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Lipitor Appetite & Cravings Changes: What Atorvastatin Does (and Doesn't Do) to Hunger

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At a glance

  • Drug / atorvastatin (Lipitor), HMG-CoA reductase inhibitor (statin), prescription only [1][2]
  • Appetite loss or anorexia in the label / not listed in the trial adverse-reaction table [1]
  • Nausea in placebo-controlled trials / 4.0% atorvastatin vs 3.5% placebo [1]
  • Diarrhea / 6.8% vs 6.3% placebo [1]
  • Stopping for nausea / 0.4% of Lipitor-treated patients, more often than placebo [1]
  • Trial database behind those numbers / 17 placebo-controlled trials, 8,755 vs 7,311 patients, median 53 weeks [1]
  • How it is taken / once daily, any time of day, with or without food [1]

Does atorvastatin change appetite?

Appetite changes are not listed in the Lipitor label's placebo-controlled trial adverse-reaction table [1]. That table reports reactions that occurred in at least 2% of atorvastatin-treated patients and more often than on placebo, so it captures common complaints rather than every event recorded in those trials [1].

Atorvastatin inhibits HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis. In animal models, it also increases the number of hepatic LDL receptors, which helps clear LDL from the blood [1]. The label's mechanism description does not mention hunger or appetite [1].

What the Lipitor label actually reports

The label's side-effect table pools 17 placebo-controlled trials: 8,755 patients on atorvastatin at any dose and 7,311 on placebo, median treatment 53 weeks [1]. The gastrointestinal entries are modest and close to placebo:

  • Nausea: 4.0% on atorvastatin vs 3.5% on placebo [1]
  • Diarrhea: 6.8% vs 6.3% [1]
  • Dyspepsia: 4.7% vs 4.3% [1]

Nausea led 0.4% of Lipitor-treated patients to stop treatment, and it was a reason for stopping more often than with placebo, behind myalgia at 0.7% and diarrhea at 0.5% [1]. The label keeps a separate list of other reactions seen in the same placebo-controlled trials, including abdominal discomfort, eructation, flatulence, malaise and pyrexia; decreased appetite is not named there either [1].

Weight and blood sugar

Weight gain is not listed among the reactions in the label's placebo-controlled trial table [1]. The label does say that HbA1c and fasting serum glucose increases have been reported with statins, including atorvastatin [1]. In SPARCL, diabetes was reported as an adverse reaction in 6.1% of patients on atorvastatin 80 mg versus 3.8% on placebo [1].

Taking it with food, and whether timing matters

The label says to take atorvastatin once daily at any time of day, with or without food, and that LDL reduction is the same with or without food and at any time of day [1]. The label also says to avoid large quantities of grapefruit juice, more than 1.2 liters daily [1].

Frequently asked questions

Does Lipitor make you lose your appetite?
The Lipitor label does not list decreased appetite or anorexia in its placebo-controlled trial adverse-reaction table or in its separate list of other trial reactions [1]. The nearest listed reaction is nausea, at 4.0% vs 3.5% on placebo [1].
Does atorvastatin cause food cravings or increased hunger?
The label lists no increased appetite or craving reaction in its placebo-controlled trial tables [1]. Nausea is the nearest stomach-related complaint, at 4.0% vs 3.5% on placebo [1].
Does atorvastatin cause weight gain?
Weight gain is not listed among the adverse reactions in the label's placebo-controlled trial table [1]. The label does report that HbA1c and fasting glucose can rise with statins [1].
Why do I feel sick after taking atorvastatin?
Nausea was reported by 4.0% of patients on atorvastatin vs 3.5% on placebo, diarrhea by 6.8% vs 6.3% and dyspepsia by 4.7% vs 4.3% in the label's pooled trials [1]. Nausea led 0.4% of Lipitor-treated patients to stop treatment and was a reason for stopping more often than with placebo [1].
Does grapefruit make atorvastatin side effects worse?
The label says to avoid large quantities of grapefruit juice, more than 1.2 liters daily, because it can raise atorvastatin levels and may increase the risk of myopathy and rhabdomyolysis [1]. The label ties the grapefruit warning to muscle risk, not appetite [1].
Does the time of day change how atorvastatin feels?
The label says to take it once daily at any time, with or without food, and states that LDL reduction is the same at any time of day [1].

References

  1. U.S. National Library of Medicine, DailyMed. Lipitor atorvastatin calcium tablets (Viatris Specialty) prescribing information. Lipitor atorvastatin calcium tablets (Viatris Specialty) label
  2. Drugs@FDA: FDA-Approved Drugs. Drugs@FDA: FDA-Approved Drugs
  3. Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361(9364):1149-58. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial
Evidence overview for atorvastatin: Lipitor Appetite & Cravings Changes: What Atorvastatin Does (and Doesn't Do) to Hunger