Endogenous cholesterol synthesis is cyclical in nature with the greatest production during fasting states. To maximize the effects of statins with a short half-life, fluvastatin, lovastatin, and simvastatin should be dosed at bedtime allowing the greatest drug concentration to be present during peak endogenous cholesterol synthesis.
The long half-life of atorvastatin, pitavastatin, pravastatin, and rosuvastatin allows for flexibility in administration time. Author: Carolyn J. Hydroxymethylglutaryl coenzyme A HMG-CoA reductase inhibitors, more commonly known as statins, are recommended as first-line agents in the reduction of low-density lipoprotein cholesterol LDL-C. There is known morbidity and mortality benefit associated with LDL-C reduction from statin therapy; therefore, it is vital that patients take the medication in a way that provides the greatest effect.
Although some cholesterol comes from dietary intake, a significant amount is produced endogenously. It was previously hypothesized that human cholesterol production may be cyclical in nature mimicking the confirmed pattern of cholesterol synthesis in animals.
Human trials then confirmed the fluctuation in cholesterol synthesis, noting the greatest cholesterol production from the liver during fasting states. The apparent circadian rhythm of cholesterol production sparked the recommendation that statins be dosed at bedtime to provide the greatest medication concentration when endogenous cholesterol production is the highest.
Investigation of pharmacokinetic properties of individual statins disproved the need for all agents to be dosed at bedtime. Therefore it is vital that you never run out of statins and keep on top of your prescriptions. Companies such as RXLive provide prescription management services that allow you to order medication from the comfort of your own home. The company also delivers all prescriptions to your chosen delivery address completely free within 48 hours. Therefore, you may wish to sign-up for the free service to ensure you never miss a statin again!
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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. These common side effects of atorvastatin happen in more than 1 in 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:.
Report any unexplained muscle aches and pains, tenderness or weakness to a doctor straight away. Less than 1 in 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 when taking atorvastatin are rare and happen in less than 1 in 1, people.
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. 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.
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.
If you're taking atorvastatin and need to take one of these medicines, your doctor may:. 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. 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.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Atorvastatin acts on the liver to stop it making cholesterol. This lowers your blood cholesterol level. For the first 12 months on this medicine, you'll be offered a couple of routine tests to make sure your liver is working normally.
Your cholesterol levels should drop noticeably within 4 weeks - if you take your medicine regularly, as prescribed. Usually, treatment with a statin such as atorvastatin is for life. The benefits will only continue for as long as you take it. If you stop taking atorvastatin without starting a different treatment, your cholesterol level may rise again.
You may have read negative stories about statins, but they're thought to be very safe, effective medicines. Statins are thought to have very few side effects. Sometimes the side effects that people report aren't related to their medicine. However, if you're concerned about the safety of statins, talk to your doctor. Atorvastatin is safe to take for a long time, even many years.
In fact, it works best when you take it for a long time. No, there's no evidence that atorvastatin is addictive. You won't get any withdrawal symptoms when you stop taking it. You may want to stop atorvastatin if you think you're having side effects. Talk to your doctor first to see if it really is a side effect of atorvastatin or an unrelated problem. Your doctor may decide to lower your dose or change your medicine. You won't get any withdrawal symptoms. However, stopping atorvastatin may cause your cholesterol to rise.
This increases your risk of heart attacks and strokes. If you want to stop taking your medicine, it's important to find another way to lower your cholesterol. There's some interest in taking CoQ10 together with statins. However there's no firm evidence that taking CoQ10 at the same time as atorvastatin will benefit your health. More research is needed. If you decide to take a CoQ10 supplement, tell your doctor or pharmacist.
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