HealthRX.com · Printable question sheet
Atorvastatin with NMN or NR: muscle and lab visit sheet
Record your atorvastatin dose, any medicines the Lipitor label links to higher statin levels or muscle injury, the NMN or NR product, and muscle symptoms with dates, then take it to the prescriber to agree on CK and liver tests.
Atorvastatin and the medicines around it
Atorvastatin dose (mg a day) and start date
Clarithromycin, itraconazole, or an HIV or hepatitis C antiviral?
Niacin, a fibrate, colchicine or cyclosporine?
Grapefruit juice: how much, how often
The supplement
Product and formNMN or NR, capsule or powder
Daily amount and start date
Any niacin or nicotinamide in the formula
Muscle symptom diary
| Date | Where it hurts or feels weak | Severity 0 to 10 | Fever or feeling unwell? | Dark urine? | Reported to |
|---|---|---|---|---|---|
Lab results
| Date | CK | ALT or AST | LDL-C | HbA1c or fasting glucose |
|---|---|---|---|---|
What the Lipitor label says
- With clarithromycin or itraconazole, atorvastatin is limited to 20 mg once daily.[1]
- Myopathy and rhabdomyolysis have been seen with lipid-modifying niacin (1 gram a day or more); the prescriber weighs benefit against that risk.[1]
- Myopathy is more likely at 65 or older, with uncontrolled hypothyroidism or kidney impairment, with certain other drugs, and at higher doses.[1]
- Liver tests are considered before starting atorvastatin and when clinically indicated.[1]
Tell the prescriber promptly
- Muscle pain, tenderness or weakness without a clear cause, particularly with malaise or fever.[1]
- Weakness of the upper arms or thighs that continues after the statin is stopped: the label describes this pattern, with raised CK, in a rare autoimmune muscle disease.[1]
Questions for the prescriber
- Do any of my other medicines change the highest atorvastatin dose I can take?
- Should CK be checked now, or only if muscle symptoms start?
- If muscle pain starts, which do we stop first, the supplement or the statin?
- Will you note the supplement in my record so any later problem can be traced?
- When is my next lipid panel due?
Sources for the facts on this sheet
- Viatris Specialty LLC, via DailyMed. Lipitor (atorvastatin calcium) tablets: prescribing information and patient information. Effective 2024-04-15. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a60cc18b-0631-4cf0-b021-9f52224ece65
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.