Have you recently been diagnosed with high cholesterol?
Is your doctor recommending that you take atorvastatin but you are concerned about the
possible side effects?
Or even more, you are concerned about all that you have been reading on the internet
about it.
If so, then this video is for you.
Keep watching to get a doctor's perspective on what to expect from this medication.
Welcome back to FamilyMed, If you are new here, I'm Dr. Erik Richardson a board certified
Family Practice physician.
On our channel we focus on trying to give you practical and accurate medical information
to help you and your family make healthy decisions.
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hit that notification button and follow along with us.
On today's episode we are going to be talking about one of the most common medications that
we use to treat high cholesterol called atorvastatin.
This is a medication that has been available in the United States since 1996.
It was originally released under the trade name of Lipitor.
Luckily, its gone generic so atorvastatin is the more common name used now.
The principle use of this medication is to help control cholesterol as well as decrease
your risk of heart attacks and stroke in diabetes or decrease your risk of a second heart attack
or stroke if you've already had one.
Atorvastatin belongs to the class of medications called HMG CoA reductase inhibitors or more
commonly referred to as Statins.
They work by inhibiting a part of an enzyme process which your body uses in the production
of cholesterol.
When you stop that process, you produce less cholesterol, so your levels go down.
That's the basic thought on how this works, but it is a lot more complex than that, and
frankly the whole processes isn't completely understood.
It's felt though, that atorvastatin specifically and the Statin medications in general, work
on the blood vessels to help stabilize plaques that can form.
If these plaques get large enough, they can either block the blood vessels or can become
weak and rupture causing an acute heart attack or stroke.
There is some thought as well, that it acts as somewhat of an anti-inflammatory on the
inside of the blood vessels and maybe even decreases the ability to form clots in these
areas.
There is a lot of discussion out there in regards to the effect that cholesterol has
in relation to heart disease and stroke.
I don't want to get into all the arguments either way with this because frankly it's
a changing topic.
What we do know , is that several very large , well designed studies showed that elevated
cholesterol does increase your risk of having a heart attack or stroke.
And going a long with that, taking the statin medications significantly decreased your risk
of those same events in those who took them.
More definitively shown, were those who have a prior history of a heart attack or stroke
or those who have diabetes, were shown to absolutely benefit from taking these medications.
This is probably one of the major reasons your doctor has recommended that you take
this.
So again, I don't want to get into the debate of whether you should be on this or not.
I'm assuming that since you watching this, your doctor has recommended you take it, so
we are going to go on the assumption that it is important for you to be on it.
Also, in this video, I'm not going to be going over the most important things you can be
doing, and that is making those diet and lifestyle changes that will make the biggest difference.
We'll get into that in a future video.
In this video we are going to help you understand what to expect with this medication and what
kind of side effects you need to watch out for.
Well, first of all it comes in a tablet of 10, 20, 40 and 80mg.
It is meant to be taken once a day with the top effective dose of 80mg.
Most cholesterol synthesis happens at night so it has been found to be most effective
to take it in the evening.
An important thing to remember about this medication specifically, and cholesterol medications
in general, is that it only works while you are taking it.
I have people come in all the time with their cholesterol high after we originally had it
controlled telling me that they stopped the medicine because we fixed it.
Unfortunately, this isn't the way it works.
Unless you have some underlying lifestyle issues that are causing your high cholesterol
and you fix those, you need to stay on the medication.
Don't stop them unless you discuss it with your doctor.
Atorvastatin is one of my favorite cholesterol medications because it usually is very well
tolerated.
It's rare the patient that I have that stops it because of any significant side effects.
That being said, any medication has a potential for side effects and atorvastatin is no different.
Just like any other medication that you take.
If you look at the package insert where they list the different side effects, you will
read a long list.
For atorvastatin, they list symptoms such as upper respiratory infection, headaches,
joint pains, diarrhea, urinary tract infection, nausea, heartburn, insomnia and some mild
liver enzyme elevations.
I would say that these are fairly uncommon in general, but certainly possible.
In my experience, as well as what we have seen in the studies, the most common reason
that we see people not tolerate being on atorvastatin is because of some sort of muscle pain symptoms.
These can be a feeling of muscle aches, similar to what you may feel when you get sick with
the flu, muscle cramps or weakness.
This still is not common, but if there is something that is going to bother a patient,
this is the most common one that we see.
In general, this doesn't mean that any significant issues are going on or any damage is being
done.
There is a problem with this that I'll talk about in a minute but Usually, all we usually
do is just have you stop the medication and the symptoms go away.
Often times, after the symptoms are gone, if it is really felt to be necessary that
you are on this type of medication, we will switch you to a different medication in this
same class and oftentimes you won't have the same problem.
There are some people though that just can't tolerate taking any of them so it's not worth
it for them to be on it.
If you are having these types of symptoms make sure you work with your doctor to find
out what is best for you.
Now, there are other things that you need to be aware of with this medication.
There are some more rare side effects that you should watch out for.
The first one is a condition that is called Rhabdomyolysis.
This is a condition where you get a breakdown of the muscles that sends byproducts to the
kidneys causing kidney damage or even failure.
This is very uncommon.
One of the first medications years ago called Baycol was pulled from the market for this
reason back in 2001.
This is not common at all.
In fact, I haven't seen or even heard of cases around me happening with the newer medications
but it still is something that is possible.
If you have severe muscle pains while taking this medication, then get into your doctor
to get some blood work and have this evaluated.
Other more serious reactions can include liver toxicity, allergic reactions, pancreatitis,
changes to your blood counts including certain anemias and decreased white blood cell productions.
These aren't common but can be monitored by your doctor while you take this medication.
There are some conditions that we need to talk about that being on these medications
for long term use can possibly put you at risk for.
There have been some concerns regarding use of statins and its effect on memory and dementia.
There have been reports of memory changes while being on this medication as well as
others in the same class.
Larger studies looking at this, haven't found a significant correlation between the two,
but it doesn't mean that it can't happen.
If you notice memory changes upon starting this medication, it would be worth talking
to your doctor about it.
Some have seen that this may be more common in medications fat bound medications like
atorvastatin and simvastatin.
Switching to one of the more water bound statins like rosuvastatin or pravastatin may be helpful.
This is definitely a discussion you should have with your doctor if you notice any issues.
Studies looking at their effect on dementia have actually shown some role in the prevention
of it happening.
Another area that needs to be discussed is the risk that statin's may play in the development
of diabetes.
Large studies looking at this have shown that there may be a small increased risk of developing
diabetes while taking these types of medications.
This risk appears to increase the higher the dose that you are taking.
The risk is small, but certainly something to keep in mind.
Overall though, when compared to the benefit that was found by taking it, for those felt
to be higher risk for heart disease, it is felt to be worth the risk.
This definitely is an individual decision that you need to discuss with your doctor
on how this may apply to you.
When you look at side effects and risks of medications, it's easy to get worried and
not want to take it due to the possibility of something that could happen.
And in actuality, this may be the right thing for you.
It's important though when making these decisions to step back and look at the big picture.
You have to look at your own individual risks and see why this may be important for you.
If you have already had a heart attack, a stroke or you have diabetes the data is very
clear that being on these medications, if you can tolerate them well, is definitely
worth the small risks of problems.
If you have not had any of these problems and your doctor is recommending you take this
for what we call primary prevention of heart disease, then talk to them about why they
think you are at higher risk.
Look at what your risk factors are and talk to your doctor about how you can change those
risk factors.
If you smoke, quit smoking, if you have a horrible diet and aren't exercising then make
the commitment to make those changes.
You can't say that you don't want to take a medication that has known benefits because
you think it's going to "kill you" and still continue to eat garbage, not exercise and
smoke.
Overall this is a great medication to treat your cholesterol and decrease your risk of
heart attack in stroke.
I use it a lot because as I said before, the side effects tend to be minimal, it has great
studies showing that it works, and finally it's pretty cheap.
Luckily its generic and you can get it for a good price.
In fact a 30 day supply will run you from 8-15 dollars at most pharmacies.
If diet and lifestyle changes have not been enough to control your cholesterol and your
doctor recommends that you take atorvastatin as part of your treatment regimen, hopefully
you have a little more confidence in using this as a part of your treatment plan.
Well, I hope found this information to be helpful.
If so, do me a favor, go ahead hit that like button and share it with your friends and
family.
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button so you don't miss out on any of our other content.
Now don't go anywhere, because if you are looking at ways that you can make that start
in your diet and lifestyle changes to treat your cholesterol, click here to watch simple
steps you can take to start your diet journey.
And click here to watch one of my other videos that can help in your health journey.
Well, until next time, this is FamilyMed with Dr. Richardson, and remember, take care of
your body because it's the only one you have.