Overview

Atorvastatin (Lipitor) is among the most popular of the statin drugs that widely prescribed for treating high cholesterol. All of these medications lower cholesterol levels by keeping the liver from manufacturing it.

This medication dramatically lowers LDL cholesterol and triglycerides.

Coronary artery disease is associated with certain risk factors, including high serum cholesterol, bad LDL cholesterol, elevated triglycerides and reduced levels of protective HDL cholesterol.

When diet, exercise and weight control are insufficient to control cholesterol, drugs like Lipitor may be important in reducing the risk of heart disease. Research shows benefit particularly in preventing a second or third heart attack in an individual who has already suffered one. Opinion is quite divided on whether atorvastatin makes sense for “primary prevention”-lowering the likelihood of an initial heart attack in an individual at average risk. You can read more about the controversy here.

Side Effects and Interactions

Some adverse reactions that may occur include headache, stomach ache, flatulence, constipation, diarrhea, indigestion, skin rash, and muscle or joint aches. Hives, mental fuzziness or diabetes are other potential side effects.

Muscle aches, tenderness or weakness are not uncommon, but in rare cases they could be a sign of a serious reaction called rhabdomyolysis or myopathy.  A test of kidney function (creatine kinase or CK) will show whether dangerous muscle breakdown is occurring. Kidney failure might be the outcome of untreated myopathy. Report any symptoms such as muscle pain or extreme weakness coupled with abdominal pain, nausea, fever, rapid heart rate or confusion to a physician immediately.

The danger of rhabdomyolysis or myopathy is increased when atorvastatin is combined with certain other drugs, particularly mifepristone used to terminate pregnancy or the antifungal drug posaconazole (Noxafil). These drugs should not be prescribed in combination with atorvastatin. Others, such as the transplant drug cyclosporine, antibiotics like erythromycin or clarithromycin (Biaxin), the heart rhythm regulator amiodarone, cholesterol-lowering medicines such as gemfibrozil (Lopid) or niacin, the gout medicine colchicine and antifungal drugs like ketoconazole or itraconazole, may also increase the risk of muscle damage and should be avoided if possible.

Other serious reactions include sun sensitivity, liver damage, pancreas inflammation and a very severe skin reaction known as Stevens-Johnson syndrome.

You can read more about statin side effects in this post.

Other Drugs That May Interact Badly with Atorvastatin

  • conivaptan
  • crizotinib
  • dabrafenib
  • danazol
  • delavirdine
  • diltiazem
  • fluvoxamine
  • imatinib
  • isonizaid
  • quinine
  • red yeast rice
  • telithromycin
  • verapamil

Atorvastatin may increase blood levels of the heart drug digoxin , so close monitoring is advised.

Blood levels of oral contraceptives may also be increased in patients on Lipitor.

Antacids such as Maalox and the cholesterol drug Colestid can reduce absorption of Lipitor if they are taken at the same time.

The herb St. John’s wort might speed elimination of Lipitor from the body, which could reduce its effectiveness.

There is a remote but untested possibility that peppermint could increase the effects of cholesterol-lowering drugs such as Lipitor. These agents work by inhibiting the enzyme HMG CoA reductase, and menthol has a similar action.

The herb gotu kola may raise cholesterol levels and should not be combined with cholesterol-lowering medications such as Lipitor.

Check with your physician and pharmacist to make sure Lipitor is safe in combination with any other drugs and herbs you take.

Special Precautions

Anyone with liver disease should not take atorvastatin. Liver enzyme changes have been reported in a small proportion of patients using this medicine, and may indicate serious problems. Liver function should be tested before anyone starts taking atorvastatin and periodically thereafter.

Because cholesterol is essential for the developing fetus and infant, pregnant or nursing women should not take atorvastatin.

Taking the Medicine

Lipitor is taken once a day, with or without meals, at any convenient time.

Grapefruit can increase blood levels of atorvastatin and should usually be avoided by those taking the medicine.

All statin drugs, including atorvastatin, lower body levels of Co-enzyme Q10, an essential compound for mitochondrial function. Most people taking a statin should take a supplement of CoQ1o of at least 100 mg/day.

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  1. MS
    Northwest Washington
    Reply

    I am a 90 yr old female. I am in relativily good health. and enjoy life. I am recently beginning to travel abroad again after a 7 year session of 24/7 care of my husband. My recent annual medical appointment came up with LDL of 115 My doctor ordered Atorvastatin, 10 mg daily. After reading comments on your website re Lipitor problems, I am concerned about a 3 week tour of Spain coming up in 5 days. If, by chance I have problems of lower stamina or any of the other problems noted will it be okay to withdraw the Atrovastatin?

    • Barry
      Ohio
      Reply

      You’re 90 years old and in relatively good health. You have a *slightly* elevated LDL. Putting someone such as yourself on a statin appears to make little sense when you take into consideration the potential side effects.

  2. Susan
    Boston
    Reply

    I am a 51 year old woman who has plaque in coronary and carotid arteries. Evidence of carotid artery plaque since age 42. My cholesterol hovers around 200+ but HDL is very high, most recently 118. Cardiologist just prescribed 40mg atorvastatin and daily baby aspirin. She mentioned that very high HDL is not necessarily a good thing. Atorvastatin is also supposed to remove current buildup of plaque. I’m a bit concerned because my left external carotid artery is almost completely blocked. I have been on drug for almost 3 weeks and only side effect has been constipation.

  3. Mark
    Calgary
    Reply

    We yes!! I too was put on this awful drug. I had a heart September, 2014, age 43. Angioplasty and Stent. They told me that I was 100% blocked, and it’s a sheer miracle I am Blessed to write this tonight!! Statin drugs like Lipitor are automatically prescribed after a heartattack (Cardiology Association). 80mg. Insanely high dose considering I have NEVER had high cholesterol. Well, not quite true, my LDL and and HDL make the TOTAL numbers a tad high. Well, when I looked at my HDL numbers (the good stuff), that’s the high one. Doctors truly aren’t taking this into account. Well and just so called ‘interactions/recommended’ things right on Lipitor sites is to NOT eat oatmeal. Well, my Lord, that’s the stuff that’s been proven to be incredibly good for you!! And yes, I phoned my doctor (I’m quite proactive about my health), got that requestion for a cholesterol test, did it, and had almost no cholesterol in my system. 75%-80% of cholesterol is made in our livers, that other is our diet. These stains work, no doubt. But they can have wicked, sometimes permanent damage. Muscle and nerve damage, and no proof that will extend anyone’s Life. There’s no evidence to support that. It will however lower your cholesterol. I’m now long off it. Thanks for reading, I hope this helped someone.

  4. mk
    Reply

    Been on atorvastatin (lipitor generic) for 3-4months. Just stopped it as I have felt achy and not a lot of energy. Work out 7 days a week. am 71. Numbers for years has been 220-250 with a good ratio. Taking red yeast rice did not lower ldl very much. Statin got me down to 150. Have just started taking Ubiqinol 100mg and high quality fish oil EPA400 mg and DHA 200mg. Am hoping this will keep the bad numbers down. Will have another blood workup 6 weeks. Any comments would be appreciated.

  5. old guy
    Reply

    I’ve been on atorvastatins for 10 years, and was recently diagnosed with Dupuytren’s in the hand. 60 years old

  6. FA
    Reply

    Been on lipitor 20 mg and aspirin 100 mg for almost six months now. Now have blurred vision and sensitivity to bright lights Doctor says could be lipitor or aspirin. He is not sure but has reduced the dosage for both.

  7. Marcus
    Reply

    I would stay away from Lipitor. Both my mom and my dad were on it for a while. It definitely helped their cholesterol go down – both of them… But they had a whole range of side effects. All of these comments seem to say much of the same thing!

  8. MAK
    Reply

    Cholesterol at 249. Goes up and down between 220 and 249. Taking red yeast rice and high quality fish oil. My ratio is 3.6 and has been around that for a long time. Just turned 70, work out every day. Really don’t want to go on lipitor, but Dr. is recommending I do. Any thoughts? would love to hear on my email. Read people’s pharmacy every day. thank you for taking the time to read my comments. mak

  9. BL
    Reply

    I recently read in your article in the Dallas Morning News that it is possible to have tired sore eyes from Lipotor. I sent it to my sister who is on Lipator and has c/o that symptom for a few years. You made mention of an article in JAMA March or April 2011 as a reference. She went to the library and found the issue but could not find the article.
    Please let me know where to find that article. She would like to read it before calling her doctor. Thank you.

  10. Tika S.
    Reply

    I have been taking Lipitor since 1999 after my first heart attack. For several years I had no reaction to it that I know of. But the last two years I have experienced pain on the bottom of my feet only when I walk and pain in my left knee when I climbed the stairs. I started taking Vitamin D after hearing your first program on it and the pain lessened but now it is back with a vengeance! Most mornings I cannot walk without a cane or my walking stick.
    It gets better after I’ve been up to point that I don’t need a cane but my feet are still very painful. I cannot walk without shoes at anytime of the day. A gentleman suggested that Lipitor may be reason. My feet are not painful when touched, rubbed or manipulated and it isn’t in the joints but seems to be in the bones. Has anyone reported this phenomenon?
    Thank you.

  11. Matt E.
    Reply

    I must say that I feel better since i started with Lipitor, my IBS and diarrhea is gone, my CRP and LDL has dropped very much , my HDL (good cholesterol) Increased. But I have one known side effect, I lose sense in my fingers in the morning in my right hand temporarily.
    Several new studies have shown that Lipitor is NOT increasing the risk of ALS, Autism and the risk of cancer and other diseases?! But it can increase the risk of diabetes from up to 9%in different populations. But the studies ruled out that the heart and health protecting effects of the medicine is by far more better and protecting and in favour for people with high cholesterol and in a positive way, than the small risk of getting diabetes of it, it save lives.
    Best wishes from sweden
    http://www.ncbi.nlm.nih.gov/sites/entrez

  12. DS
    Reply

    Dr increased my lipitor to 80mg. My glucose skyrocketed. Had a Quad bypass.
    Anyone else see this with lipitor?

  13. mikey
    Reply

    HELP !! I took myself off of lipitor approximately one week ago.. and I was wondering if the aches in the legs and the back, and neck ever really improve (over time??) any information is appreciated..Thank You, Mike

  14. mikey
    Reply

    Thank you, after reading your comment, I have decided to take myself off of lipitor, at least for a “trial period” to see for myself if I too can improve my energy levels… and as you say enjoy what I have left of this life. Thank you and best wishes to you, mikey

  15. Georgia
    Reply

    I have difficult time with statins, am on Zetia and Lescol vs Lipitor. For some reason docs want you on this stuff. My new doc said to do lots of little things to help lower like: plant sterols, the special margarines, walking, good fats, less junk, add more fiber, alternate days on meds; and it will all add up.

  16. lmm
    Reply

    After a short time on Lipitor I had weakness in my legs and then developed horrible cramps from my femurs to my feet. My hands were also cramping. My Dr. ran a CPK blood test and it was in the high 700 range indicating muscle damage/loss. When Zedia came on the market I tried that with the same results.
    My great Dr. listened to my complaints and got right to the bottom of the problem. I am one of the people with the rare but serious side effects and it is not fun.
    Drs. should pay attention to patients who complain of pain or weakness on these drugs.

  17. Nancy W.
    Reply

    I had been on Lipitor for seven years, when the doctor decided to double the dosage to 20 mg. a day. For the next seven months, I became more and more tired and lack any energy. Taking a bath and eating breakfast, meant an hour to lay down on rest.
    Finally I was laying down 16 hours out of a 24 hour day.
    My medical doctor, asked me to stop taking Lipitor for two weeks and see if anything changed. After about 5 days, my energy level began to return. At the end of two weeks, I was full of energy…not resting in the day time and actually feeling so good I was overdoing.
    It was wonderful to feel like my old self again. He wants me to return to 10 mg. of Lipitor. I haven’t done so yet; although my cholesterol level has creeped up, to a total of 199. I don’t think I will go back on it, or any other statin drug. I am 73 years old. I would rather enjoy each and every day, even if my life is shortened than to lay flat on my back day after day and be miserable and unhappy.
    Thank you for listening to my experience.
    Nancy W.

  18. Carol
    Reply

    Should mention that Statin Drugs rob the body of CoQ10 and anyone who is on a statin should take CoQ10……IT IS A MUST

  19. MP
    Reply

    I just want to add that my mom is taking 2000 mg. of fish oil, 1500 mg. of Vitamin C, and a lot of other vitamins.

  20. MP
    Reply

    My mom had 3 major blockages in 1997 and underwent angioplasty. She was on statin medications and developed burning, tingling sensations and pain in her legs. Two of her fingers became arthritic. We persuaded her doctor to lower the dosage since her cholesterol was well below normal. She was switched to Lipitor 10mg. The tingling and loss of sensation on her fingers have come back and taking Lipitor on alternate days has helped. She is also taking Co Q10. She is 83 yrs. old, pretty active.

  21. Sandi
    Reply

    My dad had a stroke 2 years ago. He’s on Lipitor and his right leg and foot are very numb and tender. A friend of his told him that he was on Lipitor, but Dr. put him on fish oil pills. Would you recommend this??? My dad did speak to his Dr. about this and he told him the weakness and numbness was from his stroke…
    Please Help!!!
    Sandi

  22. DJS
    Reply

    I had a tumor removed from my left breast last year. The doctor stated it was caused by the Lipitor that I was taking. Anybody else hear of such?

  23. Aileen
    Reply

    Has anyone out there taking statins experienced a contracture in the penis which causes pain on ejaculation and has been described as a Dupuytren’s constacture type fibrosis?

    • Neal
      USA
      Reply

      I was prescribed atorvastatin following open heart bypass surgery. I did not have a heart attack but was badly blocked with calcium plaque.

      At present I am on 10 mg atorvastatin and have been for several months. Recently noticed Dupuytren’s type connective tissue disease has worsened in my hands, also newly discovered a fibrosis on my foot and have developed a curvature of the penis (Peyronie’s disease).

      About 10% of these comments involve connective tissue disease with concurrent use of atorvastatin. I will ask the prescriber if I can hop off as I can’t risk a worsening of the Dupuytren’s in my hands, my brother recently had surgery for his DC condition, which was extremely severe.

  24. msm
    Reply

    My dad’s wife has become seriously since she’s taking Lipitor. She has serious edema -her ankles are swollen to the size of her thighs – and she has excruciating pains in her arms and legs. The docs aren’t sure that it’s the Lipitor but they’ve ruled out just about everything else. They think it’s possible that her system is not processing the Lipitor and that it’s building up in her system and is becoming toxic. She may be transferred to Stanford Medical Center for further testing.

  25. PZ
    Reply

    I have been taking Lipitor off and on since Oct. 2001, but have been taking it daily since May, 2005.
    In July 2006, I was diagnosed with multiple sclerosis, based on a series of MRIs. I have not had a lumbar puncture yet. I only have symptoms (weakness on right side) when I overexert myself physically, for instance when I overexert myself physically for more than 15 minutes. The length of time I can exercise or do yardwork has decreased gradually from longer periods in 2003, when the symptoms first started to appear, to no more than 15 minutes now (11/07).
    I have been consistently monitored for liver problems with routine blood test. The doctor tells me the results are within normal range.
    After reading your Nov. 6, 2007 newspaper article on the possible link between ALS and cholesterol drugs, I wonder if my scleroses might be caused by Lipitor, rather than MS. Any ideas?

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