Atorvastatin

Key facts

• Atorvastatin is a statin. It lowers LDL ("bad") cholesterol and raises HDL slightly, cutting the risk of heart attack and stroke over years of treatment.
• You take it once daily, at any time, with or without food. It is usually a long-term or lifelong medicine, since cholesterol rises again once you stop.
• Rarely, statins cause rhabdomyolysis, serious breakdown of muscle tissue. Unexplained muscle pain or weakness together with dark urine is the warning sign and needs same-day medical attention.
• Liver-enzyme blood tests are checked before you start and periodically afterward, and atorvastatin is avoided in pregnancy.

What atorvastatin treats

Atorvastatin treats high LDL cholesterol and mixed dyslipidaemia, and it is used to prevent heart attack and stroke in people with cardiovascular risk factors or existing cardiovascular disease. It also treats familial hypercholesterolaemia, an inherited condition that causes very high cholesterol from a young age.

How atorvastatin works

Atorvastatin blocks HMG-CoA reductase, the enzyme in the liver that makes cholesterol. With less cholesterol produced, the liver pulls more LDL out of the bloodstream to make up the difference, lowering the level circulating in your blood over several weeks.

Before you take it

• Do not take atorvastatin if you are pregnant, trying to conceive, or breastfeeding. Cholesterol is needed for fetal development, and statins can cause harm.
• Tell your prescriber about liver disease or a history of muscle disorders before you start.
• Certain antibiotics, antifungals, HIV medicines, and other cholesterol-lowering drugs such as fibrates raise atorvastatin levels and increase the risk of muscle toxicity. Check with your pharmacist before starting anything new.
• Keep alcohol intake low, since heavy drinking adds to liver strain.

Side effects

Common effects include mild digestive upset, headache, and muscle or joint aches that are usually mild.

Seek urgent medical care for:

• Muscle pain, tenderness, or weakness you can't explain, especially with fever or dark, tea-coloured urine.
• Yellowing of the skin or eyes, or unusual fatigue.
• Signs of an allergic reaction, such as swelling or difficulty breathing.

Safety essentials

• Know the warning sign: unexplained muscle pain or weakness together with dark urine can mean rhabdomyolysis, a rare but serious breakdown of muscle tissue that can harm the kidneys. Stop the medicine and get same-day medical care if this happens.
• Liver-enzyme blood tests are done before you start and periodically during treatment to catch liver strain early.
• Atorvastatin is not used in pregnancy or breastfeeding, since cholesterol is essential for fetal development and the drug can cause harm.
• Report new muscle symptoms promptly, particularly if you have recently started an interacting antibiotic, antifungal, or other cholesterol medicine.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.