15 things to know about atorvastatin
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Muscle aches or cramps — one of the better-known side effects.
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Muscle weakness — especially unexplained or persistent weakness.
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Rare severe muscle injury (rhabdomyolysis) — severe muscle pain or weakness accompanied by dark/red-brown urine needs urgent medical attention.
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Rare autoimmune muscle disease — immune-mediated necrotizing myopathy can cause weakness that persists even after the statin is stopped.
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Liver-enzyme elevations — atorvastatin can cause abnormal liver blood tests; serious liver injury is uncommon.
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Digestive problems — nausea, diarrhea, constipation, indigestion, or gas can occur.
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Headache or dizziness — reported side effects in some people.
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Sleep problems — insomnia and other sleep disturbances have been reported.
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Joint or extremity pain — these have been reported in clinical trials, although not every symptom is necessarily caused by the medicine.
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Blood-sugar changes — statins can produce small increases in glucose/HbA1c in some people. This generally has to be weighed against their cardiovascular benefits.
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Rare cognitive symptoms — memory loss or confusion have been reported with statins; persistent or permanent cognitive impairment is not established as a common effect.
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Drug interactions — some antibiotics, antifungals, antivirals, transplant medicines, fibrates, colchicine, and other drugs can increase atorvastatin exposure or muscle toxicity.
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Grapefruit interaction — large quantities of grapefruit or grapefruit juice can increase atorvastatin exposure. The risk is much more pronounced with some other statins, particularly simvastatin, so the exact advice depends on the statin.
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Age can increase muscle-toxicity risk — the FDA identifies age over 65, kidney impairment, uncontrolled hypothyroidism, higher doses, and interacting medicines as risk factors.
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Rare additional reactions — reported post-marketing reactions include pancreatitis, peripheral neuropathy, tendon problems, allergic reactions, and certain skin reactions. A reported reaction does not necessarily prove the medication caused it
