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Atorvastatin (Lipitor)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Atorvastatin

What it is

Atorvastatin is a statin: it blocks HMG-CoA reductase, the liver enzyme that makes cholesterol, so the liver pulls more LDL cholesterol out of the blood. It is used to lower cholesterol and to reduce the chance of heart attack and stroke. It is sold as Lipitor, among other names.

How genes come into it

SLCO1B1 makes a transporter that carries statins from the blood into the liver, where they work. A common variant (rs4149056, part of the *5 and *15 versions) makes the transporter less effective, so more atorvastatin stays in the blood, which is linked to a higher chance of statin muscle pain and weakness. CPIC and DPWG have published guidelines on SLCO1B1 and atorvastatin, and the US FDA lists an effect on drug levels. Studies have also looked at CYP3A4 and CYP3A5, which break atorvastatin down, and at genes linked to how much cholesterol falls, with weaker evidence.

Published guidelines

Clinical guidelines that name a gene for Atorvastatin. They sort people into groups by the gene copies they carry.

CPIC guideline: SLCO1B1. Normal Function · Poor Function · Increased Function · Decreased Function · Possible Decreased Function · Indeterminate. Strong. 2022.

DPWG guideline: SLCO1B1. Normal Function · Poor Function · Increased Function · Decreased Function · Possible Decreased Function · Indeterminate. 2024.

US FDA: SLCO1B1. Poor Function. Data that Demonstrate a Potential Impact on Pharmacokinetic Properties Only.

What research found

Every published finding on gene variants and Atorvastatin. Upload your DNA file to see which of these rows apply to you.

Rated evidence (54 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

SLCO1B1 SLCO1B1*1, SLCO1B1*5, SLCO1B1*15: Level 1A · replicated. Toxicity. 20.

SLCO1B1 rs4149056: Level 1A · replicated. Metabolism/PK. 18.

SLCO1B1 rs4149056: Level 1A · replicated. Toxicity: statin-related myopathy. 17.

SLCO1B1 SLCO1B1*1, SLCO1B1*5, SLCO1B1*15, SLCO1B1*37: Level 1A · replicated. Metabolism/PK. 9.

Metabolism (39 findings)

Studies of how quickly the body processes this medication.

AGTR1 rs5186: Genotype AC is associated with increased exposure to atorvastatin in healthy individuals as compared to genotypes AA + CC.

BDKRB2 rs1799722: Genotype CT is associated with increased exposure to atorvastatin in healthy individuals as compared to genotypes CC + TT.

CYP3A4 CYP3A4*1, CYP3A4*2, CYP3A4*22: CYP3A4 *2 + *22 (assigned as intermediate metabolizer phenotype) is associated with increased exposure to atorvastatin and atorvastatin lactone in healthy individuals as compared to CYP3A4 *1.

CYP3A4 rs2740574: Genotype TT is associated with increased concentrations of atorvastatin in people with Cardiovascular Disease or Hyperlipidemias as compared to genotypes CC + CT.

Response (100 findings)

Studies of how well it worked in people carrying a variant.

ABCA1 rs12003906: Allele C is associated with decreased response to atorvastatin, pravastatin or simvastatin in people with Hyperlipidemias as compared to allele G.

ABCA1 rs2230806: Allele T is associated with decreased response to atorvastatin, rosuvastatin or simvastatin as compared to allele C.

ABCA1 rs769705621: Allele AAAA is associated with decreased response to atorvastatin, rosuvastatin or simvastatin in people with familial hypercholesterolemia as compared to genotypes A/AA + A/del.

ABCB1 rs1045642: Genotype AA is associated with increased clinical benefit to atorvastatin in people with Coronary Artery Disease as compared to genotypes AG + GG.

Other findings (1 finding)

Studies that do not fall into the groups above.

APOA5 rs662799: Genotype AA is associated with response to atorvastatin, rosuvastatin and simvastatin in people with Dyslipidaemia as compared to genotypes AG + GG.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Baycol (Statins)

Crestor (Statins)

Lescol (Statins)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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