Atorvastatin adverse effects

Atorvastatin is generally well tolerated. Adverse effects include constipation, flatulence, dyspepsia, abdominal pain, headache, nausea, myalgia, diarrhoea, asthenia and insomnia. 

Atorvastatin is an HMG Co-A reductase inhibitor. Pooled data from 21 completed and 23 continuing trials representing 3000 patient-years have shown that constipation, flatulence, dyspepsia, abdominal pain, headache, and myalgia occur in 1-3% of patients. Under 2% of atorvastatin-treated patients discontinued treatment because of an adverse event (1). Serious events in this review amounted to one patient with pancreatitis and one with cholestatic jaundice (1). There were no differences in adverse effects in 177 patients randomized for 52 weeks to either simvastatin or atorvastatin (2). 

Adcock BB, Hornsby LB, Jenkins K. Dermographism an adverse effect of atorvastatin. J Am Board Fam Pract 2001 14(2) 148-51. 

The adverse effects of statins have been reviewed in the light of the ever increasing dosages that are being used to lower LDL cholesterol to a minimum (2). In another review high doses of atorvastatin and simvastatin were specially emphasized (3). 

Emerging data associate statins with a reduced risk of Alzheimer s disease however, two women had significant cognitive impairment temporally related to statin therapy (18). One took atorvastatin, and the other first took atorvastatin then simvastatin. Cognitive impairment and dementia as potential adverse effects associated with statins has been reviewed (17). 

Hematological adverse effects can occur during treatment with both simvastatin and atorvastatin, according to a brief review (23). They include thrombotic thrombocytopenic purpura and severe thrombocytopenic purpura. 

In a comparison of atorvastatin with pravastatin, of 224 patients taking atorvastatin, two had clinically significant increases in alanine transaminase activity (32). They recovered during the next 4 months, one after withdrawal of atorvastatin and the other after a dosage reduction. Withdrawals due to adverse effects were similar in the two groups. One patient developed hepatitis while taking atorvastatin, but was able to tolerate simvastatin (33). The authors concluded that this adverse effect was not a class effect. Eosinophils in a liver-biopsy specimen pointed to an immunological mechanism. 

ATORVASTATIN PROTEASE INHIBITORS t efficacy and t risk of adverse effects of atorvastatin Inhibition of CYP3A4-mediated metabolism of atorvastatin Use with caution monitor for atorvastatin toxicity monitor CK. Inform patient and 1 dose if necessary or start with 10 mg once daily. Use the lowest dose possible to attain target low-density lipoprotein reduction. Alternatives are pravastatin orfluvastatin... 

STATINS GRAPEFRUIT JUICE t levels with simvastatin slight rise with atorvastatin. t risk of adverse effects such as myopathy Constituent of grapefruit juice inhibits CYP3A4-mediated metabolism of simvastatin Patients taking simvastatin and atorvastatin should avoid grapefruit juice... 

STATINS PROTON PUMP INHIBITORS Possible T efficacy and adverse effects of atorvastatin Inhibition of P-gp, reducing first-pass clearance Monitor closely... 

In patients taking fenofibrate and atorvastatin, increased concentrations of plasma homocysteine were attributed to an action of the fibrates themselves and not indirectly via their lipid-lowering effect (8). Concomitant administration of folic acid, at least in part, offset this adverse effect... 

Statins also cause a small increase in HDL, and atorvastatin lowers triglycerides (TGs). They also increase NO levels and lower the levels of endothelin-1 mRNA. The adverse effects are listed. 

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