soggy asked
I have been prescribed Lipitor (atorvastatin) 20 mg for hereditary high cholesterol. I have taken 4 nights in a row and have a terrible headache in the morning. I missed a tablet 2 nights in a row and only took one-half tablet this morning to see if it reduced the chances of headaches. Is this safe to do as my doctor is on extended leave.
Answer
While we can't give you a recommendation in regard to changing the dose prescribed by your doctor, we can certainly provide some insight on how taking one-half tablet of Lipitor (atovastatin) may affect you. In situations where your doctor is inaccessible, please reach out to the office. It's fairly common practice to assign a 'covering' physician. They can typically provide you with a recommendation based on your specific situation.
Cutting Lipitor in half, resulting in 50% of the original dose, will most likely result in decreased effectiveness in regard to lowering cholesterol... the effect on certain outcome measurements such as heart attack or stroke prophylaxis is less certain.
Lipitor is classified as a HMG CoA Reductase Inhibitor (i.e. "statin") and works to decrease the synthesis of cholesterol in our body. Data shows that Lipitor has a dose dependent effect on cholesterol lowering. The Lipitor prescribing information details how each dose (in mg) will affect cholesterol values (on average) as shown below.
In your case, from the data above, you can see that 10 mg of Lipitor is less effective at lowering cholesterol than 20 mg, but the difference is relatively small. What effect this small difference has on important outcomes such as stroke prevention is unknown.
So, the data shows that cutting Lipitor tablets in half slightly reduces effectiveness but you also mentioned that you missed a dose. This brings up the idea of taking the medication every other day. This is actually a fairly commonly prescribed protocol that many doctors embrace.
Lipitor has a long half life and one dose continues to work in the body for days. Due to this, and the desire to avoid side effects, some practitioners prescribe certain statin drugs every other day (i.e. 10 mg on day 1, 10 mg on day 3 etc...). The overall effectiveness of this protocol is unknown but there is a fairly large body of evidence that shows taking a higher statin dose every other day works just as well as taking a lower dose every day.
Every other day dosing may be an option for you and you should discuss it with your doctor. It may lead to less side effects and a lower incidence of headaches.
