What are the side effects of Atorvastatin (Lipitor)?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: March 13, 2025 • View editorial policy

From the Guidelines

Lipitor (atorvastatin) commonly causes side effects including muscle pain, joint pain, diarrhea, nausea, and mild memory problems or confusion, with more serious but less common side effects including liver problems and muscle damage, as reported in the most recent study 1. The side effects of atorvastatin can be categorized into common and less common effects. Common side effects include:

  • Muscle pain
  • Joint pain
  • Diarrhea
  • Nausea
  • Mild memory problems or confusion Less common but more serious side effects include:
  • Liver problems, indicated by dark urine, upper stomach pain, or jaundice
  • Muscle damage, characterized by unexplained muscle pain, tenderness, or weakness especially with fever or unusual tiredness
  • Rarely, diabetes development in some patients Some people may also experience digestive issues like constipation or flatulence. It is essential to note that Lipitor may interact with certain medications, including some antibiotics, antifungals, and HIV medications, potentially increasing side effect risks. If severe side effects occur, especially muscle pain with weakness or fever, it is crucial to contact a healthcare provider immediately. Regular blood tests to monitor liver function are typically recommended when taking Lipitor, as suggested by the guidelines 2. Side effects often diminish after the first few weeks of treatment as the body adjusts to the medication. Lipitor works by blocking an enzyme needed for cholesterol production, which explains many of its potential side effects, particularly those affecting muscles and the liver. According to the latest guidelines, a systematic approach to evaluating statin-associated side effects is critically important to encourage adherence to evidence-based statin treatment 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 side effects of Atorvastatin (Lipitor) include:

  • Serious side effects: + Muscle pain, tenderness, and weakness (myopathy) + Liver problems + Increase in blood sugar level
  • Common side effects: + 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 3

From the Research

Side Effects of Atorvastatin (Lipitor)

The side effects of Atorvastatin (Lipitor) can be categorized into common and uncommon effects.

  • Common side effects include: + Statin-associated muscle symptoms 4 + Musculoskeletal symptoms, such as muscle pain or weakness, reported by 39.4% of patients 5
  • Uncommon side effects include: + New-onset diabetes mellitus 4 + Elevation in liver enzymes 4 + Hepatotoxicity, although rare, can occur, with 14 reported cases of significant liver dysfunction, including three deaths 6 + Mixed cholestatic/hepatocellular reaction, with a mean interval to onset of reaction of approximately 9 weeks 6 ### Genetic Factors and Side Effects Genetic factors can also play a role in the development of side effects, with certain genetic variants increasing the risk of myopathy and other adverse effects 7.
  • A genome-wide study found an association between single-nucleotide polymorphisms (SNPs) located within the SLCO1B1 gene and myopathy in patients treated with simvastatin and atorvastatin 7
  • The SLCO1B1*5 variant was associated with side effects in patients treated with atorvastatin, but not with pravastatin 7 ### Laboratory Monitoring Laboratory monitoring is essential to detect potential side effects, particularly liver and muscle injuries.
  • Patients taking atorvastatin or rosuvastatin, and those with a history of chronic renal diseases, were more likely to have creatine kinase (CK) monitored on initiation of and during statin treatment 5
  • Patients who reported musculoskeletal symptoms had significantly higher mean CK levels than those who did not report any musculoskeletal symptoms 5
  • Prior history of liver disorders was significantly associated with monitoring of alanine aminotransferase (ALT) on initiation of and during statin treatment 5

References

6
Research

Atorvastatin associated liver disease.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2006

7
Research

Role of genetic factors in statins side-effects.

Cardiovascular & hematological disorders drug targets, 2012

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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