Millions of Britons take atorvastatin to lower cholesterol and prevent heart attacks and strokes, but a pharmacist has highlighted rare yet severe side effects that require prompt medical attention.
Atorvastatin, widely known by its brand name Lipitor, was taken by more than five million people in 2024, up from 4.2 million the previous year. Up to eight million people in the UK are estimated to take a statin of one form or another.
Pharmacist's advice on side effects
The NHS says that, like all medicines, atorvastatin can cause side effects, although not everyone gets them. Pharmacist Raj Patel, known as Pharmacist Health Raj on social media, echoed this message. He explained that some side effects can be severe, and you need to "report it, review it, then decide what happens with your healthcare professional" if you suffer from them.
However, he added that people need to "keep them in perspective" and, just because you have a medical issue, it does not mean it was caused by atorvastatin. He said: "If you've read the atorvastatin leaflet inside and suddenly worried about all the side-effects listed, for more than 35 years in the pharmacy game, here's how I would take those risks and put them into perspective."
"Most people taking atorvastatin tolerate it well, but side-effects can still happen. Some people report things like headache, nausea, indigestion, diarrhoea, or muscle and joint pain."
When to seek medical help
Mr Patel continued: "Here's the important part - a symptom appearing while taking atorvastatin doesn't automatically prove that the statin caused it. Timing matters, other medicines matter, and other health problems can matter too. If a new symptom is persistent, troublesome, or started after beginning atorvastatin or increasing the dose, speak to your pharmacist or prescriber."
"Here are some symptoms you should take more seriously: Unexplained muscle pain, tenderness, or weakness - particularly if severe or your urine is darker. This needs prompt medical attention. Yellowing of your skin or eyes can be a sign of a severe liver problem. This needs urgent assessment too."
"My pharmacist tip is, don't ignore a possible side-effect, but don't diagnose yourself from the leaflet either. Report it, review it, then decide what happens with your healthcare professional."
Common and serious side effects
The NHS lists common side effects of atorvastatin as headache, dizziness, feeling sick (nausea), digestive problems such as constipation, diarrhoea, indigestion or farting, muscle aches and swollen joints, blocked or runny nose, or nosebleeds, and sleep problems.
More serious side effects are rare, but can include inflammation of the liver (hepatitis), which can cause yellowing of the skin and the whites of the eyes (yellowed skin may be less noticeable on brown or black skin); inflammation of the pancreas (pancreatitis), which can cause severe stomach pain; inflammation and damage to the muscles, which can cause muscle cramps, severe pain and weakness, possibly with a high temperature and red or brown urine; and an allergic reaction (anaphylaxis), with symptoms such as a swollen throat or tongue, a raised itchy rash, or difficulty breathing.
How atorvastatin works
Atorvastatin belongs to a group of medications known as statins, prescribed to help regulate cholesterol and lipids (fats) in the blood. Cholesterol is a fatty substance produced by the liver, used to make hormones, help build new tissue, and play a role in bile production. Blood cholesterol levels can also be affected by diet and lifestyle factors.
There are two types of cholesterol: Low Density Lipoprotein (LDL), known as 'bad' cholesterol, and High Density Lipoprotein (HDL), known as 'good' cholesterol. HDL keeps the heart and circulation healthy and carries LDL back to the liver to be broken down, while LDL can cause hardening of the arteries, which can lead to more serious health conditions if untreated. Atorvastatin helps decrease LDL cholesterol levels and increase HDL cholesterol.
