What are statins and how do they work. How to take statins effectively. What are the potential side effects and interactions of statins. How can lifestyle changes complement statin therapy. Where to find reliable information about statin medications.

What Are Statins and How Do They Function?

Statins are a class of medications designed to lower cholesterol levels and prevent the build-up of plaque in arteries. These drugs play a crucial role in reducing the long-term risk of heart attacks by inhibiting plaque formation and preventing existing plaque from worsening. The effect of statins on plaque is powerful but gradual, requiring regular cholesterol level checks to monitor their effectiveness.

Do statins only work on high cholesterol? No, statins can be beneficial even for individuals with low-to-normal cholesterol levels if their arteries are already clogged with plaque. It’s important to note that high cholesterol is not the sole factor in plaque formation, and plaque can still develop even with lower cholesterol levels.

Common Statin Medications

• Atorvastatin (Lipitor®)
• Fluvastatin (Lescol®)
• Lovastatin (Mevacor®)
• Pravastatin (Pravachol®)
• Rosuvastatin (Crestor®)
• Simvastatin (Zocor®)

Is it necessary to continue taking statins indefinitely? Yes, the anti-plaque effect of statins diminishes if you stop taking them. Therefore, statins are typically prescribed for life, even if cholesterol levels return to normal limits.

Proper Administration of Statin Medications

Statins are generally taken once daily, usually in the evening. However, Atorvastatin (Lipitor®) and Rosuvastatin (Crestor®) can be taken in the morning if it’s more convenient. Consistency in timing is key to maximizing the medication’s effectiveness.

Can the timing of statin intake affect its efficacy? While most statins are recommended to be taken at night, some studies suggest that the timing may not significantly impact their effectiveness for certain types. However, it’s always best to follow your healthcare provider’s specific instructions.

Potential Interactions and Precautions with Statin Use

When taking statins, it’s crucial to be aware of potential interactions with other substances, including food and medications. One notable interaction is with grapefruit and grapefruit juice, which should be avoided if you’re taking Atorvastatin (Lipitor®), Simvastatin (Zocor®), or Lovastatin (Mevacor®).

Why does grapefruit interfere with certain statins? Grapefruit contains compounds that can interfere with the enzymes responsible for metabolizing these statins, potentially leading to increased levels of the medication in your bloodstream and a higher risk of side effects.

Importance of Disclosing All Medications

It’s essential to inform your healthcare provider and pharmacist about all medications you’re taking, including:

• Prescription drugs
• Non-prescription medications
• Inhalers
• Topical creams or ointments
• Over-the-counter or natural health products
• Alternative therapies
• Vitamins, minerals, or supplements
• Herbal remedies
• Homeopathic medicines
• Traditional remedies, such as Chinese medicines

Why is it crucial to disclose all medications and supplements? Some non-prescription and herbal medications can interact with statins, potentially affecting their efficacy or causing other health issues. Full disclosure allows your healthcare team to assess potential interactions and adjust your treatment plan accordingly.

Understanding and Managing Statin Side Effects

While most people tolerate statins well, some individuals may experience side effects. Common side effects can include:

• Upset stomach
• Constipation
• Gas
• Sore muscles, cramping, or persistent weakness

What should you do if you experience side effects from statins? If you encounter any of these symptoms, it’s important to communicate with your healthcare provider. They may recommend adjusting the dosage or switching to a different statin to alleviate the side effects while maintaining the benefits of the medication.

Are all statin side effects the same? No, the severity and type of side effects can vary among individuals and different statin medications. Some people may experience no side effects at all, while others might be more sensitive to certain formulations.

Complementing Statin Therapy with Lifestyle Changes

While statins are effective in managing cholesterol levels and reducing heart disease risk, they work best when combined with a heart-healthy lifestyle. Medication can help control heart disease and high blood pressure, but it cannot cure these conditions entirely.

How can lifestyle changes enhance the effectiveness of statin therapy? Adopting a healthy lifestyle can potentially help minimize the need for medication and improve overall heart health. Key areas to focus on include:

• Maintaining a balanced, heart-healthy diet
• Engaging in regular physical activity
• Managing stress effectively
• Quitting smoking
• Limiting alcohol consumption

It’s advisable to consult with your healthcare provider to determine the most beneficial lifestyle goals tailored to your individual needs and medical condition.

Accessing Reliable Information on Statin Medications

To ensure you have accurate and up-to-date information about your statin medication, it’s important to rely on trustworthy sources. Your healthcare provider and pharmacist are primary resources for personalized advice and information.

Where can you find additional reliable information about statins? Several reputable online resources provide valuable information about medications, including statins:

• Health Canada – Drugs and Health Products: Offers comprehensive information on safe medicine use, generic drug safety and effectiveness, and maintains a Drug Product Database.
• MedEffect Canada: Provides safety alerts, public health advisories, warnings, and recalls related to medications.
• Provincial health ministry websites: Often offer resources specific to your region, such as Ontario’s MedsCheck program for free pharmacist consultations.

Why is it important to use trusted sources for medication information? Relying on credible sources ensures that you receive accurate, scientifically-backed information about your medication, helping you make informed decisions about your health and avoid potentially harmful misinformation.

Navigating Drug Coverage and Financial Considerations

Understanding your drug coverage options is an important aspect of managing your statin medication regimen. Coverage can vary depending on your location, insurance plan, and specific medication prescribed.

How can you determine your drug coverage for statins? Start by reviewing your health insurance policy or contacting your insurance provider directly. Many provinces also offer drug coverage programs, especially for seniors or individuals with chronic conditions.

What options are available if you’re having difficulty affording your statin medication? If cost is a concern, discuss this with your healthcare provider or pharmacist. They may be able to suggest alternatives such as:

• Switching to a generic version of the medication
• Exploring patient assistance programs offered by pharmaceutical companies
• Investigating government-sponsored drug coverage programs
• Considering a different statin that may be more affordable under your current coverage

Remember, it’s crucial not to discontinue or alter your statin regimen without consulting your healthcare provider, as this could impact your heart health and overall well-being.

Monitoring and Long-Term Management of Statin Therapy

Effective statin therapy requires ongoing monitoring and management to ensure optimal results and minimize potential risks. Regular check-ups and laboratory tests play a crucial role in this process.

How often should cholesterol levels be checked while on statin therapy? The frequency of cholesterol checks can vary based on individual factors, but typically, your healthcare provider may recommend testing every 3-12 months. These regular assessments help determine the effectiveness of the medication and whether any adjustments are necessary.

What other aspects of health should be monitored while taking statins? In addition to cholesterol levels, your healthcare provider may monitor:

• Liver function: Through periodic liver enzyme tests
• Muscle health: Especially if you experience muscle pain or weakness
• Blood sugar levels: As statins may slightly increase the risk of developing type 2 diabetes in some individuals
• Overall cardiovascular health: Including blood pressure and other risk factors for heart disease

Is it possible to reduce or discontinue statin therapy over time? While statins are often prescribed as a long-term treatment, in some cases, individuals who have significantly improved their cholesterol levels through lifestyle changes may be able to reduce their dosage or discontinue the medication under close medical supervision. However, this decision should always be made in consultation with your healthcare provider, as stopping statin therapy can increase the risk of cardiovascular events.

How can patients actively participate in managing their statin therapy? To ensure the best outcomes from your statin treatment:

1. Adhere to your prescribed medication regimen
2. Attend all scheduled follow-up appointments
3. Communicate any side effects or concerns promptly to your healthcare provider
4. Maintain a heart-healthy lifestyle to complement your medication
5. Keep track of your cholesterol levels and other relevant health metrics
6. Stay informed about your condition and treatment options

By actively engaging in your treatment plan and maintaining open communication with your healthcare team, you can maximize the benefits of statin therapy and contribute to your long-term cardiovascular health.

Cholesterol lowering medications statins | Heart and Stroke Foundation

Heart

What is this medication?

Statins help prevent the build-up of plaque in your arteries. This can lower the long-term risk of having a heart attack.

Statins include:

• Atorvastatin (Lipitor^®)
• Fluvastatin (Lescol^®)
• Lovastatin (Mevacor^®)
• Pravastatin (Pravachol^®)
• Rosuvastatin (Crestor^®)
• Simvastatin (Zocor^®)

Be aware:

• Generic names are listed first.
• Canadian brand names are in brackets.
• This list doesn’t include every brand name.
• If your prescription isn’t listed, your pharmacist is the best source for more information.

What does it do?

Statins help stop plaque from forming in your blood vessels. They can also prevent existing plaque from getting worse. Their effect on plaque is powerful but slow.

Your healthcare provider may check your cholesterol levels regularly.

• Changes in your cholesterol levels can show how much your statin is helping you.
• High cholesterol is not the only factor in plaque formation.
  • Plaque can still form with lower cholesterol levels.
• If your arteries are clogged with plaque, you will probably take a statin even if your cholesterol is low-to-normal.

Be Aware: The anti-plaque effect goes away if you stop taking your statin. So statins are usually taken for life, even if your cholesterol levels return to normal limits.

How do I take it?

Statins are taken once a day, usually at night.

• You can take Atorvastatin (Lipitor^®) and Rosuvastatin (Crestor^®) in the morning if it is easier.

Are there any interactions?

Avoid grapefruit and grapefruit juice if you are taking:

• Atorvastatin (Lipitor^®)
• Simvastatin (Zocor^®)
• Lovastatin (Mevacor^®)

Visit Health Canada to learn more about The Effects of Grapefruit and its Juice on Certain Drugs.

Some non-prescription and herbal medications can also affect statin medications. They may even cause other health problems.

Tell your healthcare provider and pharmacist about all the medications you are taking. These include:

• Prescriptions
• Non-prescription drugs
• Inhalers
• Creams or ointments
• Over-the-counter or natural health products
• Alternative therapies
• Vitamins, minerals or supplements
• Herbal remedies
• Homeopathic medicines
• Traditional remedies, such as Chinese medicines

Are there any side effects?

Most people who take statins will not have any side effects.

Some people may experience:

• Upset stomach
• Constipation
• Gas
• Sore muscles, cramping,  or weakness that doesn’t go away.
  • Lowering the dose or switching to a different statin may help.

Tell your healthcare provider if you are having problems.

Lifestyle changes that can also help

There are two ways to control and manage your heart health: medication and lifestyle.

Medication can help you control heart disease and high blood pressure, but it cannot cure it.

A healthy lifestyle can help you keep medication to a minimum.

Visit heartandstroke.ca/get-healthy. Learn how to keep your heart healthy with current information and advice from Heart and Stroke Foundation experts.

Talk to your healthcare provider about the most beneficial lifestyle goals for you.

Related information

Your healthcare provider or pharmacist are your best sources of information. You can also learn more about medications at any of these trusted sites.

Health Canada – Drugs and Health Products
Provides health and medical information for Canadians to maintain and improve their health.

Learn more about:

• Safe Use of Medicines
• Safety and Effectiveness of Generic Drugs
• Buying drugs over the Internet
• Drug Product Database
• MedEffect Canada
  Provides safety alerts, public health advisories, warnings and recalls.

Your ministry of health also offers health resources in your province or territory. For example, Ontario’s MedsCheck program provides free pharmacist consultations. And British Columbia’s Senior Healthcare web page provides information about important health programs.

Drug coverage

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Statins – Uses – NHS

Statins may be recommended if you have cardiovascular disease (CVD) or at a high risk of getting it in the next 10 years.

Cardiovascular disease (CVD)

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.

It’s often caused by high cholesterol and is a very common cause of death in the UK.

The main types of CVD are:

• coronary heart disease – when the blood supply to the heart becomes restricted as a result of the hardening and narrowing of the arteries (atherosclerosis)
• angina – chest pain caused by reduced blood flow to the heart muscles
• heart attacks – when the supply of blood to the heart is suddenly blocked
• strokes and transient ischaemic attacks (TIAs) – when the supply of blood to the brain becomes blocked or disrupted
• peripheral arterial disease (PAD) – when a build-up of fatty deposits in the arteries restricts blood supply to the limbs

Statins cannot cure these conditions, but they can help prevent them getting worse or recurring in people who have been diagnosed with them.

They can also reduce the chance of CVD developing in the first place in people at risk.

Statins are usually used in combination with lifestyle measures, such as: 

• eating a healthy diet low in saturated fat
• exercising regularly
• stopping smoking
• moderating your alcohol consumption

People at risk of CVD 

If you do not have any form of CVD, statins may still be recommended if you’re thought to be at a high risk of getting the condition.

The current recommendation is that you should be given a formal assessment of your CVD risk if you have at least a 1 in 10 chance of developing CVD at some point in the next 10 years.

A GP may also recommend a formal assessment of your CVD risk if they think you may be at an increased risk of CVD, based on your personal and family medical history.

For this formal assessment, the GP or practice nurse will use CVD risk assessment computer software that takes into account factors such as:

• your age
• if you’re male or female
• your ethnic group, as some have an increased risk of CVD
• your weight and height
• if you smoke or have previously smoked
• if you have a family history of CVD
• your blood pressure
• your blood cholesterol levels
• if you have certain long-term conditions – such as diabetes, chronic kidney disease, rheumatoid arthritis and atrial fibrillation

Other uses

Statins can also be used to treat familial hypercholesterolaemia.

This is an inherited condition caused by a genetic fault that leads to high cholesterol levels, even in people who have a generally healthy lifestyle.

Page last reviewed: 03 October 2022
Next review due: 03 October 2025

Statins: pharmacological group

Description

Statins (atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, fluvastatin) inhibit 3-hydroxy-3-methyl-glutaryl-CoA reductase, an enzyme involved in cholesterol synthesis but mainly in the liver. They are the most effective means of correcting hypercholesterolemia, as well as primary and secondary prevention of complications of atherosclerosis, reducing the incidence of myocardial infarction, stroke and coronary death.

Contraindications. Hypersensitivity, active liver disease, pregnancy (when using statins, women should use effective contraceptive methods), breast-feeding.

Warnings. Patients with a history of liver disease or alcohol abuse should be especially careful when taking statins. Prior to prescribing a statin, liver function should be assessed. Liver function tests and creatine kinase activity should be repeated 1–3 months after initiation of statin use and each dose increase, and then monitored at intervals of 6–12 months or more frequently if signs of liver or muscle damage appear. The use of the statin should be discontinued if the activity of ALT and ACT, when repeated, is 3 times the upper limit of normal. Patients should be actively questioned about the presence of muscle soreness or weakness in order to detect myopathy in a timely manner. If creatine kinase activity > 5 times the upper limit of normal and there are clinical manifestations of myopathy, you should stop taking the statin until the clinical manifestations completely disappear and creatine kinase activity normalizes. After that, therapy with the same statin at a lower dose should be resumed or another statin should be prescribed at the same minimum dose.

Side effects. Headache, liver function test changes, paresthesia, abdominal pain, flatulence, nausea, vomiting, diarrhea, constipation, allergic reactions; rarely – hepatitis.

Influence on muscles. Muscle involvement (myalgia, myositis and myopathy) occurs in 1-5% of statin therapy. The likelihood of developing myopathy increases with the use of statins in high doses, as well as when they are combined with fibrates, nicotinic acid, immunosuppressants, erythromycin, clarithromycin, azole antifungals, and with constant consumption of grapefruit juice. Therefore, if combination therapy is necessary, monitoring of enzyme activity (creatine kinase, ALT, ACT) should be carried out more often, and patients should be instructed about the possibility of developing myopathy and, in rare cases, rhabdomyolysis (muscle tissue breakdown).

Development of diabetes. There have been reports that long-term statin use may be associated with a higher risk of developing diabetes. It has been noted that high-dose statin use in individuals with low BMI, impaired glucose tolerance, the elderly, and females is associated with a slightly higher incidence of diabetes mellitus compared with moderate-dose statin use. However, the benefit of statins in reducing the risk of developing cardiovascular complications far outweighs the risk of developing diabetes.

The most effective and safe statins for cholesterol, with the least side effects of the latest generation

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Statins – what are they, benefits and harms

Statins – what kind of medicine is it? Statins are drugs that lower blood cholesterol levels. Their main purpose is the primary prevention and treatment of diseases of the cardiovascular system, since cholesterol is one of the main factors provoking their occurrence and development.

Cholesterol is an organic alcohol naturally produced in the body, as well as ingested through food, and it can cause clogging of arteries, depositing in them in the form of atherosclerotic plaques. This entails malnutrition of the brain and limbs, leads to a whole bunch of diseases in a person (ischemic heart disease, cerebrovascular insufficiency), and can even cause gangrene, stroke or heart attack.

In simple terms, what it is – these are drugs that prevent heart attacks and strokes, lower and maintain normal cholesterol levels by blocking its production by the body.

What are statins for cholesterol?

What are statins? Statins are all those drugs that inhibit cholesterol-producing enzymes in the liver. They can also improve the function and structure of the heart muscle, which is especially important in the prevention and recovery of myocardial infarction. These drugs belong to the lipid-lowering group of drugs – substances that are aimed at reducing the concentrations of certain harmful fractions in the body (to which cholesterol belongs).

How do statins work in the body?

To understand how statins lower cholesterol, it is worth explaining the mechanism of action. It lies in the fact that statins inhibit the enzyme HMG-CoA reductase, which is responsible for the synthesis of this compound. Here we get the answer to the question of why and why statins are harmful – their negative effect on the liver, which produces cholesterol.

What statins do next in the body: lower the concentration of cholesterol in the blood, and also increase the level of “good” cholesterol – HDL.

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At what cholesterol should you start taking statins?

At what cholesterol should I take statins? The normal level of total cholesterol in women is 2.9- 6 mmol / l, in men – 3.6 – 7.8 mmol / l. However, it is worth considering that it can change with age, as well as with some hormonal disruptions, so in any case, these drugs are prescribed by a doctor. He will explain at what time to take statins, how much to take statins. Also, when prescribing, he will separately consider the level of “bad” and “good” cholesterol in your body.

Don’t wonder at what age you take statins – the decision is made based on test results, not age. However, despite the safety of modern drugs, it is worth considering the possible risk for elderly patients – so the final decision should be made by the doctor.

Can I take statins every other day?

Why do people take statins at night? The answer is simple – the deposition of cholesterol on the walls of blood vessels, as well as thrombosis, is especially active at night, during sleep. Therefore, do not think about what time of day to take statins – just drink them before bedtime.

Speaking about how many years you can take statins, it is worth saying that they give a stable therapeutic effect only with constant and long-term use. When prescribed by a doctor, they can be drunk for 3-5 years and then, if necessary, continue taking them. Moreover, if there are indications, their intake can last a lifetime, and, with the right choice of the drug and the right dosage, even without pronounced side effects.

Statins: side effects on the body

Which latest generation statins are best for cholesterol? Speaking about specific names, it is worth mentioning such drugs as atorvastatin, cerivastatin, rosuvastatin, pitavastatin, fluvastatin and others. They may have different trade names – only generic international names of active substances are given here, by which you can easily find the right medicine. The benefits and harms of statins are the subject of much discussion, however, however, these drugs are modern, they have a minimum of side effects and contraindications.

However, here are the main possible side effects of statins that sometimes appear when taken:

• lower blood sugar levels
• insomnia
• obesity
• vomiting and diarrhea
• constipation
• diarrhea
• allergic reactions
• back and muscle pain

How to replace statins?

How to replace statins for lowering cholesterol is a topical issue for those who, due to contraindications or side effects, cannot take them. There is a whole list of folk remedies and products that can lower blood cholesterol levels.

There are other ways to lower cholesterol without statins. This is adequate physical activity, minimizing stress, full and sufficient sleep (at least 7-8 hours a day). You should give up bad habits – smoking, alcohol, put your diet in order by reducing the consumption of animal fats. If you have excess weight, you should get rid of it.

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