Statins: Are these cholesterol-lowering drugs right for you?

Statins: Are these cholesterol-lowering drugs right for you?

Find out whether your risk factors for heart disease make you a good candidate for statin therapy.

By Mayo Clinic Staff

Statins are drugs that can lower your cholesterol. They work by blocking a substance your body needs to make cholesterol.

Lowering cholesterol isn’t the only benefit associated with statins. These medications have also been linked to a lower risk of heart disease and stroke. These drugs may help stabilize the plaques on blood vessel walls and reduce the risk of certain blood clots.

A number of statins are available for use in the United States. They include:

• Atorvastatin (Lipitor)
• Lovastatin (Altoprev)
• Pitavastatin (Livalo, Zypitamag)
• Pravastatin (Pravachol)
• Rosuvastatin (Crestor, Ezallor)
• Simvastatin (Zocor)

Sometimes, a statin is combined with another heart medication. Examples are atorvastatin-amlodipine (Caduet) and ezetimibe-simvastatin (Vytorin).

Should you be on a statin?

Whether you need to be on a statin depends on your cholesterol levels and other risk factors for heart and blood vessel (cardiovascular) disease. Your doctor will consider all of your risk factors for heart attacks and strokes before prescribing a statin.

Knowing your cholesterol numbers is a good place to start.

• Total cholesterol. Most people should try to keep their total cholesterol below 200 milligrams per deciliter (mg/dL), or 5.2 millimoles per liter (mmol/L).
• Low-density lipoprotein (LDL) cholesterol. Aim to keep this “bad” cholesterol under 100 mg/dL, or 2.6 mmol/L. If you have a history of heart attacks or you’re at a very high risk of a heart attack or stroke, you may need to aim even lower (below 70 mg/dL, or 1.8 mmol/L).

The most important thing your doctor will keep in mind when thinking about statin treatment is your long-term risk of a heart attack or stroke. If your risk is very low, you probably won’t need a statin, unless your LDL is above 190 mg/dL (4.92 mmol/L).

If your risk is very high — for example, you’ve had a heart attack in the past — a statin may be helpful even if you don’t have high cholesterol.

Besides cholesterol, other risk factors for heart disease and stroke are:

• Tobacco use
• Lack of exercise
• High blood pressure
• Diabetes
• Overweight or obesity
• Narrowed arteries in your neck, arms or legs (peripheral artery disease)
• Family history of heart disease, especially if it was before the age of 55 in male relatives or before 65 in female relatives
• Older age

Risk assessment tools

Your doctor may use an online tool or calculator to better understand your long-term risks of developing heart disease and whether a statin may be right for you. These tools can help your doctor predict your chances of having a heart attack in the next 10 to 30 years. The formulas in these tools often consider your cholesterol levels, age, race, sex, smoking habits and health conditions.

Cholesterol guidelines

Not everyone with a heart condition needs to use a statin. Guidelines from the U.S. Preventive Services Task Force, American College of Cardiology and American Heart Association suggest four main groups of people who may be helped by statins:

• People who don’t have heart or blood vessel disease, but have one or more cardiovascular disease risk factors and a higher 10-year risk of a heart attack. This group includes people who have diabetes, high cholesterol or high blood pressure, or who smoke and whose 10-year risk of a heart attack is 10% or higher.
• People who already have cardiovascular disease related to hardening of the arteries. This group includes people who have had heart attacks, strokes caused by blockages in a blood vessel, ministrokes (transient ischemic attacks), peripheral artery disease, or prior surgery to open or replace coronary arteries.
• People who have very high LDL (“bad”) cholesterol. This group includes adults who have LDL cholesterol levels of 190 mg/dL (4.92 mmol/L) or higher.
• People who have diabetes. This group includes adults 40 to 75 who have diabetes and an LDL cholesterol level between 70 and 189 mg/dL (1.8 and 4.9 mmol/L), especially if they have evidence of blood vessel disease or other risk factors for heart disease such as high blood pressure or smoking.

The U.S. Preventive Services Task Force recommends low- to moderate-dose statins in adults ages 40 to 75 who have one or more risk factors for heart and blood vessel disease and at least a 1 in 10 chance of having a cardiosvascular disease event in the next 10 years.

Healthy lifestyle is still key for preventing heart disease

Lifestyle changes are key for reducing your risk of heart disease, whether you take a statin or not. To reduce your risk:

• Quit smoking and avoid secondhand smoke
• Eat a healthy diet rich in vegetables, fruits, fish and whole grains and low in saturated fat, trans fat, refined carbohydrates and salt
• Be physically active more often and sit less
• Maintain a healthy weight

If your cholesterol — particularly the LDL (“bad”) type — stays high after you make healthy lifestyle changes, statins might be an option for you.

Consider statins a lifelong commitment

You may think that if your cholesterol goes down, you don’t need a statin anymore. But if the drug helped lower your cholesterol, you’ll likely need to stay on it long term to keep your cholesterol down. If you make significant changes to your diet or lose a lot of weight, talk to your doctor about whether it might be possible to control your cholesterol without medication.

Side effects of statins

Statins are tolerated well by most people, but they can have side effects. Some side effects go away as the body adjusts to the medication.

But tell your doctor about any unusual signs or symptoms you might have after starting statin therapy. Your doctor may want to decrease your dose or try a different statin. Never stop taking a statin without talking to your doctor first.

Commonly reported side effects of statins include:

• Headaches
• Nausea
• Muscle and joint aches

However, studies comparing statins to a fake pill (placebo) have found a very small difference in the number of people reporting muscle aches between the groups.

Rarely, statins can cause more-serious side effects such as:

• Increased blood sugar or type 2 diabetes. It’s possible that your blood sugar (blood glucose) level may slightly increase when you take a statin, which can lead to type 2 diabetes. This is especially likely if your blood sugar is already high. However, the benefit of taking a statin may outweigh that risk. People with diabetes who take statins have much lower risks of heart attacks.
• Muscle cell damage. Very rarely, high-dose statin use can cause muscle cells to break down and release a protein called myoglobin into the bloodstream. This can lead to severe muscle pain and kidney damage.
• Liver damage. Occasionally, statin use causes an increase in liver enzymes. If the increase is mild, you can continue to take the drug. Low to moderate doses of statins don’t appear to severely raise liver enzyme levels.
• Memory problems. Some people have reported memory loss and thinking problems after using statins. But a number of studies haven’t been able to find any evidence to prove that statins actually cause these difficulties. Other studies suggest that statins may help prevent these issues.

Also, ask your doctor if the statin you use will interact with any other prescription or over-the-counter drugs or supplements you take.

Weighing the risks and benefits of statins

The U.S. Preventive Services Task Force says there’s not yet enough evidence to make a recommendation about the risks and benefits of statins for people over 75. Statins also aren’t recommended if you are pregnant or have some forms of advanced liver disease.

When thinking about whether you should take statins for high cholesterol, ask yourself these questions:

• Do I have other risk factors for heart and blood vessel disease?
• Am I willing and able to make lifestyle changes to improve my health?
• Am I concerned about taking a pill every day, perhaps for the rest of my life?
• Am I concerned about statins’ side effects or interactions with other drugs?

It’s important to consider your medical reasons, personal values, lifestyle choices and any concerns when choosing a treatment. Talk to your doctor about your total risk of heart and blood vessel disease and personal preferences before making a decision about statin therapy.

March 14, 2020

Show references

1. Cholesterol medications. American Heart Association. https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia/cholesterol-medications. Accessed Jan. 27, 2020.
2. Rosenson RS. Statins: Actions, side effects, and administration. https://www.uptodate.com/contents/search. Accessed Jan. 30, 2020.
3. Ferri FF. Hypercholesterolemia. In: Ferri’s Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 30, 2020.
4. Kellerman RD, et al. Hyperlipidemia. In: Conn’s Current Therapy 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 30, 2020.
5. Adhyaru BB, et al. Safety and efficacy of statin therapy. Nature Reviews — Cardiology. 2019; doi:10.1038/s41569-018-0098-5.
6. High blood cholesterol. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/high-blood-cholesterol. Accessed Jan. 27, 2020.
7. US Preventive Services Task Force, et al. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016; doi:10.1001/jama.2016.15450.
8. Listen to your heart: Learn about heart disease. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-truth/listen-to-your-heart. Accessed Jan. 27, 2020.
9. Grundy SM, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Journal of the American College of Cardiology. 2018; doi:10.1016/j.jacc.2018.11.003.
10. Thanassoulis G, et al. A long-term benefit approach vs standard risk-based approaches for statin eligibility in primary prevention. JAMA Cardiology. 2018; doi:10.1001/jamacardio.2018.3476.
11. AskMayoExpert. Statin intolerance. Mayo Clinic; 2019.
12. Lopez-Jimenez F (expert opinion). Mayo Clinic. Feb. 10, 2020.

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Statins – NHS

Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.

LDL cholesterol is often referred to as “bad cholesterol”, and statins reduce the production of it inside the liver.

Why have I been offered statins?

Having a high level of LDL cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD).

CVD is a general term that describes a disease of the heart or blood vessels. It’s the most 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
• 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
• stroke – when the supply of blood to the brain becomes blocked

A doctor may recommend taking statins if either:

• you have been diagnosed with a form of CVD
• your personal and family medical history suggests you’re likely to develop CVD at some point over the next 10 years and lifestyle measures have not reduced this risk

Find out more about when statins may be recommended.

Taking statins

Statins come as tablets that are taken once a day.

For some types of statin it does not matter what time of day you take it, as long as you stick to the same time.

Some types of statin should be taken in the evening.

Check with your doctor whether there’s a particular time of day you should take your statin.

You usually have to continue taking statins for life because if you stop taking them, your cholesterol will return to a high level within a few weeks.

If you forget to take your dose, do not take an extra one to make up for it. Just take your next dose as usual the following day.

If you accidentally take too many statin tablets (more than your usual daily dose), contact a doctor or pharmacist for advice or call NHS 111.

Cautions and interactions

Statins can sometimes interact with other medicines, increasing the risk of unpleasant side effects, such as muscle damage.

Some types of statin can also interact with grapefruit juice.

It’s very important to read the information leaflet that comes with your medicine to check if there are any interactions you should be aware of.

If in doubt, contact a GP or pharmacist for advice.

Find out more things to consider when taking statins.

Side effects of statins

Many people who take statins experience no or very few side effects.

Others experience some troublesome, but usually minor, side effects, such as diarrhoea, a headache or feeling sick.

Your doctor should discuss the risks and benefits of taking statins if they’re offered to you.

The risks of any side effects also have to be balanced against the benefits of preventing serious problems. 

A review of scientific studies into the effectiveness of statins found around 1 in every 50 people who take the medicine for 5 years will avoid a serious event, such as a heart attack or stroke, as a result.

Find out more about the side effects of statins.

Alternatives to statins

If you’re at risk of developing CVD in the near future, your doctor will usually recommend lifestyle changes to reduce this risk before they suggest that you take statins.

Lifestyle changes that can reduce your cholesterol level and CVD risk include:

Statins may be recommended if these measures do not help.

Read more about treating high cholesterol and preventing CVD.

Types of statin

There are 5 types of statin available on prescription in the UK:

Page last reviewed: 19 November 2018
Next review due: 19 November 2021

Cholesterol-Lowering Drugs: Benefits & Side Effects

What types of drugs are used to lower cholesterol?

Cholesterol is produced in the body by the liver, but is also taken in from food derived from animals (such as meat and dairy products.) You might have a genetic issue that leads to high blood cholesterol levels, or your cholesterol might be high due to food choices and lack of physical activity. You can improve cholesterol levels with a healthy diet and exercise, but if the cholesterol level doesn’t drop low enough to be healthy, your healthcare provider might prescribe medication.

There are several classes of drugs used to decrease cholesterol. These include:

• Statins.
• PCSK9 inhibitors.
• Fibric acid derivatives (also called fibrates).
• Bile acid sequestrants (also called bile acid resins).
• Nicotinic acid (also called niacin).
• Selective cholesterol absorption inhibitors.
• Omega 3 fatty acids and fatty acid esters.
• Adenosine triphosphate-citrate lyase (ACL) inhibitors.

Your healthcare provider will discuss these options with you and together you can decide which type of medication, if any, would be best for you.

Statins

Statins are one of the better known types of cholesterol-lowering drugs. Statins decrease cholesterol output by blocking the HMG CoA reductase enzyme that the liver uses to make cholesterol. Statins are also called HMG CoA reductase inhibitors.

Statins also:

• Improve the function of the lining of the blood vessels.
• Reduce inflammation (swelling) and damage.
• Reduce the risk of blood clots by stopping platelets from sticking together.
• Make plaques (fatty deposits) less likely to break away and cause damage.

These additional benefits help prevent coronary vascular disease (CVD) in people who have had events like heart attacks and in people who are at risk.

What statins are available to treat high cholesterol?

What are the side effects of statins?

Like any other drugs, statins may produce unwanted side effects. These may include:

• Constipation or nausea.
• Headaches and cold-like symptoms.
• Sore muscles, with or without muscle injury.
• Liver defects.
• Increased blood glucose levels.
• Reversible memory issues.

If you’re unable to take statins because of the side effects, you’re said to be statin-intolerant. If you are taking a statin, you should avoid grapefruit products because they can increase side effects. You should limit the amount of alcohol that you drink because combining alcohol and statin usage can increase your risk of liver damage. You may want to talk with your provider or pharmacist if you are concerned about any other types of interactions.

PCSK9 inhibitors

PCSK9 inhibitors are designed to attach to a particular liver protein, which results in lowered LDL cholesterol. This class of drug can be given with statins and is usually for people at high risk of heart disease who have not been able to lower their cholesterol enough through other means.

What PCSK9 inhibitors are available to treat cholesterol?

What are some possible side effects of PCSK9 inhibitors?

Possible side effects include pain, including muscle pain (myalgia) and back pain, or swelling at the injection site and cold-like symptoms. Another drawback may be cost as these products may be expensive.

Fibric acid derivatives (fibrates)

Fibric acid derivatives make up another class of drugs that reduce blood lipid (fat) levels, especially triglycerides. Triglycerides are fats that come from food that are created when you consume calories that are not spent.

Fibric acid derivatives may also increase the level of HDL, also called the “good” cholesterol, while lowering liver production of LDL, the “bad” cholesterol. People who have severe kidney disease or liver disease should not take fibrates.

What fibrates are available to treat high cholesterol levels?

What are some possible side effects of fibric acid derivatives?

Possible side effects of fibrates include:

• Constipation or diarrhea.
• Weight loss.
• Bloating, belching or vomiting.
• Stomachache, headache or backache.
• Muscle pain and weakness.

Bile acid sequestrants (also called bile acid resins)

This class of drugs works inside the intestine by attaching themselves to bile, a greenish fluid made of cholesterol that is produced by the liver to digest food. The binding process means that less cholesterol is available in the body. Resins decrease LDL cholesterol and give a slight boost to HDL cholesterol levels.

What bile acid resins are available to treat cholesterol?

Available bile acid resins Generic name (Brand name)	Dosages
Cholestyramine (Questran®)	4 – 16 g/day (once or twice daily). The dose of 4 grams one to two times per day should be increased gradually over about one month intervals to 8-16 g/day divided into two doses. The maximum dose is 24 g/day taken in divided doses.
Colestipol (Colestid®)	Granule formulation: 5 g once or twice a day increase by 5 g every 1 to 2 months if needed. Maintenance dose: 5 to 30 g/day once daily or in divided doses. Tablet formulation: 2 g once or twice a day increase by 2 g once or twice daily every 1 to 2 months if needed. Maintenance dose: 2 to 16 g/day once daily or in divided doses.
Colesevelam (Welchol®)	3.75 g/day in one to two divided doses. Product comes in tablet or powder form.

What are the possible side effects of bile acid resins?

Possible side effects of bile acid sequestrants include:

• Sore throat, stuffy nose.
• Constipation, diarrhea.
• Weight loss.
• Belching, bloating.
• Nausea, vomiting, stomach pain.

If your medication is a powder, never take it dry. It must always be mixed with at least three to four ounces of liquid such as water, juice or a noncarbonated beverage.

If you take other medications besides these, make sure you take the other drugs one hour before or four hours after taking the bile acid resin.

Selective cholesterol absorption inhibitors

This class of medication works in the intestine to stop the body from absorbing cholesterol. These inhibitors reduce LDL cholesterol, but may also help with triglycerides and HDL cholesterol. They can be combined with statins.

There is one product of this class currently available: ezetimibe (Zetia®). The usual dose is 10 mg/day. Possible side effects include diarrhea, fatigue and joint pain.

Nicotinic acid

Nicotinic acid, also called niacin, is a B-complex vitamin. You can get over-the-counter versions of this, but some versions are prescription only. Niacin decreases LDL cholesterol and triglycerides and increases HDL. If you have gout or severe liver disease, you should not take niacin.

What nicotinic acid products are available to treat cholesterol levels?

What are possible side effects of niacin?

The main side effect of niacin is flushing of the face and upper body, which might be lessened if you take it with meals. You might have less flushing if you take aspirin about 30 minutes before taking niacin.

Other side effects include:

• Skin issues, such as itching or tingling.
• Headache.
• Stomach upset.
• Can lead to increased blood sugars.
• Coughing.

Omega-3 fatty acid esters and polyunsaturated fatty acids (PUFAs)

These kinds of drugs, used to lower triglycerides, are commonly called fish oils. Some products are available as OTC items, while others are prescription only. Here are two things to consider: Fish oils might interfere with other medications, and some people are allergic to fish and shellfish.

What omega-3 products are available to treat cholesterol levels?

What are the possible side effects of omega 3 products?

Possible side effects of omega-3 products include:

• Belching.
• Skin issues like rash or itching.
• Gas.
• Fishy taste.
• Increased bleeding time.

Adenosine triphosphate-citric lyase (ACL) inhibitors

The FDA has approved bempedoic acid (Nexletol™) to lower cholesterol. Bempedoic acid works in the liver to slow down cholesterol production. The medication comes in 180-mg tablets taken once per day with or without food. It should be taken with statin medications, but there are dosage limitations if taken with simvastatin or pravastatin.

What are the possible side effects of bempedoic acid?

Some possible side effects of bempedoic acid include:

• Upper respiratory infection.
• Stomach, back or muscle pain.
• Increased levels of uric acid.
• Tendon injury.

What about using red rice yeast or plant stanols (phytosterols) instead of prescription drugs to lower cholesterol?

Many people say they prefer to take ‘natural’ medicines over prescription drugs. However, just because something is natural doesn’t mean that it’s safe. In the U.S., supplements are not regulated as closely as medicines. Supplements can also interfere in dangerous ways with medications that you already take.

However, red rice yeast extract does contain lovastatin, which is the same chemical that is in Mevacor. In some cases, you and your healthcare provider might agree that you should try the supplement with monitoring.

Plant stanols are another nonprescription choice for lowering cholesterol. Plant stanols work by stopping the body from absorbing cholesterol in the intestines. One brand is CholestOff® capsules, while plant stanols are also available in margarine substitutes like Benecol®.

How to take your cholesterol-lowering medicines

When you are taking medicines, it is important to follow your healthcare provider’s advice carefully. If you don’t take medicines exactly as prescribed, they can harm you. For example, you could unknowingly counteract one medicine by taking it with another one. Medicines can make you feel sick or dizzy if not taken properly.

Taking your medicine

Medicine can only help you reduce cholesterol if you take it correctly. You should take all medicines as advised by your provider. Don’t hesitate to let them know if you don’t think the medication is working or if you have side effects that concern you. Fill your prescriptions regularly, and don’t wait till you are out of something to get a refill.

You can ask your healthcare provider or pharmacist any questions you have. Let them know if you have problems getting to the pharmacy to pick up your medicines or if the instructions are too complicated. If you have trouble understanding your provider or pharmacist, ask a friend or family member to be with you when you ask questions. You need to know what medicines you take and what they are for.

Don’t decrease your medicine dosage to save money. You must take the full amount to get the full benefits. If your medicines are too expensive, ask your provider or pharmacist about finding financial assistance. Some companies provide discounts for certain medications.

There are now many ways to keep track of medication schedules. It might help to have a routine of taking your medicines at the same time every day. You can have a pillbox marked with the days of the week that you fill at the start of the week. Some people keep a medication calendar or journal, marking down the time and date and dose. Make use of smart phone apps and pillboxes with alarms you can set.

If you forget to take a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Don’t take two doses to make up for the dose you missed.

When traveling, keep your medicines with you so you can take them as scheduled. On longer trips, take an extra week’s supply of medicines and copies of your prescriptions, in case you need to get a refill.

Always discuss any new medication with your provider, including over-the-counter drugs, herbal or dietary supplements. Your cholesterol medicine dose might have to be adjusted. Make sure you tell your dentist and other providers what medications you are taking, especially before having surgery with a general anesthetic.

All of your medicines to lower cholesterol will be more effective if you continue to follow a low cholesterol diet. Your healthcare provider may be able to refer you to a dietitian for help in designing a diet especially for you and encouraging you to stay with it.

A note from Cleveland Clinic

You may need medications to improve your cholesterol numbers. There are several options, but any of them will work better if you eat healthy and exercise. Remember to discuss any new medication with your provider. This includes over-the-counter products like herbs or dietary supplements.

Cholesterol Medications | American Heart Association

Help to control your cholesterol levels

For some people, lifestyle changes, such as a healthier diet and more exercise, may prevent or treat unhealthy cholesterol levels. For others with high cholesterol, medication may also be needed.

Work with your doctor to develop a treatment plan that’s right for you. If medication is required, be sure to take it as prescribed. The potential benefit to your health is worth making these medications part of your normal routine.

Types of cholesterol-lowering drugs

Various medications can lower blood cholesterol levels.

Statins are recommended for most patients and have been directly associated with a reduction in the risk of heart attack or stroke. Statins continue to provide the most effective lipid-lowering treatment in most cases.

Guidelines recommend that people in any of these groups talk to their doctor about the risks and benefits of statin therapy:

• Adults with a history of cardiovascular disease, including stroke, caused by atherosclerosis
• Those with LDL-C level of greater than 190 mg/dL
• Adults 40-75 years with diabetes
• Adults 40-75 years with LDL-C level of 70-189 mg/dL and a 5% to 19. 9% 10-year risk of developing cardiovascular disease from atherosclerosis and risk-enhancing factors
• Adults 40-75 years with LDL-C level of 70-189 mg/dL and a 20% or greater 10-year risk of developing cardiovascular disease from atherosclerosis

Some people who don’t fall into these categories may also benefit from statin therapy.

It’s important to talk to your healthcare professional about your 10-year or lifetime risk. They will assess your risk factors to determine your level of risk and work with you to choose the best treatment.

View an interactive slideshow to see how cholesterol drugs work.

Some of the major types of commonly prescribed cardiovascular medications are summarized in this section. We’ve included generic names as well as major trade names to help you identify what you may be taking. Please understand that the American Heart Association is not recommending or endorsing any specific products. If your prescription medication isn’t on this list, your doctor and pharmacist are your best sources of information. It’s important to discuss all the drugs you take with your doctor and to understand their desired effects and possible side effects. Never stop taking a medication or change your dosage (or frequency) without first consulting your doctor.
Some cholesterol-lowering medications may interact with grapefruit, grapefruit juice, pomegranate and pomegranate juice. Please talk to your doctor about any potential risks.

Statins

This class of drugs, also known as HMG CoA reductase inhibitors, works in the liver to prevent cholesterol from forming. This reduces the amount of cholesterol circulating in the blood. Statins are most effective at lowering LDL (bad) cholesterol. They also help lower triglycerides (blood fats) and raise HDL (good) cholesterol.

Talk to your doctor about the possible side effects before starting statins. Most side effects are mild and go away as your body adjusts. Muscle problems and liver abnormalities are rare, but your doctor may order regular liver function tests. Women who are pregnant or people who have active or chronic liver disease should not take statins. 

Statins available in the U.S. include:

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

If statins don’t help you enough, or if you develop side effects, your doctor may recommend different medications.

Statins are also found in the combination medications Caduet® (atorvastatin + amlodipine) and Vytorin™ (simvastatin + ezetimibe).

If you have CVD and are already taking the highest tolerated statin and your LDL-C is still 70 or above, one or more of the following medicines may be prescribed. They all can be taken in combination with a statin.

Ezetimibe (cholesterol absorption inhibitors)

Prevents cholesterol from being absorbed in the intestine. It’s the most commonly used non-statin agent.

Bile Acid Sequestrants

Also called bile acid-binding agents, cause the intestine to get rid of more cholesterol. 

Those available in the U.S. include:

• Cholestyramine (Questran®, Questran® Light, Prevalite®, Locholest®, Locholest® Light)
• Colestipol (Colestid®)
• Colesevelam Hcl (WelChol®)

PCSK9 inhibitors

PCSK9 inhibitors are powerful LDL-lowering drugs. They bind to and inactivate a protein on cells found in the liver to lower LDL (bad) cholesterol. Some names are alirocumab and evolocumab

The following triglyceride-lowering drugs have mild LDL-lowering action, but data doesn’t support their use as an add on to statins.

Fibrates

Fibrates are especially good for lowering triglyceride (blood fat) levels and have a mild LDL-lowering action.  

Fibrates available in the U.S. include:

• Gemfibrozil (Lopid®)
• Fenofibrate (Antara®, Lofibra®, Tricor®, and Triglide™)
• Clofibrate (Atromid-S)

Niacin (nicotinic acid)

Niacin is a B vitamin that limits the production of blood fats in the liver. Take this only if your doctor has prescribed it. It lowers triglycerides and has mild LDL-lowering action.

Niacin side effects may include flushing, itching and upset stomach. Your liver functions may be closely monitored because niacin can cause toxicity. Nonprescription immediate-release forms of niacin usually have the most side effects, especially at higher doses. Niacin is used cautiously in diabetic patients because it can raise blood sugar levels.

Niacin comes in prescription form and as a dietary supplement. Dietary supplement niacin must not be used as a substitute for prescription niacin because of potentially serious side effects. Dietary supplement niacin is not regulated by the Food and Drug Administration and may contain widely variable amounts of niacin – from none to much more than the label states. The amount of niacin may even vary from lot to lot of the same dietary supplement brand. Consult your doctor before starting any niacin therapy.

Omega-3 Fatty Acid Ethyl Esters

These are derived from fish oils that are chemically changed and purified. They’re used in tandem with dietary changes, to help people with high triglyceride levels (over 200 mg/dL).

Omega-3 Fatty Acid Ethyl Esters available in the U.S. include:

• Lovaza®
• Vascepa™
• Epanova®
• Omtryg®

Marine-Derived Omega-3 Polyunsaturated Fatty Acids (PUFA)

Commonly referred to as omega-3 fish oils or omega-3 fatty acids, are used in large doses to lower high blood triglyceride levels. They help decrease triglyceride secretion and clear triglycerides. The amount of marine-derived omega-3 PUFAs needed to significantly lower triglyceride (2 to 4 g) is hard to get from a daily diet alone, so supplementing with capsules may be needed.

Use these supplements only under a doctor’s direction and care, because large doses may cause serious side effects. These can include increased bleeding, hemorrhagic stroke and reduced blood sugar control in diabetics. Negative interactions with other medications, herbal preparations and nutritional supplements are also possible. People with allergies to fish, shellfish or both may have a severe adverse reaction to using these supplements.

Most Statin Users Won’t Have Major Side Effects – WebMD

By Serena Gordon

HealthDay Reporter

TUESDAY, July 9 (HealthDay News) — Statins — the widely used cholesterol-lowering drugs — have few serious side effects, although they do slightly raise the risk of type 2 diabetes, according to a large new evidence review.

In the analysis of 135 previous studies, which included nearly 250,000 people combined, researchers found that the drugs simvastatin (Zocor) and pravastatin (Pravachol) had the fewest side effects in this class of medications. They also found that lower doses produced fewer side effects in general.

“As with any drugs, statins have both benefits and harms,” said study lead author Huseyin Naci, a doctoral candidate at the London School of Economics and Political Science.

“We show that harmful side effects of statins are not common, and they are greatly outweighed by their benefits,” said Naci, also a research fellow in the department of population medicine at Harvard Medical School in Boston.

Results of the study, which received no drug company funding, were released online July 9 in the journal Circulation: Cardiovascular Quality and Outcomes.

Continued

Statins are medications used to lower the amount of LDL cholesterol or “bad” cholesterol — in your blood. LDL levels can be lowered through dietary changes and exercise, but many people find it difficult to maintain these lifestyle changes.

Moreover, statins may be useful for stabilizing plaque in the blood vessels (plaque can break off and cause a heart attack or a stroke) and reducing inflammation, according to Dr. Suzanne Steinbaum, a preventive cardiologist and director of Women and Heart Health at Lenox Hill Hospital in New York City. She was not involved with the new study.

In the analysis, the researchers reviewed data from randomized clinical trials, some of which compared statins to each other, while some compared statins to an inactive placebo pill. The average follow-up time for the studies included in the analysis was 1.3 years.

The review included data from the seven statins currently on the market. Atorvastatin (Lipitor), simvastatin and pravastatin were the most commonly used statins among participants.

Simvastatin and pravastatin had the best safety profile, according to this review.

Continued

Overall, the researchers found a 9 percent increased risk of type 2 diabetes in people taking statins. Naci said it’s possible that statins may impair the secretion of insulin, although this study didn’t examine potential mechanisms for why statins might increase diabetes risk.

“The slight increase in diabetes risk is greatly outweighed by the cardiovascular benefits of statins,” he said.

Statins were not linked to any increase in the risk of cancer, according to the review. “There is conclusive evidence that statins do not raise cancer risk,” Naci said.

The use of statins, particularly atorvastatin, was linked to an increase in liver enzyme irregularities. Naci said these blood test changes don’t cause any symptoms, and are reversible when the drug is stopped. “If monitored closely, there is no cause for concern, and no specific precautions are warranted based on our study,” he said. “Switching to a statin associated with fewer elevations may be appropriate.”

The researchers also found that the higher the dose, the more likely people were to stop participating in a trial due to side effects.

Continued

“Side effects do tend to go up with higher doses,” cardiologist Steinbaum said. “You want to use as little medication as possible, and combine the use of statins with lifestyle management. There’s no medication that’s a quick fix and a cure, but it’s worth taking statins if you can manage the side effects.”

She added that while simvastatin and pravastatin may have the most favorable side effect profiles, “they tend to be the least potent statins. The statins with the greatest effects tend to have the most side effects,” Steinbaum said.

“Not all statins are the same,” noted study author Naci. “Our study provides evidence that the side effect profiles of individual statins vary, which should be considered when making prescribing decisions.”

Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Pravastatin and Lipitor (atorvastatin) are prescription medications used to treat high cholesterol. Cholesterol levels that are higher than normal can increase the risk of heart disease, vascular disease, heart attacks, and strokes. Cholesterol is primarily produced in the liver through the HMG‐CoA reductase enzyme.

Pravastatin and atorvastatin are drugs that are classified as HMG-CoA reductase inhibitors. Also known as statin drugs, pravastatin and atorvastatin inhibit, or block, the HMG-CoA reductase enzyme, which leads to decreased cholesterol production in the liver. The use of statins also increases the amount of LDL (low-density lipoprotein) receptors in the liver, which helps lower levels of LDL, or the bad type of cholesterol, in the blood.

Both pravastatin and atorvastatin work in similar ways, but they have some differences to be aware of.

What are the main differences between pravastatin and Lipitor?

Pravastatin is the generic name for Pravachol. Unlike other statin drugs, pravastatin is not extensively metabolized, or processed, by CYP3A4 enzymes in the liver. Instead, pravastatin is broken down in the stomach.

Pravastatin generic tablets are available in strengths of 10 mg, 20 mg, 40 mg, and 80 mg. Pravastatin is usually prescribed to be taken once daily in the evening. It has been shown that pravastatin is more effective when taken in the evening rather than in the morning.

Lipitor is a brand-name medication and is available in a generic version called atorvastatin. Unlike pravastatin, atorvastatin is heavily processed by the CYP3A4 enzyme in the liver. Therefore, atorvastatin may potentially interact with more medications than pravastatin.

Lipitor is available in oral tablets with strengths of 10 mg, 20 mg, 40 mg, and 80 mg. Lipitor can be taken in the morning or evening, and it is usually taken once daily.

Conditions treated by pravastatin and Lipitor

Pravastatin and atorvastatin can help reduce the risk of heart attacks and strokes in people with coronary heart disease. Both medications can also help reduce the risk of death from heart disease. Risk factors for heart disease include high blood pressure, smoking, and high cholesterol levels.

Both pravastatin and atorvastatin are FDA approved to reduce elevated total-cholesterol and LDL levels (also known as hyperlipidemia or hypercholesterolemia). Statin medications can also help treat elevated levels of triglycerides, which are another type of fats or lipids in the body. Someone with elevated levels of triglycerides has hypertriglyceridemia.

Pravastatin and Lipitor can also increase HDL levels in the blood. HDL cholesterol is what is known as the “good” cholesterol in the blood.

Is pravastatin or Lipitor more effective?

Both pravastatin and atorvastatin are effective medications for treating high blood cholesterol. The more effective drug depends on your overall condition, the severity of your condition, other drugs you might be taking, and other factors.

One comparative study found that there is no significant difference between pravastatin, simvastatin, and atorvastatin for preventing cardiovascular events. In other words, these statin drugs were similarly effective for reducing heart attacks and coronary heart disease.

A systematic review that pooled over 90 clinical trials compared statin drugs such as fluvastatin, atorvastatin, pravastatin, simvastatin, and rosuvastatin. The review concluded that atorvastatin, fluvastatin, and simvastatin had the highest probability of being the best treatment for preventing cardiovascular events.

Consult a healthcare provider to determine the best statin drug for you. After conducting a blood test and evaluating your overall condition, a provider will be able to determine whether pravastatin or atorvastatin is a more effective drug for you. They might also prescribe a different statin drug such as Zocor (simvastatin) or Crestor (rosuvastatin).

Coverage and cost comparison of pravastatin vs. Lipitor

Pravastatin is a generic medication that is usually covered by Medicare and insurance plans. The average cash price of pravastatin is around $129.99 for a 30-day supply. A SingleCare savings card may be able to lower the cost of a pravastatin prescription to less than $15.

Lipitor is a brand-name medication that is also available in a cheaper, generic version. The generic version of Lipitor, atorvastatin, is typically covered by most Medicare and insurance plans. Brand-name Lipitor may be covered by insurance plans with a high copay. The cash price of Lipitor is around $249.99. SingleCare coupons can lower the cost to $15 at participating pharmacies.

Common side effects of pravastatin vs. Lipitor

The most common side effects of pravastatin are musculoskeletal or muscle pain, nausea, vomiting, diarrhea, and headache. The most common side effects of atorvastatin are musculoskeletal or muscle pain, diarrhea, and joint pain (arthralgia). Both pravastatin and atorvastatin can also cause other side effects such as indigestion, dizziness, fatigue, rash, and urinary tract infections.

Serious side effects of statin drugs include muscle disease (myopathy) and the rapid breakdown of muscle tissue (rhabdomyolysis). Contact a healthcare provider immediately if you experience persistent or unexplained muscle pain, weakness, or tenderness.

Pravastatin and atorvastatin can also cause elevated liver enzymes. Liver enzyme levels may need to be checked before and monitored throughout treatment.

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Pravastatin), DailyMed (Lipitor)
*not reported

Drug interactions of pravastatin vs. Lipitor

Pravastatin and atorvastatin interact with similar medications. However, since atorvastatin is metabolized primarily by the CYP3A4 enzyme in the liver, it may interact with more drugs that affect the CYP3A4 enzymes in the liver.

Taking medications like cyclosporine, clarithromycin, or ritonavir with either pravastatin or atorvastatin can lead to increased statin levels in the blood, which can increase the risk of adverse effects.

Antacids can interfere with the absorption of statin medications and reduce their effectiveness. The administration of antacids and statins should be separated by at least two hours. Cholestyramine can also decrease the absorption and effectiveness of statins. The administration of cholestyramine and statins should be separated by four hours.

Niacin and fibrates can increase the risk of myopathy and rhabdomyolysis when taken with either pravastatin or atorvastatin.

The use of atorvastatin should be avoided or monitored while consuming grapefruit juice. Grapefruit juice acts as a CYP3A4 inhibitor that can lead to increased levels of atorvastatin in the blood and increase the risk of side effects.

Consult a healthcare professional for other possible drug interactions.

Warnings of pravastatin and Lipitor

Pravastatin and atorvastatin should be avoided in those with active liver disease or high liver enzyme levels. Statin medications can cause further liver damage in someone with liver disease.

Pravastatin and atorvastatin should not be used in those with a history of hypersensitivity reactions to statin medications. Signs and symptoms of a hypersensitivity reaction include rash, itching, swelling, and trouble breathing.

Statin medications carry a risk of severe muscle damage and muscle pain. There may be an increased risk of muscle pain in those who are over 65 years old or who have uncontrolled hypothyroidism or kidney problems.

Pravastatin and atorvastatin should not be used in those who are pregnant or lactating.

Talk to a healthcare provider to discuss other possible warnings or precautions associated with pravastatin or atorvastatin.

Frequently asked questions about pravastatin vs. Lipitor

What is pravastatin?

Pravastatin is a generic medication used to lower cholesterol and prevent complications caused by high cholesterol levels. The brand name of pravastatin is Pravachol. It is prescribed to be taken once daily in the evening. Pravastatin is available as an oral tablet.

What is Lipitor?

Lipitor is a brand-name medication manufactured by Pfizer. The generic name of Lipitor is atorvastatin. It is used to treat high cholesterol levels and reduce the risk of heart attack and stroke. Lipitor is prescribed to be taken once daily in the morning or evening. It is available as an oral tablet.

Are pravastatin and Lipitor the same?

Both pravastatin and atorvastatin are medications used to reduce high levels of cholesterol. However, they are not the same. Atorvastatin is primarily metabolized by the CYP P450 enzyme system in the liver while pravastatin is broken down in the stomach. Pravastatin is usually taken at night while Lipitor is taken in the morning or evening.

Is pravastatin or Lipitor better?

Both pravastatin and Lipitor are effective forms of statin therapy. Both medications can help prevent complications of high cholesterol levels, such as atherosclerosis, heart attack, and stroke. Some studies from cardiology journals have found that atorvastatin, the active ingredient in Lipitor, is more effective than other statin drugs for preventing cardiovascular events like heart attack and stroke. A healthcare provider can provide medical advice on the best statin medication for you.

Can I use pravastatin or Lipitor while pregnant?

Pravastatin and atorvastatin are not recommended to be taken while pregnant. Both medications carry a high risk of causing birth defects. Consult a healthcare provider for guidance on the best treatment for high cholesterol while pregnant.

Can I use pravastatin or Lipitor with alcohol?

There is no significant health risk involved with moderate alcohol consumption and statins. Statin drugs and excessive consumption of alcohol can damage the liver. Talk to a healthcare provider to assess whether it is safe for you to drink alcohol while taking a statin medication.

Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

According to the Centers for Disease Control and Prevention (CDC), about 38% of adults in the U.S. have high cholesterol. If you have high cholesterol, your doctor will most likely counsel you on the importance of diet and exercise. Your doctor may have also mention starting a statin medication. Statins are popular prescription medications, also known as HMG-CoA reductase inhibitors. They work by blocking an enzyme (called HMG-CoA reductase) that your body needs to make cholesterol.

Crestor and Lipitor are two popular brand-name statins used to lower cholesterol levels. Both drugs are approved by the U.S. Food and Drug Administration (FDA). They are used along with a diet low in saturated fat and cholesterol to lower cholesterol. Although Crestor and Lipitor are both statins, they are not the same. Continue reading to learn more about Crestor and Lipitor.

What are the main differences between Crestor and Lipitor?

Crestor (What is Crestor?) and Lipitor (What is Lipitor?) are both lipid-lowering medications. They are also known as statins, or HMG-CoA reductase inhibitors. Both medicines are available in brand and generic form and as tablets only. AstraZeneca manufactures the brand-name Crestor, and Pfizer makes the brand-name Lipitor. Crestor and Lipitor are mainly used in adults; however, in some instances, they may be used in children.

Conditions treated by Crestor and Lipitor

Crestor and Lipitor are used to reduce cholesterol. Crestor or Lipitor should be used, along with a diet low in saturated fat and cholesterol, when diet alone has not adequately worked to lower cholesterol. Crestor and Lipitor lower total cholesterol, LDL, ApoB, and triglycerides. They also increase HDL cholesterol, the good kind of cholesterol.

Other indications are listed in the chart below. Crestor and Lipitor have not been studied in the treatment of Fredrickson Type I and V dyslipidemias.

Is Crestor or Lipitor more effective?

Researchers compared several statins in a clinical trial called the STELLAR trial (Statin Therapies for Elevated Lipid Levels Compared Across Doses to Rosuvastatin). They looked at the effects of Lipitor, Crestor, Zocor, and Pravachol on lowering LDL (low-density lipoprotein) cholesterol after six weeks.

The study concluded that Crestor lowered LDL cholesterol by 8.2% more than Lipitor, and Crestor lowered total cholesterol significantly more than all the other statins studied. Crestor also increased HDL cholesterol (the good kind of cholesterol) more than Lipitor did. In patients who took Crestor, depending on dose, 82-89% achieved LDL cholesterol goals, compared to 69-85% of patients who took Lipitor. All statins were similarly tolerated.

Another study called the SATURN trial (Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin versus Atorvastatin) looked at high doses of Crestor—40 mg daily and Lipitor 80 mg daily—and their effect on the progression of coronary atherosclerosis. Coronary atherosclerosis is a narrowing of blood vessels and buildup of calcium and fatty deposits in the arteries, making it harder for blood to get to the heart, and increasing the risk of coronary heart disease.

The study also looked at safety and side effects. After two years of maximal dosing, the Crestor group had lower LDL levels and slightly higher HDL levels than the Lipitor group. (Although, it may be worth noting that AstraZeneca, manufacturer of Crestor, funded this study. Also, these drugs were given at the highest doses, which is not as common in a clinical setting for the average patient.) Both Crestor and Lipitor induced regression of atherosclerosis to a similar extent. Both drugs were well tolerated and had a low incidence of lab abnormalities.

In a clinical setting, both drugs are widely prescribed and well-tolerated. The most effective medication for you can be determined by your healthcare provider, who can consider your medical conditions, history, and medications you take that could interact with Crestor or Lipitor.

Coverage and cost comparison of Crestor vs. Lipitor

Crestor or Lipitor are covered by most insurance and Medicare prescription plans in their generic forms of rosuvastatin or atorvastatin. Choosing the brand-name product will likely result in a higher copay or may not be covered.

For a typical prescription of 30, 10 mg tablets of rosuvastatin (generic Crestor), the out-of-pocket price would be about $134. You can use a free SingleCare coupon to lower the price to $11 at participating pharmacies.

A typical prescription of 30, 20 mg tablets of atorvastatin (generic Lipitor) would cost approximately $82 if you paid out of pocket. A SingleCare generic Lipitor coupon can bring the price down to approximately $15.

As plans vary and can change, contact your insurance company for information regarding Crestor and Lipitor’s coverage.

Get the SingleCare prescription discount card

Common side effects of Crestor vs. Lipitor

The most common side effects of Crestor are headache, muscle pain, abdominal pain, nausea, and weakness.

Lipitor’s most common adverse effects are the common cold, joint pain, diarrhea, pain in extremities, and urinary tract infections.

A rare but serious side effect of Crestor and Lipitor is myopathy (muscle weakness) and rhabdomyolysis (the breakdown of muscle tissue, which can be very damaging). See the warnings section for more information.

The occurrence of side effects may vary with dosage. This is not a full list of side effects. Other, serious side effects may occur. Talk to your healthcare provider about what side effects to expect from Crestor or Lipitor, and how to address them.

Source: DailyMed (Crestor), DailyMed (Lipitor)

Drug interactions of Crestor vs. Lipitor

An important reaction to know about Lipitor is that you should not drink an excess amount of grapefruit juice (more than 1.2 liters per day). Too much grapefruit juice can increase Lipitor levels in your body, making you more likely to experience myopathy (muscle weakness) and rhabdomyolysis (muscle tissue breakdown, which can be very damaging).

These muscle problems are more likely to occur with higher consumption of grapefruit juice, but could potentially occur with lower amounts. If you eat grapefruit or drink grapefruit juice and take Lipitor, ask your doctor how much is safe to consume, or if it would be better to take a different medication that does not interact with grapefruit. Crestor does not have a grapefruit juice interaction.

Crestor and Lipitor have some of the same drug interactions, for example, with cyclosporine, gemfibrozil, niacin, fenofibrate, colchicine, and certain antiviral medications used for HIV. Combining Crestor or Lipitor with one of these drugs can increase the statin levels, leading to a higher risk of myopathy and rhabdomyolysis. Depending on the combination of drugs and your medical history/conditions, your doctor may need to adjust your medication dosage or select an alternate medication.

Before taking Crestor or Lipitor, tell your doctor about all of the medications you take, including prescription, over-the-counter (OTC), and vitamins, so they can determine if Crestor or Lipitor is safe for you.

Warnings of Crestor and Lipitor

• In rare cases, muscle weakness and breakdown may occur due to statin medication. This can happen with any dose but is more common with higher doses. Use with caution in patients ages 65 years or older, patients with kidney problems, and patients with hypothyroidism that is not under control. These risks also increase if certain other medications are taken in combination with Crestor or Lipitor, such as fenofibrate, niacin, cyclosporine, colchicine, or certain antiviral medicines used for HIV. If you have unexplained muscle pain, or muscle weakness, or tenderness, especially if you also feel tired and/or have a fever, notify your doctor immediately. Crestor or Lipitor should be stopped if you have significantly increased creatine kinase levels or suspected myopathy.
• In rare instances, a condition called immune-mediated necrotizing myopathy (IMNM) can occur from statin treatment. Signs and symptoms include muscle weakness and changes in labs.
• Patients should have liver enzyme lab tests before starting Crestor or Lipitor, during treatment if there are any signs of liver problems, and/or when the doctor feels it is appropriate for these blood tests. Statin medications may increase AST or ALT levels. In rare cases, liver failure (fatal or non-fatal) has occurred in patients taking statins. Crestor or Lipitor should be immediately stopped if serious liver injury occurs. If you have symptoms of fatigue, appetite loss, dark urine, or yellowing of the skin or eyes, contact your doctor right away.
• Use Crestor or Lipitor with caution in patients who drink a lot of alcohol.
• Use Crestor or Lipitor with caution in patients with a history of liver disease. People with active liver disease should not use Crestor or Lipitor.
• Changes in glucose levels and hemoglobin A1C levels may occur from Crestor or Lipitor. The risk increases with concomitant use of ketoconazole, spironolactone, or cimetidine.
• In rare cases, memory loss or confusion may occur. Contact your healthcare professional immediately for guidance if you or a loved one notice any changes.
• Do not take two doses of Crestor or Lipitor within 12 hours of each other.
• Crestor or Lipitor can be taken with or without food at any time of day. Swallow tablet whole.
• Crestor or Lipitor should never be used in pregnancy due to the risk of fetal harm. Do not breastfeed while taking Crestor or Lipitor.

Additional Crestor warnings:

• Patients who take an anticoagulant (such as warfarin) should be carefully monitored before taking Crestor, and frequently at the beginning of statin treatment, to ensure INR remains stable.
• Patients who take an antacid containing aluminum and magnesium should take the antacid at least two hours after taking Crestor.

Additional Lipitor warnings:

• Excess consumption of grapefruit and/or grapefruit juice (more than 1.2 liters daily) combined with Lipitor can increase myopathy and rhabdomyolysis risk.

Frequently asked questions about Crestor vs. Lipitor

What is Crestor?

Crestor is a statin, or HMG-CoA reductase inhibitor, commonly used to treat high cholesterol. Its generic name is rosuvastatin. Crestor is available in both brand and generic form and as a tablet.

What is Lipitor?

Lipitor, like Crestor, is a statin medication used for high cholesterol. Its generic name is atorvastatin. It is available in tablet form, in both brand and generic.

Are Crestor and Lipitor the same?

Crestor and Lipitor are both statins. They work the same way and have some similarities. However, they are not exactly the same. You can read about their differences in the information outlined above. Other statins you may have heard of include Pravachol (pravastatin), Zocor (simvastatin), Livalo (pitavastatin), Lescol (fluvastatin), and Mevacor (lovastatin).

Is Crestor or Lipitor better?

Studies show both drugs to be effective in lowering cholesterol (see above section). Some studies show Crestor to be slightly more effective; however, both drugs are effective and well-tolerated. Ask your healthcare provider if one of these drugs would be more appropriate for you, based on your medical history.

Can I use Crestor or Lipitor while pregnant?

No. Crestor or Lipitor should never be taken by a pregnant woman. Both medications are specifically contraindicated for use during pregnancy. They can cause harm to an unborn baby. If you are taking Crestor or Lipitor and find out that you are pregnant, stop taking the statin and contact your doctor immediately for medical advice.

Can I use Crestor or Lipitor with alcohol?

Generally, it is safe to consume a small to moderate amount of alcohol if you take Crestor or Lipitor. However, if you have liver problems, or drink an excessive amount of alcohol, check with your healthcare provider before mixing a statin and alcohol. People with chronic liver disease should avoid alcohol completely when taking a statin.

Is Crestor safer than Lipitor?

Crestor and Lipitor are both well tolerated. Any drug has side effects, with some rare but serious potential side effects, too. Studies (see above section) have shown that both medicines were tolerated well in trials.

What foods should be avoided when taking Crestor?

When you take Crestor (or Lipitor), you should eat a healthy diet low in saturated fat and cholesterol.

Some foods you’ll want to avoid are fatty meats, full-fat dairy, and sweets. Instead, focus on foods like fruits, vegetables, whole grains, beans, nuts, and lean protein like chicken and fish.

Although Lipitor interacts with (large amounts of) grapefruit juice, Crestor is safe to take with grapefruit juice.

Does Crestor make you gain weight?

Crestor is not directly linked to weight gain. If you are taking Crestor and notice a weight change, contact your healthcare provider.

90,000 What statins are available in the Accessible Liki program?

One of the foundations of the health of a nation and a functioning health system is the availability of medicines. Which is not surprising, because who of us today imagines our life without drugs? Moreover, in the modern world, along with drugs for the treatment of various diseases, those that are used for their prevention have been developed. Ensuring the availability of medicines implies not only their physical availability, but also their financial “lift”.In this vein, the government program “Accessible Liki” has been operating in Ukraine since April 1, 2017.

Within the framework of the Affordable Liki program, the cost of an approved range of drugs for outpatient treatment is fully or partially covered by the state. Every six months, the Register of medicinal products, the cost of which is subject to reimbursement (hereinafter referred to as the Register), is reviewed and corrected. The “fresh” version was approved by the order of the Ministry of Health of Ukraine dated January 21, 2019.No. 148.

In general, the updated Register contains 258 trade names of drugs for 3 nosologies: cardiovascular diseases, bronchial asthma and type 2 diabetes mellitus.

It should be noted that the program had an extremely positive impact on the amount of medicines consumed by the population. Some pharmaceutical companies strive not only to stay in the program with each update of the Registry, but also to maintain the status of “most accessible”. This often means that they reduce the price and the drugs are available to the patient at the pharmacy free of charge (no co-payment).On a national scale, this made it possible to achieve price stabilization in pharmacies for reimbursable drugs, as well as significantly increase their availability.

Tellingly, the new Registry has increased the number of drugs for the treatment of cardiovascular diseases. This is not surprising, because it is this class of diseases that is one of the leading causes of death in the world.

Why statins?

Statins are relatively new players in the pharmaceutical arena, but they have already firmly won their “place” in the prescriptions of doctors.Indeed, the development of most cardiovascular diseases is based on atherosclerosis, and one of the main causes of its occurrence is hypercholesterolemia.

Statins, in addition to the main cholesterol-lowering action, have a number of other (pleiotropic) effects, in particular anti-inflammatory and antiproliferative, as well as the ability to improve endothelial functions, etc. (Michels G. et al., 2007).

According to the recommendations of ESH / ESC (ESH – European Society of Hypertension), statins are used to prevent cardiovascular diseases in general and arterial hypertension in particular (Karpov Yu.A., 2018). In addition, they reduce the risk of developing life-threatening arrhythmias and sudden coronary death in patients with acute heart attacks.

Simvastatin preparations are available to Ukrainians under the “Accessible Liki” program from the statin group. At the same time, out of 13 simvastatins, only 2 drugs are available to patients without additional payment: ALLESTA ^® 20 mg and ALLESTA ^® 40 mg produced by the Macedonian company Alkaloid AD.

From April 1, 2019, the administration of the “Accessible Liki” program is transferred to the National Health Service of Ukraine (NHSU).It is she who will conclude contracts with pharmacies to participate in the program and reimburse the cost of drugs.

What is important, according to the draft Procedure for the conclusion of contracts between the NSZU and pharmacies, the latter undertakes to ensure the continuous availability of at least one drug, the cost of which is fully reimbursed, from the Register for each international non-proprietary name for dispensing in each pharmacy and pharmacy where the dispensing is carried out medicines under the contract.

Thus, pharmacies participating in the program must ensure that at least one drug is always available for each INN, which the patient can receive without additional payment. There is only one such brand among statins – ALLESTA ^® .

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Information for you:

90,000 side effects, uses and risks

Statins are a class of drugs that are used to lower blood cholesterol levels.They do this by blocking the action of an enzyme in the liver that is needed for cholesterol.

Cholesterol is essential for normal cell and body function, but very high levels can lead to atherosclerosis, a condition in which cholesterol-containing plaques build up in the arteries and block blood flow, channel
tells our health.

By lowering blood cholesterol levels, statins reduce the risk of chest pain (angina), heart attack and stroke. Here we look at how statins work, who uses them, and the risks and benefits associated with them.

Fast Facts About Statins:

Statins are used to lower blood cholesterol levels.

Statins work by inhibiting an enzyme called HMG-CoA reductase.

People with atheromania, diabetes and hereditary risk of heart attacks are often prescribed statins.

People with liver disease should carefully discuss the risks and benefits of statins with their doctor.

What are statins?

Statins are a type of medication that blocks the action of a liver enzyme that helps produce cholesterol.They are usually prescribed to lower blood cholesterol levels. Types of statins include:
atorvastatin, cerivastatin, fluvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin.

90,031 Popular 90,036 News

Atorvastatin and rosuvastatin are the most effective, while fluvastatin is the least potent. These drugs are sold under different names, including:

Lipitor (atorvastatin), Pravachol (pravastatin), Crestora (rosuvastatin), Zocor (simvastatin), Lesok (fluvastatin), Vitorin (a combination of simvastatin and ezetimibe).

Side effects
Most people on statins have side effects. Minor side effects include:

Headache, pins and needles, abdominal pain, bloating, diarrhea, sick feeling, rash.

Certain statin drugs can impair memory. Researchers at the University of Bristol in England found that two commonly prescribed statins – pravastatin (Pravachol) and atorvastatin (Lipitor) – reduced recognition and working memory in an animal study.

Statins can also increase the risk of developing cataracts. A research team at the San Antonio, Texas Military Medical Center told JAMA Ophthalmology that statin use increased the risk of developing cataracts by 27 percent.

The two most serious side effects – both of which are relatively rare – are liver failure and skeletal muscle damage.

Muscle injury is usually muscle pain that is often relieved by switching to another type of statin.In rare cases, a severe type of myopathy called rhabdomyolysis can occur.

What is rhabdomyolysis?

Rhabdomyolysis begins as muscle pain and may worsen to the extent that the patient experiences significant muscle tear, kidney failure, or dies.

The condition is more common when statins are used in combination with other drugs that carry a high risk of rhabdomyolysis or with other drugs that increase the level of statins in the blood.

Who Shouldn’t Take Statins?

People with liver disease should talk to their doctor about the risks and benefits before starting a statin. If liver disease is stable and chronic, a low-dose statin may be of greater benefit than risk.

Statins are not recommended if liver disease is progressive.

If liver disease develops while taking statins, discussion with your doctor is necessary to determine dose reduction, change in treatment, or discontinue statin use altogether.

In addition, women who are pregnant or breastfeeding, or who intend to become pregnant, should not take statins. It is generally recommended that people taking statins should not combine them with the following drugs: protease inhibitors (AIDS treatment), erythromycin,
itraconazole, clarithromycin, diltiazem, verapamil, fibrate (which also lowers LDL).
People on statins should avoid grapefruit and grapefruit juice due to the potentially dangerous interaction effects.

Function

Statins inhibit an enzyme called HMG-CoA reductase, which controls the production of cholesterol in the liver. The medicine blocks the enzyme, thereby slowing down the cholesterol production process.

People often begin treatment with statins to lower their cholesterol levels to below 5 millimoles per liter (mmol / L), or 30-60 percent. The dosage can be increased if this goal is not achieved.

Statin therapy is usually continued even after the target cholesterol level has been reached to continue to protect against atherosclerosis.

Who Should Take Statins?

Statins can be prescribed in the following cases:

Diseases associated with atheroma, such as heart disease, stroke and atherosclerosis.

Diabetes, which increases the risk of developing a disease associated with atheroma.

Elevated LDL cholesterol at 190 mg per deciliter (mg / dL) or higher.

The 10-year risk of cardiovascular disease is 7.5% or higher.

High cholesterol is the most common reason a person is prescribed statins, but the drugs also reduce the risk of heart disease by preventing atherosclerosis.

Plaques from atherosclerosis can still form even when blood cholesterol levels are low. Thus, statins can be used to treat people who already have atherosclerosis or are at a higher risk of developing it, even if they do not have high cholesterol levels.

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Who is prohibited from using them?

At present, statins are included in the list of drugs on puncture of the Ministry of Health.