Atorvastatin (patient information)

# Why this medication is prescribed
Atorvastatin is used together with lifestyle changes (diet, weight-loss, exercise) to reduce the amount of cholesterol (a fat-like substance) and other fatty substances in the blood. Atorvastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body.
Buildup of cholesterol and other fats along the walls of the blood vessels (a process known as atherosclerosis) decreases blood flow and, therefore, the oxygen supply to the heart, brain, and other parts of the body. Lowering blood levels of cholesterol and other fats may help to decrease your chances of getting heart disease, angina (chest pain), strokes, and heart attacks. In addition to taking a cholesterol-lowering medication, making certain changes in your daily habits can also lower your cholesterol blood levels. You should eat a diet that is low in saturated fat and cholesterol (see SPECIAL DIETARY), exercise 30 minutes on most, if not all days, and lose weight if you are overweight.

# How this medication should be used
Atorvastatin comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take atorvastatin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take atorvastatin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of atorvastatin and gradually increase your dose, not more than once every 2-4 weeks.
Continue to take atorvastatin even if you feel well. Do not stop taking atorvastatin without talking to your doctor.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before taking atorvastatin:
- tell your doctor and pharmacist if you are allergic to atorvastatin or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antifungal medications such as itraconazole (Sporanox) and ketoconazole (Nizoral); cimetidine (Tagamet); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin); erythromycin (E.E.S., E-Mycin, Erythrocin); oral contraceptives (birth control pills); other cholesterol-lowering medications such as fenofibrate (Tricor), gemfibrozil (Lopid), and niacin (nicotinic acid, Niacor, Niaspan); and spironolactone (Aldactone). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have liver disease. Your doctor will probably tell you not to take lovastatin.
- tell your doctor if you drink large amounts of alcohol and if you have ever had liver disease.
- tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking atorvastatin, stop taking atorvastatin and call your doctor immediately. Atorvastatin may harm the fetus.
- Do not breastfeed while you are taking this medication.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking atorvastatin.
- ask your doctor about the safe use of alcoholic beverages while you are taking atorvastatin. Alcohol can increase the risk of serious side effects.

# Special dietary instructions
Eat a low-cholesterol, low-fat diet. This kind of diet includes cottage cheese, fat-free milk, fish (not canned in oil), vegetables, poultry, egg whites, and polyunsaturated oils and margarines (corn, safflower, canola, and soybean oils). Avoid foods with excess fat in them such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter, shortening, lard, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips, coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.
Talk to your doctor about drinking grapefruit juice while taking this medication.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects

## Minor Side Effects
Atorvastatin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- diarrhea
- headache
- difficulty falling asleep or staying asleep
- dizziness
- joint pain
- sore throat
- upper respiratory infection

## Severe Side Effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- muscle pain, tenderness, or weakness
- lack of energy
- fever
- chest pain
- swelling of the hands, feet, ankles, or lower legs
- nausea
- extreme tiredness
- unusual bleeding or bruising
- loss of appetite
- pain in the upper right part of the stomach
- flu-like symptoms
- yellowing of the skin or eyes
- rash
- hives
- itching
- difficulty breathing or swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
- pain during urination
- frequent urge to urinate
Atorvastatin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests before and during treatment to check your body's response to atorvastatin.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking atorvastatin.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Lipitor