What Are Statins?
Statins are a class of drugs often prescribed by doctors to help lower cholesterol levels in the blood. By lowering the levels, they help prevent heart attacks and stroke. Studies show that, in certain people, statins reduce the risk of heart attack, stroke, and even death from heart disease by about 25% to 35%. Studies also show that statins can reduce the chances of recurrent strokes or heart attacks by about 40%.
Who Should Take Statins?
Estimates are that in addition to the people already taking them, another 15 million to 20 million people should be taking statin drugs based on their risk factors for heart disease. Your doctor can do a simple blood test to determine the amount of cholesterol in your blood. If you have high levels of LDL ("bad”) cholesterol, you have a greater chance of heart disease, especially when there are other factors that increase your risk. Based on your overall risk, your doctor may recommend you take statins to help lower your cholesterol by a certain amount.
How Statins Work
Statin drugs work by blocking the action of the liver enzyme that is responsible for producing cholesterol. Too much cholesterol in the blood can cause a buildup of plaque on the walls of the arteries. That buildup can eventually cause the arteries to narrow or harden. Sudden blood clots in these narrowed arteries can cause a heart attack or stroke.
Not all cholesterol is bad. It's good, for instance, to have high levels of HDL ("good") cholesterol. HDL cholesterol prevents plaque buildup in the arteries by transporting the bad (LDL) cholesterol out of the blood to the liver. From there, it is eliminated from the body.
Statins lower LDL cholesterol and total cholesterol levels. At the same time, they lower triglycerides and raise HDL cholesterol levels. Statins may also help to stabilize plaques in the arteries, making heart attacks less likely.
Maintaining a healthy lifestyle while taking a statin can improve the effectiveness of the drug. Be sure to:
Statin Side Effects
Most people who take statin drugs tolerate them very well. But some people have side effects.
The most common statin side effects include:
- Difficulty sleeping
- Flushing of the skin
- Muscle aches, tenderness, or weakness (myalgia)
- Nausea or vomiting
- Abdominal cramping or pain
- Bloating or gas
- Low levels of blood platelets
Less common side effects you may have with statins are:
- Hair loss
- Pins and needles sensations, such as pricking, numbness, or tingling on your skin
- Liver inflammation, which can make you feel like you have the flu
- Pancreas inflammation, which can cause stomach pain
- Skin problems such as rashes or acne
- Sexual problems, such as erectile dyfunction or a low sex drive
Statins also carry warnings that memory loss, mental confusion, neuropathy, high blood sugar, and type 2 diabetes are possible side effects. It's important to remember that statins may also interact with other medications you take.
Serious Side Effects of Statins
Statins are linked to a few rare but potentially serious side effects, including:
- Myositis, which is inflammation of the muscles. The risk of muscle injury increases when certain other medications are taken with statins. For example, if you take a combination of a statin and a fibrate -- another cholesterol-reducing drug -- the risk of muscle damage increases greatly compared to someone who takes a statin alone.
- Elevated levels of CPK, or creatine kinase, a muscle enzyme that when elevated, can cause muscle pain, mild inflammation, and muscle weakness. This condition, though uncommon, can take a long time to resolve.
- Rhabdomyolysis, extreme muscle inflammation and damage. With this condition, muscles all over the body become painful and weak. The severely damaged muscles release proteins into the blood that collect in the kidneys. The kidneys can become damaged trying to eliminate a large amount of muscle breakdown caused by statin use. This can ultimately lead to kidney failure or even death. Fortunately, rhabdomyolysis is extremely rare. It happens in less than one in 10,000 people taking statins.
If you have any unexplained joint or muscle pain, tenderness, or weakness while taking statins, you should call your doctor immediately.
Some studies link statin use with birth defects. Doctors advise pregnant women not to use these drugs.
Statin Side Effects Risk Factors
Some things can increase your risk of side effects with statins. You may be more likely to have side effects if you:
- Take more than one medication to control your cholesterol
- Are a woman
- Have a small body frame
- Are 80 or older
- Have kidney or liver disease
- Drink a lot of alcohol
- Have some other health conditions, such as hypothyroidism or neuromuscular disorders
Statin Drug and Food Interactions
Some foods and medications don’t mix well with statins and can make side effects worse:
- Grapefruit juice, which has chemical that can change the way your body breaks down statins
- A drug for irregular heart rhythms called amiodarone (Cordarone, Pacerone)
- Gemfibrozil (Lopid), a cholesterol drug
- Protease inhibitors, a type of HIV medication that includes saquinavir (Invirase) and ritonavir (Norvir)
- Some antibiotic and antifungal drugs, such as clarithromycin and itraconazole
- Certain medications, such as cyclosporine, that lower your immune system activity
There are other medications that can cause problems if you take them with statins. You should tell your doctor about all over-the-counter or prescription drugs, herbal supplements, or vitamins that you use.
Get Relief from Statin Side Effects
Your doctor may be able to suggest some ways to relieve the side effects you have with statins. These changes may help, but talk to your doctor first:
- Take a break from statins, which can help you know if the drugs are the cause of muscle aches or other side effects
- Try a different statin drug or dose
- Change your exercise routine gradually and skip intense workouts if you’re not used to them
- Try another type of medication to lower your cholesterol
- Take coenzyme Q10 supplements, which may stave off side effects in some people
The statin medications that are approved for use in the U.S. include:
Since their arrival on the market, statins have been among the most prescribed drugs in the U.S., with up to 56 million users.