• It is important that you continue to eat healthily and do regular exercise while you are taking this medicine. Discuss this with your doctor.
• This medicine may cause dizziness. Avoid driving and operating machinery if affected.
• This medicine may rarely cause liver problems. For this reason your doctor will want you to have blood tests to monitor your liver function (liver function tests) before starting treatment and regularly throughout treatment with this medicine. Consult your doctor promptly if you develop unexplained itching, yellowing of the skin or whites of the eyes (jaundice), unusually dark urine, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms while taking this medicine, as these could be signs of a liver problem.
• It is recommended that you avoid drinking excessive amounts of alcohol while taking this medicine, because this may increase the risk of liver problems or side effects on the muscles (see below).
• This medicine may rarely have side effects on the muscles that may progress to cause kidney problems. For this reason, you should inform your doctor immediately if you experience any muscular symptoms such as pain, tenderness, cramps, or weakness while taking this medicine, particularly if it is accompanied by a fever or feeling generally unwell. Your doctor may need to check for side effects on the muscles by taking a blood test to measure the level of a compound called creatinine kinase in your blood. If this is the case, the test should not be done following strenuous exercise.
• Statins may very rarely be associated with a type of lung disease. For this reason, you should consult your doctor if you experience shortness of breath or difficulty breathing, a non-productive cough and deterioration in your general health (eg weight loss, fever, fatigue) while taking this medicine.
• A 40mg dose of this medicine should only be used in people with very high cholesterol levels and a high risk of heart disease, whose cholesterol is not lowered sufficiently with a 20mg dose and who can have regular check-ups with their doctor. A 40mg dose should not be used in people with moderately decreased kidney function, an underactive thyroid gland, a personal or family history of hereditary muscle disorders, or a history of muscle side effects on previous statin or fibrate medicines. A 40mg dose should also not be used in children and adolescents, people of Asian origin, people taking fibrate medicines and people who drink large amounts of alcohol.
• People who are taking a 40mg dose of this medicine should have their kidney function monitored.
• This medicine is not licensed for children under 10 years of age. There is currently only limited experience of the long-term safety of the medicine in children aged 10 to 18 years. If you are concerned about your child taking this medicine you can ask your doctor or pharmacist for more information and advice.