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DOWNRIVER CARDIOLOGY CONSULTANTS
PATIENT EDUCATION INFORMATION: REGARDING LIPITOR
Lipitor is the most frequently utilized cholesterol-lowering agent. Although there are multiple other
drugs in this category, which are nicknamed “statins” the general consensus is that they all work in a
similar fashion. Some are more potent than others, and the exact dosages are not always equivalent
between them.
Lipitor is started at 10 mg a day. The maximum dose is 80 mg a day. This may be taken with or
without meals and at any time of the day. The goal of Lipitor therapy is to reduce cholesterol and the
more dangerous form of fat called low-density lipoprotein (LDL). In general our recommendation is
to focus on LDL. Cholesterol levels themselves should be utilized only if reliable LDL levels cannot
be obtained. The aim of LDL therapy is the reduction of cardiac events including heart attacks, chest
pain, and death. We are recommending that if you do not have proven coronary artery disease that you
have an LDL below 130 mg%. If coronary artery disease has been proven, then the LDL should be
lower and the goal is 60 mg% to 80 mg%. This difference in goal is the variation between trying to
prevent heart disease and more aggressive therapy if it has already been proven.
The LDL level should be rechecked 2-4 weeks after starting the drug and/or changing the dose. After
the proper dosage has been achieved repeat levels of the LDL and/or cholesterol should be performed
every six months.
Generally Lipitor is well tolerated and less than 2% of patients end up discontinuing the drug because
of adverse reactions. There are some definite warnings about this medication that you need to be
aware of. All drugs in this category have the potential for causing abnormalities in liver function
testing. Abnormalities greater than 3 x the normal levels of these tests occur in less than 1% of the
patients taking the drug.
It is recommended that liver function testing be performed prior to the
institution of Lipitor and at 12 weeks following the start of therapy or change of dose. Following this,
liver function testing should be performed every six months. Active liver disease or excessive alcohol
intake may be a contraindication to taking this drug.
Muscle aches, pains or weakness may be associated with drugs in the statin class. You should notify
your physician promptly if you have any unexplained muscle pain, tenderness or weakness,
particularly if associated by malaise or fever. A blood test (CPK) that indicates muscle inflammation
can be obtained to prove that the medication is indeed causing this discomfort.
The use of a statin with other medications to lower cholesterol such as Niacin or a fibric acid derivative
(Tricor or Lopid) may increase this potential for muscle injury. Particularly when on this combination
of drugs, if you develop any symptoms that are flu like in nature, the medication should be
discontinued temporarily and your physician notified.
Antifungal agents, Erythromycin and
cyclosporin may also increase the effect and blood level of a statin, especially if the drug is used with
other cholesterol lowering medications.
Lipitor therapy should be temporarily withheld or discontinued in any patient with acute indication of
muscle problems such as a severe acute infection, low blood pressure, major surgery, trauma, serious
metabolic, endocrine or electrolyte disorders, and uncontrolled seizures.
DCC, December 2007
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LIPITOR INFORMATION SHEET
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The use of a statin is contraindicated during pregnancy. This medication should not be utilized in women of
childbearing age unless they are highly unlikely to conceive.
LAB
START
1 MONTH
3 MONTHS
9 MONTHS
15 MONTHS
DATE
DATE
DATE
DATE
DATE
LIVER FUNCTION
CHOLESTEROL
LDL
HDL
TRIGLYCERIDES
*This lab work needs to be performed fasting (nothing to eat or drink 12 hours prior to testing). However,
please take all of your medications with a small sip of water.
DCC, December 2007