DrugindexOnline^{2nd edition}

Generic name: Atorvastatin calcium
Brand names: Lipitor

Why is Lipitor prescribed?

Lipitor is a cholesterol-lowering drug. Your doctor may prescribe it along with a special diet if your blood cholesterol or triglyceride level is high and you have been unable to lower your readings by diet alone. The drug works by helping to clear harmful low-density lipoprotein (LDL) cholesterol out of the blood and by limiting the body's ability to form new LDL cholesterol.

Your doctor may prescribe Lipitor to reduce your chances of having a heart attack or developing heart disease if you have any of the following risk factors:

• Are age 55 years or older.
• Smoke.
• Have high blood pressure.
• Have low levels of HDL (high-density lipoprotein--the good cholesterol).
• Have a family history of early heart disease.

For people at high risk of heart disease, the doctor may suggest a cholesterol-lowering medication if LDL readings are 130 or more. For those at low risk, a medication is considered at readings of 190 or more.

Most important fact about Lipitor

Lipitor is usually prescribed only if diet, exercise, and weight loss fail to bring your cholesterol levels under control. It's important to remember that Lipitor is a supplement--not a substitute--for those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because they may lower your risk of heart disease.

How should you take Lipitor?

Lipitor should be taken once a day, with or without food. You can take it in the morning or the evening, but should hold to the same time each day. The drug generally begins working within 2 weeks.

For an even greater cholesterol-lowering effect, your doctor may prescribe Lipitor along with a different kind of lipid-lowering drug such as Questran or Colestid. It's important to avoid taking the two drugs at the same time of day. Take Lipitor at least 1 hour before or 4 hours after the other drug.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Lipitor.

• More common side effects may include:
  Abdominal pain, abnormal heartbeat, accidental injury, allergic reaction, arthritis, back pain, bronchitis, chest pain, constipation, diarrhea, dizziness, flu symptoms, fluid retention, gas, headache, indigestion, infection, inflammation of sinus and nasal passages, insomnia, joint pain, muscle aching or weakness, nausea, rash, stomach pain, urinary tract infection, weakness

Why should Lipitor not be prescribed?

Never take Lipitor during pregnancy or while breastfeeding. You should also avoid Lipitor if you have liver disease, or if the drug gives you an allergic reaction.

Special warnings about Lipitor

There is a slight chance of liver damage from Lipitor, so your doctor may order a blood test to check your liver function before you start taking the drug, again 12 weeks after you begin therapy or your dosage is increased, and periodically thereafter. If the tests reveal a problem, you may have to stop using the drug.

Drugs like Lipitor have occasionally been known to damage muscle tissue, so be sure to tell your doctor immediately if you notice any unexplained muscle tenderness, weakness, or pain, especially if you also have a fever or feel sick. Your doctor may want to do a blood test to check for signs of muscle damage.

If you are scheduled for major surgery, your doctor will have you stop taking Lipitor a few days before the operation.

Possible food and drug interactions when taking Lipitor

If you take Lipitor with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lipitor with any of the following:

Antacids such as Maalox TC Suspension
Clofibrate (Atromid-S)
Colestipol (Colestid)
Cyclosporine (Sandimmune, Neoral)
Digoxin (Lanoxin)
Drugs that suppress the immune system
Erythromycin (E.E.S., Erythrocin, others)
Fenofibrate (Tricor)
Fluconazole (Diflucan)
Gemfibrozil (Lopid)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Niacin (Niaspan, Niacor, Slo-Niacin)
Oral contraceptives

Special information if you are pregnant or breastfeeding

Developing babies need plenty of cholesterol, so this cholesterol-lowering drug should never be used during pregnancy. In fact, your doctor is unlikely to prescribe Lipitor if there is even a chance that you may become pregnant. If you do conceive while taking Lipitor, notify your doctor right away. Lipitor does make its way into breast milk, so you should not take the drug while breastfeeding your baby.

Recommended dosage

You need to follow a standard cholesterol-lowering diet before starting Lipitor, and should continue following it throughout your therapy.

ADULTS

The recommended starting dose is 10 or 20 milligrams once a day. (The doctor may start with 40 milligrams daily if your LDL levels need to be reduced by more than 45 percent.) The doctor will check your cholesterol levels every 2 to 4 weeks and adjust the dose accordingly. The maximum recommended daily dose is 80 milligrams.

CHILDREN 10 to 17 YEARS OLD

The recommended starting dose is 10 milligrams once a day. The dosage may be increased after 4 weeks, as determined by the doctor, up to a maximum of 20 milligrams a day. Girls must be having regular menstrual cycles before starting therapy with Lipitor.

The safety and effectiveness of Lipitor in children under 10 years old or in doses greater than 20 milligrams a day have not been studied.

Overdosage

Although no specific information about Lipitor overdose is available, any medication taken in excess can have serious consequences. If you suspect an overdose of Lipitor, seek medical attention.