Atorvastatin 10 mg Film-coated Tablets

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1. What Atorvastatin is and what it is used for
2. What you need to know before you take Atorvastatin
3. How to take Atorvastatin
4. Possible side effects
5. How to store Atorvastatin
6. Contents of the pack and other information.

Do not take Atorvastatin:

• if you are allergic to Atorvastatin, to any similar medicines used to lower blood lipids or any of the other ingredients of this medicine (listed in section 6).
• if you have or have ever had a disease which affects the liver.
• if you have had any unexplained abnormal blood tests for liver function.
• if you use the combination of glecaprevir/pibrentasvir in the treatment of hepatitis C
• if you are a woman able to have children and not using reliable contraception.
• if you are pregnant, or trying to become pregnant.
• if you are breast-feeding.

Warnings and precautions

Talk to your doctor or pharmacist before taking Atorvastatin

• If you are taking or have taken in the last 7 days a medicine called fusidic acid, (a medicine for bacterial infection) orally or by injection. The combination of fusidic acid and Atorvastatin can lead to serious muscle problems (rhabdomyolysis).

The following are reasons why Atorvastatin may not be suitable for you.

• if you have had a previous stroke with bleeding into the brain, or have small pockets of fluid in the brain from previous strokes
• if you have kidney problems
• if you have an under-active thyroid gland (hypothyroidism)
• if you have had repeated or unexplained muscle aches or pains, a personal history or family history of muscle problems.
• if you have had previous muscular problems during treatment with other lipid-lowering medicines (e.g. other ‘-statin’ or ‘-fibrate’ medicines)
• if you regularly drink a large amount of alcohol
• if you have a history of liver disease
• if you are older than 70 years.

Check with your doctor or pharmacist before taking Atorvastatin

• if you have severe respiratory failure.

If any of these apply to you, your doctor will need to carry out a blood test before and possibly during your Atorvastatin treatment to predict your risk of muscle related side effects. The risk of muscle related side effects e.g. rhabdomyolysis is known to increase when certain medicines are taken at the same time (see section 2 “Other medicines and Atorvastatin”).

Also tell your doctor or pharmacist if you have a muscle weakness that is constant. Additional tests and medicines may be needed to diagnose and treat this.

While you are on this medicine your doctor will monitor you closely if you have diabetes or are at risk of developing diabetes. You are likely to be at risk of developing diabetes if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure.

Other medicines and Atorvastatin

There are some medicines that may change the effect of Atorvastatin or their effect may be changed by Atorvastatin. This type of interaction could make one or both of the medicines less effective. Alternatively it could increase the risk or severity of side-effects, including the important muscle wasting condition known as rhabdomyolysis described in section 4 “Possible side effects”:

• Medicines used to alter the way your immune system works, e.g. ciclosporin
• Certain antibiotics or antifungal medicines, e.g. erythromycin, clarithromycin, telithromycin, ketoconazole, itraconazole, voriconazole, fluconazole, posaconazole, rifampin, fusidic acid
• Other medicines to regulate lipid levels, e.g. gemfibrozil, other fibrates, colestipol
• Some calcium channel blockers used for angina or high blood pressure, e.g. amlodipine, diltiazem; medicines to regulate your heart rhythm e.g. digoxin, verapamil, amiodarone
• Medicines used in the treatment of HIV e.g. ritonavir, lopinavir, atazanavir, indinavir, darunavir, the combination of tipranavir/ritonavir etc.
• Some medicines used in the treatment of hepatitis C e.g. telaprevir, boceprevir and the combination of elbasvir/grazoprevir
• Other medicines known to interact with Atorvastatin include ezetimibe (which lowers cholesterol), warfarin (which reduces blood clotting), oral contraceptives, stiripentol (an anti-convulsant for epilepsy), cimetidine (used for heartburn and peptic ulcers), phenazone (a painkiller), colchicines (used to treat gout) and antacids (indigestion products containing aluminium or magnesium)
• Medicines obtained without a prescription: St John’s Wort

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

• If you need to take oral fusidic acid to treat a bacterial infection you will need to temporarily stop using this medicine. Your doctor will tell you when it is safe to restart Atorvastatin. Taking Atorvastatin with fusidic acid may rarely lead to muscle weakness, tenderness or pain (rhabdomyolysis). See more information regarding rhabdomyolysis in section 4.

Atorvastatin with food, drink and alcohol

See section 3 for instructions on how to take Atorvastatin.

Please note the following:

Grapefruit juice

Do not take more than one or two small glasses of grapefruit juice per day because large quantities of grapefruit juice can change the effects of Atorvastatin.

Alcohol

Avoid drinking too much alcohol while taking this medicine. See above in this section “Warnings and precautions” for details.

Pregnancy and breast-feeding

Do not take Atorvastatin if you are pregnant, or if you are trying to become pregnant.

Do not take Atorvastatin if you are able to become pregnant unless you use reliable contraceptive measures.

Do not take Atorvastatin if you are breast-feeding.

The safety of Atorvastatin during pregnancy and breast-feeding has not yet been proven.

Ask your doctor or pharmacist for advice before taking any medicine

Driving and using machines

Normally this medicine does not affect your ability to drive or operate machines. However, do not drive if this medicine affects your ability to drive. Do not use any tools or machines if your ability to use them is affected by this medicine.

Atorvastatin contains lactose

If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicine

Atorvastatin contains less than 1 mmol sodium (23 mg) per tablet, i.e. essentially ‘sodium- free’.

The duration of treatment with Atorvastatin is determined by your doctor.

Please ask your doctor if you think that the effect of Atorvastatin is too strong or too weak.

If you take more Atorvastatin than you should

If you accidently take too many Atorvastatin tablets (more than your usual daily dose), contact your doctor or nearest hospital for advice

If you forget to take Atorvastatin

If you forget to take a dose, just take your next scheduled dose at the correct time. Do not take a double dose to make up for a forgotten dose.

If you stop taking Atorvastatin

If you have any further questions on the use of this medicine, or wish to stop your treatment, ask your doctor or pharmacist.

If you experience any of the following serious side effects or symptoms, stop taking your tablets and tell your doctor immediately or go to the nearest hospital accident and emergency department.

Rare (may affect 1 to 10 patients in 10,000)

• Serious allergic reaction which causes swelling of face, tongue and throat that can cause great difficulty in breathing.
• Serious illness with severe peeling and swelling of the skin, blistering of the skin, mouth, eyes, genitals and fever. Skin rash with pink-red blotches especially on palms of hands or soles of feet which may blister.
• Muscle weakness, tenderness, pain or rupture, red-brown discolouration of urine and particularly, if at the same time, you feel unwell or have a high temperature it may be caused by an abnormal muscle breakdown. The abnormal muscle breakdown does not always go away, even after you have stopped taking atorvastatin it can be life-threatening and lead to kidney problems.

Very rare (may affect up to 1 in 10,000 patients)

• If you experience problems with unexpected or unusual bleeding or bruising, this may be suggestive of a liver complaint. You should consult your doctor as soon as possible.
• lupus-like disease syndrome (including rash, joint disorders and effects on blood cells)

Other possible side effects with Atorvastatin

Common side effects (may affect 1 to 10 patients in 100) include

• inflammation of the nasal passages, pain in the throat, nose bleed
• allergic reactions
• increases in blood sugar levels (if you have diabetes continue careful monitoring of your blood sugar levels), increase in blood creatine kinase
• headache
• nausea, constipation, wind, indigestion, diarrhoea
• joint pain, muscle pain and back pain
• blood test results that show your liver function can become abnormal

Uncommon side effects (may affect 1 to 10 patients in 1,000) include

• anorexia (loss of appetite), weight gain, decreases in blood sugar levels (if you have diabetes you should continue careful monitoring of your blood sugar levels)
• having nightmares, insomnia
• dizziness, numbness or tingling in the fingers and toes, reductions of sensation to pain or touch, change in sense of taste, loss of memory
• blurred vision
• ringing in the ears and/or head
• vomiting, belching, abdominal pain upper and lower, pancreatitis (inflammation of the pancreas leading to stomach pain)
• hepatitis (liver inflammation)
• rash, skin rash and itching, hives, hair loss
• neck pain, muscle fatigue
• fatigue, feeling unwell, weakness, chest pain, swelling especially in the ankles (oedema), raised temperature
• urine tests that are positive for white blood cells

Rare side effects (may affect 1 to 10 patients in 10,000) include

• visual disturbance
• unexpected bleeding or bruising
• cholestasis (yellowing of the skin and whites of the eyes)
• tendon injury

Very rare side effects (may affect up to 1 in 10,000 patients) include

• an allergic reaction - symptoms may include sudden wheezing and chest pain or tightness, swelling of the eyelids, face, lips, mouth, tongue or throat, difficulty breathing, collapse
• hearing loss
• gynaecomastia (breast enlargement in men).

Not known (frequency cannot be estimated from the available data)

• muscle weakness that is constant

Possible side effects reported with some statins (medicines of the same type)

• Sexual difficulties
• Depression
• Breathing problems including persistent cough and/or shortness of breath or fever.
• Diabetes. This is more likely if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure. Your doctor will monitor you while you are taking this medicine.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App store. By reporting side effects you can help provide more information on the safety of this medicine.

What Atorvastatin 10 mg, 20 mg, 40 mg, 80 mg film-coated tablets contain:

The active substance in Atorvastatin film-coated tablets is atorvastatin as atorvastatin calcium trihydrate. Each film-coated tablet contains 10 mg, 20 mg, 40 mg or 80 mg atorvastatin.

The other ingredients are:

Tablet core: Microcrystalline cellulose (E460), Lactose monohydrate, Colloidal anhydrous silica, Croscarmellose sodium (E468), Sodium hydrogen carbonate, Sodium carbonate, anhydrous, Hyproxypropylcellulose (E463), Magnesium stearate (E470b), Butylhydroxyanisole, Butylhydroxytoluene

Film coating: Opadry White YS-1-7040 (Hypromellose (E464), macrogol 8000, titanium dioxide (E171), talc (E553b)

What Atorvastatin 10 mg, 20 mg, 40 mg, 80 mg film-coated tablets look like and contents of the pack

Atorvastatin 10 mg:

White to off white, film-coated oval tablets about 6.1 mm wide and about 8.6 mm long, debossed with ‘A30’ on one side and plain on other side

Atorvastatin 20 mg:

White to off white, film-coated oval tablets about 6.6 mm wide and about 12.1 mm long, debossed with ‘A31’ on one side and plain on other side

Atorvastatin 40mg:

White to off white, film-coated oval tablets about 8.1 mm wide and about 16.9 mm long, debossed with ‘A32’ on one side and plain on other side

Atorvastatin 80mg:

White to off white, film-coated oval tablets about 10.8 mm wide and about 21.7 mm long, debossed with ‘A33’ on one side and plain on other side

Atorvastatin is supplied in the pack of:

Cold form blister laminate (structure: oriented polyamide/ aluminium foil/ PVC) with the backing of hard tempered, aluminium foil coated with heat seal lacquer on inner side

Packs of 10, 14, 20, 28, 30, 50, 56, 60, 84, 90, 98, 100 film-coated tablets each.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

Manufacturer

This medicinal product is authorised in the Member States of the EEA under the following names:

Bulgaria: ATORVISTAT K 10/20 mg филмирани таблетки

Finland: Atorvastatin Orion 10/20/40/80 mg tabletti, kalvopäällysteinen

France: ATORVASTATINE SUN 10/20/40/80 mg, comprimé pelliculé

Ireland: Atorvastatin 10/20/40/80 mg film-coated tablets

Latvia: Atorvastatin SUN 10/20/40/80mg apvalkotās tabletes

Lithuania: Atorvastatin SUN 10/20/40/80 mg plėvele dengtos tabletės

Poland: Storvas CRT

Romania: Atorvastatin Terapia 10/20/40/80 mg comprimate filmate

Spain: ATORVASTATINA SUN 10-20-40-80 mg COMPRIMIDOS RECUBIERTOS CON PELÍCULA EFG

United Kingdom: Atorvastatin 10/20/40/80 mg Film-coated Tablets