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 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
• 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.

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 serious 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 side effects, but these are usually minor, 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. 

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:

• eating a healthy, balanced diet
• exercising regularly
• maintaining a healthy weight
• limiting the amount of alcohol you drink
• stopping smoking

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:

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• pravastatin (Lipostat)
• rosuvastatin (Crestor)
• simvastatin (Zocor)

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

Statins – Side effects – NHS

Like all medicines, statins can cause side effects. But most people tolerate them well and do not have any problems.

You should discuss the benefits and risks of taking statins with your doctor before you start taking the medicine.

If you are having problems with side effects, talk to the doctor in charge of your care. Your dose may need to be adjusted or you may need a different type of statin.

The main side effects of statins are listed here. Some of these will not necessarily apply to the specific statin you’re taking.

For details of the side effects of a particular statin, check the information leaflet that comes with your medicine.

Common side effects

Side effects can vary between different statins, but common side effects include:

• headache
• dizziness
• feeling sick
• feeling unusually tired or physically weak
• digestive system problems, such as constipation, diarrhoea, indigestion or farting
• muscle pain
• sleep problems
• low blood platelet count

Uncommon side effects

Uncommon side effects of statins include:

• being sick
• memory problems
• hair loss
• pins and needles
• inflammation of the liver (hepatitis), which can cause flu-like symptoms
• inflammation of the pancreas (pancreatitis), which can cause stomach pain
• skin problems, such as acne or an itchy red rash
• sexual problems, such as loss of libido (reduced sex drive) or erectile dysfunction

Rare side effects

Rare side effects of statins include:

• muscle weakness (myopathy)
• loss of sensation or tingling in the nerve endings of the hands and feet (peripheral neuropathy)
• tendon problems (tendons are tough cords of tissue that connect muscles to bones)

Muscle effects

Statins can rarely cause muscle inflammation (swelling) and damage. Speak to your doctor if you have muscle pain, tenderness or weakness that cannot be explained – for example, pain that is not caused by physical work.

Your doctor may carry out a blood test to measure a substance in your blood called creatine kinase (CK), which is released into the blood when your muscles are inflamed or damaged.

If the CK in your blood is raised, your doctor may advise you to stop taking the statin. Regular exercise can sometimes lead to a rise in CK, so tell your doctor if you’ve been exercising a lot.

Once your CK level has returned to normal, your doctor may suggest you start taking the statin again, but at a lower dose.

Reporting side effects

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you’re taking.

It’s run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).

See the Yellow Card Scheme website for more information.

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

Statins: pharmacological group

Statins (atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, fluvastatin) inhibit 3-hydroxy-3-methyl-glutaryl-CoA reductase, an enzyme involved in cholesterol synthesis, 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, changes in liver function tests, 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.

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Statins – what is it, 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 with food, and it can cause blockage of blood vessels, being deposited 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 one 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 indicated, they can be taken for 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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