When to Take Atorvastatin: Morning or Night?

Key Takeaways

Atorvastatin (Lipitor) is a long-acting statin, and it can be taken at any time, but you should take it at the same time every day to prevent fluctuations in blood levels of atorvastatin.
Your prescribing doctor may recommend taking atorvastatin at night for maximum effectiveness because that is when the liver produces the most cholesterol.
Atorvastatin will work well regardless of when you take it, as long as you take it around the same time every day, but some statin drugs need to be taken in the evening to be most effective.

Statins, also called Hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors, are commonly prescribed cholesterol-lowering drugs. They lower LDL cholesterol levels and reduce the risk of cardiovascular disease. One of the statin medications is atorvastatin, also sold under the trade name Lipitor.

Atorvastatin is a long-acting statin, and it can be taken at any time of the day, morning or evening. But you should take atorvastatin consistently at the same time every day without missing doses. This will prevent fluctuations in blood levels of atorvastatin in your body.

Please continue reading for more information on taking atorvastatin morning or night for maximum effectiveness in lowering high cholesterol.

How does atorvastatin lower LDL cholesterol?

Atorvastatin and other statins work by blocking a liver enzyme called hydroxymethylglutaryl-CoA (HMG-CoA) reductase that is needed for cholesterol production in the body. These drugs help to decrease LDL-C (low-density lipoprotein or “bad” cholesterol levels) and increase HDL-C (high-density lipoprotein or “good” cholesterol) levels. Statins are used, along with lifestyle modifications such as healthy diets and regular exercise to lower cholesterol levels. Maintaining a healthy lifestyle also helps you to stay at a healthy weight. Besides other risk factors such as high blood pressure and diabetes, obesity can also increase the risk of heart disease, heart attack, and stroke.

How does the body process long-acting statins and short-acting statins?

There are two types of statin drugs:

Short-acting statins (lovastatin, fluvastatin, simvastatin, and pravastatin)
Long-acting statins (atorvastatin and rosuvastatin)

Short-acting statins have a half-life of 2-5 hours (less than six hours). Long-acting statins have a half-life of 14-19 hours. A medication’s half-life is the time it takes for drug levels to fall to half their original value. The body processes short-acting statins faster than long-acting statins. This influences the dose timing of statins.

Systematic reviews have found that most short-acting statins work better when they are taken in the evening. This is because the liver makes more cholesterol at night. Studies have shown that people who took short-acting statins in the evening had lower LDL-C (bad cholesterol) and total cholesterol levels compared to people who took them in the morning. On the other hand, long-acting statins stay in the body longer and can be taken at any time of the day.

What is the best time of day to take atorvastatin?

Atorvastatin (Lipitor) is a long-acting statin, and it can be taken at any time of the day, morning or evening. But you should take atorvastatin consistently at the same time every day without missing any doses. This will prevent fluctuations in blood levels of atorvastatin in your body.

Why is atorvastatin better taken at night?

Your prescribing doctor may recommend taking atorvastatin at night for maximum effectiveness because that is when the liver produces the most cholesterol.

Can atorvastatin cause sleep problems?

Large trials have shown that statins do not cause sleep problems such as insomnia. In fact, statins can reduce the number of nighttime awakenings and the time spent awake during the night. Studies have also shown that people taking atorvastatin (Lipitor) have fewer sleep disturbances compared to those taking a placebo (inactive pill).

Note: Sometimes, sleep problems on statins can occur due to a nocebo effect. Research has shown that a person taking statins is more likely to experience a side effect if they have heard about it and are anticipating it. You might feel like you are experiencing muscle aches or sleep disturbances on atorvastatin because you are expecting these statin side effects.

What happens if you take atorvastatin in the morning?

Atorvastatin will work as well if you take it in the morning. It is a long-acting statin, meaning it remains present in the body for a longer time compared to short-acting statins.

Some other statin drugs that are short-acting (see list above) need to be taken in the evening to be most effective. They only remain in the body for a short time. If you take them in the morning, the level of the drug will fall by nighttime when the liver cells produce cholesterol.

Can atorvastatin cause serious new-onset diabetes?

Atorvastatin and other statin medications can increase insulin resistance and lead to high blood sugar levels, especially in women and people with pre-diabetes. However, doctors recommend that most people, with or without diabetes, should take statin medications if needed because the benefits outweigh the risks. Statins keep cholesterol levels in a healthy range and lower the risk of heart disease, heart attack, and stroke.

How to take atorvastatin?

Atorvastatin tablets, chewable tablets, and oral suspension should be taken once a day, morning or night, with or without food. If you experience gastrointestinal side effects like stomach pain, heartburn, or gas, taking atorvastatin with food might help.

Atorvastatin is generally safe and well-tolerated by most people, but keep the following things in mind when taking this cholesterol-lowering drug:

Tell your doctor if you have ever had an allergic reaction to a statin drug or other medications in the past.
Do not take any other prescription drugs, over-the-counter medicines, dietary supplements, or herbal products without checking with your doctor first. Possible interactions between atorvastatin and your other medicines can cause serious adverse effects.
If you miss a dose of atorvastatin, take it as soon as you remember. But if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose or extra medicine to make up for a missed dose.
Call your healthcare provider immediately or seek emergency medical attention if you develop severe muscle pain, weakness, extreme tiredness, and dark urine. These may be signs of a serious complication of statin use called rhabdomyolysis (muscle breakdown), which can lead to kidney problems, including renal failure.

What should you not take with atorvastatin?

Do not eat saturated fats and trans fats, fried foods, processed foods, red meat, and full-fat dairy. These foods can lead to high cholesterol.
Avoid drinking grapefruit juice while on atorvastatin, especially in large quantities (more than 1.2 liters a day).
Do not drink alcohol while on atorvastatin. Alcohol can increase your risk of liver damage. Before starting atorvastatin, tell your doctor if you drink more than 2 alcoholic beverages a day.

What happens if you drink grapefruit juice while on Lipitor?

Grapefruit juice affects how atorvastatin is metabolized in the body. Drinking grapefruit juice while on atorvastatin can lead to high levels of the drug in your body with an increased risk of side effects. Avoid drinking large quantities of grapefruit juice (more than 1.2 liters per day) while on atorvastatin. However, an occasional glass should be okay. If you enjoy eating grapefruit or drinking its juice regularly, talk to your doctor about taking a different statin medication (for example, rosuvastatin, fluvastatin, pravastatin, or pitavastatin) that does not interact with grapefruit.

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