3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, commonly referred to as "statins"
Some common statins include:
|Generic Name||Brand Name|
Conditions that may require statins:
Hypercholesterolemia (high cholesterol) High triglyceride levels
What statins do: Help certain people decrease their risk of cardiovascular disease, stroke, and death if used along with diet and exerciseLower total cholesterolLower LDL-cholesterol (bad cholesterol)Raise HDL-cholesterol (good cholesterol)Lower triglyceridesLower C-reactive protein levels (a marker of inflammation)
Before prescribing a statin, your doctor will suggest that you try to reduce your risk of heart attack and stroke by diet and exercise. This typically involves reducing your intake of total fat, saturated fat, and, if you are overweight, total calories. Some people are able to lower their cholesterol and decrease their risks of heart attack and stroke by these changes alone. Medicine is prescribed only when additional help is needed. It is most effective in combination with dietary changes and regular exercise.
Statins block an enzyme in the liver (HMG-CoA reductase) that produces cholesterol. They are particularly effective at reducing LDL-cholesterol.
It is important that your doctor check your progress. Regular visits will allow for dosage adjustments and to help monitor for any side effects.
Statins should not be taken during pregnancy. Cholesterol production is essential for normal fetal development. Statins decrease cholesterol production and therefore may cause birth defects. Women who are able to become pregnant should use birth control while taking a statin drug. Tell your doctor if you think you might be pregnant or you are considering becoming pregnant. Also tell your doctor if you are breastfeeding, as statins may cause problems for a nursing baby.
If you are overweight or obese, losing weight may help decrease the need for or amount of medicine. Check with your doctor about this.
Tell your doctor about all the medicines you take. Some medicines should not be taken with statins, while others may require a different dosage level. Examples of these include:
(eg, Lanoxin)—Some statins may increase blood levels of digoxin, increasing the risk of side effects.
Macrolide antibiotics—erythromycin, clarithromycin
Fibric acid derivatives—gemfibrozil
or nicotinic acid—Use of this type of medicine with a statin may increase the risk of developing muscle problemsOral contraceptives/birth control pills—Some statin drugs may increase the blood levels of the hormones in birth control pills, increasing the risk of side effects.Nefazodone
Talk to your doctor about the medicines that you take and whether there could be an interaction with the statin.
The presence of other medical problems may affect the use of statins. Tell your doctor if you have any other medical problems, especially:
Alcohol abuseEpilepsy that is not well controlledElectrolyte or metabolic enzyme deficiencies or disordersInfectionLiver disease or persistently high levels of liver enzymes—Statin drugs may make liver problems worse.Low blood pressureOrgan transplant with therapy to prevent transplant rejection
Kidney failureRecent major surgery or trauma, which may increase the risk of problems that may lead to kidney failureImpending surgery, including dental surgery or emergency treatment—Be sure to tell the doctor or dentist treating you that you are taking a statin drug.
Excessive amounts of alcohol combined with statin drugs can have bad affects on the liver. Moderation in alcohol consumption is generally defined as one drink per day for women and two drinks per day for men.
Grapefruit juice appears to interfere with the metabolism of most statin drugs. It is best to avoid it during treatment.
Do not stop taking your statin medicine without first checking with your doctor. When you stop, your cholesterol levels may increase, and your doctor may want to use other ways to keep cholesterol levels within a more desirable range.
Lovastatin works better when it is taken with food. If you are taking lovastatin once a day, take it with the evening meal. If you are taking more than one dose a day, take each dose with a meal or snack.
If you are taking another kind of statin, ask the pharmacist if you need to take it with food.
If you miss a dose of your statin drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Avoid double doses.
Statin drugs are generally considered safe and few patients need to discontinue them due to adverse effects. The side effects listed here have been reported for at least one of the statins, not necessarily all of them. However, since many of the effects of statins are similar, it is possible that these side affects may occur with any one of these medicines, although they may be more common with some than with others.
The most significant adverse effects, though rare, involve the liver (elevated liver enzymes) and the muscles (different conditions called myopathy and rhabdomyolysis).
Other potential adverse effects include changes in mental status (eg, memory loss and confusion) and increased blood sugar levels.
Following up regularly with your doctor will allow him or her to detect these problems through your medical history and blood tests.
Common side effects include:
ConstipationDiarrheaFlatulence (gas)HeartburnAbdominal painHeadacheJoint pain
Check with your doctor as soon as possible if any of the following side effects occur:
Muscle aches, cramps, stiffness, tenderness, or weakness, especially if accompanied by unusual tiredness and/or feverMemory loss and/or confusionSymptoms of high blood sugar (eg, increased urination, extreme thirst, hunger, fatigue)Brown urineAnkle, feet, or leg swellingChest painFeverSkin rashConstant or worsening stomach painUnusual tiredness or weaknessJaundice
(yellowing of the eyes or skin)
Check with your doctor if any of the following side effects occur frequently and/or become bothersome:
ConstipationDiarrheaDizzinessGasHeadacheHeartburnIndigestionNauseaStomach painDecreased sexual abilityTrouble sleeping
1/30/2009 DynaMed's Systematic Literature Surveillance
: Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients.
J Am Coll Cardiol.
Last reviewed June 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.