Information About Atorvastatin (Lipitor)

Atorvastatin (brand name: Lipitor) is a cholesterol-lowering medication that belongs to the statin class of drugs. It is currently the second most potent statin on the market. Like other statins, atorvastatin affects all aspects of your cholesterol profile: It lowers LDL and triglycerides and raises HDL. Atorvastatin is not currently available in generic form.Atorvastatin blocks the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, which is an important protein needed in the production of cholesterol.This medication may be taken with or without food, as directed by your healthcare provider. This medication should not be taken with grapefruit or grapefruit juice, since this can increase the amount of atorvastatin in the blood and, therefore, increase the incidence of side effects.The following individuals should not take atorvastatin:

• Those who have had an allergic reaction to atorvastatin or any of its components.
  
• Women who are pregnant.
  
• Women who are breastfeeding.
  
• Those who have active liver disease or have abnormally high liver enzyme levels.
  
• Those who have a history of alcohol abuse.

The most common side effects include headache, chest pain, rash, pharyngitis, joint pain, gastrointestinal problems (such as abdominal pain, diarrhea, constipation, or gastroenteritis).The following are serious side effects of atorvastatin. If you experience any of these rare side effects, contact your healthcare provider immediately:

• myopathy - such as progressive muscle soreness or weakness
  
• red- or brown-colored urine

The following drugs may interact with atorvastatin, increasing the likelihood of experiencing side effects (especially myopathy). With the exception of cholesterol-lowering drugs listed below, the remaining drugs also increase levels of atorvastatin in your body. If you are required to take one of the drugs listed below, your healthcare provider may need to adjust your dose, monitor you more closely for side effects, or discontinue one of the drugs:

• Cholesterol lowering drugs (nicotinic acid, fibrates)
  
• Cyclosporine
  
• Fluvoxamine
  
• Antifungal drugs ending in "-azole" (ketoconazole (Nizoral), fluconazole (Diflucan), miconazole (Mycelex), itraconazole (Sporanox))
  
• Antibiotics ending in "-mycin" (erythromycin, clarithromycin (Biaxin))
  
• Nefazodone
  
• High blood pressure medications - diltiazem and verapramil
  
• Amiodarone (Cordarone)
  
• HIV Protease Inhibitors - ritonavir (Norvir), amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept)

  The following drugs may also be affected if taking with atorvastatin:

  • Warfarin (Coumadin) - may cause blood to not clot as well.
    
  • Oral contraceptives - may increase the concentration of these hormones in the body.
    
  • Digoxin (Lanoxin) - may increase the concentration of this drug in the body.
    
  • Levothyroxine (Synthroid) - levels may increase due to the presence of atorvastatin.

  The following drugs may interact with atorvastatin by decreasing the amount of atorvasatin in the body:

  • Antacids containing magnesium or aluminum hydroxide may decrease the concentration of atorvastatin in the blood. In order to avoid this interaction, separate your atorvastatin dose and antacid dose by at least two hours.
    
  • St. John's Wort can lower levels of atorvastatin in the blood.
    
  • Cholesterol-lowering drugs, like bile acid sequestrants, may reduce the absorption of atorvastatin into the blood. In order to avoid this, separate your atorvastatin dose and bile acid sequestrant dose by at least four hours.

  Disclaimer

  This information is just a brief listing and it not inclusive and should not replace the information provided by your healthcare provider or the manufacturer of this drug.

  _Sources:

  Amarenco P. Atorvastatin in prevention of stroke and transient ischaemic attack. Expert Opin Pharmacother.8(16):2789-97.

  Dipiro JT, Talbert RL. Pharmacotherapy: A Pathophysiological Approach, 6th ed 2005.

  Lacy CF, Armstrong LL, Goldman MP, et al. Lexicomp's Drug Information Handbook, 15th ed 2007.