What is a Patient Information Leaflet and why is it useful?

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged.

Below is a text only representation of the Patient Information Leaflet. The original can be viewed in PDF format using the link above.

The text only version may be available from RNIB in large print, Braille or audio CD. For further information call RNIB Medicine Leaflet Line on 0800 198 5000. The product code(s) for this leaflet is: PL 14017/0199.

Atorvastatin 10mg, 20mg, 40mg Film-Coated Tablets

PACKAGE LEAFLET: INFORMATION FOR THE USER

Atorvastatin 10 mg film-coated tablets

Atorvastatin 20 mg film-coated tablets

Atorvastatin 40 mg film-coated tablets

Atorvastatin

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, pharmacist or nurse.
  • 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 of the side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

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

1. WHAT ATORVASTATIN TABLETS ARE AND WHAT THEY ARE USED FOR

Atorvastatin Tablets belong to a group of medicines known as statins, which are lipid (fat) regulating medicines.

Atorvastatin Tablets are used to lower lipids known as cholesterol and triglycerides in the blood when a low-fat diet and lifestyle changes on their own have failed.

If you are at an increased risk of heart disease, Atorvastatin Tablets can also be used to reduce such risk even if your cholesterol levels are normal. You should maintain a standard cholesterol lowering diet during treatment.

2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE ATORVASTATIN TABLETS

Do not take Atorvastatin Tablets

  • if you are allergic to atorvastatin or any of the other ingredients of this medicine (listed in section 6)
  • if you have or have ever had a disease that 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, pharmacist or nurse before taking Atorvastatin Tablets.

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

  • if you have severe respiratory failure
  • 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 Tablets can lead to serious muscle problems (rhabdomyolysis).
  • if you have had a previous stroke with bleeding into the brain, or have small pockets of fluid in the brain from previous stroke
  • 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

If any of these apply to you, your doctor will need to carry out a blood test before and possibly during your treatment with Atorvastatin Tablets 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 Tablets”).

Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness. This is because on rare occasions, muscle problems can be serious, including muscle breakdown, resulting in kidney damage, and very rare deaths have occurred.

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 Tablets

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. There are some medicines that may change the effect of Atorvastatin Tablets or their effect may be changed by Atorvastatin Tablets. 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:

  • 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 Tablets include ezetimibe (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), colchicine (used to treat gout) and antacids (indigestion products containing aluminium or magnesium)
  • Medicines obtained without a prescription: St John’s Wort
  • 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 Tablets. Taking Atorvastatin Tablets with fusidic acid may rarely lead to muscle weakness, tenderness of pain (rhabdomyolysis). See more information regarding rhabdomyolysis in section 4.

Atorvastatin Tablets with food and drink

See Section 3 for instructions on how to take Atorvastatin Tablets.

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 Tablets.

Alcohol

Avoid drinking too much alcohol while taking this medicine. See Section 2 “Warnings and precautions” for details.

Pregnancy and Breast-feeding

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

Do not take Atorvastatin Tablets if you are breast-feeding.

The safety of Atorvastatin Tablets 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 Tablets contain lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. HOW TO TAKE ATORVASTATIN TABLETS

Before starting treatment, your doctor will place you on a low-cholesterol diet, which you should maintain also during therapy with Atorvastatin Tablets.

The usual starting dose of Atorvastatin Tablets is 10 mg once a day in adults and children aged 10 years or older. This may be increased if necessary by your doctor until you are taking the amount you need. Your doctor will adapt the dose at intervals of 4 weeks or more. The maximum dose of Atorvastatin Tablets is 80 mg once a day.

Atorvastatin Tablets should be swallowed whole with a drink of water, and can be taken at any time of day, with or without food. However, try to take your tablet at the same time every day.

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

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

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

If you take more Atorvastatin Tablets 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 Tablets

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 Tablets

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

4. POSSIBLE SIDE EFFECTS

Like all medicines, this medicine can cause side effects, although not everybody gets them.

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

Rare: may affect up to 1 in 1,000 people

  • serious allergic reaction which causes swelling of the 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 or pain and particularly, if at the same time you feel unwell or have a high temperature it may be caused by abnormal muscle breakdown (rhabdomyolysis). The abnormal muscle breakdown does not always go away, even after you have stopped taking atorvastatin, and it can be life-threatening and lead to kidney problems.

Very rare: may affect up to 1 in 10,000 people

  • 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
  • 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.

Other possible side effects with Atorvastatin Tablets:

Common: may affect up to 1 in 10 people

  • inflammation of the nasal passages, pain in the throat, nose bleed
  • allergic reactions
  • increases in blood sugar (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: may affect up to 1 in 100 people

  • 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: may affect up to 1 in 1,000 people

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

Very rare: may affect up to 1 in 10,000 people

  • hearing loss
  • gynecomastia (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, pharmacist or nurse. 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

By reporting side effects you can help provide more information on the safety of this medicine.

5. HOW TO STORE ATORVASTATIN TABLETS

Keep this medicine out of the sight and reach of children.

Store in the original package in order to protect from moisture.

Store below 25°C.

Do not use this medicine after the expiry date which is stated on the carton label and blister foil after Exp. The expiry date refers to the last day of that month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6. CONTENTS OF THE PACK AND OTHER INFORMATION

What Atorvastatin Tablets contains

The active substance is atorvastatin.

Each film-coated tablet contains 10 mg of atorvastatin as atorvastatin calcium hemi-hydrate.

Each film-coated tablet contains 20 mg of atorvastatin as atorvastatin calcium hemi-hydrate.

Each film-coated tablet contains 40 mg of atorvastatin as atorvastatin calcium hemi-hydrate.

The other ingredients are: Starch pregelatinized, lactose monohydrate, crospovidone, hydroxypropyl cellulose, silica colloidal anhydrous, magnesium stearate.

The film-coating of Atorvastatin Tablets contains lactose monohydrate, hypromellose, titanium dioxide (E-171), macrogol 4000 and carnauba wax.

What Atorvastatin Tablets looks like and contents of the pack

Atorvastatin 10, 20 and 40 mg film-coated tablets are white with a round shape, embossed “10”, “20” and “40”, respectively, on one side.

Atorvastatin Tablets are available in blister packs containing 28 film-coated tablets.

Marketing Authorisation Holder and Manufacturer

Dexcel®-Pharma Ltd.
7 Sopwith Way
Drayton Fields
Daventry
Northamptonshire
NN11 8PB
UK

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

Ireland, UK Atorvastatin 10 mg/20 mg/40 mg film-coated tablets

This leaflet was last revised in September 2018.

1203500120-E