Statin use is on the rise, with more than 92 million people taking these medications in the U.S. today, according to the Cleveland Clinic. Also known as HMG-CoA reductase inhibitors, statins are medications commonly used to treat hyperlipidemia, or high levels of fats in the blood. In fact, the United States Preventive Services Task Force (USPSTF) recommends statins to help prevent atherosclerotic cardiovascular disease (ASCVD) in adults between the ages of 40 and 75 with at least one risk factor, such as diabetes, dyslipidemia, hypertension, or smoking.
Atorvastatin, also known by the brand name Lipitor, is perhaps the most commonly used statin in the U.S. “It is considered a very effective drug to treat hyperlipidemia and reduce the risk of cardiovascular events due to its long half-life, effectiveness in reducing triglycerides and LDL (low density lipoprotein), anti-inflammatory properties, and anti-atherogenic properties,” says Dr. Charu Sawhney, DO, an internist with Harbor Health in Round Rock, Texas. To get the most benefit from this popular medication and reduce the possibility of side effects, it’s important to take it correctly each day. Because atorvastatin is long-acting, you can take it at the time that works best for you. Here’s why.
When is the best time to take atorvastatin?
Atorvastatin is a long-acting statin, which means you can choose the time of day that works best for you, and it remains effective when your body needs it the most.
Statins come in two formulations:
- Short-acting statins, such as Zocor (simvastatin), Mevacor (lovastatin), and Lescor (fluvastatin) should be taken in the evening, close to bedtime, because your body makes cholesterol when you sleep.
- Longer-acting statins like Crestor (rosuvastatin) and atorvastatin can be taken at any time of the day.
Because atorvastatin has a half-life of 14 hours, you can take your dose at any time of the day. It will remain in your body long enough to target the synthesis of low-density lipoprotein cholesterol (LDL cholesterol), aka “bad cholesterol,” that occurs after you fall asleep that evening.
“The best time of day to take it is the time the patient remembers,” says Sarah Yandell, Pharm.D., a clinical pharmacist with Scriptology Health. However, it’s important to take it at approximately the same time each day so the levels of the medication remain steady.
You can take the tablet form of atorvastatin with or without food. The oral suspension version should be taken on an empty stomach, two hours after a meal, or one hour prior.
What if I miss a dose of atorvastatin?
If you forget to take a dose but remember within a couple of hours, it’s okay to go ahead and take it then, says Dr. Yandell. However, timing matters! If it’s close to your next dose, you should not double up.
“If you miss a dose of atorvastatin by more than 12 hours, you should not take an extra dose to make up for the missed one,” explains Allison Hinkle, Pharm.D., clinical pharmacy manager with HCA Florida Healthcare. “Instead, skip the missed dose and take the next dose at the regularly scheduled time.”
Taking two doses of atorvastatin at once can increase your risk of side effects.
What are the side effects of atorvastatin?
Some people should not take atorvastatin, such as people who have advanced liver disease or who are pregnant or breastfeeding. Generally speaking, though, statin therapy is considered safe, with a relatively low risk of side effects, especially clinically significant adverse effects.
However, as with any medication, side effects of statin medications can happen. Possible side effects of atorvastatin include:
- Muscle Pain (myalgia)
- Dyspepsia (indigestion)
- Diarrhea
- Joint pain (arthralgia)
- Nausea
- Cold symptoms (nasopharyngitis)
- Insomnia
- Urinary tract infection
- Pain in the extremities
The most commonly reported side effects are joint pain and cold-like symptoms. Other, less common side effects are also possible, such as myopathy—a condition that causes muscle pain, tenderness, and weakness. Rare, but serious side effects may occur, such as rhabdomyolysis or liver function abnormalities.
If you develop new symptoms that concern you, especially symptoms of an allergic reaction, seek emergency medical attention immediately and call your healthcare provider for medical advice.
How do I get the most out of my atorvastatin?
To get the most out of atorvastatin, consider it just one part of your approach to improving your health. Following these guidelines can enhance the medication’s effectiveness.
- Make lifestyle changes to lower cholesterol. “Pairing it with lifestyle modifications such as a healthy diet and exercise, along with reducing fast, fried, and processed foods, will give one the best lipid-lowering benefit from taking the medication,” says Dr. Sawhney.
- Avoid drinking grapefruit juice. In large amounts, it can interact with atorvastatin and increase the risk of side effects. “The juice is concentrated,” explains Dr. Yandell. “Eating a grapefruit is not as risky because it’s not as concentrated.”
- Check in with your provider regularly. There aren’t any obvious signs that atorvastatin is doing its job. “The only way to know that it is working is through lab results,” says Dr. Sawhney. Your provider can check your cholesterol levels with a blood test called a lipid panel and determine if any additional treatment or a dose adjustment is needed.
- Avoid taking over-the-counter or prescription medications and dietary supplements that interact with atorvastatin. Some examples include heart failure medications (such as digoxin), certain antibiotics (such as erythromycin and clarithromycin), ritonavir, cyclosporine, niacin (vitamin B3), St. John’s wort, and oral contraceptives. Due to the many food and drug interactions with atorvastatin, it is important to speak with a healthcare provider before starting any new medications.
- Use strategies to remember your dose. It’s only effective if you take it, and as with any daily medication, that can be tricky. Try coordinating taking your medication with another activity that you do daily, such as taking a shower in the morning or brushing your teeth at night. Or, use a pillbox that’s labeled with each day of the week, and put it in an easily visible location.
The bottom line
Atorvastatin can help reduce your risk of heart disease and other complications by helping reduce high cholesterol levels. However, it’s critical to take it every single day. With that in mind, the best time to take atorvastatin is the time you are most likely to remember to take it daily—whether that’s morning, afternoon, or evening—as long as you take it consistently.
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