13 Atorvastatin Side Effects and How to Manage Them

GoodRx Health

Atorvastatin (Lipitor) is a statin medication used to treat high cholesterol. It's also used to lower the risk of heart attack or stroke in certain people who are at high risk. If you're prescribed atorvastatin, it's important to stick with treatment. But if you're experiencing side effects, you may be wondering if there's anything you can do to find relief.

Some of the most common atorvastatin side effects include muscle pain, joint pain, and diarrhea. But for most people, these side effects may go away over time. If they don't, there are steps your prescriber can take to find a solution that's right for you.

Atorvastatin side effects at a glance

Below are both common and rare (but potentially serious) atorvastatin side effects. Keep in mind, everyone responds differently to medication. Let your prescriber know about any side effects you experience while taking atorvastatin.

The most commonly reported atorvastatin side effects include:

• Muscle pain

• Joint pain

• Common cold symptoms

• Diarrhea

• Urinary tract infection

• Upset stomach and nausea

• Muscle spasms

Less common atorvastatin side effects include:

• Liver damage

• Severe muscle damage

• Blood glucose (sugar) changes

• Kidney damage

• Memory problems

• Hair loss

• Peripheral neuropathy (nerve pain)

• Tendon rupture

• Chest pain

• Loss of appetite

• Headache

Let's look more closely at 13 of these side effects.

1. Muscle pain

Muscle pain is one of the most commonly reported atorvastatin side effects. It seems to happen most often in the calves and thighs. A recent meta-analysis found a small increased risk of muscle pain with statins, usually within the first year. But it also found that most reports of muscle symptoms may not actually be due to the statin.

But if you do experience muscle pain while taking atorvastatin, there's a good chance it will go away over time. And if it doesn't or it becomes bothersome, you have a few options. Your prescriber may lower your dose, change your dosing schedule, or have you take a temporary break. In some cases, they may have you try a different statin.

Don't try stopping atorvastatin or changing your dose without your prescriber's guidance.

2. Joint pain

Joint pain is another possible atorvastatin side effect. But some people may think atorvastatin is causing their joint pain when it's actually arthritis. And people already living with arthritis may feel that atorvastatin makes their joint pain worse.

Joint pain from atorvastatin often goes away over time. If it becomes bothersome, your prescriber may suggest an over-the-counter (OTC) pain reliever to help in the meantime. But if your joint pain doesn't go away or becomes worse, your prescriber may adjust your statin regimen.

3. Common cold symptoms

Some people taking atorvastatin report experiencing common cold symptoms. This might include a runny or stuffy nose, sneezing, or a sore throat.

If you come down with a cold while taking atorvastatin, it should go away on its own. That's because colds are usually caused by viruses. Antibiotics don't work against viruses, so they won't make it go away any faster. In the meantime, your prescriber or pharmacist can recommend OTC cold remedies to manage your symptoms.

Let your prescriber know if your symptoms are severe or if they don't start getting better within 10 days. They can determine the potential cause and next steps.

4. Diarrhea

Diarrhea is possible with all statins, including atorvastatin. Similar to muscle and joint pain, diarrhea often gets better over time. Avoiding fatty and fried foods may help lessen diarrhea and provide benefits for your cholesterol at the same time. Be sure to drink plenty of water so you don't get dehydrated.

Talk to your prescriber if your diarrhea is bothersome, severe, or not going away.

5. Upset stomach (indigestion) and nausea

In addition to diarrhea, stomach-related side effects such as nausea and an upset stomach (indigestion) are possible with atorvastatin. If this happens to you, certain lifestyle changes can help:

• Take your dose with food. Atorvastatin can be taken with or without food. But if your stomach is upset after taking your dose, see if taking it with a meal or snack helps.

• Avoid spicy or fried foods. These foods can make nausea worse. Instead, temporarily sticking with bland, starchy foods for the time being may be easier on your stomach.

• Take your dose before bedtime. Taking atorvastatin at night may keep you from noticing the nausea since you'll be asleep.

• Try an OTC nausea medication. Talk to your pharmacist or prescriber about OTC nausea remedies that can give you some relief. Stronger prescription nausea medications are available too, if needed.

6. Liver damage

While rare, liver damage has been reported in some people taking atorvastatin. Signs and symptoms of liver damage include dark urine, stomach pain, or yellowing of the skin or eyes. Loss of appetite is also possible.

In most cases, liver damage is mild, short-lived, and doesn't cause noticeable symptoms. But your prescriber might notice a change in your liver tests. So, be sure to keep up with any follow-up appointments during treatment, and let them know if you develop any symptoms.

The risk of liver damage appears to slightly go up with higher atorvastatin doses. And it may be more likely if you drink large amounts of alcohol or have a history of liver problems. If there are any changes in your liver tests, your prescriber may lower your atorvastatin dose.

7. Blood glucose changes

Atorvastatin can cause changes in your blood glucose levels. This can increase the risk of developing Type 2 diabetes, especially in people at higher risk. It may also worsen existing diabetes in people already living with the condition.

Even so, the benefits of atorvastatin often outweigh this risk - especially for people with diabetes. In fact, experts recommend statin therapy for certain people with diabetes to prevent problems down the road, including heart attack or stroke.

If you have diabetes or are at risk of developing diabetes, your prescriber may want to monitor your blood glucose more closely during treatment.

8. Severe muscle damage

While rare, rhabdomyolysis is possible with atorvastatin. This is when damaged muscle breaks down and its byproducts are released into the bloodstream. Symptoms include intense muscle pain, dark or red urine, and feeling weak or tired. Seek medical attention right away if these symptoms develop.

The risk of developing rhabdomyolysis can go up if you take atorvastatin with certain interacting medications. Examples of these include erythromycin (Ery-Tab) and itraconazole (Sporanox). Make sure your healthcare team has your current medication list to check for interactions.

9. Kidney damage

Kidney damage from atorvastatin is also rare. When it happens, it's most commonly caused by rhabdomyolysis. This is because components from broken down muscle can clog up your kidneys, resulting in kidney failure.

Kidney failure from rhabdomyolysis can happen quickly. And it can be life-threatening if left untreated. So, it's important to seek immediate medical treatment if symptoms of rhabdomyolysis develop.

10. Memory problems

Some people report experiencing memory problems while taking statins like atorvastatin. However, current evidence doesn't strongly link statins as the cause. In fact, there's some evidence suggesting that statins may even lower the risk of dementia.

Even so, it's important to let your prescriber know if you notice any memory changes while taking atorvastatin. They can help determine the potential cause and work with you to find the best next steps. Thankfully, most reported cases of memory changes have been reversible.

11. Hair loss

While uncommon, there have been some reports of hair loss in people taking atorvastatin. Keep in mind that hair loss can have many causes, including stress, health conditions, older age, and genetics (androgenetic alopecia).

The type of hair loss that may be caused by atorvastatin isn't usually permanent. In other words, your hair should grow back after stopping the medication. But it's important to continue taking atorvastatin since its benefits outweigh the risk of this side effect.

If you notice hair thinning or loss while taking atorvastatin, your prescriber can help determine the cause. If needed, they can also suggest ways to lessen or manage hair loss.

12. Chest pain

While muscle pain is most common in the calves and thighs, atorvastatin can cause muscle pain anywhere in the body. While uncommon, there has been at least one reported case of someone taking statins who experienced muscle pain in their chest. In this case, the pain went away after the statin was stopped.

Keep in mind that statins like atorvastatin are often prescribed to lower the risk of major cardiovascular events, such as heart attack. Chest pain from a heart attack often travels down the arms, neck, or jaw. Other symptoms include shortness of breath, sweating, and nausea. Seek immediate medical attention if you think you're having a heart attack.

If you develop chest pain while taking atorvastatin, it's best to go to the nearest ER to be safe. That way, you can receive treatment if it's something serious. If atorvastatin is the cause, your prescriber may lower your dose or have you stop taking it. Don't try to stop it on your own.

13. Headache

Headache may be possible with statins, including atorvastatin. In one study of older adults, about 1 in 3 people taking either atorvastatin or rosuvastatin got a headache. But another study found that statins might lower your risk for a headache if you have adequate vitamin D levels.

If you're experiencing headaches after starting atorvastatin, they may get better over time as you adjust to the medication. You can also speak to your pharmacist or prescriber about taking an over-the-counter headache medication. Staying well hydrated, managing stress, and getting enough exercise may help, too.

When should you contact your healthcare team about atorvastatin side effects?

If any side effects you experience while taking atorvastatin start affecting your daily life, reach out to your healthcare team. In some cases, atorvastatin may not actually be the cause. And your prescriber can help determine the culprit as well as how to address it.

While rare, serious atorvastatin side effects are possible. Dark urine, severe muscle pain, and decreased urination are a few side effects that require medical attention. Seek medical attention right away if any of these develop.

If you're having difficulty tolerating atorvastatin, don't stop taking it on your own. There are several options your prescriber can recommend to help you stick with treatment. Examples include lowering your dose, changing your dose schedule, and switching statins.

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