Phil Day By Superintendent Pharmacist Published:

Atorvastatin is a medication which is commonly prescribed to help manage high cholesterol, a common medical condition which, if left untreated, can lead to other conditions which are more serious and potentially life threatening. Over 15% of patients at Pharmacy2U are prescribed this medication by their NHS GP and we’ve dispensed over 25,000 packs of atorvastatin medication in just the past 2 years. Here, I’m going to take a closer look at Atorvastatin – a commonly prescribed medicine for high cholesterol. 

What is atorvastatin and what is it prescribed for?

Atorvastatin belongs to a group of medications known as statins, which are prescribed to help regulate cholesterol and lipids (fats) in the blood. Atorvastatin is prescribed for people with high cholesterol levels, when lifestyle changes and a low fat diet have failed to lower cholesterol levels to within a normal range. Used alongside these interventions, it can help reduce the risk of heart attacks and strokes.

How does atorvastatin work?

Cholesterol is a fatty substance found in the blood, produced by the liver. It’s used to make hormones, help build new tissue, and has a role in the production of bile. The amount of cholesterol found in the blood can also be affected by the food we eat and various lifestyle factors.

There are two types of cholesterol; Low Density Lipoprotein (LDL) cholesterol which is also known as ‘bad’ cholesterol and High Density Lipoprotein (HDL) cholesterol which is also known as ‘good’ cholesterol. 

HDL cholesterol keeps the heart and circulation healthy, and carries LDL back to the liver to be broken down. LDL cholesterol can cause hardening of the arteries which can eventually lead to more serious health conditions if left untreated. Atorvastatin helps to decrease LDL cholesterol levels, and increase HDL cholesterol.

Atorvastatin should be taken as follows:

Before being prescribed atorvastatin or any similar medicines, your doctor will place you on a low-cholesterol diet which should be maintained during the course of treatment.

In adults, the usual starting dose for atorvastatin is 10mg taken once daily. This may be increased by your doctor until you’re taking the optimum amount at intervals over a 4 week period. The maximum daily dose of atorvastatin is 80mg.

How and when should I take atorvastatin?

Atorvastatin tablets should be swallowed whole, with a drink of water. There is a brand of chewable tablets which can be chewed, but also swallowed whole with water if you prefer. 

You should take the tablets at roughly the same time each day. Your doctor may advise taking it in the evenings as that’s when the body makes most of its cholesterol, but because atorvastatin is a long-acting statin, the most important thing is to take it at time of day when you won’t forget it, even if that’s in the morning. (However, some other short-acting statins, such as simvastatin, do work better when they’re taken in the evening.) If you forget to take a dose, don’t take an extra one to make up for it. Just take your next dose as usual.

It doesn’t upset your stomach so there’s no need to take it with food. 

You should take atorvastatin exactly as agreed with your doctor or pharmacist. Contact them if you’re unsure about anything. 

How long does it take for atorvastatin to work?

When taking atorvastatin (or any other statins), your cholesterol level should begin to drop noticeably within 4 weeks. This is dependent on it being taken daily, as prescribed, and adhering to a low-cholesterol diet and any other recommended lifestyle changes. It’s usually necessary to keep taking a statin for life for the effect to be maintained.

What are the side effects associated with atorvastatin?

As with all medicines, there’s a chance that some people may experience side effects when taking atorvastatin; but not everybody has them.

There’s a chance that you may experience one or more of the common side effects. Normally these side effects will improve when you’ve taken it for a few days and your body gets used to it. You shouldn’t need to stop taking the medicine, but if you continue to experience any of the following common side effects then you should contact a doctor or pharmacist:

One rare but serious side effect is unexplained pains and muscle aches as well as tenderness or weakness. If it’s going to happen, it’s normally a few weeks or months after you start taking atorvastatin. Contact your doctor if you think you’re experiencing these symptoms. 

What other drugs does atorvastatin interact with?

Taking other medicines whilst taking atorvastatin may increase your chances of experiencing unwanted side effects. Talk to your doctor before taking atorvastatin if you’re already using any of the following medicines:

  • Some antibiotics and antifungals
  • Some HIV medicines
  • Some hepatitis C medicines
  • Warfarin (stops blood clotting)
  • Ciclosporin (treats psoriasis and rheumatoid arthritis)
  • Colchicine (a medicine for gout)
  • Contraceptive pills
  • Verapamil, diltiazem, amlodipine (for high blood pressure and heart problems)
  • Amiodarone (makes your heart rhythm stable)

If you’re taking any of these medicines your doctor may lower the dose of atorvastatin, prescribe you a different medicine for cholesterol, or recommend not taking it for a while. If you do experience side effects you should also report them directly via the Yellow Card Scheme. Reporting side effects helps provide more information on the safety of this medicine.

Can I take atorvastatin with alcohol?

You can drink alcohol in moderation whilst taking atorvastatin. However, drinking excessively (more than 14 units of alcohol per week) increases the chance you’ll experience side effects related to the liver or muscles.

Taking atorvastatin during pregnancy or while breastfeeding

Taking atorvastatin during pregnancy isn’t recommended as there’s no conclusive evidence that it’s safe. Talk to your doctor if you want to get pregnant. They’ll often advise you to stop taking atorvastatin for a period of time.  

Is there anyone who shouldn’t take atorvastatin?

Atorvastatin isn’t suitable for some people. Talk to your doctor if any of the following are relevant to you:

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

Sources of information