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Atorvastatin

Sounds like 'a-tor-va-stat-in'

Key points about atorvastatin

Atorvastatin is used to lower raised cholesterol and reduce your chance of heart disease and stroke.
Atorvastatin is also called Lorstat®.
Find out how to take it safely and possible side effects.

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Atorvastatin is a medicine that reduces the amount of cholesterol made by your body by blocking the action of a certain enzyme which is needed to make cholesterol. It belongs to a group of medicines known as statins.

If you have high cholesterol

Having high cholesterol increases your risk of cardiovascular disease and having a heart attack or stroke. Read more about high cholesterol.

Cholesterol is a type of lipid that is made by your liver and from the fatty foods that you eat. Everyone has cholesterol and triglycerides in their blood. They are fatty substances needed by the body for many things.
Your body needs some cholesterol but if the amount in your blood gets too high, it can cause small fatty patches called plaques (or atheroma).
Over time, these patches can accumulate and make the blood vessels narrow and stiff (a process called atherosclerosis). The narrowing reduces the blood flow through the arteries and can cause heart attack, angina and stroke.
Atorvastatin helps to reduce atherosclerosis and reduces your risk of having a heart attack or stroke.

In people with normal cholesterol but at risk of heart disease and stroke

Atorvastatin can also reduce your chance of heart disease and stroke if you have an increased risk of it, even if your cholesterol levels are normal.

When deciding whether you should take a statin or not, your doctor will look at your overall risk of having a heart attack or stroke in the future.
They use calculations to work out your individual risk, including information on your age, sex, ethnicity, blood pressure, whether you smoke and if you have diabetes. Read more about heart risk assessment.
If your overall risk of having a heart attack or stroke is high, regardless of your cholesterol level, a statin may be recommended. This is because even if the amount of cholesterol in your blood is normal according to the numbers on your blood test results, there may already be plaque present in your arteries that indicates you’re at risk of cardiovascular disease.
Note: Taking a statin, such as atorvastatin is just one factor in reducing your risk of cardiovascular disease. Making lifestyle changes including eating a healthy diet, staying active, keeping a healthy weight, drinking less alcohol, and not smoking can also reduce your risk of cardiovascular disease.

After a heart attack or stroke

Atorvastatin is used after a heart attack or stroke to lower the risk of another heart attack or stroke. Statins also reduce the lipid content of fatty patches and stabilise them, when started early following a heart attack. This also help reduce your chance of having another heart attack.

Atorvastatin tablets are available in different strengths; 10 mg, 20 mg, 40 mg and 80 mg.

The dose of atorvastatin will depend on your cardiovascular disease (CVD) risk, which is calculated by completing a heart risk assessment. Your healthcare provider will discuss your CVD risk with you and then determine what dose of atorvastatin is best for you.
After a heart attack or stroke, your doctor may start you on a high dose of atorvastatin (40 to 80 mg once daily).
Always take your atorvastatin exactly as your healthcare provider has told you.
The pharmacy label on your medicine will tell you how much atorvastatin to take, how often to take it and any special instructions.

Timing: Take atorvastatin once a day, at around the same time each day.
Food: You can take atorvastatin with or without food.
Missed dose: If you forget your dose, take it as soon as you remember that day. But if it's nearly time for your next dose, just take the next dose at the usual time. Don't take double the dose.

Here are some things to know when you're taking atorvastatin. Other things may be important as well, so ask your healthcare provider what you should know about.

Alcohol: Avoid drinking large amounts of alcohol while you're taking atorvastatin. Heavy drinking can increase your risk of side effects such as problems with your liver.
Avoid large quantities of grapefruit: Having large quantities of grapefruit while taking atorvastatin can increase your risk of side effects. But eating 1 serving of marmalade, no more than half a grapefruit or drinking no more than a standard glass (250 mL) of grapefruit juice each day, shouldn't be a problem. It's best to allow 12 hours between having these foods and taking your atorvastatin dose, so if you take your statin in the morning have your grapefruit at night.
Monitoring: You may need to see your healthcare provider regularly when you first start taking atorvastatin to make sure the dose is right for you. High cholesterol doesn’t have any symptoms so you won’t notice any changes after taking atorvastatin. That's why it’s important to have a blood test to check the changes in your cholesterol levels.
Keep taking atorvastatin regularly: To reduce your cholesterol effectively, you must keep taking atorvastatin every day. Treatment with atorvastatin is usually long term.
Get the full benefit: To get the full benefit of a statin, it's important to eat a healthy diet, exercise regularly and have no more than 1 alcoholic drink a day. It's best to eat a low-fat diet, and reduce the amount of saturated fat you eat.
Other medicines: Atorvastatin interacts with some medicines, herbal supplements and rongoā Māori, so check with your healthcare provider or pharmacist before starting atorvastatin or before starting any new medicines or supplements.
Pregnancy or breastfeeding: Talk to your healthcare provider if you're pregnant, planning a pregnancy or want to breastfeed.

Like all medicines, atorvastatin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Muscle pain or weakness

Some people will have muscle pain or weakness when taking statins. This is rarely serious and often goes away with time. If your pain comes on shortly after you start your statin, or gets worse, see your healthcare provider. They'll check an enzyme called creatine kinase to see if the aches and pains are possibly being caused or made worse by the statins. If so:

a lower dose or a different statin may be prescribed, or
you may choose to continue living with the aches because of the benefits of the statin, or
you may discuss stopping taking your statin with your healthcare provider.

Your healthcare provider will also want to check for a rare but serious condition called rhabdomyolysis and will check any other medicines you're taking. Rhabdomyolysis can be caused by an interaction between statins and some other medicines including antibiotics.

Other side effects

Side effects	What should I do?
Headache	This is quite common when you first start taking atorvastatin, and usually goes away with time. Tell your healthcare provider if this bothers you.
Constipation (hard to poo) or diarrhoea (runny poo) Stomach upset Bloating or gas in the tummy Nausea (feeling sick)	These are quite common when you first start taking atorvastatin, and usually go away with time. Tell your healthcare provider if these bother you.
Muscle aches and pain or muscle weakness	This is common and may not be anything to be worried about but you should still tell your healthcare provider so they can check it’s not a rare but serious side effect that affects the muscles.
Signs of problems with your liver such as dark coloured urine, yellowing of the skin or eyes, sharp pain in your stomach area	Tell your healthcare provider immediately or ring Healthline 0800 611 116.
Signs of an allergic reaction such as itchy skin, and rash	This is rare. Stop taking atorvastatin and phone 111 for an ambulance.