What are the side effects of Lipitor and niacin?

Lipitor

Lipitor is generally well tolerated. Minor side effects include:

Other commonly reported side effects include:

Lipitor may cause liver and muscle damage. Serious liver damage caused by statins is rare. Liver tests should be performed at the beginning of treatment then as needed thereafter.

Inflammation of the muscles caused by statins can lead to serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood, and myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolysis in less than one percent of patients. To prevent the development of serious rhabdomyolysis, patients taking atorvastatin should contact their health-care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.

Statins have been associated with increases in HbA1c and fasting serum glucose levels as seen in diabetes.

Post-marketing reports for atorvastatin of adverse events include:

Symptoms may start one day to years after starting treatment and resolve within a median of three weeks after stopping the statin.

Niacin

The most common side effects of niacin are:

Flushing may be reduced by taking 325 mg of aspirin 30 minutes before the niacin and by increasing the dose of niacin slowly. Drinking hot liquids or alcohol shortly before or after niacin is taken may increase the occurrence of flushing. Extended release formulations of niacin may cause flushing less frequently than immediate release formulations.

Rare cases of liver failure or muscle injury have occurred from the use of niacin. Blood tests to monitor for liver injury should be performed before niacin therapy begins, every 6-12 weeks for the first year, and then occasionally thereafter. Niacin should be discontinued if liver tests are greater than three times the upper limit of normal, are persistently elevated, or are accompanied by nausea, vomiting, or weakness.