Lipid-Lowering Agent Pregnancy: Contraindicated during pregnancy and breast-feeding. Women of child-bearing potential should use appropriate contraceptive measures; suspend treatment for the duration of pregnancy.

Atorvastatin

Brand names: Lipitor

Atorvastatin is an oral statin (HMG-CoA reductase inhibitor) used to lower cholesterol and reduce cardiovascular risk in both primary and secondary prevention.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 10 mg once daily (usual starting dose); range 10 mg to 80 mg once daily

Route: Oral

Frequency: Once daily

Max: 80 mg once daily

Dose individualised according to baseline LDL-C, goal of therapy and patient response; adjust at intervals of 4 weeks or more. Primary hypercholesterolaemia and combined (mixed) hyperlipidaemia: majority controlled with 10 mg once daily. Heterozygous familial hypercholesterolaemia: start 10 mg daily, adjust every 4 weeks to 40 mg daily, then increase to a maximum of 80 mg daily or combine a bile acid sequestrant with 40 mg once daily. Homozygous familial hypercholesterolaemia: 10 to 80 mg daily as adjunct to other lipid-lowering treatments. Prevention of cardiovascular disease: 10 mg/day in primary prevention trials; higher doses may be needed to attain cholesterol targets. May be taken at any time of day with or without food. Do not exceed 20 mg/day with elbasvir/grazoprevir or letermovir.

Dose adjustments

Renal

No adjustment of dose is required.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Active liver disease or unexplained persistent elevations of serum transaminases exceeding 3 times the upper limit of normal
Pregnancy, breast-feeding, and women of child-bearing potential not using appropriate contraceptive measures
Treatment with the hepatitis C antivirals glecaprevir/pibrentasvir

Side effects

Nasopharyngitis
Headache
Constipation, flatulence, dyspepsia, nausea, diarrhoea
Myalgia, arthralgia, pain in extremity, muscle spasms, back pain
Hyperglycaemia

Interactions

Elbasvir/grazoprevir or letermovir: do not exceed atorvastatin 20 mg/day
Letermovir co-administered with ciclosporin: use of atorvastatin not recommended
Glecaprevir/pibrentasvir: contraindicated
CYP3A4 and transporter (OATP1B1/1B3, P-gp, BCRP) inhibitors: increased atorvastatin exposure and risk of myopathy/rhabdomyolysis

Clinical monograph

How it works

It competitively inhibits HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis, upregulating LDL receptors and lowering circulating LDL-cholesterol.

Prescribing in practice

Advise patients to report unexplained muscle pain, tenderness or weakness, as statins can rarely cause myopathy and, very rarely, rhabdomyolysis.
It is contraindicated in active liver disease and in pregnancy and breastfeeding, and effective contraception should be in place in women of childbearing potential.
Be alert to interactions, including with certain antibiotics, antifungals and some other drugs that raise statin exposure, and limit or avoid large quantities of grapefruit juice.

Monitoring

Check lipids and liver transaminases before starting and on treatment, with creatine kinase if muscle symptoms occur, and review response to therapy.

Counselling the patient

It is usually taken once daily and can be taken at any time of day.
Report any new or persistent muscle pain, tenderness or weakness.
Continue a healthy diet and lifestyle alongside the tablet.

Evidence & guidelines

Statins have extensive trial evidence for reducing cardiovascular events, and NICE recommends atorvastatin as a first-line option for primary and secondary prevention.

Reference: NICE NG185 (Cardiovascular Disease Prevention); MHRA Statin Safety Advice; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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