Experiences with
Atorvastatin

Atorvastatin belongs to a group of medicines called statins. It is used to lower cholesterol if you've been diagnosed with high blood cholesterol and prevent heart disease, including heart attacks and strokes.

Your doctor may also prescribe atorvastatin if you have a family history of heart disease, or a long-term health condition such as type 1 or type 2 diabetes or rheumatoid arthritis.

This medicine is available on prescription only. It comes as tablets, including chewable tablets for people who have difficulty swallowing.

Who can take atorvastatin

Most adults and children aged 10 years and over can take atorvastatin.

Atorvastatin is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

have ever had an allergic reaction to atorvastatin or any other medicine
have liver or kidney problems
think you might be pregnant, are already pregnant, or you're breastfeeding
have lung disease
have previously had a stroke caused by bleeding into the brain
regularly drink large amounts of alcohol
have an underactive thyroid
have had muscular side effects when taking a statin in the past
have ever had a muscle disorder (including fibromyalgia)

Lipitor chewable tablets contain something called aspartame. Check with your doctor before taking these if you have phenylketonuria (a rare inherited disorder of protein metabolism).

Dosage and strength

Atorvastatin comes as:

10mg, 20mg, 30mg, 40mg, 60mg and 80mg tablets
10mg and 20mg chewable tablets

The usual dose for adults is between 10mg and 80mg a day.

Your dose depends on the reason why you're taking it, your cholesterol levels, and what other medicines you're taking.

Do not reduce your dose without talking to your doctor first.

Ask your doctor or pharmacist for advice if you're unsure how much to take.

The usual starting dose for children is 10mg, taken once a day. This dose may be increased to a maximum of 80mg.

Your child's doctor will work out the right dose for your child. The dose will depend on why they need atorvastatin, their age and any other medicines they are already taking.

How to take it

Take atorvastatin once a day. You can choose to take it at any time, as long as you stick to the same time every day. This prevents your blood levels from becoming too high or too low.

Sometimes doctors may recommend taking it in the evening. This is because your body makes most cholesterol at night. If you're not sure when to take your medicine, ask a pharmacist or your doctor for advice.

You can take atorvastatin with or without food, but taking it after food may help if it makes you feel sick.

Swallow atorvastatin tablets whole with a drink of water. If you've been given chewable tablets, you can chew them or swallow them whole with a drink of water.

How long to take it for

Depending on the reason why you're taking atorvastatin, you may have to take it for a long time, even for the rest of your life.

You may want to stop atorvastatin if you think you're having side effects. Talk to your doctor first to see if it really is a side effect of atorvastatin or an unrelated problem. Your doctor may decide to lower your dose or change your medicine.

You will not get any withdrawal symptoms. However, the benefits will only continue for as long as you take it. If you stop taking atorvastatin without starting a different treatment, your cholesterol level may rise again. This increases your risk of heart attacks and strokes.

If you want to stop taking your medicine, it's important to find another way to lower your cholesterol.

If you forget to take it

If you forget to take your dose, take it as soon as you remember. If you do not remember until the next day, skip the missed dose and take the next one at the usual time.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking more than your prescribed dose of atorvastatin is unlikely to harm you. Talk to your pharmacist or doctor if you're worried, or if you take more than 1 extra dose.

Common side effects

These common side effects of atorvastatin happen in more than 1 in 100 people. There are things you can do to help cope with them:

If this advice does not help and any of these side effects continue or bother you, keep taking the medicine, but tell your doctor or pharmacist.

Stop taking atorvastatin and contact 111 or call your doctor if:

you get unexplained muscle pain, tenderness, weakness or cramps – these can be signs of muscle breakdown and kidney damage
the whites of your eyes turn yellow, or your skin turns yellow, although this may be less obvious on brown or black skin, or if you have pale poo and dark pee – these can be signs of liver problems
you get a skin rash with pink or red blotches, especially on the palms of your hands or soles of your feet – this could be a sign of erythema multiforme
you have severe stomach pain – this can be a sign of acute pancreatitis
you have a cough, feel short of breath, and are losing weight – this can be a sign of lung disease

Go to 111.nhs.uk or call 111.

Drinking a lot of alcohol regularly increases the chance of you having side effects with atorvastatin, and liver problems.

If you think that atorvastatin is causing side effects and they're making you want to stop taking it, talk to your doctor first. They may be caused by another problem and not the medicine. Your doctor may suggest lowering your dose or changing your medicine.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to atorvastatin.

These are not all the side effects of atorvastatin. For a full list, see the leaflet inside your medicine packet.

Atorvastatin and pregnancy

Atorvastatin is not recommended during pregnancy. If you become pregnant while taking atorvastatin, stop taking the medicine and tell your doctor.

Talk to your doctor if you are trying to get pregnant. Whether you continue to take atorvastatin or not depends on your reason for taking it. It may be possible to switch to an alternative medicine that is better during pregnancy. Sometimes it may be better to keep taking atorvastatin until you have a positive pregnancy test and then stop.

It might be OK to take atorvastatin while breastfeeding, but you might also be advised to stop taking your medicine until you are no longer breastfeeding. Your doctor or pharmacist will help you decide.

It's not yet known how much atorvastatin passes into breast milk, but it's likely to be a very small amount. It is unlikely to cause any side effects in your baby, or affect their cholesterol.

If you notice that your baby is not feeding as well as usual, or not putting on weight as you would expect, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.

Atorvastatin and fertility

There's no clear evidence to suggest that taking atorvastatin will reduce fertility in either men or women.

However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.

Cautions with other medicines

Some medicines can affect the way atorvastatin works and can increase the chances of you having serious side effects, such as muscle damage.

Tell your doctor or pharmacist if you are taking any of the following medicines:

antibiotics such as erythromycin, clarithromycin, rifampicin or fusidic acid
antifungals such as ketoconazole, voriconazole or fluconazole
some HIV medicines
some hepatitis C medicines
warfarin, a medicine to help prevent blood clots
ciclosporin, a medicine for psoriasis and rheumatoid arthritis
colchicine, a medicine for gout
contraceptive pills, such as the combined pill
verapamil, diltiazem or amlodipine, medicines for high blood pressure and heart problems
amiodarone, a medicine that helps if you have an irregular heartbeat (atrial fibrillation)

If you're taking atorvastatin and need to take one of these medicines, your doctor may:

prescribe a lower dose of atorvastatin
prescribe a different statin medicine
recommend that you stop taking atorvastatin for a while

These are not all the medicines that can affect the way atorvastatin works. For a full list see the leaflet inside your medicine packet or check with your pharmacist.

St John's wort, a herbal remedy taken for depression, reduces the amount of atorvastatin in your blood, so it does not work as well.

Talk to your doctor if you're thinking about starting St John's wort, as it will change how well atorvastatin works.

Sometimes, people take a supplement called CoQ10 with statins. There's no clear evidence that taking it at the same time as atorvastatin benefits your health.

If you decide to take a CoQ10 supplement, tell your doctor or pharmacist. Supplements can affect the way other medicines you're taking work.

There's not enough information to say that other herbal remedies and supplements are safe to take with atorvastatin. They're not tested in the same way as pharmacy and prescription medicines.