Even if you do not have cardiovascular disease, statins may still be able to reduce the incidence of
stroke, and death.
Before prescribing medication to lower your cholesterol, your doctor will probably suggest that you try to control the levels of cholesterol in your blood through diet and exercise. This typically involves reducing your intake of total fat, saturated fat, and, if you are overweight, total calories. Some, but not all, people are able to lower their cholesterol through such changes. Medicine is prescribed only when additional help is needed. It is most effective in combination with dietary changes and regular exercise.
How Statins Work
Statins block an enzyme in the liver (HMG-CoA reductase) that produces cholesterol. They are particularly effective at reducing LDL-cholesterol.
Precautions While Using These Medicines
See Your Doctor Regularly
It is important that your doctor check your progress. Regular visits will allow for dosage adjustments and to help monitor for any side effects.
Statins should not be taken during pregnancy. Cholesterol production is essential for normal fetal development. Statins decrease cholesterol production and therefore may cause birth defects. Use birth control while taking a statin drug. Tell your doctor if you think you might be pregnant or you are considering becoming pregnant. Also tell your doctor if you are breast feeding, as statins may cause problems for a nursing baby.
Control Your Weight
If you are overweight or obese, losing weight may help decrease the need for or amount of medication. Check with your doctor about this.
Manage Your Medications
Tell your doctor about all the medications you take. Some medications should not be taken with statins, while others may require a different dosage level. These include:
or nicotinic acid ( eg Endur-Acin, Nia-Bid, Niacor, Nico-400, Nicobid Tempules, Nicolar, Nicotinex Elixir, Slo-Niacin)—Use of this type of medicine with a statin may increase the risk of developing muscle problems and kidney failure.
Oral contraceptives/birth control pills (estrogens and progestins)—Some statin drugs may increase the blood levels of the hormones in birth control pills, increasing the risk of side effects.
Convulsions (seizures) that are not well-controlled
Electrolyte or metabolic enzyme deficiencies or disorders
Liver disease or persistently high levels of liver enzymes—Statin drugs may make liver problems worse.
Low blood pressure
Organ transplant with therapy to prevent transplant rejection
Recent major surgery or trauma, which may increase the risk of problems that may lead to kidney failure
Impending surgery, including dental surgery or emergency treatment—Be sure to tell the doctor or dentist treating you that you are taking a statin drug.
Avoid Excessive Alcohol
Excessive amounts of alcohol combined with statin drugs can have bad affects on the liver. Moderation in alcohol consumption is generally defined as one drink per day for women and two drinks per day for men.
Avoid Grapefruit Juice
Grapefruit juice appears to interfere with the metabolism of most statin drugs. It is best to avoid it during treatment.
Don't Stop On Your Own
Do not stop taking your statin medication without first checking with your doctor. When you stop, your cholesterol levels may increase, and your doctor may want to implement other means to keep cholesterol levels within a more desirable range.
Mind Your Meals with Lovastatin
Lovastatin works better when it is taken with food. If you are taking lovastatin once a day, take it with the evening meal. If you are taking more than one dose a day, take each dose with a meal or snack.
If you miss a dose of your statin drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Avoid double doses.
Possible Side Effects
Statin drugs are generally considered safe and few patients need to discontinue them due to adverse effects. The side effects listed here have been reported for at least one of the statins, not necessarily all of them. However, since many of the effects of statins are similar, it is possible that these side affects may occur with any one of these medicines, although they may be more common with some than with others.
The most significant adverse effects, though rare, involve the liver (elevated liver enzymes) and the muscles (different conditions called myopathy and rhabdomyolysis). Following up regularly with your doctor will allow him or her to detect these problems through your medical history and blood tests.
1/30/2009 DynaMed's Systematic Literature Surveillance
: Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients.
J Am Coll Cardiol.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a