Health Centres - Lipitor
How does it work?
Lipitor tablets contain the active ingredient atorvastatin, which is a type of medicine called a statin. It works by reducing the production of cholesterol by the liver.
For the sake of simplicity, there are two sorts of cholesterol; a 'bad' sort called low density lipoprotein (LDL) and a 'good' sort called high density lipoprotein (HDL). LDL is deposited in the arteries and increases the risk of heart disease by clogging and narrowing the arteries (atherosclerosis), while HDL actually protects the arteries against this.
Atorvastatin decreases the production of LDL cholesterol by blocking the action of the enzyme in the liver (called HMG-CoA reductase) that is responsible for its production. This decreases the amount of cholesterol in the liver cells, which causes them to take up LDL cholesterol from the blood. The decreased cholesterol production and increased removal of LDL cholesterol from the blood ultimately results in lowered blood cholesterol levels.
As the body produces most cholesterol at night, statins are generally more effective if taken at night.
Atorvastatin also causes a small decrease in the production of other 'bad fats' in the blood called triglycerides, and a small increase in the level of HDL cholesterol. This results in lowered levels of 'bad fats' and raised levels of 'good fats' in the blood.
Statins have an important role in the prevention of coronary heart disease. They reduce the risk of excess cholesterol being deposited in the major blood vessels of the heart. Any blockage in the blood vessels limits the amount of blood and therefore oxygen being carried to the heart muscle. This can cause chest pain (angina) and in severe cases can result in a heart attack (myocardial infarction).
Statins also reduce the risk of stroke by decreasing the risk of excess cholesterol being deposited in the blood vessels leading to the brain. These fat deposits can cause blockage and therefore limit blood and oxygen supply to certain parts of the brain.
Atorvastatin is used to lower cholesterol and other bad fats in people who have high levels either due to genetics (familial hypercholesterolaemia) or as a result of diet and lifestyle. This helps to reduce the risk of hardening of the arteries (atherosclerosis) and the problems described above that this can cause.
Atorvastatin can also be used to reduce the risk of coronary heart disease in people with diabetes, regardless of their cholesterol levels. It has been shown to reduce the risk of needing procedures to improve blood supply to the heart, such as a balloon dilation of an artery or a heart bypass graft. It also reduces the risk of heart attack, stroke and death from heart disease.
It is important to continue to follow a cholesterol-lowering diet and exercise regime while taking atorvastatin. Discuss this with your doctor.
What is it used for?
-
High blood cholesterol levels
-
Inherited high blood cholesterol levels
- High levels of any or all of the fats in the blood, such as cholesterol, triglycerides and lipoproteins (mixed hyperlipidaemia)
- Reducing the risk of cardiovascular events such as heart attacks, strokes or needing heart bypass surgery, in people with diabetes who have at least one other risk factor (for example smoking, high blood pressure, diabetic eye disease or diabetic kidney disease). The medicine can be used for this purpose in people who don't currently have evidence of coronary heart disease, irrespective of what their cholesterol levels are.
Warning!
- You should should continue eating a cholesterol-lowering diet during treatment with this medicine. Discuss this with your doctor.
- It is recommended that you avoid drinking excessive amounts of alcohol while taking this medicine.
- You should avoid drinking grapefruit juice while taking this medicine. This is because grapefruit juice can affect the metabolism of atorvastatin and could increase the amount of the medicine in your blood, thus increasing the risk of side effects.
- This medicine may very rarely have side effects on the muscles. For this reason you should inform your doctor immediately if you experience any muscular symptoms such as pain, tenderness, cramps, or weakness while taking this medicine, particularly if it is accompanied by a fever or feeling generally unwell. Your doctor may need to check for side effects on the muscles by taking a blood test to measure the level of a compound called creatinine kinase in your blood. If this is the case, the test should not be done following strenuous exercise.
- You will need to have blood tests to monitor your liver function (liver function tests) before starting treatment and regularly throughout treatment with this medicine.
- The manufacturer has not studied the effect of this medicine in children aged under 10 years, or in girls who have not yet started their periods. The medicine is not recommended for children under ten years of age. The long-term effects of the medicine in children aged 10 to 18 years have not been studied.
Use with caution in
- People aged over 70 years
- Decreased kidney function
- Decreased liver function
- History of liver disease
- People who drink large amounts of alcohol
-
Hypothyroidism
- Personal or family history of hereditary muscle disorders
- History of muscular side effects during previous treatment with a statin or fibrate medicine
Not to be used in
- Active liver disease
- Unexplained raised results in liver function tests
-
Pregnancy
-
Breastfeeding
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy because it may be harmful to a developing foetus. Pregnancy should also be avoided for one month after stopping treatment. Women who could get pregnant should use an effective method of contraception to prevent pregnancy both during treatment with this medicine and for one month after stopping. Seek further medical advice from your doctor.
- It is not known if this medicine passes into breast milk. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Headache
- Difficulty in sleeping (insomnia)
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Excess gas in the stomach and intestines (flatulence)
- Muscle pain
- Feeling of weakness
- Dizziness
- Chest pain (angina)
- Decreased sensitivity to touch or pain, pins and needles sensations
- Back pain, joint pain
- Hair loss (alopecia)
- Loss of appetite
- Muscle cramps
- Skin reactions such as rash and itch
- Erectile dysfunction (impotence)
- Decrease in the number of blood cells called platelets in the blood (thrombocytopenia)
- Weight gain
- Memory loss
- Liver disorders
- Muscle disorders
- Changes in blood sugar levels
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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