When to Take Atorvastatin: Morning or Night?

Medically reviewed by Femi Aremu, PharmD

Atorvastatin, also known by its brand name Lipitor, is a cholesterol medication that can be taken once daily. It belongs to a drug class known as statins. Some statins have specific recommendations around what time of the day to take them.

For atorvastatin specifically, you can take it either in the morning or at night, as long as you take it consistently. Mostly, what time of day you take your statin will depend on the type of statin.

Statins are commonly used to lower bad cholesterol or low-density lipoprotein (LDL). These medications can also effectively lower the risk of serious complications, such as heart attacks and strokes.

This article will discuss how and when to take atorvastatin, recommendations around timing and dosing for other statins, and the reasoning behind it.

When and How to Take Atorvastatin

The dosing and timing for taking atorvastatin depend on when it is most convenient.

Generally, you will take one tablet by mouth once a day. Unlike some other statins, atorvastatin has a longer half-life (14 hours) when compared to other statins. Because of this, it is known as a long-acting statin.

The term "half-life" means the time it takes for half of the drug to be removed by the body. When considering the reasoning behind why some statins are recommended to be taken at bedtime, it is important to take into account both the medication’s half-life as well as how cholesterol is made.

Cholesterol production in the body tends to peak at night. Since most of the cholesterol in your body comes from the liver, taking a statin at bedtime will target the time when cholesterol production is at its greatest.

However, since atorvastatin's half-life is 14 hours, when you take it should not matter greatly. This drug will be present in sufficient amounts throughout the day and night. What matters most is choosing a time that will allow you to take it consistently.

Statins work by stopping the activity of an enzyme called HMG-CoA reductase, which is a protein that the body needs to make cholesterol. By taking this medication at around the same time each day, you will have enough of the drug to stop the activity of HMG-CoA reductase.

Which Statins Should You Take at Night?

Some statins are usually recommended to be taken at bedtime or with dinner instead of in the morning. The reasoning is that these medications have a short half-life, meaning they will only be present in the body for a short time. These are known as short-acting statins.

If these medications are taken in the morning, the time your body makes most of its cholesterol will not be greatly impacted. Therefore, unlike long-acting statins, you may need to be more strategic about when you take them.

The following are statins that are recommended to be taken in the evening or with your dinner:

• Zocor (simvastatin)

• Pravastatin

• Lovastatin

• Fluvastatin

Which Statins Can You Take in the Morning?

Some statins can be taken at any time of the day, such as in the morning or at night. These statins have a longer half-life, meaning you will have enough of the medication in the body to last the whole day.

The important thing with these statins is to pick a time that is best for you and to be consistent with taking it at around the same time each day.

The following are statins that can be taken at night or in the morning:

• Atorvastatin

• Crestor (rosuvastatin)

• Lescol XL (extended-release fluvastatin)

Considerations for Taking Atorvastatin and Other Statins

There may be other considerations to keep in mind while taking atorvastatin or other statins. These may influence how you take your medication.

Side Effects

More common side effects that may occur while you are taking atorvastatin include:

• Muscle pain (myalgia)

• Nasal congestion (stuffy nose)

• Diarrhea

• Indigestion

• Insomnia

• Nausea

• Urinary tract infection

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Muscle problems, including rhabdomyolysis (muscle breakdown), which can cause muscle pain, tenderness, or weakness that is unexplained, especially if it is accompanied by a fever or extreme fatigue

Drug Interactions

Statins are medications that have a lot of drug interactions due to how they are broken down in the body. The following are medications that interact with atorvastatin:

• Cyclosporine

• Gemfibrozil

• Antiviral drugs, such as tipranavir, ritonavir, lipinavir, and nelfinavir

• Colchicine

• Niacin

• Certain antifungals or antibiotics, such as itraconazole, ketoconazole, and clarithromycin

Statins can also interact with grapefruit juice, so it is recommended to avoid drinking large amounts (more than 1.2 liters per day).

Ask your healthcare provider or pharmacist for a complete list of all possible interactions.

Can I Take Atorvastatin With Food?

You can take atorvastatin with or without food. If your stomach feels upset after taking atorvastatin, it may help you to take this medication with a meal.

Other Ways to Reduce Cholesterol

While statins are an effective way to lower cholesterol, it is important to recognize lifestyle changes can also help you reach your cholesterol goal.

For starters, the foods you eat can greatly affect your cholesterol levels. In particular, the types of fats you eat will play a big role in your LDL cholesterol.

Limiting foods high in saturated fat and trans fat is one way to lower your LDL. These types of fats are commonly found in foods like:

• Fast food

• Processed foods

• Desserts, such as doughnuts, cookies, cakes, and pies

• Red meats

• Dairy products, such as butter, cheese, and milk

While these fats should be limited, others can help improve your cholesterol when eaten in moderation. These are known as unsaturated fats, which can be found in:

• Fish like salmon and tuna

• Seeds

• Nuts

• Avocados

• Vegetable oils

Along with a healthy diet, engaging in exercise has been shown to be very effective at lowering your cholesterol. Performing at least moderate-intensity exercise regularly can lower your bad cholesterol and increase your high-density lipoprotein (HDL) or good cholesterol.

Limiting your alcohol intake and quitting smoking are also strategies that you can do to lower your cholesterol.

Consider working with your healthcare provider and a registered dietitian nutritionist (RDN) for a better understanding of how to manage cholesterol through diet.

Summary

The dosing and timing of statins can depend on the type of statin you've been prescribed.

While it is typically recommended to take short-acting statins at night, long-acting statins like atorvastatin can be taken at any time of the day.

Since the body takes longer to process long-acting statins, they are just as effective in the morning versus the evening. However, short-acting statins tend to work better at night because that is when your body produces most of its cholesterol, and short-acting statins clear from the body more quickly.

If you are taking atorvastatin, your healthcare provider may suggest picking a time that will be convenient for you to take it consistently at that time each day.

Frequently Asked Questions

Will atorvastatin affect how I sleep?

Insomnia and worsened sleep quality are potential side effects of using statins. Consult your healthcare provider if you have difficulty sleeping after starting atorvastatin.

Who should not take atorvastatin?

You should not take atorvastatin if you have liver problems, such as acute liver failure, or are allergic to atorvastatin.

Which statins must be taken at night?

The following are statins that must be taken at night:

• Simvastatin

• Pravastatin

• Lovastatin

• Fluvastatin

The author would like to recognize and thank Cody Ryan Thomas for contributing to this article.