Side Effects of atorvastatin: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Atorvastatin is a widely used medication to lower cholesterol levels. Studies have shown that atorvastatin is effective in reducing the risk of heart disease. 4 However, it has been reported that atorvastatin can cause side effects such as muscle pain and weakness. 21 Atorvastatin can rarely cause serious side effects such as hepatitis. 5 It has also been shown that atorvastatin can affect male reproductive ability. 14

Reasons for Side Effects

Atorvastatin works by inhibiting the enzyme (HMG-CoA reductase) involved in cholesterol synthesis. 14 This enzyme plays an important role in tissues such as muscles and liver. Inhibition of this enzyme in these tissues by atorvastatin can cause side effects such as muscle pain and weakness, hepatitis.

Common Side Effects

Muscle pain and weakness

Atorvastatin can cause side effects such as muscle pain and weakness. 21 This is thought to be due to the inhibition of HMG-CoA reductase in muscle tissue. 14 These side effects are usually mild and improve when atorvastatin is stopped. 7 However, in rare cases, it can cause muscle inflammation and necrosis. 6

Liver abnormalities

Atorvastatin can cause liver abnormalities. 5 This is thought to be due to the inhibition of HMG-CoA reductase in liver tissue. 14 These side effects are usually mild and improve when atorvastatin is stopped. 7 However, in rare cases, it can cause serious side effects such as hepatitis. 5

Gastrointestinal symptoms

Atorvastatin can cause gastrointestinal symptoms (e.g. constipation, diarrhea, abdominal pain). 22 These side effects are usually mild and improve when atorvastatin is stopped. 7

Headache

Atorvastatin can cause headaches. 22 These side effects are usually mild and improve when atorvastatin is stopped. 7

Diplopia

Atorvastatin can cause diplopia, which is a condition that causes double vision. 2 This is a rare side effect, but it has been reported in some cases. 2

Other side effects

In addition to muscle pain and weakness, liver abnormalities, gastrointestinal symptoms, and headaches, atorvastatin can cause side effects such as rash, itching, dizziness, and fatigue. 7

Countermeasures for Side Effects

Muscle pain and weakness

If you experience muscle pain or weakness, stop taking atorvastatin and consult your doctor. 21 Your doctor will determine the cause of the muscle pain or weakness and prescribe appropriate treatment. 7

Liver abnormalities

If you suspect liver abnormalities, stop taking atorvastatin and consult your doctor. 5 Your doctor will perform blood tests, etc. to check for liver abnormalities. 7 If liver abnormalities are confirmed, you will need to stop taking atorvastatin and receive appropriate treatment. 7

Gastrointestinal symptoms

If you are concerned about gastrointestinal symptoms, consult your doctor. 22 Your doctor will determine the cause of the symptoms and prescribe appropriate treatment. 7

Headache

If you are concerned about headaches, consult your doctor. 22 Your doctor will determine the cause of the headache and prescribe appropriate treatment. 7

Other side effects

If you are concerned about other side effects, consult your doctor. 7 Your doctor will determine the cause of the side effects and prescribe appropriate treatment. 7

Comparison between Studies

Commonalities in Studies

Many studies have shown that atorvastatin is effective in reducing the risk of heart disease. 4 Also, many studies have shown that atorvastatin can cause side effects such as muscle pain and weakness. 21

Differences in Studies

The incidence and severity of atorvastatin side effects vary depending on the study. 21 This is thought to be due to differences in study subjects and methods. 14

Points to Note Regarding Application to Real Life

Atorvastatin is an effective drug for reducing the risk of heart disease, but it can cause side effects such as muscle pain and weakness. 21 If you are taking atorvastatin, you should discuss the risks of side effects with your doctor and take the medication carefully. 7

Limitations of Current Research

There is still not enough research on the side effects of atorvastatin. 14 In particular, there is still not enough research on the effects of atorvastatin on male reproductive ability. 14

Future Research Directions Needed

Further research on the side effects of atorvastatin is needed. 14 In particular, more research is needed on the effects of atorvastatin on male reproductive ability. 14 Also, the development of new treatments to reduce the side effects of atorvastatin is needed. 14

Conclusion

Atorvastatin is an effective drug for reducing the risk of heart disease, but it can cause side effects such as muscle pain and weakness. 21 If you are taking atorvastatin, you should discuss the risks of side effects with your doctor and take the medication carefully. 7

Keywords
Benefit Keywords
Cardiovascular disease prevention
1
Cardiovascular disease treatment
2
Optimized atorvastatin dosage
Reduced LDL-C
4
DIAIH diagnosis
DIAIH management
5
Lower cholesterol
Lower triglycerides
6
Treats COVID-19
7
Cardiovascular benefit
8
Improved mitochondrial function
Potential biomarker of treatment response
9
Reduced DDI-related ADEs
Transplant patient care
10
Improved drug absorption
Lowered lipid levels
11
Plaque stabilization
Stenosis reduction
12
LDL-C reduction
13
Anti-inflammatory effects
Cardioprotective effects
14
Anti-cancer properties
Prevention of carcinogenesis
Reduction of cardiovascular disease
15
CKD management
16
CV benefits
Lipid lowering
Well-tolerated
17
Hypercholesterolemia treatment
18
Genetic testing
Precision therapeutics
Statin efficacy
21
Drug-drug interaction management
Pharmacogenomic analysis
22
SAMS risk identification
23
Drug safety assessment
24
Atorvastatin treatment
25
Risk Keywords
Muscle pain
Muscle weakness
1
Diplopia
Statin-induced myopathy
2
Statin-associated muscle symptoms
3
Variable LDL-C response
4
DIAIH development
5
Diarrhea
Headache
Myalgia
Nausea
Statin-induced IMNM
6
INR prolongation
7
Motor impairment
Muscle pain
8
Statin-induced side effects
9
Hypertension
Nephrotoxicity
10
Side effects
13
Altered semen parameters
Erectile dysfunction
Modified steroid hormone production
Testicular discomfort
14
Drug-drug interaction
Side effects
16
Myopathy
Side effects
17
Gastrointestinal symptoms
Liver disease
Muscle symptoms
Neurological symptoms
19
Atorvastatin discontinuation
Statin-associated musculoskeletal symptoms
20
Statin intolerance
21
ADRs
Drug-drug interactions
Multi-organ toxicity
22
Atorvastatin accumulation
Muscle complaints
25
Literature analysis of 25 papers
Positive Content
20
Neutral Content
2
Negative Content
3
Article Type
3
0
0
3
22
1.

Study protocol for statin web-based investigation of side effects (StatinWISE): a series of randomised controlled N-of-1 trials comparing atorvastatin and placebo in UK primary care.

Author: HerrettEmily, WilliamsonElizabeth, BeaumontDanielle, ProwseDanielle, YoussoufNabila, BrackKieran, ArmitageJane, GoldacreBen, MacDonaldThomas, StaaTjeerd van, RobertsIan, Shakur-StillHaleema, SmeethLiam

Cardiovascular disease prevention
Muscle pain
Muscle weakness

N-of-1 trials are a valuable tool to investigate the relationship between statins and muscle symptoms in individual patients. They can help determine whether muscle symptoms experienced during statin use are caused by the medication or other factors.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

A Rare Case of Statin-Induced Diplopia: An Often-Overlooked but Reported Side Effect.

Author: AbdelmasihRanda, AbdelmaseihRamy, ReedJustin

Cardiovascular disease treatment
Diplopia
Statin-induced myopathy

This report presents a rare case of statin-induced diplopia in a patient who had been on atorvastatin therapy for years.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

3.

Clinical and psychological factors in coronary heart disease patients with statin associated muscle side-effects.

Author: PeersenKari, MunkhaugenJohn, SverreElise, KristiansenOscar, FagerlandMorten, VetheNils Tore, PerkJoep, HusebyeEinar, DammenToril

Statin-associated muscle symptoms

Patients with confirmed statin-associated muscle symptoms (SAMS) are more likely to present with bilateral lower extremity muscle symptoms compared to those with refuted SAMS. However, psychological factors were not found to be associated with self-perceived SAMS or confirmed SAMS. Careful pain history and evaluation for alternative causes of muscle symptoms may reduce statin discontinuation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Plasma concentration of atorvastatin metabolites correlates with low-density lipoprotein cholesterol reduction in patients with coronary heart disease.

Author: SverreE, MunkhaugenJ, KristiansenO, Weedon-FekjaerH, PeersenK, GjertsenE, GullestadL, BerganS, HusebyeE, VetheN T

Optimized atorvastatin dosage
Reduced LDL-C
Variable LDL-C response

This study investigated the relationship between atorvastatin metabolite plasma concentrations and LDL-C reduction in patients with coronary heart disease who experienced muscular side effects from statins. A moderate correlation was observed between the sum of 4-OH-atorvastatin acid and lactone and LDL-C reduction. The findings suggest that monitoring atorvastatin metabolite concentrations may be helpful in optimizing individual dosage for patients experiencing side effects.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Atorvastatin-Induced Autoimmune Hepatitis: A Case Report.

Author: TseJonathan, NatlaSam, MekalaRohit, CrummIan, OlkenMelissa H

DIAIH diagnosis
DIAIH management
DIAIH development

This case report describes a patient who developed drug-induced autoimmune hepatitis (DIAIH) due to atorvastatin, highlighting the diagnostic approach and management strategies for this condition.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

6.

Statin Induced Immune Mediated Necrotizing Myopathy: More Than Just Sore Muscles.

Author: NewtonJazmin, SimmonsMatthew

Lower cholesterol
Lower triglycerides
Diarrhea
Headache
Myalgia
Nausea
Statin-induced IMNM

This case report describes a 66-year-old man who developed statin-induced immune-mediated necrotizing myopathy (IMNM) after starting atorvastatin. It reviews the laboratory findings, imaging, and treatment strategy for this rare but potentially serious side effect of statins.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

7.

[Significant Prolongation of the International Normalized Ratio Associated with COVID-19 Treatment: Possible Drug Interaction with Remdesivir].

Author: IshiiHidetoshi, YokotaNorio, BandoYuki, OtoriKatsuya

Treats COVID-19
INR prolongation

This case report discussed the potential for drug interactions between remdesivir (RDV), dexamethasone (DXM), and warfarin (WF) in a patient with COVID-19 and hypertrophic cardiomyopathy. It highlighted the importance of close monitoring of INR levels when co-administering these medications.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Japanese

10.

Real clinical impact of drug-drug interactions of immunosuppressants in transplant patients.

Author: Gago-SánchezAna Isabel, FontPilar, CárdenasManuel, AumenteMaría Dolores, Del PradoJosé Ramón, CallejaMiguel Ángel

Reduced DDI-related ADEs
Transplant patient care
Hypertension
Nephrotoxicity

Real drug-drug interactions (DDIs) between immunosuppressants are prevalent in transplant patients, leading to adverse drug events. This highlights the importance of careful monitoring and management of DDI risks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

12.

PCSK9 inhibition in patients with acute stroke and symptomatic intracranial atherosclerosis: protocol for a prospective, randomised, open-label, blinded end-point trial with vessel-wall MR imaging.

Author: HuangYen-Chu, ChangChia-Hao, TsaiYuan-Hsiung, WengHsu-Huei, LinLeng-Chieh, LeeJiann-Der

Plaque stabilization
Stenosis reduction

Dual antiplatelet therapy and high-intensity statins are the mainstay treatment for symptomatic intracranial atherosclerotic stenosis (ICAS). Alirocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 and effectively lowers low-density lipoprotein cholesterol levels. This study hypothesizes that alirocumab treatment in addition to statin therapy could stabilize intracranial plaque and reduce arterial stenosis.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Statins and Male Fertility: Is There a Cause for Concern?

Author: OmolaoyeTemidayo S, HalabiMouhammad Omar, MubarakMaitha, CyrilAsha Caroline, DuvuruRuthwik, RadhakrishnanRajan, Du PlessisStefan S

Anti-inflammatory effects
Cardioprotective effects
Altered semen parameters
Erectile dysfunction
Modified steroid hormone production
Testicular discomfort

This review explores the contradictory findings on the effects of statins on male sexual health and reproductive parameters. While some studies suggest negative effects on fertility due to altered steroid hormone production, others suggest potential benefits from statins' anti-inflammatory properties.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Understanding Statin-Roxadustat Drug-Drug-Disease Interaction Using Physiologically-Based Pharmacokinetic Modeling.

Author: DongJin, Prieto GarciaLuna, HuangYingbo, TangWeifeng, LundahlAnna, ElebringMarie, AhlströmChristine, VildhedeAnna, SjögrenErik, NågårdMats

CKD management
Drug-drug interaction
Side effects

This study used physiologically-based pharmacokinetic (PBPK) modeling to understand the impact of severe chronic kidney disease on statin pharmacokinetics and drug-drug interactions. PBPK models were used to predict statin-roxadustat DDI risks in patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Adverse drug reactions of statin therapy in China from 1989 to 2019: a national database analysis.

Author: TsuiLeo, YePeiying, XuShiling, LinYuan, ChenBin, ChenSy-Ping, ChengRuoh-Yi

Gastrointestinal symptoms
Liver disease
Muscle symptoms
Neurological symptoms

Gastrointestinal symptoms were the most common ADR of statin use in Chinese clinical trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Drug-drug-gene interactions as mediators of adverse drug reactions to diclofenac and statins: a case report and literature review.

Author: BožinaNada, GanociLana, SimičevićLivija, GvozdanovićKatarina, DomjanovićIva Klarica, Fistrek PrlićMargareta, KrižTena, Borić BilušićAna, LaganovićMario, BožinaTamara

Drug-drug interaction management
Pharmacogenomic analysis
ADRs
Drug-drug interactions
Multi-organ toxicity

This case report highlights the potential for drug-drug-gene interactions to cause adverse drug reactions (ADRs) in a patient treated with multiple medications, including statins and NSAIDs. The case demonstrates the importance of pharmacogenomic analysis in personalized medicine, as it can help predict and prevent ADRs.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Genetic polymorphisms in ABCB1 are correlated with the increased risk of atorvastatin-induced muscle side effects: a cross-sectional study.

Author: LalatovićNinoslava, ŽdralevićMaša, AntunovićTanja, PantovićSnežana

SAMS risk identification

This study found a significant association between specific polymorphisms in the ABCB1 gene, which encodes the efflux transporter of statins, and statin-associated muscle symptoms (SAMS). Genotyping for these polymorphisms may help identify patients at higher risk of developing SAMS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Genetic Polymorphisms in SLCO2B1 and ABCC1 Conjointly Modulate Atorvastatin Intracellular Accumulation in HEK293 Recombinant Cell Lines.

Author: HosteEmilia, PaquotAdrien, PaninNadtha, HorionShaleena, El HamdaouiHalima, MuccioliGiulio G, HaufroidVincent, ElensLaure

Atorvastatin treatment
Atorvastatin accumulation
Muscle complaints

Transporters expressed in muscle tissue play a role in the accumulation of atorvastatin (ATV), which can lead to muscle complaints. Common genetic variations in transporter genes may influence the risk of these side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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