How does Lipitor affect cholesterol levels. What are the common and rare side effects of taking Lipitor. How can Lipitor side effects be managed effectively. Is weight gain a side effect of Lipitor. What precautions should be taken when using Lipitor.

Understanding Lipitor and Its Uses

Lipitor, also known by its generic name atorvastatin, is a widely prescribed medication used to treat high cholesterol and reduce certain cardiovascular risks. As a member of the statin class of drugs, Lipitor works by inhibiting an enzyme involved in cholesterol production in the liver.

The primary uses of Lipitor include:

• Lowering cholesterol levels in adults and some children
• Reducing heart risks in adults with high cholesterol
• Complementing diet and exercise for better cholesterol management

Lipitor comes in tablet form and is taken orally, typically once daily. While it’s highly effective in managing cholesterol levels, like all medications, it can cause various side effects ranging from mild to severe.

Common Side Effects of Lipitor

Many patients taking Lipitor experience mild side effects that often subside as the body adjusts to the medication. Some of the most commonly reported side effects include:

• Infections (e.g., common cold, urinary tract infections)
• Nausea
• Pain in arms or legs
• Joint pain
• Diarrhea
• Mild muscle pain

Are these side effects a cause for concern? In most cases, these common side effects are temporary and manageable. However, if they persist or become bothersome, it’s important to consult with your healthcare provider. They may suggest ways to alleviate these symptoms or adjust your treatment plan if necessary.

Serious Side Effects and Risks

While less common, Lipitor can potentially cause more serious side effects that require immediate medical attention. These include:

• Severe muscle pain
• Rhabdomyolysis (breakdown of muscle tissue)
• Immune-mediated necrotizing myopathy (a rare muscle condition)
• Liver damage
• Severe allergic reactions

How can you recognize these serious side effects? Symptoms may include unexplained muscle weakness or pain, dark-colored urine, yellowing of the skin or eyes (jaundice), or signs of an allergic reaction such as difficulty breathing or swelling of the face, lips, tongue, or throat. If you experience any of these symptoms, seek medical help immediately.

Managing Lipitor Side Effects

Effectively managing side effects is crucial for patients taking Lipitor. Here are some strategies to consider:

1. Regular monitoring: Schedule regular check-ups with your doctor to monitor your cholesterol levels and check for any potential side effects.
2. Dose adjustment: Your doctor may adjust your Lipitor dosage to find the right balance between effectiveness and minimizing side effects.
3. Lifestyle modifications: Adopting a healthy diet and regular exercise routine can complement Lipitor’s effects and potentially reduce the need for higher doses.
4. Timing of medication: Taking Lipitor at a specific time of day, as recommended by your doctor, may help minimize certain side effects.
5. Staying hydrated: Drinking plenty of water can help alleviate some side effects, such as muscle pain.

Can changing your diet help manage Lipitor side effects? While diet alone may not eliminate side effects, a heart-healthy diet low in saturated fats and rich in fruits, vegetables, and whole grains can support overall cardiovascular health and potentially enhance Lipitor’s effectiveness.

Lipitor and Weight Gain: Separating Fact from Fiction

A common concern among patients is whether Lipitor causes weight gain. Is weight gain a documented side effect of Lipitor? Contrary to popular belief, Lipitor is not directly associated with weight gain. In fact, clinical studies have not shown a significant link between Lipitor use and increased body weight.

However, it’s important to note that some patients may experience slight weight changes due to various factors:

• Lifestyle changes: Patients starting Lipitor may also be advised to make dietary and exercise changes, which can influence weight.
• Improved health: As cholesterol levels improve, some patients may feel better overall and become more active, potentially affecting weight.
• Individual variations: Each person’s body responds differently to medications, and some may experience minor weight fluctuations.

If you notice significant weight changes while taking Lipitor, it’s advisable to discuss this with your healthcare provider. They can help determine if the weight change is related to the medication or other factors.

Drug Interactions and Precautions

Understanding potential drug interactions and taking necessary precautions is essential for safe Lipitor use. Some key considerations include:

Drug Interactions

Lipitor may interact with various medications, including:

• Certain antibiotics
• Antifungal medications
• HIV medications
• Other cholesterol-lowering drugs
• Some blood pressure medications

How can you prevent drug interactions? Always inform your healthcare provider about all medications, supplements, and herbal products you’re taking. They can assess potential interactions and adjust your treatment plan if necessary.

Special Precautions

Certain groups of people may need to take special precautions when using Lipitor:

• Pregnant or breastfeeding women
• People with liver disease
• Individuals with a history of muscle problems
• Older adults
• Heavy alcohol users

Does age affect the risk of Lipitor side effects? Older adults may be more susceptible to certain side effects and may require closer monitoring. Your doctor will consider your age and overall health when prescribing and monitoring Lipitor use.

Monitoring and Long-Term Use of Lipitor

Long-term use of Lipitor requires ongoing monitoring to ensure its effectiveness and safety. Here’s what you need to know about long-term Lipitor use:

Regular Check-ups

Your doctor will likely schedule regular appointments to:

• Monitor cholesterol levels
• Check liver function
• Assess for any developing side effects
• Adjust dosage if necessary

How often should you have check-ups while on Lipitor? Typically, your doctor may recommend blood tests every 3-6 months initially, and then annually once your cholesterol levels stabilize. However, this can vary based on individual factors.

Long-Term Benefits vs. Risks

While considering long-term use of Lipitor, it’s important to weigh the benefits against potential risks:

Benefits:

• Significant reduction in cholesterol levels
• Decreased risk of heart attack and stroke
• Potential slowing of atherosclerosis progression

Risks:

• Potential for long-term side effects
• Need for ongoing medical monitoring
• Possible drug interactions over time

Is long-term use of Lipitor safe? For many patients, the cardiovascular benefits of long-term Lipitor use outweigh the potential risks. However, this decision should be made in consultation with your healthcare provider, considering your individual health profile and risk factors.

Alternatives to Lipitor: Exploring Options

While Lipitor is effective for many, some patients may need to explore alternatives due to side effects or other factors. Here are some potential alternatives:

Other Statins

Different statins may have varying side effect profiles:

• Rosuvastatin (Crestor)
• Simvastatin (Zocor)
• Pravastatin (Pravachol)

Non-Statin Cholesterol Medications

Alternative cholesterol-lowering medications include:

• Ezetimibe (Zetia)
• PCSK9 inhibitors
• Bile acid sequestrants

Lifestyle Modifications

Some patients may be able to manage cholesterol through lifestyle changes alone:

• Heart-healthy diet
• Regular exercise
• Weight management
• Smoking cessation

Can lifestyle changes replace Lipitor? For some individuals with mildly elevated cholesterol, lifestyle modifications may be sufficient. However, for those with significantly high cholesterol or additional cardiovascular risk factors, medication like Lipitor may still be necessary in conjunction with lifestyle changes.

Understanding Lipitor’s Mechanism of Action

To fully appreciate how Lipitor works and why it may cause certain side effects, it’s important to understand its mechanism of action:

HMG-CoA Reductase Inhibition

Lipitor belongs to a class of drugs called HMG-CoA reductase inhibitors, commonly known as statins. It works by:

• Blocking the enzyme HMG-CoA reductase in the liver
• Reducing the liver’s production of cholesterol
• Increasing the liver’s ability to remove LDL cholesterol from the blood

Impact on Cholesterol Types

Lipitor affects different types of cholesterol:

• Lowers LDL (bad) cholesterol
• Reduces triglycerides
• May slightly increase HDL (good) cholesterol

How quickly does Lipitor start working? While the effects on cholesterol production begin almost immediately, it usually takes about 2-4 weeks to see significant changes in cholesterol levels through blood tests.

Broader Cardiovascular Benefits

Beyond cholesterol reduction, Lipitor may offer additional cardiovascular benefits:

• Stabilizing existing plaque in arteries
• Reducing inflammation in blood vessels
• Improving overall endothelial function

These broader effects contribute to Lipitor’s role in reducing the risk of heart attacks and strokes in high-risk individuals.

Managing Lipitor Side Effects Through Diet and Lifestyle

While Lipitor is effective in managing cholesterol, complementing it with appropriate diet and lifestyle changes can enhance its benefits and potentially mitigate some side effects:

Heart-Healthy Diet

Adopting a diet that supports cardiovascular health can complement Lipitor’s effects:

• Increase intake of fruits, vegetables, and whole grains
• Choose lean proteins and fish rich in omega-3 fatty acids
• Limit saturated and trans fats
• Reduce sodium and added sugars

Regular Physical Activity

Exercise can enhance Lipitor’s cholesterol-lowering effects:

• Aim for at least 150 minutes of moderate-intensity aerobic activity per week
• Include strength training exercises twice a week
• Start slowly and gradually increase intensity if you’re new to exercise

Stress Management

Chronic stress can impact cholesterol levels and overall heart health:

• Practice relaxation techniques like meditation or deep breathing
• Engage in hobbies or activities you enjoy
• Ensure adequate sleep (7-9 hours for most adults)

Can lifestyle changes reduce the need for Lipitor? For some individuals, significant lifestyle changes may lead to improved cholesterol levels, potentially allowing for a reduction in Lipitor dosage. However, this should only be done under medical supervision.

Navigating Insurance Coverage and Cost Considerations for Lipitor

While Lipitor is an effective medication, cost can be a concern for some patients. Understanding insurance coverage and exploring cost-saving options can help ensure continuous treatment:

Insurance Coverage

Coverage for Lipitor varies among insurance plans:

• Check your plan’s formulary to see if Lipitor is covered
• Understand copayments or coinsurance requirements
• Be aware of any prior authorization needs

Generic Options

Generic atorvastatin is often more affordable:

• Discuss with your doctor if switching to generic is appropriate
• Compare costs between brand-name and generic versions
• Be aware that some insurance plans may require trying generic before covering brand-name Lipitor

Patient Assistance Programs

Various programs can help with Lipitor costs:

• Manufacturer discount programs
• Non-profit organization assistance
• State-specific programs for eligible individuals

How can you find affordable options for Lipitor? Consult with your healthcare provider and insurance company to explore all available options. Pharmacists can also be valuable resources in finding cost-saving strategies.

The Future of Cholesterol Management: Beyond Lipitor

While Lipitor remains a cornerstone in cholesterol management, ongoing research is exploring new approaches and treatments:

Emerging Therapies

New cholesterol-lowering treatments in development or recently approved include:

• PCSK9 inhibitors for more aggressive LDL reduction
• RNA interference therapies targeting cholesterol production
• Novel combinations of existing medications

Personalized Medicine Approaches

Advancements in genetic testing and biomarkers may lead to more tailored treatments:

• Genetic testing to predict statin response and side effect risk
• Biomarker-guided therapy selection
• Customized dosing based on individual metabolic profiles

Lifestyle and Technology Integration

Future cholesterol management may increasingly integrate technology and lifestyle interventions:

• Wearable devices for real-time monitoring of cardiovascular health
• AI-powered diet and exercise recommendations
• Virtual reality tools for patient education and lifestyle modification

What does the future hold for cholesterol management? While Lipitor and other statins are likely to remain important tools, the future may offer more precise, personalized, and integrated approaches to managing cholesterol and overall cardiovascular health.

Lipitor Side Effects and How to Manage Them

Lipitor (atorvastatin) is a prescription drug that’s used to treat high cholesterol and reduce certain heart risks. Lipitor can cause side effects, also called adverse effects, that range from mild to serious. Examples include muscle pain and liver damage.

Lipitor is used along with diet and exercise to:

• lower cholesterol levels in adults and some children
• reduce other heart risks in adults with high cholesterol

The active ingredient in Lipitor is atorvastatin. (An active ingredient is what makes a drug work.) The drug comes as a tablet that you swallow.

Keep reading to learn about the common, mild, and serious side effects that Lipitor can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during Lipitor treatment. Examples of Lipitor’s commonly reported side effects include:

• infections, such as the common cold or urinary tract infection (UTI)
• nausea
• pain in your arms or legs
• joint pain*
• diarrhea*

* To learn more about this side effect, see the “Side effects explained” section below.

Examples of mild side effects that have been reported with Lipitor include:

• infections, such as the common cold or urinary tract infection (UTI)
• pain in the legs or arms
• nausea
• mild muscle pain*
• joint pain*
• diarrhea*
• mild allergic reaction*

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects are temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And, do not stop taking Lipitor unless your doctor recommends it.

Lipitor may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Lipitor, visit MedWatch.

Serious side effects that have been reported with Lipitor include:

• serious muscle pain
• rhabdomyolysis, a serious condition caused by the breakdown of muscle
• immune-mediated necrotizing myopathy, a rare muscle condition
• liver damage*
• severe allergic reaction*†

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Lipitor. But it’s unclear whether this side effect occurred in studies.

If you develop serious side effects while taking Lipitor, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Get answers to some frequently asked questions about Lipitor’s side effects.

Do Lipitor and atorvastatin (generic name for Lipitor) have similar side effects?

Yes. Lipitor and its generic version, atorvastatin, typically have the same side effects. Both drugs contain the same active ingredient, which is atorvastatin. An active ingredient is what makes a drug work.

But the inactive ingredients in Lipitor and atorvastatin may be different. So it’s possible to have different side effects due to the inactive ingredients in these drugs.

If you’re interested in switching between the brand-name and generic forms of Lipitor, talk with your doctor or pharmacist. They can discuss with you possible differences in the generic’s side effects compared with Lipitor’s.

Is there any difference between the side effects Lipitor may cause in females and males?

No, Lipitor should not cause different side effects in females and males.* In studies of Lipitor, there weren’t differences in side effects in men compared with side effects in women.

It’s important to note that doctors may not prescribe Lipitor during pregnancy or breastfeeding. This is because the drug may cause other side effects while pregnant and breastfeeding. For more information, see the “Warnings for Lipitor” section below.

* In this article, we use the terms “male,” “female,” “men,” and “women” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Does my risk of side effects depend on what dose of Lipitor I take (10 mg, 20 mg, 40 mg, and 80 mg)?

It’s possible that the strength of Lipitor you take may change your risk of side effects. Lipitor is available in four strengths:

• 10 milligrams (mg)
• 20 mg
• 40 mg
• 80 mg

Taking a higher dose of Lipitor may increase the risk of side effects. So, if you’re taking a dose of 80 mg per day, your risk of side effects may be higher than that of someone taking a 10-mg dose.

If you’re having side effects from taking Lipitor, talk with your doctor. They can check whether your dose of Lipitor needs adjusting.

For more information about Lipitor’s dosages, see this article.

Are weight gain and hair loss side effects of Lipitor?

No, weight gain and hair loss are not side effects of Lipitor.

But there may be a link between taking statin medications such as Lipitor and an increase in appetite. An older study showed that people taking statins consumed more calories and fat than people not taking such drugs. So it is possible that this increase in appetite may lead to weight gain. But this was not reported in studies of the drug.

If you’re taking Lipitor to reduce your risk of heart problems due to type 2 diabetes, you may notice hair loss. This is because diabetes may increase the risk of hair loss in females and males.*

If you have weight gain or hair loss during your treatment with Lipitor, talk with your doctor or pharmacist. They may be able to recommend ways to manage your weight gain or hair loss.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Does Lipitor cause any eye-related side effects?

Although rare, it’s possible for Lipitor to cause blurry vision. This side effect was reported in studies of Lipitor.

In addition, eye-related side effects may be a symptom of another side effect that Lipitor causes. Lipitor can increase your risk of liver problems. One side effect of liver problems is yellowing of the eyes or skin.

If you have yellowing of the eyes or other eye-related changes while you’re taking Lipitor, contact your doctor. They can find out what may be causing your eye-related side effects and the best way to treat them.

Learn more about some of the side effects Lipitor may cause.

Muscle pain

You may develop muscle pain during treatment with Lipitor. Muscle pain was a common side effect reported in studies of the drug.

This side effect can be mild or severe. In some cases, muscle pain can also be a sign of a more serious side effect. Examples include rhabdomyolysis, a condition caused by the breakdown of muscle, and immune-mediating necrotizing myopathy, a rare muscle condition.

What might help

If you have muscle pain while taking Lipitor, talk with your doctor. They can determine what may be causing it.

If your muscle pain is mild, your doctor may recommend decreasing your Lipitor dose to see if the side effect lessens.

If you have severe muscle pain, contact your doctor as soon as possible. This may be a sign of a more serious condition. Your doctor might recommend that you stop taking Lipitor right away. And they’ll likely check you for rhabdomyolysis or immune-mediating necrotizing myopathy.

Liver damage

It’s possible to develop liver damage from taking statin medications such as Lipitor. Although liver damage was not a common side effect, it may still occur during Lipitor treatment.

Lipitor may cause increases in liver enzymes, which may indicate liver damage. Symptoms of liver damage include:

• yellowing of the eyes or skin
• belly pain
• nausea or vomiting

What might help

If you have any symptoms of liver damage during your treatment with Lipitor, tell your doctor right away. They can order blood tests to see how well your liver is working.

Your doctor will also check your liver function by ordering blood tests before you start taking Lipitor and throughout treatment.

If you develop increased liver enzymes or liver damage during treatment with Lipitor, your doctor may recommend decreasing your dose of Lipitor. Or they may pause your treatment until your liver enzyme levels increase to the point that it’s safe to resume treatment.

In more severe cases, your doctor may recommend that you take a different medication instead of Lipitor to treat your condition.

Joint pain

Lipitor can cause joint pain. This was one of the more common side effects reported in studies of Lipitor.

What might help

If you experience joint pain during your treatment with Lipitor, tell your doctor. They may be able to recommend ways to decrease this side effect. For example, they may suggest taking an over-the-counter pain medication, such as Tylenol (acetaminophen) or Advil (ibuprofen).

Diarrhea

It’s possible that you may have diarrhea during Lipitor treatment. Diarrhea was a common side effect reported in studies of the drug.

Symptoms of diarrhea include:

• belly pain or cramping
• bloating
• watery stools
• having frequent bowel movements

What might help

If you have diarrhea while taking Lipitor, tell your doctor. They can determine whether Lipitor is causing your diarrhea and the best ways to treat it.

If you have diarrhea, it is important to stay hydrated. Your doctor or pharmacist may also be able to recommend other ways to treat your diarrhea. For example, they may recommend taking an over-the-counter medication such as Imodium (loperamide).

Allergic reaction

Like most drugs, Lipitor can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.

Symptoms can be mild to serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

• an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Lipitor, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Lipitor, they may have you switch to a different treatment.

Keeping track of side effects

During your Lipitor treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

• what dose of the drug you were taking when you had the side effect
• how soon you had the side effect after starting that dose
• what your symptoms were
• how it affected your daily activities
• what other medications you were taking
• any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Lipitor affects you. They can then use this information to adjust your treatment plan if needed.

Lipitor may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Lipitor is a good treatment option for you.

Talk with your doctor about your health history before starting Lipitor. The list below includes factors to consider.

Allergic reaction. If you’ve had an allergic reaction to Lipitor or any of its ingredients, your doctor will likely not prescribe Lipitor. Ask them what other medications are better options for you.

Diabetes. It’s possible that Lipitor may worsen diabetes. If you have diabetes, tell your doctor before starting treatment with Lipitor. Your doctor can determine if it’s safe for you to take the drug. Or they may recommend a different treatment option for you.

Thyroid problems. People with certain thyroid problems may have an increased risk of side effects, such as muscle pain, from taking Lipitor. Before you start taking Lipitor, tell your doctor about any thyroid problems that you have. Your doctor can help treat your thyroid condition before Lipitor treatment.

Kidney problems. Lipitor can cause muscle problems, which in rare cases may lead to kidney problems. If you already have kidney problems, taking this medication may worsen your condition. Your doctor can determine if it’s safe for you to take Lipitor with your kidney condition.

Stroke or mini-stroke in the last 6 months. Taking Lipitor after having a stroke or mini-stroke in the last 6 months may increase your risk of having another stroke. If you’ve had a recent stroke or mini-stroke, tell your doctor before starting treatment with Lipitor.

Liver problems. People with liver problems should not use Lipitor due to the risk of harm. Lipitor may cause liver problems to occur. If you already have a liver problem, taking this drug may worsen your condition. Due to this risk, your doctor will likely recommend a different treatment option for you.

Alcohol and Lipitor

There aren’t any known interactions between Lipitor and alcohol. But alcohol and Lipitor can both cause liver damage. So drinking alcohol while taking Lipitor may further increase the risk of liver problems.

If you drink alcohol, talk with your doctor about how much alcohol, if any, may be safe to drink during Lipitor treatment.

Pregnancy and breastfeeding while taking Lipitor

Lipitor may not be safe to take during pregnancy or while breastfeeding.

Currently, there is not enough information to determine if Lipitor affects a developing fetus, but it is possible. So, your doctor may not prescribe the drug during pregnancy.

It’s also unknown if Lipitor passes into breast milk or affects a child who is breastfed. Due to the possible risks, your doctor may advise you to avoid breastfeeding while taking Lipitor.

If you’re pregnant or breastfeeding or planning to become pregnant or breastfeed, tell your doctor before starting Lipitor treatment. They can help you understand the risks of taking Lipitor during these times. They may also recommend a different treatment option for you.

You may have side effects during your treatment with Lipitor. In most cases, its side effects are mild. But it’s possible to develop serious side effects from this medication.

Before you start treatment with Lipitor, talk with your doctor about side effects that could occur. Here are some questions to help get you started:

• Can Lipitor cause long-term side effects?
• Do I have an increased risk of Lipitor’s side effects due to my other medical conditions?
• How do the side effects of Lipitor compare with those of other drugs used to treat my condition?
• What should I do if I become pregnant during treatment with Lipitor?

To learn more about Lipitor, see these articles:

• All About Lipitor
• Dosage for Lipitor: What You Need to Know
• Lipitor Interactions: Alcohol, Medications, and Others
• Lipitor vs. Crestor: What You Should Know

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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Editor’s Note

July 2014

Rita F.  Redberg, MD, MSc

JAMA Intern Med. 2014;174(7):1046. doi:10.1001/jamainternmed.2014.1994

There remains much controversy over the risks and benefits of statins for primary prevention. Besides the risks of muscle aches, diabetes, and cognitive dysfunction, I have observed over the years that for many patients, statins provide a false reassurance, as people seem to believe that statins can compensate for poor dietary choices and a sedentary life. In an elegantly performed analysis of NHANES data from 1999 to 2010, Sugiyama and colleagues¹ have documented exactly such behavior. They found that compared with statin nonusers, statin users significantly increased their fat intake and calorie consumption, along with their BMI, in the last decade. This article raises concerns of a potential moral hazard of statin use, in addition to the already known adverse effects. Focusing on cholesterol levels can be distracting from the more beneficial focus on healthy lifestyle to reduce heart disease risk.

References

1.

Sugiyama
 T, Tsugawa
 Y, Tseng
 C-H, Kobayashi
 Y, Shapiro
 MF.  Different time trends of caloric and fat intake between statin users and nonusers among US adults: gluttony in the time of statins? [published online April 24, 2014].  JAMA Intern Med. doi:10.1001/jamainternmed.2014.1927.Google Scholar

Lipitor tablets 20 mg, 30 pcs 10 Dosage form

Coated tablets

Indications for use

Primary hypercholesterolemia (heterozygous familial and non-familial hypercholesterolemia, Frederickson type IIa), combined (mixed) hyperlipidemia (Frederickson type IIb and III), dysbetalipoproteinemia (Frederickson type III) (as an adjunct to diet), familial endogenous hypertriglyceridemia (Frederickson type IV), resistant to dietary treatment.

Homozygous hereditary hypercholesterolemia (as an adjunct to lipid-lowering therapy, including autohemotransfusion of LDL-purified blood).

Also indications for treatment are cardiovascular diseases against the background of dyslipidemia, secondary prevention in order to reduce the overall risk of death, myocardial infarction and re-hospitalization for angina pectoris.

Contraindications

Hypersensitivity to the components of the drug, active liver diseases (including active chronic hepatitis, chronic alcoholic hepatitis), increased activity of “liver” transaminases (more than 3 times) of unknown origin, liver failure (severity A and B on the Child-Pugh scale), pregnancy, lactation.

Caution. Severe electrolyte imbalance, endocrine and metabolic disorders, alcoholism, history of liver disease, arterial hypotension, severe acute infections, uncontrolled seizures, major surgery, trauma, childhood (efficacy and safety of use have not been established).

How to use: dosage and course of treatment

By mouth, taken at any time of the day, with or without food. The initial dose is 10 mg 1 time per day. The dose should be changed at intervals of at least 4 weeks. The maximum daily dose is 80 mg in 1 dose.

For primary hypercholesterolemia and combined (mixed) hyperlipidemia, 10 mg once a day is prescribed. The effect of treatment is manifested within 2 weeks, the maximum effect is observed within 4 weeks.

In homozygous familial hypercholesterolemia, 80 mg is prescribed once a day (lowering LDL by 18-45%).

Before starting therapy, the patient must be prescribed a standard hypocholesterolemic diet, which he must follow during treatment.

Pharmacological action

Lipid-lowering drug from the statin group. Selective competitive inhibitor of HMG-CoA reductase, an enzyme that converts 3-hydroxy-3-methylglutaryl coenzyme A to mevalonic acid, which is a precursor of sterols, including cholesterol.

TG and cholesterol in the liver are included in the composition of VLDL, enter the plasma and are transported to peripheral tissues. LDL is formed from VLDL during interaction with LDL receptors.

The drug reduces plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase, cholesterol synthesis in the liver and increasing the number of “liver” LDL receptors on the cell surface, which leads to increased uptake and catabolism of LDL.

Reduces the formation of LDL, causes a pronounced and persistent increase in the activity of LDL receptors. Reduces LDL levels in patients with homozygous familial hypercholesterolemia, which usually does not respond to lipid-lowering drugs.

Reduces total cholesterol by 30-46%, LDL – by 41-61%, apolipoprotein B – by 34-50% and TG – by 14-33%; causes an increase in the level of HDL-cholesterol (high density lipoprotein) and apolipoprotein A.

Taking the drug Lipitor dose-dependently reduces the level of LDL in patients with homozygous hereditary hypercholesterolemia, resistant to therapy with other lipid-lowering drugs.

Treatment with Lipitor significantly reduces the risk of ischemic complications (including the development of death from myocardial infarction) by 16%, the risk of re-hospitalization for angina pectoris accompanied by signs of myocardial ischemia – by 26%.

Atorvastatin is not carcinogenic or mutagenic.

Side effects

From the side of the nervous system: more often than 2% – insomnia, dizziness; less often 2% – headache, asthenia, malaise, drowsiness, unusual dreams, amnesia, paresthesia, peripheral neuropathy, amnesia, emotional lability, ataxia, facial paralysis, hyperkinesis, depression, hyperesthesia, loss of consciousness.

From the senses: less than 2% – amblyopia, ringing in the ears, dryness of the conjunctiva, disturbance of accommodation, hemorrhage in the eyes, deafness, glaucoma, parosmia, loss of taste, taste perversion.

From the digestive system: more often 2% – nausea; less than 2% – heartburn, constipation or diarrhea, flatulence, gastralgia, abdominal pain, anorexia, decreased or increased appetite, dry mouth, belching, dysphagia, vomiting, stomatitis, esophagitis, glossitis, erosive and ulcerative lesions of the oral mucosa, gastroenteritis, hepatitis, biliary colic, cheilitis, duodenal ulcer, pancreatitis, cholestatic jaundice, liver dysfunction, rectal bleeding, melena, bleeding gums, tenesmus.

From the respiratory system: more often than 2% – bronchitis, rhinitis; less than 2% – pneumonia, dyspnea, bronchial asthma, epistaxis.

From the CCC: more often than 2% – chest pain; less than 2% – palpitations, vasodilation, migraine, postural hypotension, increased blood pressure, phlebitis, arrhythmia, angina pectoris.

From the side of the hematopoietic system: rarely 2% – anemia, lymphadenopathy, thrombocytopenia.

From the musculoskeletal system: more often 2% – arthritis; less than 2% – leg muscle cramps, bursitis, tendosynovitis, myositis, myopathy, arthralgia, myalgia, rhabdomyolysis, torticollis, muscle hypertonicity, joint contractures.

From the genitourinary system: more often 2% – urogenital infections, peripheral edema; less often 2% – dysuria (including pollakiuria, nocturia, urinary incontinence or urinary retention, imperative urge to urinate), nephritis, hematuria, vaginal bleeding, nephrourolithiasis, metrorrhagia, epididymitis, decreased libido, impotence, impaired ejaculation.

On the part of the skin: more than 2% – alopecia, xeroderma, increased sweating, eczema, seborrhea, ecchymosis, petechiae.

Allergic reactions to the components of the drug: less than 2% – pruritus, skin rash, contact dermatitis, rarely – urticaria, angioedema, facial edema, photosensitivity, anaphylaxis, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome).

Laboratory indicators: less than 2% – hyperglycemia, hypoglycemia, increased serum CPK, albuminuria.

Other: less than 2% – weight gain, gynecomastia, mastodynia, exacerbation of gout.

Overdose.

Treatment of overdose: there is no specific antidote, symptomatic therapy is carried out. Hemodialysis is ineffective.

Special instructions

Treatment may cause an increase in serum CPK, which should be taken into account in the differential diagnosis of retrosternal pain.

It is necessary to regularly monitor liver function indicators before starting treatment, 6 and 12 weeks after the start of the drug or after increasing the dose, and periodically during the entire period of use (until the condition of patients with transaminase levels exceeding normal is completely normalized). An increase in “liver” transaminases is observed mainly in the first 3 months of using the drug.

It is recommended to stop the drug or reduce the dose if the increase in AST and ALT values ​​is more than 3 times. The use of the drug should be temporarily discontinued with the development of clinical symptoms suggesting the presence of acute myopathy, or in the presence of factors predisposing to the development of acute renal failure against the background of rhabdomyolysis (severe infections, hypotension, traumatic surgery, trauma, metabolic, endocrine or severe electrolyte disturbances). Patients should be warned that they should immediately consult a doctor if unexplained pain or weakness in the muscles occurs, especially if they are accompanied by malaise or fever.

Women of reproductive age should use reliable methods of contraception.

Limited experience with 80 mg/day in children. Controlled studies in children have not been conducted, however, adverse reactions when using the drug in 8 children older than 9 years with familial homozygous hypercholesterolemia at a dose of up to 80 mg / day for 1 year were not detected.

Use in pregnancy and lactation

The drug is contraindicated in pregnancy and lactation.

Interactions

Co-administration of cyclosporine, fibrates, erythromycin, clarithromycin, immunosuppressive, antifungal drugs (related to azoles) and nicotinamide with atorvastatin increases plasma concentrations of atorvastatin (and the risk of myopathy).

Antacids reduce concentration by 35% (the effect on LDL cholesterol does not change).

Simultaneous use of atorvastatin with protease inhibitors, known as inhibitors of cytochrome CYP3A4, is accompanied by an increase in plasma concentrations of the drug.

When digoxin is used in combination with atorvastatin at a dose of 80 mg/day, the concentration of digoxin increases by approximately 20%.

Increases the concentration by 20% (when administered with the drug at a dose of 80 mg / day) of oral contraceptives containing norethindrone and ethinyl estradiol.

The lipid-lowering effect of the combination with colestipol is superior to that of either drug alone.

Storage conditions

Keep out of reach of children at temperatures up to 25°C.

Shelf life

2 years.

Terms of dispensing from pharmacies

By prescription.

Brand:

Phizer

Brand:

Turkey

Active ingredient ENG:

atorvastatin

Barcode:

8 699532095015

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Weight gain preparations – indications and contraindications

To improve physical indicators bodybuilders, bodybuilders and athletes buy drugs for weight gain. One of the most popular varieties of such drugs are drugs that contain peptides. The class of medical devices in most cases is effective when an athlete needs a quick and high-quality weight gain.

Weight gain preparations with peptides

Peptides in weight gain preparations consist of protein fragments. Depending on the type of peptide preparation, the protein can be of both artificial and natural origin. Amino acid residues in the composition of medical products are linked by a peptide bond, which is why they are called so. Otherwise, weight gain drugs with peptides are called “information agents.” The active substance is responsible for the transfer of data between the smallest particles of the body.

Peptide weight gainers have the following effects on the body:

• gain muscle mass;
• balance of body functioning;
• stress reduction;
• Increase endurance and strength.

The advantage of weight gain products with peptides is that they are easily absorbed, and the risk of negative effects on the body during the course is minimized.

The best weight gain drugs with peptides

In sports pharmacology, there are 10 weight gain drugs with peptides that are in consistently high demand among athletes:

• Thymosin beta-4;
• Sermorelin;
• PEG-MGF;
• Melanotan 1;
• Melanotan 2;
• Ipamorelin;
• IGF1-LR3;
• GH FRAG 176-191;
• Hexarelin;
• GHRP-6 and GHRP-2;
• CJC-1295 DAC.