Understanding Cholesterol-Lowering Medications (cont.)
Statins: Interactions and Side Effects
Drug or food interactions: Consuming large quantities of grapefruit juice, more than 1 quart per day, decreases the ability of the liver to metabolize some statins, such as atorvastatin, simvastatin, or lovastatin. Also, and possibly more importantly, statins and certain other medications can interact, causing serious side effects. Tell the doctor about any prescription and nonprescription medications the patient is taking, including the following:
- Herbal supplements
- Medication for your immune system, such as cyclosporine, a drug prescribed following organ transplantation
- Other cholesterol medications, such as fibrates or nicotinic acid
- Medication for infections, such as erythromycin, telithromycin, clarithromycin (Biaxin), itraconazole (Sporanox), or ketoconazole (Nizoral, Extina, Xolegel, Kuric)
- Verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS), diltiazem (Cardizem, Dilacor, Tiazac and several others), amiodarone (Cordarone), or dioxin
- Birth control pills
- Medication for HIV or AIDS, such as indinavir (Crixivan) or ritonavir (Norvir)
- Warfarin (Coumadin) (warfarin may have an increased effect when administered with some statins, such as rosuvastatin, lovastatin, or simvastatin. The international normalized ratio [INR] must be closely monitored when warfarin is administered with statins.)
Side Effects: Statins are well tolerated, and serious side effects are rare.
- If you experience diffuse muscle soreness, pain, and weakness; vomiting; or stomach pain or if your urine is brown (a possible sign of muscle breakdown), contact your doctor immediately and stop taking the statin medication. You may need blood tests for possible muscle problems. Rarely, widespread muscle breakdown, known as rhabdomyolysis, can occur, usually in people who are taking other drugs that interfere with the breakdown of the statin and in people with advanced kidney problems. This is a medical emergency.
- Some people experience an upset stomach, gas, constipation, and abdominal pain or cramps. These symptoms are usually mild to moderate and generally disappear as the body adjusts to the medication. Liver function is usually monitored in patients taking statins. Rare reports of neuropathy (numbness and tingling) affecting the hands, arms, feet, and legs have been described.
Medically Reviewed by a Doctor on 11/6/2015
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