Restarting Atorvastatin 40mg After a Hiatus

Safety and Efficacy

Restarting statin therapy after discontinuation is generally safe and important, especially for patients at high risk of cardiovascular events, as recommended by the American Heart Association 1, 2
High-intensity statin therapy (atorvastatin 40mg) reduces LDL-C by approximately 50% and reduces the risk of major adverse cardiovascular events (MACE) in patients with established cardiovascular disease, according to the American College of Cardiology 1, 2, 4
The American Heart Association suggests that the benefits of statin therapy appear early after acute coronary syndrome and persist over time 1

The American Heart Association recommends checking baseline liver function tests (ALT, AST) and creatine kinase (CK) before restarting atorvastatin 40mg, and assessing for any contraindications that may have developed during the hiatus 3
The American College of Cardiology suggests restarting at the previous dose of 40mg once daily, usually at bedtime, with no need for dose titration if the patient previously tolerated 40mg well 2, 3
Schedule follow-up in 4 weeks to measure fasting lipid profile, CK, ALT, and AST, and monitor for any symptoms of myopathy (muscle pain, tenderness, weakness) 3

The American Heart Association states that high-intensity statin therapy (atorvastatin 40mg) reduces the risk of major adverse cardiovascular events (MACE) in patients with established cardiovascular disease, with a 16% reduction in composite cardiovascular endpoints compared to moderate-dose pravastatin 1, 2, 4