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How does this medication work? What will it do for me?

Atorvastatin belongs to the group of medications known as HMG CoA reductase inhibitors ("statins"). It is used to treat people who have high cholesterol levels, including those people who have certain inherited cholesterol disorders. When you use this medication, you also need to make lifestyle changes, including switching to a diet low in fat and cholesterol, quitting smoking, and increasing the amount of exercise you do.

Atorvastatin works by blocking an enzyme that is used to make cholesterol in the liver. When that enzyme is blocked, less cholesterol is produced and the amount of cholesterol in the blood decreases. Atorvastatin lowers the level of total cholesterol and low-density lipoprotein (LDL; or "bad" cholesterol), and raises the high-density lipoprotein (HDL; or "good" cholesterol) levels. Reduction of cholesterol levels in the blood has been shown to reduce the risks associated with heart disease, such as heart attack.

Atorvastatin is also used to reduce the risk of heart attack and stroke in people who have multiple risk factors for heart disease whether or not they are experiencing any symptoms associated with heart disease. The risk factors for heart disease include:

being male
being 55 years old or older
high blood pressure
smoking
type 2 diabetes
enlarged heart ventricles
family history of heart disease

The medication usually takes about 2 to 4 weeks to have a significant effect on the cholesterol level in your blood. After this time, your doctor will likely send you for a blood test to check for changes in your cholesterol levels.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

When you start taking atorvastatin, you should be on a cholesterol-lowering diet. If appropriate, a health care professional will discuss an individualized program of weight control and physical exercise with you.

The recommended adult dose of atorvastatin ranges from 10 mg to 80 mg daily, preferably in the evening, with or without food. Tell your pharmacist or doctor if you regularly drink grapefruit juice, because grapefruit juice may interact with atorvastatin.

For children 10 to 17 years of age who are taking this medication to treat inherited cholesterol disorders, the recommended dose ranges from 10 mg to 20 mg daily. Doses greater than 20 mg have not been studied.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

For best results in lowering cholesterol, it is very important to closely follow the diet suggested by your doctor. It is also very important that atorvastatin be taken regularly, exactly as prescribed by your doctor.

If you miss a dose of this medication, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Atorvastatin should not be used by anyone who:

is allergic to atorvastatin or to any of the ingredients of the medication
is pregnant or plans on becoming pregnant
is breast-feeding
has active liver disease or unexplained increases in liver function tests

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

constipation
diarrhea
gas
headache
heartburn
nausea
rash
stomach upset
vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

symptoms of liver damage (such as yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
symptoms of nerve damage (such as muscle weakness, decreased sensation in the hands and feet, loss of balance, numbness, or tingling or prickling sensations)
Stop taking the medication and seek immediate medical attention if any of the following occur:

symptoms of muscle damage, such as muscle pain, tenderness or weakness, or brown or discoloured urine, especially if you also have a fever or a general feeling of being unwell
severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
symptoms of a serious allergic reaction such as swelling of the face or throat, hives, or difficulty breathing
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: People who drink large quantities of alcohol should be closely monitored by their doctor while they are taking this medication.

Kidney problems: People with decreased kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver: Laboratory tests show signs of harmful effects to the liver may occur for a small percentage of adults who take atorvastatin for long periods of time. When this medication is stopped, liver function usually slowly returns to normal. It is important to have tests done regularly. Check with your doctor.

Your doctor will perform regular tests to check your liver function. This medication should not be used by people with active liver disease or by people whose liver function tests are higher than normal. People with a history of liver disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Muscle effects: In rare cases, serious muscle pain, cramps, and weakness have been associated with the use of statin medications (i.e., cholesterol-lowering medications whose names end in -statin, such as atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin), especially at higher doses.

Before taking this medication, tell your doctor or pharmacist if you:

have kidney or liver problems
are taking niacin or a fibrate medication (such as gemfibrozil, fenofibrate)
have an underactive thyroid gland (hypothyroidism)
regularly drink more than three alcoholic drinks per day
have a history of muscle pain or weakness while taking other cholesterol-lowering medications such as atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin
have a personal or family history of inherited muscle problems
are of Asian background (Chinese, Filipino, Japanese, Korean, Vietnamese, or Asian-Indian origin)
are more than 70 years old
have undergone surgery or suffered any traumatic injury
are frail
do excessive physical exercise
have diabetes

Seek immediate medical attention if you notice any unexplained muscle pain, tenderness, weakness or cramps, or any brown or discoloured urine, particularly if you are also experiencing malaise (a general feeling of being unwell) or fever.

Pregnancy: Atorvastatin should not be taken by pregnant women. If you become pregnant while taking this medication, stop taking it immediately and call your doctor.

Breast-feeding: It is not known if atorvastatin passes into breast milk. Women taking atorvastatin should not breast-feed.

Children: There is limited experience with the use of this medication by children. Atorvastatin has only been studied for use by children aged 10 to 17 years who have inherited cholesterol disorders (also known as familial hypercholesterolemia).

Seniors: If you are more than 70 years old, you may experience more side effects. Your doctor will monitor you closely while you are taking this medication.

What other drugs could interact with this medication?

There may be an interaction between atorvastatin and any of the following:

amiodarone
antacids
antifungal medications (e.g., itraconazole, ketoconazole)
birth control pills
cholestyramine
cimetidine
colestipol
corticosteroids (i.e., prednisone, prednisolone, etc)
cyclosporine
digoxin
diltiazem
fibrates (e.g., bezafibrate, gemfibrozil, fenofibrate)
grapefruit juice
macrolide antibiotics (e.g., erythromycin, clarithromycin)
nefazodone
niacin (nicotinic acid)
protease inhibitors (e.g., nelfinavir, ritonavir)
rifampin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (nonprescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Important Note and Disclaimer
The information provide by World Canadian Pharmacy is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other health care professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. The information provided here is for informational purposes only and must not be used or relied upon for making a diagnosis or treatment decision. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. Always seek the advice of your physician or other qualified health care provider regarding any questions you may have about a medical condition. Consult your health care professional before using any one of these products, changing your lifestyle, or beginning or discontinuing any course of treatment. If you suspect that you are ill or may have a medical emergency, contact a physician, a health professional or call 911 immediately.