Can Lipitor (Atorvastatin) tablets be crushed?

Can Lipitor (Atorvastatin) Be Crushed?

Yes, Lipitor (atorvastatin) tablets can generally be crushed for patients with swallowing difficulties, as atorvastatin is an immediate-release tablet without special coating or extended-release properties that would be compromised by crushing.

Key Considerations for Crushing Atorvastatin

Tablet Formulation Characteristics

• Atorvastatin is formulated as a standard immediate-release tablet without enteric coating, sustained-release mechanisms, or specialized drug delivery systems that would be disrupted by crushing 1, 2
• The medication does not contain components that require protection from gastric acid or timed release for proper absorption 1

Administration Guidelines When Crushing

• Crush the tablet immediately before administration to minimize degradation from light and moisture exposure 1
• Mix the crushed powder with a small amount of soft food (applesauce, pudding) or liquid for immediate consumption 2
• Administer the entire dose within a short timeframe to ensure full therapeutic effect 2, 3
• For enteral feeding tubes, suspend crushed tablets in water and administer through gastric tubes (not jejunal tubes), flushing with at least 30 mL of water before and after 4, 2

Important Drug Interaction Caveat

• If the patient is taking bile acid sequestrants (cholestyramine, colestipol, colesevelam), atorvastatin must be given at least 4 hours before the bile acid sequestrant to prevent reduced absorption 5
• When crushing atorvastatin for patients on bile acid sequestrants, maintain this 4-hour separation to preserve efficacy 5

Clinical Practice Recommendations

• Consult with a pharmacist before crushing to confirm no contraindications specific to the patient's medication regimen 2
• Document the crushing practice and rationale in the medical record 6
• Consider whether an alternative statin formulation or dosing strategy might be more appropriate for long-term management 2, 7

When NOT to Crush

• Do not crush if the patient can safely swallow the tablet whole, as this remains the preferred administration method 7, 6
• Avoid crushing if there are concerns about caregiver exposure to drug particles, particularly in pregnant healthcare workers, though atorvastatin is not classified as a hazardous drug 1

Dose Adjustment Considerations

• When used with weak CYP3A4 inhibitors, atorvastatin dosing may need adjustment, but crushing does not alter this interaction 5
• Maximum dose limitations apply when combined with certain medications (e.g., lomitapide limits atorvastatin to 30 mg daily), regardless of whether the tablet is crushed 5