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Lipitor is a HMG-CoA Reductase Inhibitor, also known as a statin. This class of treatments for high cholesterol is fairly new, and appears to work by blocking a liver enzyme which generates cholesterol. This medication appears to be the most effective in this class of drugs at lowering unhealthy LDL (low-density lipoprotein) cholesterol levels, in some cases up to 51%. It can be virtually as effective as an angioplasty in treating stable coronary artery disease.

Currently, this drug is approved for use in patients with high cholesterol (hypercholesterolemia) due to high LDL levels, hereditary elevated fat levels (dysbetalipoproteinemia), familial high cholesterol, and to increase HDL (high-density lipoprotein) levels in patients with high cholesterol and those with both high cholesterol and high triglycerides (mixed dyslipidemia).

Other accepted uses include the treatment of stable coronary artery diseas, preventing coronary heart disease, preventing clogged stents (tubes) placed in coronary arteries after surgery, preventing bone loss in type two diabetics, stabilizing lipid levels that have been altered by treatment with protease inhibitors.

This treatment should be considered a last resort. The best way to lower cholesterol is through a program of healthy diet and exercise, and these should be maintained during treatment with Lipitor.

Lipitor is only available by prescription.

Lipitor Side Effects

Mild Side Effects: These side effects are unexpected, and should be reported to your doctor for evaluation. Allergy (skin rash), constipation, diarrhea, drowsiness, flu-like symptoms, gas, headache, muscle pain (inform your doctor immediately if you experience muscle pain).

Serious Side Effects: These side effects are very rare and potentially dangerous. Seek medical treatment immediately if you experience any of the following. Abnormal liver tests, kidney failure, severe muscle pain or tenderness. There is a case report of confusion, short-term memory trouble, and unusual feelings of well-being.

In very rare cases, rhabdomyolosis may occur. This is a breakdown of muscle tissue, sometimes accompanied by dark urine or muscle aching. Common rhabdomyolosis risk factors include alcohol or drug abuse, soft tissue trauma, lack of blood supply to tissue, and seizure activity. Report muscle aches to your doctor immediately. If the muscle aches are severe, and accompanied by dark urine, seek emergency medical treatment at once. Do not exert yourself beyond your doctor's guidelines or normal activities.

Cautions: This medication is not for everyone. Discuss any of the following situations or conditions with your doctor to ensure safe and effective treatment.

• Alcohol: Frequent alcohol use should be discussed with your doctor prior to treatment. Heavy alcohol use may worsen your condition.
• Allergies: An allergy to this medication in the past, or to any other statin, indicates that this treatment is unsuitable for you. Inform your doctor of any other food or drug allergies you may have when beginning treatment.
• Kidney Disease: This treatment may cause kidney damage in rare cases.
• Liver Disease: Active liver disease is a contraindication for treatment. Impaired liver function is a caution for treatment, but may not completely rule it out. If you have unexplained abnormal liver tests, your doctor will likely want to figure out the cause before starting treatment. This medication may cause abnormal liver tests.
• Muscle Weakness: Unexplained weakness or tenderness, or any muscle disorder may indicate that your treatment proceed with caution. Your doctor may urge you to try other treatments.
• Pregnancy: This drug is not recommended for pregnant women, or women who are breast-feeding. If you become pregnant while using Lipitor, stop your treatment immediately and contact you doctor. Women of childbearing age are encouraged to use an effective method of contraception while they take this medicaition.
• Previous Treatment: If you have been treated with another statin in the past, or if past treatment with Lipitor was unsuccessful, inform your doctor.

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Not all medications will be safe to mix with Lipitor (atorvastatin) treatment. Some of the following medications will require dosage adjustments in one of your treatments to be used safely, others should not be combined at all. Speak to your doctor if you take, or plan to take any of the following. If you visit multiple prescribing physicians for specialist treatment, be sure to keep each of them fully informed regarding medications that may have been prescribed by another doctor.

• Alcohol - For some individuals, avoidance of alcohol will be an important part of an overall plan to manage their cholesterol levels. Follow your doctor's directions regarding alchohol use. Excessive use is not recommended during treatment for any individuals.
• Antacids - Reduces atorvastatin absorption. If you must use these, speak to your doctor or pharmacist about preventing them from interfering with your treatment.
• Antiseizure treatments like Cerebyx (fosphenytoin) and Dilantin (phenytoin) may make atorvastatin less effective.
• Atromid-S (clofibrate) - This medication, and other fibric acid preparations, can increase the risk of muscle damage and kidney failure when used with statins.
• Azole antifungals - Drugs like Diflucan (fluconazole), Nizoral (ketoconazole), or Sporanox (itraconazole), etc., increase the risk of muscle damage. Caution is advised, you may want to consider all of your treatment options carefully.
• Calan (verapamil) - Increased risk of muscle damage.
• Colestid (colestipol) - Lowers atorvastatin levels in the body, but the combination may provide more effective treatment for lowering unhealthy LDL cholesterol.
• Garlic - Supplement level dosing not recommended during treatment, may overly inhibit blood clotting. The small amount of garlic found in most foods is probably too little for concern, but speak to your doctor about this if you feel it might be an issue.
• Grapefruit juice - May lead to muscle damage and Lipitor toxicity. Do not combine.
• Lanoxin (digoxin) - This drug may build up to toxic levels when taken with atorvastatin.
• Lopid (gemfibrozil) - Increased risk of muscle damage and kidney failure when used with statins.
• Macrolide antibiotics like erythromycin (Ery-tab, etc.) may increase the risk of muscle damage.
• Niacin (vitamin B3) - This vitamin may increase the risk of muscle damage during treatment, and can increase levels of homocysteine, an oxidant which increases the risk of heart disease. Taking supplemental niacin on its own is not recommended, speak to your doctor regarding safe levels in multivitamin supplements.
• Oral Contraceptives - Birth control pills may be blocked from clearing from the body when used with this medication, undesirable high levels of hormone may result.
• Plavix (clopidogrel)
• Protease inhibitors - Drugs like Agenerase (amprenavir), Crixivan (indinavir), Fortovase (saquinavir), Norvir (ritonavir), or Viracept (nelfinavir), can increase levels of atorvastatin in the body, leading to a greater chance of muscle damage.
• Sandimmune (cyclosporine) - Increased risk of muscle problems when used with statins.
• Serzone (nefazodone) - Toxic levels of atorvastatin may build up when these treatments are combined.
• Synercid (dalfopristin, quinupristin) - Can increase the risk of muscle damage.
• Tricor (fonefibrate) - Increased risk of muscle damage and kidney failure when used with statins.
• Welchol (colesevelam) - This combination may provide more effective treatment for lowering unhealthy LDL cholesterol.

Lipitor is presently available in 10 mg, 20 mg, 40 mg, and 80 mg tablets. The white, elliptical tablets have their dosage number stamped on one side, and 'PD' followed by a three-digit number on the other.

The usual starting dose is 10 mg, up to a maximum of 80 mg daily. Your doctor will base your individual dosage recommendation on their examination findings.

Lipitor Directions

If you miss a dose of Lipitor, take it as soon as you remember, unless you are within a few hours of your next dose. In that case, skip the missed dose and go back to your schedule. Taking double doses of Lipitor is not recommended, as it may lead to an increased risk of adverse side effects.

These tablets may be split, or crushed. They may be mixed with most beverages, but avoid taking with grapefruit juice, as there is an increased risk of muscle damage. If higher dosages of Lipitor are priced identically with lower dosages, it may be cost effective to purchase a higher dosage tablet and use a pill splitter to get the correct dose. Your doctor or pharmacist can advise you on this.

Lipitor should be taken on an empty stomach for best absorption. As most cholesterol is thought to be produced at night, the most recommended time of use is at bedtime.

This medication may reduce the body's ability to produce Coenzyme Q10 (CoQ10), also called ubiquinone, an important antioxidant. Supplementation is recommended. Certain nutritionists suggest that the gel or liquid forms of this supplement are more available to the body, use as directed.

Stopping this medication abruptly may lead to a significant increase in cholesterol levels. Seek your doctor's advice when considering whether or not to discontinue treatment.

Store Lipitor away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.

Keep Lipitor away from children; both when storing it, and when discarding any unused medication.

Lipitor and Pregnancy

This drug appears to lead to increased infant mortality in animal studies. It is not considered safe for use during any portion of a pregnancy. This drug is not considered safe to use during breast-feeding.

Lipitor and Children

No information is available on the safety and effectiveness of this medication in children. It is not presently prescribed for them.

Lipitor and Seniors

Seniors tend to build up higher levels of Lipitor in their blood than adults under 65, and the lowest starting dose of 10 mg is recommended. Careful monitoring may still be necessary to ensure that toxic levels of this treatment do not build up in the body.

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Lipitor is a trademark of Parke-Davis and Pfizer

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The information contained in this document is provided for educational purposes and information only. It is not a substitute for consultation with a physician or Health professional, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor, physician or Health professional can say if a medication, a drug alternative or drug combination, is safe for you. Information intended for US residents only.