Skip to main content
Drug Info

What are the side effects of atorvastatin for older adults?

Muscle-related side effects from atorvastatin are more common in older adults
Ashley Broadwater, writer for SingleCare
By | Updated on Apr. 9, 2026 Medically reviewed by Leslie Greenberg, MD & Samantha Marr, DNP, APN, AGPCNP-BC, CCRN
Three Rx bottles: What are the side effects of atorvastatin for older adults?

Key takeaways

  • Atorvastatin is a generic statin drug that lowers cholesterol. The brand-name version is Lipitor.

  • Atorvastatin can cause side effects, and older adults may be more susceptible to side effects such as muscle pain or weakness and falls.

  • Side effects can start quickly, but they don’t often last long. 

In this article:

Atorvastatin, a medication in the statin drug class, is prescribed to treat high cholesterol levels. Lipitor is the brand-name version of atorvastatin, which blocks the enzyme needed to make low-density lipoprotein (LDL) cholesterol (aka “bad” cholesterol) in the liver. Since high cholesterol can cause heart attacks and strokes, and the risk of heart disease increases as people age, older adults may be more likely to need lipid-lowering agents like atorvastatin. Although atorvastatin is among the best statins for elderly patients, there are interactions and side effects to be aware of.

   Most common side effects of atorvastatin
Side effect Percentage of participants who reported the side effect in clinical trials
Nasopharyngitis (the common cold) 8.3%
Arthralgia (joint stiffness) and joint pain 6.9%
Diarrhea 6.8%
Pain in extremities  6%
Urinary tract infections 5.7%
Dyspepsia (indigestion) 4.7%
Nausea 4%
Musculoskeletal pain 3.8%
Muscle spasms  3.6%
Myalgia (muscle aches) 3.5%
Insomnia 3%
Pharyngolaryngeal (voice and throat) pain 2.3%

 

“In clinical trials, side effects from statins are relatively infrequent; however, in clinical practice, side effects are more common, especially muscle-related side effects,” says Edo Paz, MD, the SVP of Medical Affairs at Hello Heart, who is board-certified in cardiology, internal medicine, echocardiography, and nuclear cardiology.

Side effects of atorvastatin in older adults

Older adults may be more susceptible to some of the most common side effects of statins, including atorvastatin.

  • Musculoskeletal complaints: Muscle pain and weakness are the most commonly reported side effects of statins. Adults ages 65 and older were slightly more likely than younger adults to report these symptoms while taking atorvastatin. The increased risk is attributed to comorbidities and other medications they’re taking.
  • Gait disturbances: Muscle weakness can lead to abnormal walking patterns and foot shuffling, increasing the risk of falls. 
  • Diabetes risk: The risk of new-onset diabetes increases when adults 75 years and older take high doses of statins; however, the risk is small.

It’s important to note that older adults have been underrepresented in clinical trials. More large studies about the effects of statins in the primary prevention of cardiovascular disease among adults 75 years and older are needed.

RELATED: Does atorvastatin cause weight gain?

Serious side effects of atorvastatin 

According to the medication’s FDA label, you should stop taking atorvastatin and call your healthcare provider ASAP if any of the following symptoms appear:

  • Muscle problems
  • Allergic reactions, like skin rashes
  • Nausea or vomiting
  • Brown or dark-colored urine
  • Extra tiredness
  • Your skin and/or the whites of your eyes become yellow
  • Stomach pain
  • Other concerning symptoms, especially if they get worse or don’t go away

How soon do atorvastatin side effects start?

Older adults may quickly experience side effects of atorvastatin, especially in their muscles. “Muscle side effects can occur with as few as one or two doses,” says Yu-Ming Ni, MD, a board-certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.

How long do atorvastatin side effects last?

Side effects of atorvastatin are generally temporary, although they might last longer in older patients. “Muscle aches are typically temporary, and I generally find that it takes about two to four weeks for the body to adjust to it,” Dr. Ni says. “In most of my younger patients, two weeks is enough time. But perhaps an older patient may take longer.”

What are the long-term side effects of atorvastatin?

When it comes to atorvastatin, patients don’t have to worry too much about long-term side effects. Dr. Ni says the major one is a slightly higher rate of onset of diabetes in people who have never had it, but again, the keyword is “slightly.”

“The risk is quite small, around 1-2% in a five-year period,” he says. “We do not quite understand why this happens, but often the risks associated with needing a statin are greater.”

Put another way, according to a 2018 article in the European Heart Journal, statin treatment is “remarkably safe,” with the only risk being that around one in 1,000 patients will become exposed to new-onset diabetes mellitus.

Statins and dementia

Dr. Ni also wants to clear a wide misconception that statins cause dementia. “While it is true that patients taking statins are more likely to have dementia, it is not because the statin is causing it,” Dr. Ni says. “Rather, it is the kinds of people that might need to take a statin that are at risk for developing dementia.” 

Possible reasoning behind that, he says, could be a cholesterol plaque build-up in the arteries (such as those in the brain), a previous stroke, or taking statins for diabetes, all of which heighten the risk of dementia.

Atorvastatin interactions

Atorvastatin interactions include the following: 

  • Strong inhibitors of CYP3A4: Combining atorvastatin and strong inhibitors of CYP3A4, an enzyme, can increase plasma concentrations of atorvastatin.
  • Grapefruit juice: This beverage contains components that can inhibit CYP3A4, so drinking it while on this medication can also increase plasma concentrations of atorvastatin. 
  • Cyclosporine: As mentioned, atorvastatin can cause myopathy (aka muscle aches or weakness). Combining higher doses of that with cyclosporine can increase the risk of myopathy and/or rhabdomyolysis (muscle inflammation and breakdown). 
  • Rifampin or other inducers of cytochrome P450 3A4: Combining these two medications can reduce plasma concentrations of atorvastatin. Typically, it is recommended to take the medications together (versus delaying the atorvastatin).
  • Digoxin: While patients taking any medication need professional monitoring, it’s especially important for people taking atorvastatin and digoxin to have levels monitored closely.  
  • Alcohol: Atorvastatin should be used cautiously in patients who drink alcohol, specifically more than two glasses a day. Patients who have chronic alcoholic liver disease may be more likely to see increases in plasma concentrations of atorvastatin.
  • Coffee: Coffee (and other forms of caffeine) may make atorvastatin less effective.

Safety measures while using atorvastatin

Atorvastatin is generally safe and one of the most prescribed medications for high cholesterol. Still, it is important to use it safely. Atorvastatin can exacerbate other health conditions or symptoms. This is one of several reasons why it’s important to discuss your health history with your healthcare provider before going on any new medication or supplement. For example, Dr. Ni says atorvastatin can be problematic if you have a serious liver condition or moderate kidney disease.  

Even though atorvastatin is not habit-forming, and discontinuing it does not cause withdrawal symptoms, people can still overdose on the medication. Atorvastatin 80 mg is the maximum dose for the average patient, but Dr. Ni says healthcare providers may recommend lower doses if they have other medical conditions. “In the event of an overdose, immediately seek medical attention or call 911.”

RELATED: What is considered a high dose of atorvastatin?

How to avoid atorvastatin side effects

Avoiding side effects of atorvastatin is as easy as following a few tips:

  1. Take atorvastatin exactly as prescribed. You can take it any time of day since it lasts for 24 hours. (The same can’t be said for all other statins.) However, you should take it at the same time every day, with or without food.
  2. Don’t take atorvastatin if you have liver problems or are allergic to the medication or any of its ingredients.
  3. Report any adverse reactions to your healthcare provider.

How to treat the side effects of atorvastatin

Muscle pain is the most commonly reported side effect of atorvastatin. Some people have found relief by also taking coenzyme Q 10, but it’s not necessarily doctor-recommended. “I have found that it is only occasionally effective, and I do not routinely recommend coenzyme Q 10 with a statin,” Dr. Ni says. 

It’s crucial to pay attention to other side effects that may pop up, too, like a change in the color of your urine. Dark-colored urine can come from rhabdomyolysis, Dr. Ni says, which is a muscle injury where your muscles break down, and it’s a very serious condition requiring immediate medical attention. Thankfully, it’s pretty rare.

Bottom line: Is atorvastatin safe for older adults?

Generally speaking, healthcare providers say atorvastatin is safe for older adults to take.

“Several studies have evaluated the use of statins in adults ages 75 and older, and have generally found them to be safe despite a higher risk of muscle-related side effects,” Dr. Paz says.

At the same time, older adults should be cautious if they have certain medical conditions, such as liver problems. It’s important to report all medical conditions and any medications and supplements you’re taking to your healthcare provider so they can help determine what the best statin therapy is for you. 

Browse drugs A-Z:

View all
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z