Atorvastatin

Atorvastatin is a medicine known as a ‘statin’. It helps reduce the amount of cholesterol in your body to protect you from heart disease and blood vessel damage.

There are 2 main types of cholesterol in your body, and we call them:

• LDL (low density lipoproteins)
• HDL (high density lipoproteins)

It’s the LDL type that is known as ‘bad’ cholesterol and atorvastatin helps lower how much of it you have.

You need to take atorvastatin at the same time each day, and you can choose whether you want to take it in the morning or at night.

To take atorvastatin you should:

1. Pop one atorvastatin tablet out of the strip of tablets
2. Swallow your atorvastatin tablet with a full glass of water, and do not crush or chew it
3. You can eat before or after you take your atorvastatin tablet, but avoid having grapefruits or grapefruit juice at the same time

You normally start with 10mg strength atorvastatin tablets, but a doctor may increase this after 4 weeks if your cholesterol levels do not come down. For adults, the highest dose is 80mg per day.

While you’re on atorvastatin, you should start to eat less fat and exercise more on a daily basis to help lower your cholesterol faster.

If you forget to take a dose of atorvastatin, just take your next one at your usual time and do not take any extra tablets.

Atorvastatin works in two ways to lower the levels of LDL (bad cholesterol) in your body.

The first way is by stopping specific enzymes in your liver from making cholesterol. These enzymes are called ‘HMG-CoA reductase’ and they are most active at night.

The second way is by increasing how much cholesterol your liver can capture from your blood, so there is less of it travelling around your body.

These two actions lower your chances of cholesterol building up and damaging the walls of your blood vessels.

Atorvastatin is highly effective at lowering your cholesterol because it:

• stops your liver from producing cholesterol
• helps your liver remove cholesterol from your bloodstream

You should see a noticeable drop in your blood cholesterol levels after taking atorvastatin for 4 weeks. As your liver enzymes that make cholesterol are most active at night, we recommend you take your atorvastatin in the evening. This will help make it more effective.

The effects of atorvastatin will only last as long as you take it. But you can reduce your dose of atorvastatin and come off them if:

• your body weight goes down
• you improve what you eat on a daily basis
• you exercise daily

You may experience some side effects when taking atorvastatin and some common ones include:

• headache
• nausea
• constipation
• indigestion, such as heartburn
• diarrhoea
• pain in joints or muscle aches
• increase in blood sugar levels

Uncommon side effects of atorvastatin include:

• feeling less hungry than usual
• body weight changes
• decrease in blood sugar levels
• feeling dizzy
• vomiting
• skin rash
• tiredness

For a full list of side effects, including rare side effects, please read the patient information leaflet that comes with your atorvastatin tablets. If you do experience any side effects when taking atorvastatin, please speak to a doctor straight away.

You might need to take atorvastatin if:

• you have a condition where your cholesterol is always high
• heart disease runs in your family
• anyone in your family has had a stroke or heart attacks
• you have diabetes or rheumatoid arthritis

But you should not take atorvastatin if you:

• are allergic to atorvastatin or any other ingredients in the tablets
• are allergic to medicines that are similar to atorvastatin, such as rosuvastatin
• have liver disease
• use glecaprevir and pibrentasvir to treat hepatitis C
• are pregnant or trying to get pregnant
• are breastfeeding

Speak to your doctor before taking atorvastatin if you:

• have used fusidic acid in the past 7 days
• have had a stroke
• have kidney disease
• have an under-active thyroid
• regularly have muscle pains
• drink alcohol regularly
• are over 70 years old

You can talk to a doctor or read the patient information leaflet to check if you can take atorvastatin.

If you take other medicines at the same time as atorvastatin, they may interact and make you feel unwell. So before you take atorvastatin let your doctor know if you take any medicines, including:

• ciclosporin, which affects how your immune system works
• antibiotics, such as erythromycin, clarithromycin, telithromycin, rifampin and fusidic acid
• antifungals, such as ketoconazole, itraconazole, voriconazole, fluconazole and posaconazole
• ezetimibe, gemfibrozil, fibrates or colestipol, which also help lower your cholesterol
• calcium channel blockers, such as amlodipine, for high blood pressure
• diltiazem, for angina
• digoxin, verapamil or amiodarone, to regulate your heart rhythm
• ritonavir, lopinavir, atazanavir, indinavir, darunavir or tipranavir, to treat HIV
• hepatitis C medicines such as telaprevir, boceprevir, elbasvir or grazoprevir
• herbal supplements that contain St. John’s wort, for low mood
• warfarin, to thin your blood
• some oral contraceptives
• colchicine, for gout
• antacids, for heartburn or indigestion

For more information, please read the patient information leaflet that comes with your atorvastatin tablets.

You should avoid drinking grapefruit juice while you are taking atorvastatin. Drinking more than one or two glasses of grapefruit juice each day can affect how atorvastatin works.

You should also avoid drinking a lot of alcohol whilst taking atorvastatin, as you might get muscle pains and affect how your liver works. 14 units of alcohol per week should be the maximum amount you drink.

Alternative treatments to atorvastatin that have the same blood cholesterol lowering effect include:

• Lipitor
• Simvastatin
• Crestor
• Rosuvastatin
• Pravastatin
• Fluvastatin

If you want to try an alternative treatment to atorvastatin, get in touch with ZAVA Online Doctor and we can help you decide on a treatment that is right for you.