The short answer:
Lipitor is a well-tolerated cholesterol-lowering agent with good safety and efficacy profiles even for long-term treatments. However, rare and serious side effects may be associated with the long-term treatment with Lipitor such as elevated liver enzymes, increased risk of kidney damage, and increased risk of developing type 2 diabetes mellitus, and may lead to impaired congestive functions. Despite the associated side effects with long-term treatment with Lipitor, however, the benefits outweigh this risk.
Key facts:
- Lipitor is a cholesterol-lowering agent with good safety and efficacy profiles. It is well-tolerated even for long-term treatments
- Long-term treatment with Lipitor is associated with serious side effects, However, it is rarely to occur.
- The long-term treatment with Lipitor may be associated with elevated liver enzymes.
- Elevated creatine phosphokinase is also a rarely reported side effect of long-term therapy of atorvastatin.
- The treatments with highly potent statins for the long term are associated with an elevated risk of acute renal failure compared with low-potency statins.
- Atorvastatin therapy is associated with an increased risk of type 2 diabetes mellitus.
- Long-term treatments with atorvastatin result in cognitive function impairments.
Content:
Benefits of long-term treatments with Lipitor
Side effects of long-term treatments with Lipitor
Long-term uses of Lipitor
Lipitor is commonly prescribed for long-term uses to lower blood cholesterol levels. It has great benefits for those at high risk of coronary heart disease with a good safety profile.
Benefits of long-term uses of statin
- Reduction in mortality (24% to 42%) for patients with coronary artery diseases.
- The long-term treatment of patients with coronary heart disease with atorvastatin significantly reduces coronary mortality, coronary morbidity, and stroke (Ref).
- Provide protection against heart attack and stroke in patients with diabetes mellitus.
- Long-term treatments with statins reduce the incidence of Alzheimer’s disease and other dementias (Ref).
A study investigated the efficacy and safety of long-term uses of atorvastatin 40 mg in patients with dysbetalipoproteinemia and severe combined dyslipidemia. Results showed that:
- After 40 weeks of 40 mg atorvastatin treatment, the total cholesterol, triglycerides, and apolipoprotein B decreased by 40%, 43%, and 41%, respectively in the combined dyslipidemia group.
- In patients with dysbetalipoproteinemia total cholesterol, triglycerides, and apolipoprotein B decreased by 46%, 40%, and 43% respectively.
- The authors reported that the long-term treatment with atorvastatin (40 mg for 40 weeks) was well tolerated and no serious side effects were reported.
long term side effects of Lipitor
Lipitor (atorvastatin) is commonly used in the long term to lower blood cholesterol levels.
The difference in physicochemical and pharmacokinetic properties between statin members may translate into significant differences in long-term safety.
In 2001, the withdrawal of cerivastatin from the global market, due to the severe cases of rhabdomyolysis, highlighted concerns regarding the safety profile of all statin members (Ref).
The long-term usage of Lipitor could be associated with serious side effects, however, such side effects are rare to occur.
These side effects include the following:
Elevated liver enzymes and increased risk of liver damage
Lipitor could increase your liver enzymes which may indicate damage to liver tissue. It is a rare but possibly serious side effect of long-term treatments with Lipitor.
This may be associated with symptoms such as jaundice (yellow skin and eyes), belly pain, and nausea with vomiting.
An old study investigated the safety profile of long-term treatments with atorvastatin in patients with hypercholesterolemia. Patients received atorvastatin in doses of 10 to 80 mg/ per day. Results showed the following:
- Atorvastatin was well tolerated.
- Less than 2% of the atorvastatin-treated patients withdrew due to drug-attributable adverse events.
- The most commonly reported side effects of atorvastatin were constipation, flatulence, dyspepsia, diarrhea, and abdominal pain.
- About 5% of atorvastatin-treated patients had serious side effects.
- About 0.7% of the treated patients had confirmed transaminase elevations greater than 3 times the upper limit of the normal range. Most cases of transaminase elevations occurred within 16 weeks of beginning treatment.
- No patients showed drug-induced myopathy.
A summary report on safety in the first 44 atorvastatin trials sponsored by Pfizer Inc. was published in the American Journal of Cardiology and investigated the safety of atorvastatin in 10- to 80-mg in patients with dyslipidemia. Results showed that
- Only 3% of atorvastatin-treated patients withdrew from studies due to treatment-associated adverse events.
- Serious side effects were rare and seldom led to withdrawal.
- Only 0.5 % of atorvastatin-treated patients showed persistent elevations in hepatic transaminases more than 3 times the upper limit of normal value.
- The incidence of treatment-associated myalgia was reported in 1.9% of atorvastatin-treated patients.
- No cases of rhabdomyolysis or myopathy were reported.
- The incidence of atorvastatin treatment-associated side effects did not increase in the 10- to 80-mg dose range.
Acute renal failure
Acute renal failure is among the rare but serious side effects associated with treatment with statin, especially high potency members.
Renal failure associated with long-term treatments with atorvastatin is known to be attributed to rhabdomyolysis. It involves muscle breakdown which produces metabolites that could clog up your kidney leading to renal failure.
Kidney failure for atorvastatin therapy may occur quickly and could be fatal if not treated.
Symptoms of kidney damage include the following:
- Decreased urination frequency
- Nausea
- Weakness and tiredness
- Swelling of your legs
- Confusion.
A large, population-based cohort study of over 2,000,000 patients reported that the use of statins (Keep in mind that Lipitor is a statin) was associated with a greater than 50% increase in risk of acute renal failure after 12 months of therapy.
Confirmatory results were reported by another study which showed that the use of high-potency statins is associated with an increased rate of acute kidney injury in hospital admissions compared with low-potency statins. This effect seems to be strongest in the first 4 months after initiation of statin treatment.
A study showed that the long-term treatments with atorvastatin led to a persistent elevation in creatine phosphokinase (higher 10 × ULN) in only 1 atorvastatin-treated patient and was not associated with myopathy.
Effect on brain functions
Cognitive function impairment is also a serious and rare side effect of the long-term use of atorvastatin. The long-term use of atorvastatin (the generic name of Lipitor) leads to alterations in cognitive functions in animal experiments (mouse model). The Food and Drug Administration (FDA) warns that statin could lead to cognitive impairment (Ref).
This may be attributed to the action of atorvastatin on inhibiting the HMG-CoA reductase, the rate-limiting enzyme in mevalonic biosynthesis which is a precursor to cholesterol formation.
A study published in the Journal of Behavior Brain Research investigated the effect of long-term atorvastatin treatment (5mg/kg/per day for 7 months by oral gavage) on behavior, cognition, and brain biochemistry in a mouse model.
Results showed that:
- Atorvastatin treatment for the long term resulted in behavioral deficits as measured in paradigms for basic exploration and cognitive function without impairment in global motor function (Rotor Rod).
- Significant changes in Membrane/lipid rafts-associated proteins (syntaxin-1α and synaptophysin) and a global change of post-synaptic density protein-95 were observed.
Does memory improve after stopping statins?
Yes, studies showed that memory could improve after stopping statins.
Despite the fact that statins are used to treat hyperlipidemia which is a reported risk factor for Alzheimer’s disease and dementia. However, numerous studies showed that dementia and memory loss due to statin administration were resolved after stopping statins (Ref).
Increase the risk of type 2 diabetes Mellitus
Atorvastatin is found to alter your blood glucose levels and increase your risk of developing type 2 diabetes Mellitus, especially in patients at higher risk.
Also, atorvastatin may worsen the condition of type 2 Diabetes Mellitus in those already living with this condition.
Therefore, if you are at high risk of diabetes mellitus or already have diabetes mellitus type 2, you should monitor your atorvastatin therapy.
