When pregnancy is detected, discontinue atorvastatin as soon as possible
Atorvastatin (Lipitor) use is contraindicated (not advisable) during pregnancy and lactation.
The FDA currently recommends against Lipitor (atorvastatin calcium) use during pregnancy as experts have not established the safety of this drug for use in pregnant individuals. Furthermore, the FDA also states that there is “no apparent benefit of lipid lowering drugs during pregnancy.” In other words, safety is not guaranteed for the pregnant parent and fetus and there are no major benefits of taking this drug during pregnancy. Therefore, given the fact that the risks far outweigh the benefits, Lipitor use during pregnancy is not recommended.
Experts currently don’t know if atorvastatin is present in human milk. However, another statin has appeared in human breast milk and atorvastatin itself has appeared in rat milk. As such, the FDA currently advises against the use of Lipitor while breastfeeding as the risks to the breastfeeding child are unknown.
Can you take a statin while pregnant?
The FDA currently advises against statin use during pregnancy.
Can atorvastatin cause miscarriage?
According to the FDA, limited research shows no increased risk of miscarriage from use of Lipitor.
When should I stop taking statins before pregnancy?
Anyone taking a statin who wants to become pregnant needs to talk to their doctor about the best course of action.
Does atorvastatin affect fertility?
The potential link between atorvastatin and cisgender male fertility is unknown.
Animal studies leave plenty of room for speculation as to how these drugs would affect human fertility. In some studies with rats, for example, female subjects given 56 times the human dose experienced no fertility changes, nor did male subjects given 15 times the normal human dose. However, another study, where ten rats were given “100 mg/kg/day of atorvastatin for 3 months” (a dose far exceeding the human one), did show some cause for concern. In particular, two of the 10 rats displayed symptoms such as aplasia (an organ malfunctioning) and aspermia (no semen or no sperm present in semen). Studies with dogs, however, discovered no adverse effects on fertility.
Human studies are no more conclusive.
One study published in Reproductive Biology and Endocrinology, for example, examined atorvastatin’s effects on male fertility in 17 subjects; subjects received 10 mg a day for five months and had normal lipid levels and spermatozoa parameters (aka normal sperm count and health). While gonadotropins and testosterone levels did not suffer, other reproductive-related issues did occur, such as as live spermatozoa percentage. It’s important to note, though, that this study has plenty of limitations, including such a low sample size and no placebo control group.
More research, however, reached a different conclusion. One 2018 Andrologia article, for example, examined data from over 10,000 patients from a fertility clinic. Of that number, 118 patients had used some sort of statin for at least 3 months before providing semen samples. After researchers made adjustments for age, they found that statin use did not significantly affect semen parameters. And, when statins were used with other medications, semen volume was decreased by such a small amount that researchers deemed it not clinically significant.
All in all, more research is needed to definitively say how much atorvastatin affects human fertility, if it affects human fertility at all. It’s worth noting, though, that experts associate high cholesterol—for which atorvastatin is indicated—with decreased fertility.