Warnings
Contraindications
Hypersensitivity to atorvastatin
Active liver disease or unexplained transaminase elevation
Pregnancy, lactation
Cautions
Nonserious and reversible cognitive side effects may occur
Increased blood sugar and glycosylated hemoglobin (HbA1c) levels reported with statin intake
Use with caution in the elderly; risk of myopathy
Heavy alcohol use, renal failure, history of liver disease
Fatal and nonfatal hepatic failure reported (rare)
Risk of rhabdomyolysis
Risk of myopathy: Increased by coadministration with fibrates, niacin, cyclosporine, macrolides, telaprevir, boceprevir, combinations of HIV protease inhibitors (eg, saquinavir plus ritonavir, lopinavir plus ritonavir, tipranavir plus ritonavir, darunavir plus ritonavir, fosamprenavir, and fosamprenavir plus ritonavir), or azole antifungals
Withhold or discontinue treatment in any patient developing myopathy, renal failure, or transaminase levels >3x ULN
Temporary therapy discontinuation recommended for patients with acute surgical or medical conditions, elective major surgery, or serious condition suggestive of a myopathy or risk factor predisposing to development of renal failure secondary to rhabdomyolysis
Rare reports of immune-mediated necrotizing myopathy (IMNM), characterized by increased serum creatine kinase that persists despite discontinuation of statin
Use caution in hepatic impairment, recent stroke
CYP3A4 substrate; avoid grapefruit products and caution with other CYP3A4 inhibitors
Secondary causes of hyperlipidemia should be ruled out before initiating therapy