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Statins (Cholesterol Lowering Drugs)

Reviewed on 3/18/2020

What Are Statins, and Why Are They Used?

  • Statins, also known as HMG-CoA reductase inhibitors, are effective cholesterol-lowering medications and increase clearance of low-density lipoprotein (LDL).
  • The benefits of statin use decreases the risk of heart attack, stroke, and other arterial diseases that are related to high cholesterol levels in the body.
  • The majority of physicians and researchers support the use of statins but there are some investigators that suggest they may be "overused".
  • Cholesterol is a soft, waxy substance found in the blood and in all cell membranes; it is also used to form some hormones. It is an integral part of a normal person's body. Cholesterol can be absorbed from food and also synthesized in the liver.
  • High levels of cholesterol in the blood is referred to as hypercholesterolemia. Hypercholesterolemia is a major risk factor for cardiac, stroke, and other diseases because high levels of cholesterol in the blood cause cholesterol to be deposited in arteries, which then forms plaque, and eventually may participate in artery blockage.
  • Statins are not the only treatments used to lower cholesterol; for example, nicotinic acid, fibric acid, and cholesterol absorption inhibitors are prescribed to lower cholesterol levels.
  • In addition to medication, risk modifiers to lower cholesterol include the following:
  • Often, a health-care professional may ask the patient to try to modify these risks factors for a few months before prescribing the statin medication to see the impact of lifestyle changes on cholesterol, triglyceride, and other levels.
  • Statins do not replace making positive lifestyle changes to lower blood cholesterol levels; they work together in decreasing cholesterol levels and results are usually seen after 4-6 weeks of taking statins.

List of Brand and Generic Names of Statins Available In the US

Commonly prescribed statins include:

Statins come in tablet or capsule forms and are usually taken with the evening meal or at bedtime.

How Effective Are Satins in Lowering Cholesterol?

Statins may lower cholesterol levels by 20% to 60% by slowing the production of cholesterol and by increasing the liver's ability to remove LDL (low density lipoprotein) or bad cholesterol. Statins lower LDL levels more effectively than other types of drugs. They also modestly increase HDL (high-density lipoprotein) or good cholesterol levels and decrease total cholesterol and triglyceride levels.

What Are the Side Effects of Statins?

Statins are safe and well tolerated; however, side effects may occur. They include:

  • Muscle pain or soreness
  • Leg pain
  • Muscle weakness
  • Generalized pain and weakness
  • Vomiting
  • Stomach cramps
  • Brown discolored urine caused by breakdown of muscles cells being passed in the urine

These symptoms may suggest possible muscle problems such as myopathy and rhabdomyolysis. Rhabdomyolysis a in which the muscle cells break down and cause kidney failure. These symptoms may present a medical emergency and should not be ignored. You should stop taking the statin medication and contact your health-care professional immediately for advice. Liver inflammation may occur with statin use and often blood tests monitoring liver function are done on a routine basis.

Less serious side effects may include upset stomach, bloating and gas, constipation, and abdominal cramps. These symptoms are usually mild to moderate and generally disappear as the body adjusts to the medication.

Other side effects associated with statins include:

QUESTION

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Can You Take Statins and Grapefruit Juice?

Grapefruit juice may decrease the ability of the liver to metabolize some statins, for example, atorvastatin (Lipitor), simvastatin (Zocor), and lovastatin (Mevacor, Altocor), and should not be consumed at the same time as the statin medication is taken. Some doctors recommend avoiding any grapefruit juice. Also, and possibly more importantly, tell your doctor about any prescription and nonprescription medications you are taking.

Do Statins Affect People with Diabetes?

Statins have been associated with increased fasting blood glucose (blood sugar) levels, HbA1C, and diabetes.

Do Statins Cause Memory Loss?

Statins have been associated with memory loss, forgetfulness, amnesia, memory impairment, and confusion. Memory loss and other cognitive side effects are rare side effects of statins and they are not serious. Symptoms may begin 1 day to years after stating the statin and resolve within a median time of 3 weeks after the statin is stopped.

What Foods and Other Drugs Interact with Statins?

Statins and other medications may interact, causing serious side effects. These can include the following:

Health-care professionals or pharmacists will be able to give advice and direction regarding potential interactions between statins and other medications and dietary supplements.

Are Statins Safe to Take?

Individuals should not use statins if they:

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Cholesterol drugs picture

Cholesterol Lowering Medications

Cholesterol-lowering medications include:

  • statins,
  • PCSK9 inhibitors
  • bile acid sequestrants,
  • cholesterol absorption inhibitors,
  • nicotinic acid agents, and
  • fibrates.
Reviewed on 3/18/2020
References
Rosenson, R. MD. "Statins: Actions, side effects, and administration." UpToDate. Updated: Aug 13, 2019.
<http://www.uptodate.com/contents/statins-actions-side-effects-and-administration>
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