Side-effects of Atorvastatin / Lipitor usage

Treatment with Atorvastatin / Lipitor is not without some unwanted side-effects but is frequently well tolerated. Many side-effects experienced are often mild and transient (short-lived).

Not every patient will experience all known side-effects while on a treatment plan. Some side-effects, although not pleasant, may not require additional medical treatment either as they typically resolve once the body adjusts to use of the medication (i.e. temporary discomfort).

If a side-effect is bothersome, it is best to discuss it with the treating doctor. Depending on the side-effect and level of severity, it may be possible to either prevent or reduce the adverse reaction through dosage control or even a change in medication.

Here is a breakdown of side-effects with a known association with this medication…

1. Highly common side-effects (high frequency occurrence)

• Diarrhoea (5-14%)
• Nasopharyngitis (common cold / viral infection of the nose and throat – nasal congestion, runny nose and sore throat) (4-13%)
• Joint pain (arthralgia) (4-12%)

2. Some other side-effects known to occur (in order of percentage frequency)

• Urinary tract infection (including painful / difficulties with urination – increased frequency, urinary urgency or retention and urinary incontinence) (4-8%)
• Nausea (4-7%)
• Limb pain (3-8%)
• Muscle pain (myalgia) (3-8%)
• Indigestion (dyspepsia) (3-6%)
• Muscle spasms (2-5%)
• Musculoskeletal pain (especially the lower back and side, or around the eyes and cheekbones) (2-5%)
• Joint swelling (more than 2%)
• Dizziness (more than 2%)
• Angina pectoris (chest pain) (more than 2%)
• Swelling (peripheral oedema) (more than 2%)
• Fever (less than 2%)
• Neck pain (rigidity) (less than 2%)
• Malaise (less than 2%)
• Generalised swelling (less than 2%)
• Flatulence (gas) (less than 2%)
• Constipation (less than 2%)
• Belching (eructation) (less than 2%)
• Photosensitivity (sun urticaria) (less than 2%)
• Gastroenteritis (less than 2%)
• Colitis (inflammation of the colon (less than 2%)
• Gastritis (less than 2%)
• Vomiting (less than 2%)
• Stomach ulcer (less than 2%)
• Dry mouth (less than 2%)
• Mouth ulceration (less than 2%)
• Glossitis (inflammation of the tongue) (less than 2%)
• Increased appetite (less than 2%)
• Hepatitis (less than 2%)
• Cholestatic jaundice (reduction or cessation of bile flow from the liver) (less than 2%)
• Pancreatitis (less than 2%)
• Pneumonia (less than 2%)
• Dyspnea (breathing difficulties – shortness of breath or laboured breathing) (less than 2%)
• Asthma (less than 2%)
• Epistaxis (nose bleeds) (less than 2%)
• Leg cramps (less than 2%)
• Myositis (muscular inflammation) (less than 2%)
• Tendinous contracture (muscular or joint shortening) (less than 2%)
• Myasthenia (skeletal muscle weakness) (less than 2%)
• Tenosynovitis (tendon sheath inflammation) (less than 2%)
• Bursitis (inflammation of the bursae – fluid-filled sacs near the joints) (less than 2%)
• Contact dermatitis (skin rash) (less than 2%)
• Dry skin (less than 2%)
• Pruritus (itching of the skin) (less than 2%)
• Sweating (less than 2%)
• Hives (urticaria) (less than 2%)
• Eczema (less than 2%)
• Alopecia (less than 2%)
• Acne (less than 2%)
• Tinnitus (ringing / noise in the ears) (less than 2%)
• Dry eyes (less than 2%)
• Glaucoma (vision loss) (less than 2%)
• Deafness (less than 2%)
• Loss of taste (less than 2%)
• Migraine / headache (less than 2%)
• Syncope (fainting) (less than 2%)
• Postural hypotension (low blood pressure when standing up from a lower position – lying down or seated) (less than 2%)
• Palpitations (rapid heartbeat) (less than 2%)
• Arrhythmia (abnormal heart rhythm) (less than 2%)
• Phlebitis (inflammation of the veins) (less than 2%)
• Hyperglycaemia (high blood sugar) and hypoglycaemia (low blood sugar) (less than 2%)
• Gout (less than 2%)
• Weight gain (less than 2%)
• Anaemia (less than 2%)
• Thrombocytopenia (low platelets in the bloodstream) (less than 2%)
• Petechia (bleeding into the skin from broken capillary vessels, forming small spotty discolourations on the skin) (less than 2%)
• Ecchymosis (bruising discolouration caused by bleeding beneath the skin) (less than 2%)
• Pharyngolaryngeal pain (inflammation) and a hoarse voice (1-4%)
• Insomnia (1-5%)

Other common effects a doctor may pick up on include:

• Increased serum transaminase levels (alanine aminotransferase / ALT, aspartate transaminase / AST)
• Increased blood bilirubin
• Elevated levels of blood serum alkaline phosphatase
• Increased levels of creatine phosphokinase

3. Some other adverse reactions to note but which do not have a defined frequency (‘incidence unknown’) include:

• Increased thirst
• Black / tarry stool
• Cloudy or bloody urine
• Difficulties with night vision (seeing at night)
• Sensitivity to light (vision disturbances)
• Excessive muscle tension or tone
• Increased body movements
• Sensitivity to touch or pain
• Breath changes – fruit-like odour
• Pain in the groin area or scrotum
• Erectile dysfunction
• Low sex drive, desire or ability
• Menstrual bleeding abnormalities (menstrual periods becoming irregular or longer bleeding)
• Pale skin complexion
• Slurred speech
• Swollen lymph glands (in the neck, armpit or groin)
• Abnormal bleeding or bruising
• Increased nervousness
• Paranoia
• Weight loss

4. Adverse reactions which require urgent medical attention

• Breathing difficulties
• Wheezing
• Swelling affecting the facial area, lips, tongue and throat
• Hives (allergic reaction)
• Unexplained muscle pain, tenderness and weakness
• Fever
• Extreme tiredness / fatigue
• Dark coloured urine
• Fainting / syncope (loss of consciousness)

5. Signs which may signal problems with the liver and thus require prompt medical evaluation include:

• Upper stomach pain
• Body weakness
• Fatigue
• Loss of appetite
• Dark coloured urine
• Jaundice

6. Signs which may signal problems with the kidneys and thus require prompt medical evaluation include:

• Decreased urination (little to none)
• Swollen feet and ankles (fluid retention)
• Fatigue and drowsiness
• Shortness of breath

7. Signs of overdose

• Peripheral neuropathy
• Elevated potassium levels (K+) in the blood
• Diarrhoea
• Myopathy
• Rhabdomyolysis
• Acute renal failure / acute renal injury (decreased urination, fluid retention, drowsiness, shortness of breath, fatigue, confusion, nausea, chest pain or pressure and seizures)
• Eye lens opacities, such as cataracts
• Elevations indicated in liver function tests

Signs of over-dosage must be evaluated by a medical professional as soon as possible. Once a thorough evaluation has taken place, a doctor is likely to treat a patient in a supportive manner according to the combination of overdose symptoms displayed. There is no specific / set treatment procedure for Atorvastatin / Lipitor medication overdose.