off patent and become generic. They go generic because they have been proved to be very effective. They are still produced in a highly regulated way and to rigorous quality standards.

Mater123 profile image
Mater123 in reply to Jay777

excellent explanation thank you

Brown_Rabbit profile image
Brown_Rabbit in reply to Jay777

Thank you... a useful explanation and very reassuring. Ironically, score retirement, I used to conduct the systematic reviews that form the evidence part of each NICE guideline, but my subject area was cancer.

So... I think that if I, for example, take Lansoprolol 30 minutes before all the other tablets following breakfast, then round it all off with aspirin a few minutes after that this might give me an effective regime which would be easiest on my poor gut.

Despite the NHS website and the Atorvastatin box (and the hospital pharmacist) instructions to take this drug at night... I thought that since it has such a long (~19hrs) half life, it shouldn’t really make much difference taking it in the morning as long as the timing was consistent each day. I used to take Simvastatin & Ezetimibe but they have a short half life (~7hrs) so I see why that was appropriate at night.

Thanks again 🙂

Bradee12 profile image
Bradee12

Yep. I was changed 3x (after 2 stents) before they gave up giving me statins. Terrible tummy problems. Also got really sore Achilles tendons that 6 months since stopping statins are dreadfully painful.

Brixcos profile image
Brixcos

Hi Brown Rabbit, I've been on Atorvastatin since my HA last December. I take it last thing at night without food. It doesn't make me nauseous, but I am definitely far more windy than previously. Sometimes it's quite uncomfortable but I've learnt to live with it as it doesn't affect my sleeping like it does you, it's just rather antisocial. I will mention to my doctor when I get my meds reviewed in a couple of months. It's well worth talking to your doctor to see if he can either reduce the dose or return you to your previous meds. Do report back, I'd be interested in what he says. Good luck x

Brown_Rabbit profile image
Brown_Rabbit in reply to Brixcos

Hi... Jay’s response and my reply may be useful? 🙂

richard_jw profile image
richard_jw

It's not dissimilar to IBS. Try ensuring you are regular by something like Fybogel, or try colofac (mebeverin)

Brown_Rabbit profile image
Brown_Rabbit in reply to richard_jw

I do have IBS-C... yet another unwanted complication and one which I haven’t got around yet with these drugs. In these very early days of rehab I’m not doing my usual levels of activity - that and my natural disinclination to eat insoluble fibre and it’s unbearable consequences, I might have to investigate the dreaded world of laxatives 🙀 I did try Senekot a couple of days ago... not an experience I’d wish to repeat in a hurry; the pain was excruciating; I couldn’t do that more than once a lifetime... something less ‘aggressive’ on the the abdomen would be preferable... !. I’ll give your suggestions a go... with trepidation 😆 Thanks.

richard_jw profile image
richard_jw in reply to Brown_Rabbit

I use Psyllium husks. Simply because they are cheaper than fybogel. For me they work very well. Also make sure you drink a lot. A doctor told me that it's not a good idea to take mebeverin as well as a fybogel type laxative. They work against each other

Brown_Rabbit profile image
Brown_Rabbit in reply to richard_jw

OK... psyllium is unknown to me... where do you buy these and how effective are they? Sounds like a better option than some of the drastic treatments out there! Any info would be very useful 🙂

richard_jw profile image
richard_jw in reply to Brown_Rabbit

Here is where I bought itamazon.co.uk/dp/B07PWGK9X7/...

Brown_Rabbit profile image
Brown_Rabbit in reply to richard_jw

Thanks 😊

richard_jw profile image
richard_jw

There are side effects from some of the other pills you may be taking (e.g. Bisoprolol) which only manifest themselves at night when you lie down

Mater123 profile image
Mater123 in reply to richard_jw

what effects does Bisop have please

richard_jw profile image
richard_jw in reply to Mater123

There are lots. These forums are full of people who are having probs with it. Trouble is that the other beta blockers are said to have more, so cardiologists prescribe Bisoprolol.Here are some

headache

feeling dizzy or weak

cold hands or feet

feeling or being sick (nausea or vomiting) or diarrhoea

constipation

As I say, when you lie down digestive problems often get worse.

Mater123 profile image
Mater123 in reply to richard_jw

thanks a mil Richard

Brown_Rabbit profile image
Brown_Rabbit in reply to richard_jw

As far as I know I’ve been lucky with that (I’d already been taking that for a few years) 🙂

Tonedeaf67 profile image
Tonedeaf67 in reply to richard_jw

Best statin

JennyRx profile image
JennyRx

I’m on statin and ezetimibe- dreadful combo for flatulence! Ezetimibe is the main culprit though. I avoid omeprazole as a regular med as can cause osteoporosis and overgrowth of gut bacteria. I’m at risk of osteoporosis due to cancer med so not willing to increase my risk. I eat smaller meals to avoid reflux. I know I will suffer if I overeat.

Brown_Rabbit profile image
Brown_Rabbit in reply to JennyRx

It strikes me that most drugs have side effects of one sort or another and it depends on what, if any, other conditions you have. Until the HA, a couple of weeks ago, I’d been taking Simvastatin and Ezetimibe for years (FH) and had become used to the constant muscle aches... I’m a very active person, which made them worse, but I had no choice. Now I have a bunch of new drugs and the adventure start all over again...

I don’t know how long it’ll last but I haven’t been this pain free for years 🙂

JennyRx profile image
JennyRx

I’m sort of ok pain wise. Just. The cancer drug can cause joint pain too. I’ve just been doing some training on the new NICE approach to holistic pain relief. Very interesting. Still processing what it might mean for both myself and my patients.

Brown_Rabbit profile image
Brown_Rabbit in reply to JennyRx

Weirdly, if it’s breast or ovarian cancer I will have written the original evidence reviews in those NICE guidelines... my job before retiring; I expect they’ve been updated by now anyway. ‘My’ guideline was published in February 2009 and I was diagnosed with breast cancer in the August, so I kind of wrote my own treatment path 😆

I’ve been on Arimidex for more than ten years and my bone density did drop etc... all of these aggressive treatments seem to have consequences.

JennyRx profile image
JennyRx

Ah ha. These are the new guidelines on acute and chronic pain using a holistic approach rather than medication alone. It’s partly to avoid the opioid crisis that’s happening in the USA, being repeated over here. And also because most painkillers don’t actually work.

Brown_Rabbit profile image
Brown_Rabbit in reply to JennyRx

Sounds interesting… and probably relevant… most painkillers don’t work, it’s true.

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