What are the side effects of Atorvastatin (Lipitor)?

From the Guidelines

Atorvastatin can cause several side effects, including muscle pain, digestive issues, headaches, and mild joint pain, with more serious but less common side effects including liver problems and elevated blood sugar levels 1.

Common Side Effects

• Muscle pain or weakness, affecting approximately 5-10% of users
• Digestive issues such as constipation, diarrhea, nausea, or stomach pain
• Headaches and mild joint pain

Serious Side Effects

• Liver problems, indicated by unusual fatigue, pain in the upper right abdomen, or yellowing of skin/eyes
• Memory problems or confusion
• Elevated blood sugar levels that could potentially lead to type 2 diabetes
• Rhabdomyolysis, a severe condition involving muscle breakdown that can damage kidneys, especially when taking certain medications alongside atorvastatin, such as certain antibiotics, antifungals, or other cholesterol medications 1

Special Considerations

• Patients should be aware of potential drug interactions, especially when taking multiple medications, and inform their healthcare provider about all medications they are taking 1
• Regular monitoring of liver function and blood sugar levels may be necessary, especially in individuals with a history of liver disease or diabetes 1
• It is essential to seek medical attention immediately if experiencing severe muscle pain, weakness, or dark urine while taking atorvastatin 1

From the FDA Drug Label

Atorvastatin calcium tablets may cause serious side effects including: Muscle pain, tenderness and weakness (myopathy). Muscle problems, including muscle breakdown, can be serious in some people and, rarely, cause kidney damage that can lead to death. Liver problems. Your healthcare provider should do blood tests to check your liver before you start taking atorvastatin calcium tablets and if you have symptoms of liver problems while you take atorvastatin calcium tablets Increase in blood sugar level. The most common side effects of atorvastatin calcium tablets include:

• nasal congestion,
• sore throat,
• runny nose
• diarrhea
• urinary tract infection
• nausea
• muscle spasms
• throat pain
• muscle and joint pain
• pain in extremity
• upset stomach
• musculoskeletal pain
• trouble sleeping

The possible side effects of atorvastatin include muscle problems, liver problems, and increased blood sugar levels. The most common side effects are nasal congestion, sore throat, runny nose, diarrhea, urinary tract infection, nausea, muscle spasms, throat pain, muscle and joint pain, pain in extremity, upset stomach, musculoskeletal pain, and trouble sleeping 2.

From the Research

Side Effects of Atorvastatin

• Atorvastatin is generally well tolerated, with adverse events usually being mild and transient 3
• Common side effects include elevations of liver transaminases and creatine phosphokinase, although these are infrequent 3
• Rare case reports have shown that atorvastatin can cause rhabdomyolysis, particularly when used in conjunction with other drugs 3
• A study found that atorvastatin can cause a transient rise in serum transaminases in up to 3% of patients, but this is usually self-limiting and inconsequential 4
• However, there have been reports of more serious idiosyncratic reactions related to atorvastatin, including liver dysfunction and death 4
• Another study found that statins, including atorvastatin, can cause dose-dependent borderline elevations of liver function tests over time, although these elevations are typically clinically and statistically insignificant 5
• Atorvastatin has also been associated with muscle symptoms, such as myalgia, although the use of Coenzyme Q10 supplementation has not been shown to be effective in relieving these symptoms or improving adherence to statin therapy 6

Liver-Related Side Effects

• Atorvastatin has been associated with liver dysfunction, including elevations of liver transaminases and rare cases of liver failure 4
• A study found that atorvastatin can cause a mixed cholestatic/hepatocellular reaction, with a mean interval to onset of reaction of approximately 9 weeks 4
• The liver often takes several months to recover from atorvastatin-induced liver dysfunction, and there have been reports of death due to hepatobiliary disease associated with atorvastatin treatment 4

Muscle-Related Side Effects

• Atorvastatin has been associated with muscle symptoms, such as myalgia, which can affect adherence to statin therapy 6
• However, the use of Coenzyme Q10 supplementation has not been shown to be effective in relieving muscle symptoms or improving adherence to statin therapy 6