Preventive Cardiology: Statins
Commonly Prescribed Statins
Mechanism for How It Works
- Protease inhibitors to treat HIV, such as indinavir, nelfinavir, ritonavir, saquinavir
- Grapefruit juice —increases the absorption of most statins, allowing potentially excessive levels to build up in the bloodstream
- Chaparral, comfrey, and coltsfoot—may increase the risk of liver problems
- St. John’s wort—may decrease blood levels of some statins
- Vitamin B3— possibly increases the risk of developing a potentially fatal condition called rhabdomyolysis
- Red yeast rice—contains a mixture of statins and should not be combined with statin drugs
Other Potential Concerns
- Allergy or intolerance to statins or allergies to other substances, including food
- Obesity—can make statins less effective
- Positive changes in diet and exercise—may need a lower dose
- Alcohol abuse
- Liver disease
- Organ transplant and take medicine to prevent transplant rejection
- Recent major surgery
- Pregnant or breastfeeding—Statins are not recommended in pregnant or nursing women.
Common Side Effects
- Upset stomach
- Abdominal pain
- Flu-like symptoms
- Muscle pain
- Skin rash
Less Common Side Effects
- Liver problems
- Myopathy (muscle weakness)
- Kidney failure
- Memory problems and confusion
- Increased blood sugar levels
- Take only the amount of statin ordered by your doctor
- Do not stop taking this medication without first checking with your doctor
- Tell your doctor or dentist about taking this medicine before having any kind of surgery, dental procedure, or emergency treatment
American Heart Association http://www.heart.org
US Food and Drug Administration http://www.fda.gov
Health Canada http://www.hc-sc.gc.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.com
Amarenco P, Bogousslavsky J, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549-559.
Grundy SM, Cleeman JL, et al. National Heart, Lung, and Blood Institute, American College of Cardiology Foundation; American Heart Association. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines. Circulation. 2004;110:227-239.
Lemaitre RN, Psaty B, et al. Therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) and associated risk of incident cardiovascular events in older adults. Arch Intern Med. 2002;162:1395-1400.
Lipid-lowering pharmacotherapy overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 12, 2014. Accessed December 11, 2014.
Middleton A, Binbrek AS, et al. Achieving 2003 European lipid goals with rosuvastatin and comparator statins in 6,743 patients in real-life clinical practice: DISCOVERY meta-analysis. Curr Med Res Opin. 2006;22: 1181-1191.
Statins. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 4, 2014. Accessed December 11, 2014.
Statins. Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm294358.htm. Updated November 21, 2012. Accessed December 11, 2014.
Statin drugs. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated September 18, 2014. Accessed December 11, 2014.
Statins for prevention of cardiovascular disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 15, 2014. Accessed December 11, 2014.
Stender S, Schuster H, et al. Comparison of rosuvastatin with atorvastatin, simvastatin, and pravastatin in achieving cholesterol goals and improving plasma lipids in hypercholesterolaemic patients with or without the metabolic syndrome in the MERCURY I trial. Diabetes Obes Metab. 2005;7:430-438.
Tahara N, Kai H, et al. Simvastatin attenuates plaque inflammation: evaluation by fuorodeoxyglucose positron emission tomography. J Am Coll Cardiol. 2006;48:1825-1831.
1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills EJ, Rachlis B, et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients. J Am Coll Cardiol. 2008;52:1769-1781.
3/6/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA announces safety changes in labeling for some cholesterol-lowering drugs. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm. Updated March 2, 2012. Accessed December 11, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014 -
- Update Date: 12/11/2014 -