General Information About Lipitor (Atorvastatin)

Lipitor is a cholesterol-lowering drug.
Lipitor is a cholesterol-lowering drug.. Scott Olson/Getty Images

Lipitor (atorvastatin) is a cholesterol-lowering medication that belongs to the statin class of drugs. It is used to treat elevated total cholesterol levels, LDL cholesterol, triglyceride, and apolipoprotein B levels in individuals diagnosed with primary hyperlipidemia or mixed dyslipidemia in cases where diet, lifestyle changes, or other medications are not completely lowering lipid levels. Additionally, Lipitor is used to reduce the risk of having a heart attack and stroke in individuals with or without cardiovascular disease and in individuals with angina or type 2 diabetes having certain cardiovascular risk factors.

Lipitor is one of the more potent statins on the market. Pivotal studies examining the effect of Lipitor on lipid levels has shown that Lipitor 10 mg taken daily can:

  • Lower LDL cholesterol by up to 29%.
  • Lower total cholesterol levels by an average of 36%.
  • Lower triglycerides by an average of 19%.
  • Increase HDL cholesterol levels by at least 6%.
  • Lower apolipoprotein B is lowered by up to 34%.

Lipitor has also been shown in studies to lower your risk of  experiencing major cardiovascular events by up to 37% compared to placebo.

Lipitor was approved for use in the United States by the Food and Drug Administration (FDA) in December of 1996.

How Does Lipitor Work?

Lipitor works by blocking -  3-hydroxy-3methylglutaryl coenzyme A (HMG CoA) reductase – an enzyme in the body that plays an important role in making cholesterol in the liver. This action subsequently reduces the amount of cholesterol in the body.

How Should Lipitor be Taken?

Lipitor is available in a tablet form and can be taken with or without food once a day, as directed by your healthcare provider. Although doses are available from 10 to 80 mg, your healthcare provider may start you on a lower dose and slowly increase your dose, based upon your LDL levels and your response to the medication.

Lipitor should be taken in conjunction with a diet to lower your cholesterol and triglycerides. Lipitor is usually prescribed when lifestyle changes or other medications are not effectively lowering your lipids.

You should make sure that you attend your healthcare provider’s appointments regularly since she or he will need to monitor your lipid levels, as well as other parameters, while you are taking this medication.

Who Should Not Take Lipitor?

If you have one of the medical conditions listed below, you should not take Lipitor. In these cases, your healthcare provider may place you on a different treatment to lower your lipids:

  • Allergies. If you have had a previous allergy to Lipitor or any of its ingredients, you should not take this medication.
  • Active liver disease. If you have active liver disease or unexplained, abnormally elevated liver enzyme levels, Lipitor should not be taken.
  • Pregnancy. Lipitor is categorized as a Pregnancy Category X. Lipitor has been shown to cross the placental barrier in rats and there have been reports of miscarriages and fetal abnormalities in animal studies. Additionally, this has also been reported in pregnant women taking statin medications. If you are planning to become pregnant or are already pregnant and are taking Lipitor, your healthcare provider will weigh the benefits of taking the medication on your health and the possible risks to your child.
  • Nursing. Lipitor has been shown to cross into breast milk. It is not known what type of effect this can have on your child.

What Conditions Need to Be Monitored While Taking Lipitor?

If you are taking Lipitor, your healthcare provider may need to monitor you more closely if you have certain medical conditions that could be aggravated by taking the medication. If you have any of the following conditions below, your healthcare provider may decide to start you on Lipitor at a lower dose, and will need to monitor you to determine whether or not taking Lipitor will be potentially harmful to you. These medical conditions include:

  • Elevated liver enzymes. In studies, Lipitor increased the liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in studies. Although in most cases this increase is temporary, your healthcare provider will monitor these levels to make sure that your liver enzymes are not elevated to dangerous levels.
  • Elevated blood glucose levels. Studies have shown that Lipitor may increase hemoglobin A1C and fasting glucose levels. If you have diabetes, your healthcare provider may monitor these components in your blood and adjust your dose of Lipitor.

What Types of Side Effects Will Lipitor Cause?

The most common side effects include nausea, diarrhea, muscle pain, and increased liver enzymes. Other side effects, including diarrhea, nasopharyngitis, and joint pain, were also noted in studies. If you are experiencing any side effects from taking Lipitor that become prolonged or bothersome, you should let your healthcare provider know.

As with other statins, a rare side effect – rhabdomyolysis - may also occur in individuals taking Lipitor. Symptoms of rhabdomyolysis include muscle soreness and weakness, as well as soda-colored urine. Your risk of experiencing this side effects may occur if you are taking other medications, increased age, and other medical conditions. If you experience any symptoms of rhabdomyolysis, you should immediately notify your healthcare provider.

Are There Any Medications that Could Interact with Lipitor?

The following drugs may interact with Lipitor, increasing the likelihood of experiencing side effects (especially myopathy). With the exception of cholesterol-lowering drugs listed below, these drugs can increase levels of Lipitor in your body.

  • Cholesterol-lowering drugs (nicotinic acidfibrates)
  • Clarithromycin
  • Cyclosporine
  • Protease inhibitors
  • Colchicine
  • Oral contraceptives
  • Alcohol
  • Grapefruit juice
  • Itraconazole

This is not a complete list. You should let your healthcare provider know of all medications – including herbal medications and over-the-counter drugs – that you are taking while taking Lipitor. This will help your healthcare provider to monitor you for possible drug interactions while taking the medication. If you are required to take one of the drugs listed above, your healthcare provider may need to adjust your dose, monitor you more closely for side effects, or discontinue one of the drugs.

The Bottom Line

Lipitor is one of the most popular lipid-lowering medication in the United States – not only due to its ability to positively affect all aspects of your lipid profile but also because of its ability to reduce your risk of experiencing a cardiovascular event – such a heart attack or stroke. Because of potential issues with other medical conditions and drug interactions, you should make sure that you attend all healthcare provider appointments so that he or she can monitor you for potential issues while taking Lipitor.

Sources:

Lipitor [package insert]. Pfizer: New York, New York. 3.2015.

Micromedex 2.0.  Truven Health Analytics, Inc. Greenwood Village, CO.  Available at: http://www.micromedexsolutions.com.  Accessed February 10, 2016

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