Atorvastatin belongs to a group of medicines called statins.

It's used to lower cholesterol if you've been diagnosed with high blood cholesterol. It's also taken to prevent heart disease, including heart attacks and strokes. Your doctor may prescribe atorvastatin if you have a family history of heart disease, or a long-term health condition such as type 1 or type 2 diabetes or rheumatoid arthritis.

This medicine is available on prescription only. It comes as tablets, including chewable tablets for people who have difficulty swallowing.

• It's usual to take atorvastatin once a day.
• The most common side effects are headaches, feeling sick (nausea), diarrhoea and cold-like symptoms.
• Do not take atorvastatin if you're pregnant, trying to get pregnant or breastfeeding.
• Keep taking atorvastatin even if you feel well, as you will still be getting the benefits. Most people with high cholesterol don't have any symptoms.
• Atorvastatin is also called by the brand name Lipitor.

Atorvastatin can be taken by adults and children over the age of 10 years.

Atorvastatin isn't suitable for some people. Tell your doctor if you:

• have had an allergic reaction to atorvastatin or any other medicines in the past
• have liver or kidney problems
• are trying to get pregnant, think you might be pregnant, you're already pregnant, or you're breastfeeding
• have severe lung disease
• have previously had a stroke caused by bleeding into the brain
• drink large amounts of alcohol
• have an underactive thyroid
• have had muscular side effects when taking a statin in the past
• have had, or have, a muscle disorder (including fibromyalgia)

Lipitor chewable tablets contain a substance called aspartame - check with your doctor before taking these if you have phenylketonuria (a rare inherited disorder of protein metabolism).

Take atorvastatin once a day. You can choose to take it at any time, as long as you stick to the same time every day.

Sometimes doctors may recommend taking it in the evening. This is because your body makes most cholesterol at night. If you're not sure when to take your medicine, ask a pharmacist or your doctor for advice.

Atorvastatin doesn't upset the stomach, so you can take it with or without food.

Swallow atorvastatin tablets whole with a glass of water. If you've been given chewable tablets, you can chew them or swallow them whole with a glass of water.

How much to take

The usual dose for adults is between 10mg and 80mg a day.

In children, the usual dose is 10mg to 20mg once a day. Your doctor will use your child's age to work out the amount of atorvastatin that's right for them.

Your dose depends on the reason for taking it, your cholesterol levels, and what other medicines you're taking. Ask your doctor or pharmacist for advice if you're unsure how much to take. Don't reduce your dose without talking to your doctor first.

What if I forget to take it?

If you occasionally forget to take a dose, take your next dose the next day at the usual time. Never take 2 doses at the same time. Never take extra doses.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking an extra dose of atorvastatin by accident is unlikely to harm you.

Talk to your pharmacist or doctor if you're worried or take more than 1 extra dose.

Like all medicines, atorvastatin can cause side effects in some people - and different statins affect people in different ways.

One rare but serious side effect is unexplained muscle aches and pains, tenderness or weakness. This can happen a few weeks or months after you first start taking this medicine.

Talk to your doctor or a pharmacist if side effects are bothering you. They may recommend trying an alternative statin.

Common side effects

These common side effects of atorvastatin happen in more than 1 in 100 people.

Some side effects may improve after the first few days, as your body gets used to the medicine.

Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or don't go away:

• feeling sick (nausea) or indigestion
• headaches
• aches and pains in your back and joints
• nosebleeds
• sore throat
• cold-like symptoms, such as a runny nose, blocked nose or sneezing
• constipation or wind
• diarrhoea

Report any unexplained muscle aches and pains, tenderness or weakness to a doctor straight away.

Less than 1 in 100 people may have some memory loss. Talk to your doctor or pharmacist if this side effect bothers you. It usually goes away after you stop taking the medicine.

Serious side effects

Serious side effects when taking atorvastatin are rare and happen in less than 1 in 1,000 people.

Stop taking atorvastatin and call a doctor if you get:

• muscle pain, tenderness, weakness or cramps - these can be signs of muscle breakdown and kidney damage
• yellow skin or the whites of your eyes turn yellow, or if you have pale poo and dark pee - this can be a sign of liver problems
• a skin rash with pink-red blotches, especially on the palms of the hands or soles of the feet
• severe stomach pain - this can be a sign of pancreas problems
• a cough, feeling short of breath, and weight loss - this can be a sign of lung disease

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to atorvastatin.

These are not all the side effects of atorvastatin. For a full list see the leaflet inside your medicines packet.

What to do about:

• feeling sick (nausea) or indigestion - stick to simple meals and do not eat rich or spicy food. It might help to take your atorvastatin after a meal or snack. If you continue to get symptoms of indigestion ask your pharmacist to recommend an antacid. Contact your doctor if your symptoms continue for more than a few days or if they get worse.
• headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking atorvastatin. Talk to your doctor if they last longer than a week or are severe.
• aches and pains in your back and joints - if you get unusual muscle pain, weakness or tiredness which isn't from exercise or hard work, talk to your doctor. You may need a blood test to check what might be causing it. You can also ask your pharmacist to recommend a painkiller.
• nosebleeds - try applying a thin layer of Vaseline to the inside edges of your nose.
• sore throat - try gargling with warm salty water (children shouldn't try this), or use paracetamol or ibuprofen to ease any pain or discomfort. If the symptoms last longer than a week ask your pharmacist or doctor for advice.
• cold-like symptoms - try taking paracetamol or ibuprofen regularly for a few days. If the symptoms return when you stop taking the painkillers ask your doctor for advice.
• constipation or wind - eat more high-fibre foods such as fresh fruit, vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example, by going for a daily walk or run. If this doesn't help, talk to your pharmacist or doctor. Watch this short video about how to treat constipation.
• diarrhoea - drink plenty of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Atorvastatin isn't recommended during pregnancy or breastfeeding, as there's no firm evidence it's safe.

Talk to your doctor if you want to get pregnant. It's best to stop taking atorvastatin at least 3 months before you start trying for a baby.

If you become pregnant while taking atorvastatin, stop taking the medicine and tell your doctor.

Atorvastatin and breastfeeding

It's not known if atorvastatin gets into breast milk, but it may cause problems for your baby.

Speak to your doctor about what's best for you and your baby while you're breastfeeding. It may be possible to delay starting or restarting atorvastatin until you've stopped breastfeeding completely.

Some medicines affect the way atorvastatin works and can increase the risk of serious side effects.

Medicines that may not mix well with atorvastatin include:

• some antibiotics and antifungals
• some HIV medicines
• some hepatitis C medicines
• warfarin (stops blood clotting)
• ciclosporin (treats psoriasis and rheumatoid arthritis)
• colchicine (a medicine for gout)
• contraceptive pills
• verapamil, diltiazem, amlodipine (for high blood pressure and heart problems)
• amiodarone (makes your heart stable)

If you're taking atorvastatin and need to take one of these medicines, your doctor may:

• prescribe a lower dose of atorvastatin
• prescribe a different statin medicine
• recommend that you stop taking atorvastatin for a while

These are not all the medicines that can interfere with atorvastatin. For a full list see the leaflet inside your medicine packet or check with your pharmacist.

Mixing atorvastatin with herbal remedies and supplements

St John's wort, a herbal medicine taken for depression, reduces the amount of atorvastatin in your blood, so it doesn't work as well.

Talk to your doctor if you're thinking about starting St John's wort, as it will change how well atorvastatin works.