The NHS has issued guidance for patients taking the commonly prescribed statin atorvastatin, warning of the risk of "serious" side effects if it is taken alongside certain other medications. Atorvastatin is used to lower cholesterol levels in the blood, reducing the risk of heart attacks and strokes. It is often prescribed to patients with high cholesterol, a family history of heart disease, or long-term conditions such as type 1 or type 2 diabetes and rheumatoid arthritis.
Drug Interactions and Cautions
The NHS website stresses that some medicines can affect how atorvastatin works and increase the chance of serious side effects, including muscle damage. Patients must inform their doctor or pharmacist if they are taking any of the following: contraceptive pills (such as the combined pill), antifungals (ketoconazole, voriconazole, fluconazole), warfarin, ciclosporin, some HIV medicines, antibiotics (erythromycin, clarithromycin, rifampicin, fusidic acid), colchicine, verapamil, diltiazem, amlodipine, some hepatitis C medicines, and amiodarone.
If a patient is taking atorvastatin with any of these, the GP may recommend stopping atorvastatin temporarily, prescribing a different statin, or reducing the dose. The NHS notes that this list is not exhaustive, and patients should check the leaflet inside the medicine packet or consult a pharmacist for a full list.
Common Side Effects
Common side effects, occurring in more than 1 in 100 people, include headaches, sore throat, nosebleeds, constipation or flatulence, diarrhoea, nausea or indigestion, and cold-like symptoms such as a runny or blocked nose and sneezing. The NHS advises that drinking a lot of alcohol regularly increases the risk of side effects and liver problems. Patients should talk to their doctor before stopping atorvastatin due to side effects, as the issue may be caused by another problem.
Serious Side Effects Requiring Immediate Action
The NHS warns that patients should stop taking atorvastatin and contact a doctor or call 111 immediately if they experience: unexplained muscle pain, tenderness, weakness or cramps (signs of muscle breakdown and kidney damage); yellowing of the eyes or skin, pale poo, or dark pee (signs of liver problems); a skin rash with pink or red blotches on the palms or soles (possible erythema multiforme); severe stomach pain (possible acute pancreatitis); cough, shortness of breath, and weight loss (possible lung disease); or weakness in arms or legs that worsens after activity, double vision, drooping eyelids, problems swallowing, or shortness of breath (possible myasthenia gravis).
Patients considering St John's wort or CoQ10 supplements should consult their GP or pharmacist first. For further information, visit the NHS website.
