From the Guidelines
Atorvastatin is best taken in the evening or at bedtime, as this timing allows the medication to work when cholesterol synthesis is at its peak. This recommendation is based on the drug's mechanism of action and the body's natural cholesterol production cycle, as well as guidance from expert panels 1. The liver produces most cholesterol at night when HMG-CoA reductase enzyme is most active, so taking atorvastatin in the evening allows the medication to work optimally.
According to the expert panel on integrated guidelines for cardiovascular health and risk reduction 1, atorvastatin and rosuvastatin can be taken in the morning or evening because of their long half-lives. However, starting with the lowest dose once daily, usually at bedtime, is recommended 1. It is essential to take atorvastatin at the same time each day to maintain consistent blood levels. The medication can be taken with or without food, which offers flexibility in your dosing schedule.
Some key considerations when taking atorvastatin include:
- Starting with the lowest dose once daily 1
- Measuring baseline CK, ALT, and AST 1
- Instructing the patient to report all potential adverse effects, especially muscle cramps, weakness, asthenia, and more diffuse symptoms suggestive of myopathy 1
- Advising female patients about concerns with pregnancy and the need for appropriate contraception 1
- Advising about potential future medication interactions, especially cyclosporine, niacin, fibric acid derivatives, erythromycin, azole antifungal agents, nefazodone, and HIV protease inhibitors 1
It is crucial to consult with your healthcare provider about potential interactions and to follow their guidance on taking atorvastatin, especially if you're also taking certain medications that interact with atorvastatin, such as antacids or certain antibiotics.
From the FDA Drug Label
2.1 Important Dosage Information Take atorvastatin calcium tablet orally once daily at any time of the day, with or without food.
The best time to take atorvastatin is once daily at any time of the day, with or without food 2.
From the Research
Administration Time of Atorvastatin
The optimal time for taking atorvastatin, an HMG-CoA reductase inhibitor, can be considered based on its pharmacokinetics and efficacy.
- Atorvastatin can be given either in the morning or in the evening, as its efficacy in lowering plasma low-density lipoprotein (LDL) cholesterol levels is not significantly affected by the time of administration 3.
- Food decreases the absorption rate of atorvastatin acid after oral administration, which may be a consideration for patients 3.
Efficacy and Safety
Studies have shown that atorvastatin is effective in reducing total cholesterol, triglyceride, and LDL-c levels, regardless of whether it is taken in the morning or evening 4, 5.
- A study found that atorvastatin 10 mg every other day, taken before bedtime, significantly reduced total cholesterol, triglyceride, and LDL-c levels in patients with hypercholesterolemia 4.
- Another study compared the effects of morning versus evening administration of atorvastatin in patients with hyperlipidemia and found no statistically significant differences in lipid values between the two groups 5.
Considerations for Administration Time
The time of administration may be more important for short-acting statins, as their efficacy may vary depending on the timing of the dose 6.
- Long-acting statins, such as atorvastatin, may be given at any time of day, allowing for more flexibility and potentially better adherence to therapy 6.
- However, it is essential to consider individual patient factors, such as lifestyle and other medications, when determining the optimal time for atorvastatin administration 6.