PFC Steve asked
The VA issues me a Rx of Atorvastatin Calcium 20 mg with instructions to cut in half and take 1/2 tablet each day. I believe that the government gets a bigger discount to purchase the 20 mg and in my case cut in half. I have been cutting the 45 tablets in half just before I start the next bottle. By reading some of your answers, I think taking a whole tablet every other day would be okay, but I know taking one-half everyday keeps me from forgetting if I took a dose of not. So is my cutting the tablets safe for me in this way?
Answer
It is becoming more common to see long acting "statin" medications dosed every other day, as opposed to every day. The two most common statin medications utilized for every other day dosing are Lipitor (atorvastatin) and Crestor (rosuvastatin).
Every other day dosing is being utilized for a few reasons, including:
- Lower patient cost (as a 90 day supply of medication would only require 45 tablets).
- Reduction of adverse muscle symptoms.
In regard to muscle symptoms specifically, they are among the most commonly reported side effects of statin drugs, like Lipitor.
In fact, according to one study, nearly 30% of users report some sort of adverse muscle symptoms such as pain, tenderness, stiffness, cramps, weakness, or fatigue.
Taking Lipitor Every Other Day
One method that practitioners use to help mitigate or lessen the side effects of Lipitor is to dose it every other day. While not FDA approved for every other day dosing, a number of studies have reported positive results with this dosing, most likely due to the high potency and long half-life of Lipitor.
One study reported the following results:
Alternate-day treatment with [Lipitor] atorvastatin is comparable in efficacy and safety to the established daily treatment regimen, thus being a cost effective alternative."
Another study reported similar results, that every other day dosing of long acting statins, like Lipitor, lowered cholesterol levels just as effectively as taking the drugs every day.
Based on data from studies, it may be a viable option to take your Lipitor every other day as opposed to every day. However, it is important to talk with your doctor regarding your therapy before altering your dosing.
It is important to note that while studies do show comparable cholesterol reductions with daily vs. every other day Lipitor dosing, these studies did not evaluate outcomes, such as reductions in heart attack, stroke etc... It is certainly possible that while cholesterol lowering is comparable, there are differences in outcomes when dosing is altered.
Cutting Lipitor Tablets
If you are looking to save money by splitting Lipitor tablets, that is an option as well. Lipitor tablets are safe to split or cut.
Summary
- Lipitor has a long half-life and has been utilized for every other day dosing as opposed to dosing every day.
- Studies have shown that Lipitor every other day may be as effective in reducing cholesterol as taking the drug every day.
- However, data is lacking in regard to how intermittent dosing affects outcomes such as reduction in heart attack or stroke.
