Standard Starting Dose for High Cholesterol
Doctors typically start Lipitor (atorvastatin) at 10 mg or 20 mg once daily for most adults with high cholesterol or to prevent heart disease. This applies to patients not on lipid-lowering drugs before.[1][2]
Starting Dose After a Heart Attack or Stroke
For patients who've had a heart attack, stroke, or have cardiovascular disease, the usual starting dose is 10 mg daily, with potential increase based on response.[1]
Adjustments for Children and Teens
Kids ages 10-17 with familial hypercholesterolemia often start at 10 mg daily. Doses under 10 mg aren't studied in this group.[1]
Why Start Low and Adjust?
Treatment begins at the lowest effective dose to minimize muscle pain or liver risks while targeting LDL cholesterol goals. Max dose is 80 mg daily; changes happen after 2-4 weeks based on blood tests.2
Common Dose Increases
If 10-20 mg doesn't lower cholesterol enough:
- Increase to 20-40 mg after 2-4 weeks.
- Up to 80 mg if needed for very high cholesterol.[1][2]
Factors That Change Starting Doses
- Kidney or liver issues: Start lower, like 10 mg, and monitor closely.[2]
- Asian patients: May start at 5-10 mg due to higher drug levels in blood.[1]
- Drug interactions (e.g., with cyclosporine): Limit to 10 mg max.[2]
- Elderly: No routine change, but watch for side effects.3
[1]: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020702s073lbl.pdf
[2]: https://www.lipitor.com/