Doctors' Answers to "Frequently Asked Questions" - Lipitor

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Lipitor and Higher Blood Pressure [posted 1/14/99]
Question: I was running high normal blood pressure (140/90) when I began taking Lipitor to reduce cholesterol. The cholesterol has gone down dramatically, but my blood pressure has gone up (165/105). Is there any possible connection between beginning Lipitor and the rise in blood pressure?

Answer: Shouldn't be.

Lipitor [posted 1/13/99]
Question: Please tell me about the drug Lipitor.

Answer: Lipitor is an HMG Co A Reductase Inhibitor. This class of drugs inhibits an enzyme in the liver, which is responsible for cholesterol metabolism in the body. Lipitor currently is the most potent per mg of the class. Side effects are usually pretty minimal, but serial testing of liver enzymes is necessary and occasional patients will have marked muscle inflammation, which necessitates stopping the drug. There is a long list of other minor problems.

Lipitor vs. Zocor [posted 1/13/99]
Question: What are the pros and cons on Lipitor vs. Zocor? Is one preferred over the other?

Answer: They're pretty similar. Lipitor is somewhat more potent mg for mg, but they have similar side effects and lowering of cholesterol. I use them interchangeably.

Lipitor and the sun [posted 1/12/99]
Question: Our pharmacy has printed the we should avoid exposure to the sun when taking lipitor. No where else is this mentioned. Would you reply to this?

Answer: Not usually a concern.

Lipitor and Kidney Stones [posted 1/12/99]
Question: I have been taking Lipitor for three months. I have had a history of kidney stones for years, but recently the stone formation has increased considerably. Could there be a connection between the Lipitor and the formation of kidney stones?

Answer: Wouldn't think so.

Lipitor [posted 1/8/99]
Question: I began taking Lipitor (10 mg/day) for about six months ago for high cholesterol (250). Prior to that I took Gemfibrozil for 2 years. Since starting the Lipitor I have developed very dry skin on my hands which crack and bleed constantly. Also a large patch of dead skin has broken out into a lump in the small of my back. I also take one aspirin and one over the counter multi-vitamin pill each day. I also have a mild case of psoriasis on an elbow. Could the Lipitor be causing the problem with my hands and back?

Answer: Wouldn't think so. Probably the psoriasis, but stopping the Lipitor for a month might answer the question and wouldn't be a big deal.

Lipitor and Muscles [posted 1/7/99]
Question: I have been on Zocor and more recently Lipitor for about 3 years. During that time I have been experiencing joint and muscle aches. Today my blood work indicated the CPK enzyme in the blood. My physician is taking me off the Lipitor and in 3 weeks, I will have my blood re-tested. Does either of these two medications cause arthritis-like pains in the joints, a feeling of "achy" muscles, and a lack of energy? I also take tenormin 50 mg, zoloft 25 mg, ativan 2 mg, and use the inhaler serevent, together with a full regiment of vitamins and minerals. I am a 60 year old male and have been on a low fat diet with exercise program of walking 40+ minutes 6 of 7 days a work.

Answer: All the HMG Co A Reductase drugs can affect muscle inflammation and cause an elevated CPK. This is an indication to stop this class of drugs. However, it does not cause joint pains.

Lipitor and Grapefruit juice[posted 1/6/99]
Question: I read not to take lipitor with grapefruit juice. Is it ok to take with orange Juice? What effect does taking it with grapefruit juice have?

Answer: Grapefruit has a chemical, which blocks certain drugs from being absorbed properly. I have not heard this about Lipitor.

Lipitor and Fertility [posted 1/5/99]
Question:  Is there any reason to think that Lipitor (a cholesterol-lowering drug) could affect sperm count? If so, are other cholesterol-lowering drugs to be preferred?

Answer: No evidence of this.

Possible Side Effect of Lipitor   [posted 12/10/98]
Question:  My husband started taking Lipitor yesterday. Last night he woke up during the night and went into a tantrum-throwing pillows, swearing. He has always been very laid back-I've never seen anything like this from him. Is this possible a side effect of the Lipitor?

Answer: Possibly, but, would be very unusual. Muscle inflammation and liver problems are the most common. But, different people have different reactions. I would check with his doctor.

Lipitor & Alcohol  [posted 12/10/98]
Question:  I am taking the medication lipitor. I want to know if drinking alcohol with this medication is dangerous. I know the medication effects the liver so that is way I am kind of concerned. Also the warning label on the medication states no alcohol while taking this medication. I have not seen anything in the studies of lipitor that indicate any problems with alcohol consumption.

Answer: Both can affect the liver, hence the warning. However, low alcohol intake is probably ok. Keep an eye on your liver, but probably no big deal if you keep it under 2-3 drinks a day.

Lipitor, Dantrium & Liver Function Concerns   [posted 12/08/98]
Question: Should Lipitor and Dantrium be taken together as they both seem to have effects on liver function. The physiotherapist is concerned that the dantrium will reduce the tone in the weak muscles I use as well as the ones with high tone and make physiotherapy difficult. I have chosen not to take the dantrium at the current time because the tone is coming down without medication -- slowly yes. I also take Folic Acid 5 Mg and B12 250 mcg for high homocysteine levels these are prescribed by the cardiologist.

Answer: I think if you monitored the liver function tests, it would be ok. This should be ongoing with the Lipitor in any case.

Concerns about Restarting Lipitor   [posted 12/08/98]
Question: If you are taking Lipitor and monitoring tests show inflammation/damage to the liver is occurring, as you mentioned you should stop taking the drug. My mothers doctor did just this. However if this is occurring why would you then restart taking the drug, wouldn't you just discontinue rather than risk further damage? In her case her cholesterol level dropped but not significantly (approx. drop 20-30). What's the benefit of restarting the drug when you know there is a problem? Are you then experimenting with the patient to find the drug level that least affects the liver but still gives the gain and if so what's considered a fair gain based on the risk( i.e. a gain of a  drop of 80 might be worth it but a drop of 20 isn't?, when your level is 280) .  Do you change the cholesterol level ceiling for using this drug when you encounter this?  Can the liver regenerate an infinite number of times or does it have its limits? After all you only have one so I'm wondering if its worth the russian roulette with it?

Answer: Most elevations of liver functions are not due to the medications but the several hundred other causes of liver inflammation, usually viral or fatty liver. If one experiences elevated liver functions immediately, it is probably the drug. But, if it comes after one is on the drug for awhile, it is probably not the drug. Considering how effective the drug is, it doesn't make sense to stop it-if it is not the culprit. The best option, followed by most physicians, is to stop the drug for a couple of months and see if the liver functions go back to normal. Then restart the drug and follow the liver functions closely. If they again rise, stop the drug. If they do not, continue the drug. Her doctor is doing what most of us would do.

Is Dry Mouth a Lipitor Side Effect   [posted 12/04/98]
Question: Could dry mouth be caused by taking 10 mil of lipitor daily. I also take 400 mil sectral.

Answer: Probably not, but, I do have some patients who experience GI symptoms on lipitor and not on other HMG-CoA Reductase drugs.

  Lipitor & Lactose  [posted 12/04/98]
Question: Our doctor has recommended that my husband take Lipitor instead of  Zocor and suggested looking up the information on the net. His questions have been answered, but mine have not. I have not been able to take any of the cholesterol lowering drugs because they all use lactose as a filler. Does Lipitor have lactose in it? The doctor has tried having me take Cholestid, but the severe side effects were not worth the possible benefits of somewhat lower cholesterol readings. Our doctor has left the decision of taking medication up to me; we are on a  low-fat diet, but that does not affect my cholesterol level nor does most of the other medications.

Answer: I am not aware of lactose being used, but, you might check with the company to get an answer-Parke-Davis 800-223-0432.

Lipitor & Tiredness   [posted 12/02/98]
Question: Can you tell me if fatique and/or being "tired" is a side effect of Lipitor? I've been taking it for about a month. I sleep well at night and get about 7 to 8 hours of sleep a night. Please advise.

Answer: Not usually, check your liver functions and CPK levels if elevated could be the Lipitor.

Lipitor Concerns   [posted 11/25/98]
Question: I was currently told to take Lipitor for cholesterol of 270. I have heard all of the talk of the side effects and liver problems it can cause. I know that while on Lipitor you should be monitored, but can this medication ever cause enough liver damage in the first six weeks that the damage would be irreversible? Thank you for your help.

Answer: Shouldn't if started in small doses.

Lipitor Side Effect Information   [posted 11/24/98]
Question: I am taking lipitor and recently noticed breast enlargement. In searching the literature I can find only limited information on this side effect. My question is how prevalent is this and what, if anything can be done to correct it?  Evidently the manufacturer does not list this in the "side effects" portion of the write up.

Answer: I've had two patients with this problem out of probably 200 women on this or equivalent drugs. I haven't found any way to correct it other than to stop the medication and I have never come up with an adequate explanation of why this should occur, nor does the company know.

Where to go for Lipitor Information   [posted 11/24/98]
Question: I would like to know who to contact, other than my doctor regarding the side effects of lipitor. Thank you

Answer:  The company has a good scientific department-Pfizer 800-438-1985.

Lipitor & Kidney Concerns  [posted 11/17/98]
Question: I have always had very high cholesterol - as it appears to be hereditary. It was as high as 302 and as low as 354. Four months ago it was 386. I used Lipitor for 4 weeks and my cholesterol was lowered to 219! I always have eaten low fat diets and try to exercise regularly. Obviously, the Lipitor worked. My question is: I have only one kidney (Whilmes tumor as a child).I am a 47 year old female. As great as Lipitor has been to lower my cholesterol, is it possible it could cause any kidney damage? How long does a person have to take Lipitor -or is it a lifetime medication? Thank you for any answers regarding this drug - it has worked miracles for me.

Answer: You'll need to take it as long as your cholesterol is high. Weight loss is about the only fix for this problem. Kidney problems don't seem very prominent currently either long or short term.

Lipitor & Miscarriages [posted 11/13/98]
Question: I am a 29 year old female. I was recently told by my doctor that my Cholesterol was 250, and she put me on lipitor 10 mg. A day. She never told me of the risk involved with this drug. Two weeks after I started Taking lipitor I found out I was pregnant. I soon miscarried. Could Lipitor have caused this and shouldn't I have been warned of the side effects.

Answer: Wouldn't expect it too, but, not specifically studied in humans.

Could Lipitor be Causing Joint Pain [posted 11/4/98]
Question: I have a Cholesterol count of 248 and my bad cholesterol level is 130, I'm 59 yr. old female and take 10mg. of Inderal along with .0625 of Premarin, 200mg Vit. E, and Vit. C daily. I have tried several other cholesterol lowering drugs, but have had muscle aching. I started taking Lipitor and after about 3 weeks, experienced joint pain and some muscle pain. After going off of it, I still have joint pain, in knees and hip area. Could the Lipitor be aggravating the joints.

Answer: Not usually the joints, muscle inflammation yes-but, you should see an increase in a lab test called CPK.

General Lipitor Side Effects [posted 11/04/98]
Question: What are the side effects of lipitor?

Answer: Usually very few. Some patients experience GI symptoms and there can be elevation of liver enzymes-these need to be checked by blood tests so that the medication can be stopped if they rise while taking the medication.

Lipitor & Muscles Soreness [posted 11/03/98]
Question: I understand that Lipitor usage sometimes causes muscle soreness, but how does a cholesterol lowering drug interact with muscles? I am feeling a general soreness of the chest and neck muscles.

Answer: Hard to know, but, there should be an elevation of a lab test called CPK if there really is a problem. Have this checked.

Should You Mix Lipitor & Creatine [posted 10/30/98]
Question: I am currently taking Lipitor 10mg a day. My Cholesterol Level is down from 230 to 103 and liver functions look good. I work out about 3 times a week and was wondering if any information is available about taking creatine and/or andro-6 while taking Lipitor. Will they raise my cholesterol level? What about effects on my liver?

Answer:The only way to know is to start them and check your levels closely. However, I'd recommend avoiding them. You should be working on lean muscles not bulk if you want to help your heart.

Can You Consume Alcohol with Lipitor [posted 10/30/98]
Question: Is alcohol consumption while taking this drug OK? At what levels of consumption.

Answer: Moderate levels are ok, understand that alcohol has an effect on cholesterol metabolism and there is clearly an interaction. Also, both drugs can cause liver toxicity, whether they are additive is unclear. However, one or two a day seems clinically ok, higher intakes should be avoided.

Can Lipitor Cause Muscle Tension & Lymph Nodes Problems [posted 10/30/98]
Question: The lymph nodes on my right neck and muscle tension and strain have been quite a problem in the past two months for me. I have been to an ENT specialist and my family doctor and took antibiotics for an infection for 24 days. I still have poofiness in my neck and occasional muscle strain. Could Lipitor which I have been on for about 5 months be causing this?. Everything else seems to be eliminated as a source to my discomfort.

Answer: Shouldn't be;but, stop it for 4 weeks and see what happens. I doubt that you will see a change.

Best Time to Take Lipitor [posted 10/28/98]
Question: Should Lipitor be taken at a specific time of time - with/without food? I have been on Zocor and Pravachol and gotten some small improvements. How long will it take to see if Lipitor has a better effect?

Answer: Lipitor works quickly, so a week or so will tell. Bedtime is the recommended time;but, it probably doesn't matter a lot.

High Gamma-Glutamyl Transpeptidase [posted 10/20/98]
Question: Question: My level of ggtp is 183mg/dl, I was taking Mevacor, 40mg daily total cholesterol 218, ggt 119 switched to Lipitor 10mg daily and after 3 weeks use total at 190. Is there anything that would elevate the ggtp other than alcohol, could any high use of vitamins elevate ggtp.

Answer: The statin drugs certainly can and you should probably have a 30-45 day holiday to see what the effect of a lipitor holiday would be on your liver functions. Also, the next most likely cause is so called "fatty liver" probably an early marker for diabetes.

Myopathy & Malaise, a Lipitor Side Effect? [posted 10/16/98]
Question: Is it common to have side effects with Lipitor/Sortis such as myopathia and malaise? I don't always have these symptoms on a daily basis but I do get them often enough to notice. I am taking 20mg daily along with a glass of Quantalan/Questran 9g at different times of the day so they don't bind.

Answer: About 1% of patients will develop myositis according to the literature. In my experience, it is much less depending on the dosage. Check your CPK and liver enzymes if normal, shouldn't be a problem. If high, you should avoid this medication.

Is Weight Gain a Lipitor Side Effect? [posted 10/13/98]
Question: I am a 27 year old female and am taking Lipitor. In January, my cholesterol was 354. I was not overweight and ate very well. Both of my parents have high cholesterol(my father takes Lipitor, as well). I started out on Lopid, but it only brought my cholesterol down to 280. I have been on Lipitor for 4 months and it is down to 242. However, I have gained 15 pounds and have not changed my eating habits. Is this a side effect?

Answer: Not usually.

Is Breast Pain Related to Lipitor ? [posted 10/8/98]
Question: I recently developed a problem w/ Pericarditis which has the same distinct painful condition in the left breast area discussed above. I pass this on to you because of the similarities to the question posed here on 7/30/98.

Answer: I doubt that the breast pain is the Lipitor. It is possible that you are experiencing GI symptoms that you feel in your left chest-really from your stomach. Secondly, some patients have GI symptoms on Lipitor who do not on Zocor, I'd switch and see if the symptoms persist, or give it a drug trial for 3 weeks and see if the problem persists. It should be gone in about one week if it is the Lipitor.

Lipitor [posted 10/8/98]
Question: I am currently taking the drug, Lipitor, to lower my cholesterol and was wondering if there was any side effects with the drug? One thing that I have noticed is that there is a sore spot on my rectum area. If I stop taking the drug for a week or so, the soreness goes away. It is like a bump that forms making it hard to sit or even use the restroom. Any other related side effects like this reported? This has happened to me twice now, so I am going to discontinue using the drug until further notice concerning this side effect.

Answer: Usual side effects are muscle inflammation(1%), liver inflammation (5%) usually dose dependent, and a host of other problems which are relatively individual. In general, a well tolerated drug. I have had some patients develop constipation. This may be the cause of your peri rectal problem. I'd try Zocor next if Lipitor can't be tolerated. For some reason, patients usually have different reactions even though it is in the same class of drugs.

Concerns about New Study with Lipitor [posted 10/8/98]
Question:I have recently started taking lipitor. A friend copied an article for me which says and I quote "An article published in the JAMA summarized the carcinogenicity studies of cholesterol-lowering drugs and clearly demonstrated that the risk of carcinogenicity for these drugs is far above recently issued FDA guidelines". The article specifically mentions the liver in connection with the carcinogenicity and describes the drugs as extremely carcinogenic. This particularly worries me as I have suffered from cancer. I feel that I need to know as much as possible about the carcinogenic risks from this drug due to my history. Please can you forward any information that you have.

Answer: I don't agree with this. There can be an effect on the liver, but, this is easily monitored. I would check with the scientific department of the company for the drug you are taking. Easily done by your doctor for more specific information. But, I wouldn't be concerned with this-at least at this time-things change with time/research.

When to take Lipitor [posted 10/6/98]
Question:My husband has been taking Lipitor for about 5 weeks. He has developed a red, itchy, rash on both upper arms that comes and goes. Is this a side effect of the medication.

Answer: Possibly, but, would be uncommon. Stop the drug for several weeks and see if the rash disappears. Then restart the Lipitor and see if it returns, this is probably the best test to see if it is responsible.

When to take Lipitor [posted 10/2/98]
Question: The cardiologist recently suggested I cut my Lipitor 20 MG pills in half and increase the amount to 30 MGs a day in order to lower my LDLs. My LDL were about 100. Should I take the 30 MGs all at once or should I take them at different times of the day? Is there a "best" time to take Lipitor to maximize its effects?

Answer: Nighttime is thought to be the best time since cholesterol metabolism rises during the night. Take them all at once.

Lipitor Side Effects [posted 10/2/98]
Question:I have had some side affects while taking lipitor for 8 weeks. During the first week I experienced vivid nightmares, they stopped after the second week. I'm now having a lot of dizziness. I'm taking 10mg. of lipitor. 150 mg. of Zoloft, 25 mg. of Atenolol and 40 mg. of Prilosec daily. I feel I'm on way to many drugs and am very concerned. The dizziness is almost daily. My doctor doesn't seem concerned. Any suggestions please.

Answer: Well, first is the Lipitor responsible for the dizziness? I'd suspect either the zoloft or the atenolol. Get established first which drug is the culprit.

Lipitor [posted 10/2/98]
Question:I have been having increasing muscle pain in my arms and legs, cloudiness in my head and tiredness. I feel it is being caused by the Lipitor. My question is how long after you stop taking the drug can you expect the side effects to go away. Is there a danger if you stop and start this drug? I also take prempro and wondered if the two drugs together could be causing my problems.

Answer: About a week usually, there is no problem in abruptly stopping the drug. Offhand, there should be no interactive problem;however, both are metabolized by the liver-a potential interaction there.

Lipitor [posted 10/2/98]
Question:I have been taking Lipitor for chlolesterol  for 6 months. I have had muscle aches in my calves from the onset. I originally attributed the pain to jogging, but due to an ankle injury, I stopped jogging about 2 months ago. The muscle aches in my calves got worse. I quit Lipitor for a week and the aches subsided. I resumed and the pain returned, even more severe. I now have reduced the dose by 50% and the aches are much reduced. Should I continue with the medication?

Answer: Lipitor and the whole class of HMG CoA Reductase cholesterol lowering agents can inflame muscle in about 1% of patients. You need to check your cpk levels with your doctor. If elevated stop this class of drugs for good.

Lipitor [posted 10/2/98]
Question:My doctor has me on a drug called Lipitor, to decrease my cholesterol, and he recommended that I take it at night, about two hours before retiring, and not to eat or drink anything after I take the drug until I get up the next morning. My question is how long should that be in hours, or do you have a suggestion. He indicated that giving my liver a break after taking the drug would make it work better. I take 10 milligrams a day.

Answer:The lack of food intake is not usually recommended. Also, you should be having regular liver function tests and stop the drug if they become elevated. It is not thought that you need to "give your liver a rest" if there is no elevation of the liver function tests.

Lipitor [posted 10/2/98]
Question: I have read an article that suggested that LIPITOR could be linked to depression.However no source was quoted. Have you heard anything similar?

Answer: No. I have had one or two patients who did experience difficulty concentrating and/or a feeling of being intoxicated.

Lipitor [posted 10/1/98]
Question: I take 10mg lipitor at bedtime. I awake with a stiff neck and sore shoulder muscles in the morning that diminishes as the day goes on. My blood work did not indicate anything unusual. On the few times that I forgot to take it, there was no soreness in the morning. Lipitor has lowered my ldl, but has not had an impact yet on hdl or triglicerides.

Answer: The class of HMG Co A reductase medications can produce muscle inflammation in about 1% of patients. This is a relative contraindication to using the medication. Checking of your CPK levels is usually done to confirm the diagnosis. However, if elevated, I would use a different medication class.

Lipitor [posted 8/14/98]
Question: Does lipitor have any negative effect on men's sexual drive?

Answer: Not a common problem, but it can cause breast enlargement. Hence, it’s clear that it can have some sexual effect in occasional patients.

Lipitor [posted 8/14/98]
Question: I am female, 46, who managed to lower triglycerides and cholesterol to 388 (tris) and 279 cholesterol with diet and herbs. The doctor put me on lipitor about 3 weeks ago and I am tired, cloudy-headed and have developed severe acid reflux. Also I have some elevated liver readings. Would pravachol be better for me?

Answer: They should act about the same in terms of side effects. However, pravachol is somewhat different structurally and may be worth a try. I suspect the liver functions will persist. The other symptoms are probably not the lipitor.

Lipitor and Liver Function [posted 8/11/98]
Question: I am taking lipitor to reduce my LDL cholesterol and increase my HDL. How often should my blood be tested to determine whether the drug is having an adverse impact on my liver function?

Answer: I’d do it at one month, then every 3-4 months for a year and then every 6 months (unless the dosage is increased).

Lipitor and the Liver [posted 8/11/98]
Question: My husband was put on Lipitor 6 months ago due to high cholesterol. He is 37 years old. He had a stroke when he was 32 and a blood clot in the entire right leg vein last year. His doctor put him on this drug treatment due to his past history and family history. His cholesterol was over 340. He was on 10 mg daily for 2 months and his cholesterol level didn't drop much. For the past 4 months he has been on 20 mg daily and he just had a check up and his cholesterol is finally down to 217. However, his blood work showed an increase in an enzyme being released by his liver. He has more blood work done in a week to double check this. What kind of an enzyme is it? What does this mean? Does alcohol consumption play a role in all of this?

Answer: One of the potential tonicities is liver. The test is enzymes produced by the liver which rise when inflammation/damage to the liver occurs. Many things can cause this and if it is only one enzyme, usually not a big deal. However, we usually stop the drug to see if they return to normal and then restart the drug with close monitoring of the liver tests. If numerous enzymes rise and especially if double normal values, more of a potential problem. By the way, there are other familial factors that should have been checked with the clotting. These would include homocysteine levels, Protein S and Protein C deficiency, Antithrombin III levels, Factor V Leyden levels, etc. Lastly would be Lupus anticoagulants. These must be checked in young patients with clots - they can be treated and will occur in sibling/children if not diagnosed. If your physician is not familiar with these see a good Internist or a Hematologist.

Side Effects of Lipitor [posted 8/11/98]
Question: I am concerned with any side effects that the drug Lipitor may cause. Could you inform me of any?

Question: Generally a very well tolerated drug. Occasional patients experience liver inflammation and liver enzymes should be checked a few times a year. Occasional patients will experience muscular inflammation. This is usually almost immediate with taking the drug and is experienced as stiff, sore muscles. CPK levels are elevated and the drug must be immediately discontinued. There is a long list of occasional problems - on the order of 1%, but very unpredictable. Most patients do not know they are taking the drug. Side effects are reversible when stopped.

Lipitor [posted 8/7/98]
Question: I have been taking 10 mg of Lipitor for about 4 months now. My cholesterol level has been recorded as high as 404 untreated. My doctor has prescribed all other cholesterol lowering drugs, Mevacor and Zocor have done the best (80 mg), but he decided that Lipitor would be worth a try as my level was still 246. My good cholesterol vs. the bad cholesterol is close to 136 vs. 110. Should I worry? He wants me to increase my Lipitor to 20 mg a day. I have been experiencing stomach pain, nausea and light-headedness (more recently) and flatulence also. I was wondering if the light-headedness could be related to Lipitor? My triglyicerides are very low prior to treatment, about 45. I also take estrogen daily and Zestril for high blood pressure (5 mg a day). What other enzymes does Lipitor effect while preventing the production of cholesterol by the liver? I was wondering how or what this does to my body?

Answer: It is supposed to affect only one enzyme and works in a very similar way to Zocor and Mevacor. Generally, there are few differences. However, I have a couple of patients who are ok on Zocor, but cannot take Lipitor - nausea primarily. I suspect the only way you will know is to stop it for 3-4 weeks and see if the symptoms abate, then restart the drug and see if they return. There is no specific advantage of Lipitor over Zocor except that it is somewhat more specific in inhibiting the liver enzyme responsible for cholesterol metabolism.

Lipitor [posted 8/7/98]
Question: What are the side effects of lipitor?

Answer: Lipitor is a newer cholesterol lowering agent. Like most drugs there is a large list of potential problems. However, in general there are very few problems with the class of HMG CoA Reductase Inhibitors and Lipitor in particular. This is because it inhibits one specific enzyme in the liver responsible for cholesterol metabolism. Regular blood checks should be done to look for elevated liver enzymes and the drug stopped if this occurs. Occasional patients have inflamed muscles the major symptom being pain, soreness, etc. This is also a contraindication to taking the drug. Occasional patients have isolated problems here and there, but in general it is a very safe, tolerated drug.

Lipitor and Niacin [posted 7/31/98]
Question: I had a follow-up blood cholesterol/triglyceride test done in January 1998 and the results were no improvement over results of testing done last September. My physician had prescribed my taking 81 mg aspirin daily, along with Niacin (100 mg), doing some dieting and getting more exercise. I am 44, weigh 180-185, and stand at 5"10". My last blood test showed my Triglycerides were at 461mg/dl and Cholesterol at 251 mg/dl. My father died from a heart attack at age 48 back in 1970, and his father had died from a heart attack at age 56 back in 1945. There is definitely a risk factor in the male blood line on my father's side. I decided to supplement my pill taking with a few more vitamins - Vitamin C with Rose Hips (1000 mg), Zinc (50 mg) and every third day, Vitamin E (400 IU USP). Now that I have been given a prescription for Lipitor (10 mg), my physician says that the Niacin supplement has to be stopped, and the drug interaction section of the pharmacists letter specifically mentions Niacin (nicotinic acid) as something my physician needs to know about. What are the contraindications for use of Lipitor with Niacin? Can I use a regular vitamin supplement which contains only 100% of daily recommended dosage versus the 500% I was taking? Should I discontinue taking any of these other vitamins - or avoid any other over-the counter medications while taking Lipitor?

Answer: Both work in the liver and there can be liver toxicity in taking both. It can be done, but needs to have close observation of liver functions and is rarely done by physicians unless the Lipitor is insufficient alone. With your cholesterol this will not be the case, stop any oral Niacin. The Vitamin C and Vitamin E are ok, same with the zinc. No problem with most over the counter medications, just niacin.

Lipitor & Breast Pain: Any Relation? [posted 7/30/98]
Question: My doctor prescribed Lipitor to reduce my cholesterol and I have been taking it for about 2.5 months. It has caused a pain in my upper left breast area ever since I started it. My doctor checked my liver enzymes and they were fine. However, the pain has progressed to the point I can no longer take the drug. I also have a lot of gastric and digestive symptoms. I was curious if others had experienced these symptoms on lipitor?

Answer: Very unusual - if it is affecting your breasts why not both? Stop it for a trial. Off hand I don't have any great ideas.

Lipitor's Effect on Sexual Desire [posted 7/30/98]
Question: Does this drug have any effect on sexual desires?

Answer: Usually has no effect.

Lipitor Side Effects [posted 7/30/98]
Question: Can a possible side effect of Lipitor be muscle pain and joint pain?

Answer: Muscle pain yes, Joint pain rarely.

Reactions to Lipitor [posted 7/27/98]
Question: I just started taking lipitor. I take it during the daytime and it makes me real nervous. I also have to also urinate every 30 minutes or so. Are these common reactions to Lipitor? Also, does taking lipitor cause long term damage to the kidneys, liver, etc.?

Answer: Very uncommon, especially the urinary frequency. Does it stop if you stop the medication? Long term there should be no damage if occasional tests are done. This class of drugs necessitates occasional liver function tests. Yearly, renal function would be appropriate.

Rash, Lipitor and Lamisil [posted 7/24/98]
Question: I have been taking both Lipitor and Lamisil for 3 and one half weeks. I developed a rash that forms scratch marks and red streaks and then an itchy rash that disappears in about 30 minutes only to reappear later. I discontinued the Lamisil after the doctor visit a week ago, but I still have the condition. Could I be having a reaction to the Lipitor?

Answer: Hard to know, both of these drugs potentially affect the liver. Have you had liver function tests? I'd stop both, and restart the lipitor after the problem is completely gone a month or so. If it goes then assume it is the lamisil or the interaction of the two.

Lipitor and hair loss
Question: I was taking provacal and it caused my hair to thin out. Is there any such side effect with lipitor?

Answer: I don't know why you should have this symptom with pravachol, but lipitor is similar although a structurally different drug. I guess I'd stop the drug and see if the thinning stops prior to starting a new drug. Are you taking any other drugs? Beta blockers are notorious for thinning of hair.

High Triglycerides
Question: My cardiologist suggested Lipitor because my triglycerides are high(442) and my HDL is low(27). I have been on Mevacor which has been controlling my total cholesterol(166) and LDL. I have read about Niacin, which might help this situation, and have been taking 500mg daily. My cardiologist said that the Lipitor hasn’t been approved in this country, so I was concerned. Should I try the Niacin or consider the Lipitor?

Answer: Lipitor is the first HMG-Co A Inhibitor to have an effect on triglycerides. This is due to the high affinity for lipitor to the enzyme that it is inhibiting. Lipitor will be released at the end of this month. I'd try it first. Also, triglycerides have a minimal effect (if any) on increasing cardiac risk. I think they are useful to decrease, but they are a minor player compared to cholesterol. Lipitor has the potential to be the best of the HMG-Co A drugs.

Question: Do you have any data on Lipitor (Atorvastatin)?

Answer: Lipitor(Atorvastatin) is the newest HMG Co-A drug. This is a class of drugs that works on the enzyme in the liver responsible for " turning on" cholesterol production. About 80% or so of cholesterol is produced by your liver. Reducing the liver’s production will decrease cholesterol. Lipitor seems to be more effective and efficient than its predecessors. It also is the first HMG Co-A which is approved by the FDA to reduce triglyceride levels, a major improvement. Side effects seem to be the same as for the other drugs in this class. However, like most drugs, time may change out opinion. The drug has only been out 2 to 3 months here in the U.S. and the U.S. is much more critical and observant of drug performance than other countries where it has already been tried. My personal opinion is that it is a major advance compared to other drugs of its class. The company has also been smart and priced it to be competitive with Zocor, the previous best HMG Co-A.

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