In recent weeks, atorvastatin, a common drug prescribed in the UK for the treatment of high cholesterol has been out of stock. The atorvastatin shortage has caused a bit of turmoil, putting extra pressure on pharmacies and GP surgeries to prescribe alternative drugs.
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What is atorvastatin?
Atorvastatin is a medication that belongs to a class of drugs known as statins. It is primarily used to lower levels of cholesterol and triglycerides in the blood. High levels of cholesterol can lead to the formation of plaques in the arteries, increasing the risk of heart disease, heart attacks, and strokes.
Atorvastatin works by inhibiting an enzyme called HMG-CoA reductase, which plays a key role in cholesterol production in the liver. By reducing the amount of cholesterol synthesized, atorvastatin helps lower overall cholesterol levels in the bloodstream.
This medication is commonly prescribed to individuals with high levels of low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol. It may also be used to increase high-density lipoprotein (HDL) cholesterol, known as “good” cholesterol, and reduce triglyceride levels.
Atorvastatin is available in tablet form and is typically taken once daily, with or without food. The dosage and duration of treatment depend on various factors, including the individual’s medical condition, cholesterol levels, and response to the medication. It is important to follow the prescribed dosage and consult with a healthcare professional for proper guidance and monitoring while taking atorvastatin.
As with any medication, atorvastatin may have potential side effects, although not everyone experiences them. Common side effects can include muscle aches or weakness, digestive issues, headaches, and changes in liver function tests. Rarely, more serious side effects such as liver problems, diabetes, or muscle breakdown (rhabdomyolysis) may occur. It is important to promptly report any unusual or severe symptoms to a healthcare provider.
Atorvastatin is usually prescribed as part of a comprehensive approach to managing high cholesterol, which may include dietary changes, exercise, and lifestyle modifications. It is essential to maintain regular medical check-ups to monitor cholesterol levels and assess the effectiveness of treatment.
What strength do atorvastatin tablets come in?
In the UK atorvastatin tablets are available in the following strengths:
- Atorvastatin 10mg tablets
- Atorvastatin 20mg tablets
- Atorvastatin 40mg tablets
- Atorvastatin 60mg tablets
- Atorvastatin 80mg tablets
Which atorvastatin is most commonly prescribed?
Atorvastatin 20mg is the most commonly prescribed strength of atorvastatin with almost 28 mln prescription items issued in the last 12 months (Mar ’22—Feb ’23). Prescribing statistics for all atorvastatin strengths (OpenPrescribing.net, 2023):
- Atorvastatin 10mg: 5.2 mln
- Atorvastatin 20mg: 27.9 mln
- Atorvastatin 40mg: 16.5 mln
- Atorvastatin 60mg: 0.7 mln (the latest strength of atorvastatin which became available in the UK)
- Atorvastatin 80mg: 10.6 mln
Atorvastatin shortage: the latest news
At the beginning of May pharmacies in the UK started to receive some strengths of atorvastatin. Initially, atorvastatin 10mg tablets came back in stock allowing many patients on atorvastatin 20mg to get new prescriptions and double their dose. Atorvastatin 20mg and other strengths became intermediately available in the second week of May. Currently, the availability of all strengths of atorvastatin changes daily. With a huge backlog of prescriptions for atorvastatin intermediate supply problems are expected over the next couple of weeks.
Atorvastatin out of stock – July update
As expected atorvastatin has been in and out of stock. Atorvastatin 20mg has been out of stock throughout June. Many patients were switched to atorvastatin 40mg. At the beginning of July Atorvastatin 40mg became low in supply. Wholesalers increased the price of atorvastatin, somewhere around 500% higher than what pharmacies are expected to be paid by NHS, making supply to patients more difficult.
Atorvastatin shortage – August update
It seems that the shortage of atorvastatin is not near the end. Throughout August, atorvastatin 80mg tablets were mostly out of stock. Patients have been prescribed atorvastatin 40mg tablets as a replacement. With the increased demand for 40mg tablets, towards the end of the month, some suppliers ran out of 40mg tablets as well.
My pharmacy does not have atorvastatin in stock what should I do?
Patients who ran out of atorvastatin and cannot get it from their usual nominated pharmacy can try another pharmacy to get their medication. Electronic prescriptions can be returned to NHS Spine and downloaded by another pharmacy. EPS tokens can also be given to patients which can be taken to another pharmacy for dispensing.
Partly dispensed prescriptions, for example, a prescription which contains atorvastatin and another drug cannot be returned once the patient has taken drug(s) away. In this case, patients need to request another prescription from their GP.
What is causing the atorvastatin shortage?
The exact reasons for the atorvastatin shortage are not known. Over the last two years drug shortages in the UK became more noticeable with many common medicines going out of stock. HRT drugs have been subject to shortages for many months.
Can I stop taking atorvastatin?
This is a common question asked by patients. Stopping treatment with atorvastatin short-term (few days) most likely will not have any negative effects on the patient’s health.
Atorvastatin is a medication commonly prescribed to lower cholesterol levels and reduce the risk of cardiovascular events.
Statins like atorvastatin are typically prescribed as long-term medications to manage cholesterol levels effectively.
I was prescribed atorvastatin 20mg tablets, can the pharmacist give me 10mg tablets instead?
Pharmacists cannot change medication issued unless a Serious Shortage Protocol (SSP) is issued by the Department of Health and Social Care (DHSC). SSPs are usually issued with delays. Since we may be close to the end of the atorvastatin shortage it is unlikely that SSP is issued at this time.
Atorvastatin alternatives
There are several atorvastatin alternative drugs that belong to the same class of medications (statins) and are used to treat high cholesterol. Some commonly prescribed statins in the UK include:
- Simvastatin
- Rosuvastatin
- Pravastatin
- Fluvastatin
Each of these statins works in a similar way to lower cholesterol levels, but they may have slightly different efficacy and side effect profiles. The choice of alternative statin will depend on various factors, including your individual health condition, cholesterol levels, and any specific considerations or contraindications.
References:
OpenPrescribing.net (2023). Analyse. Available at: https://openprescribing.net/bnf/ Accessed on 13/05/2023
