Statins

What are statins?

Statins are prescription medications that people take to bring their cholesterol down to normal levels. Some statins can decrease your LDL (low-density lipoprotein or “bad”) cholesterol by 50% or more. Providers often call LDL “bad” because it builds up inside your arteries, making it harder for blood to move through them.

Statins also decrease your triglycerides and help your liver get rid of more cholesterol. They may increase your HDL (high-density lipoprotein or “good”) cholesterol. HDL is good because it brings cholesterol to your liver, which gets it out of your body.

Different brands of statins are available, as well as generic forms that cost less. Statin drugs are tablets or capsules that you swallow whole once a day with or without food. You should take them at the same time each day.

The label on your medicine bottle will tell you if you need to take your statin medication at a certain time of day. Statins that stay in your system for a short time work best if you take them in the evening (before your body starts making cholesterol overnight). Statin drugs that stay in your system longer work just as well if you take them at other times of the day.

How do statins work?

Statins get in the way when your liver is trying to make cholesterol. Like a good basketball player who doesn’t let an opponent get the ball, statins don’t let your liver have an enzyme (HMG CoA reductase) it needs to create cholesterol. Your body makes 75% of your cholesterol, so helping it make less can make a big difference. The rest of your body’s cholesterol comes from what you eat.

Why are they used?

Statin drugs lower your cholesterol level to make you less likely to have a heart attack or stroke. Your body uses cholesterol when it makes vitamin D, hormones and the acid you use to digest food. But if you have too much cholesterol in your blood, it can collect inside your arteries. This creates obstacles that make it harder for your blood to get through your blood vessels.

If cholesterol keeps building up in your arteries, it can do more than just make them narrow. The plaque (obstacles) in your blood vessels can become unstable and break open, leading to a heart attack or stroke.

Types of statin drugs

Types of statin drugs include:

• Atorvastatin (Caduet^® or Lipitor^®).
• Fluvastatin.
• Lovastatin (Mevacor^® or Altoprev^™).
• Pitavastatin (Livalo^® or Zypitamag^®).
• Pravastatin.
• Rosuvastatin (Crestor^® or Ezallor Sprinkle^®).
• Simvastatin (FloLipid^®, Vytorin^® or Zocor^®).

You can also get statins in combination with another medicine in one pill, such as:

• Simvastatin with ezetimibe or niacin.
• Atorvastatin with ezetimibe or amlodipine.
• Lovastatin with niacin.

Who needs to take statins?

Statins can help people who can’t bring their cholesterol into a normal range by changing what they eat and getting more physical activity.

Your healthcare provider will look at your individual risk of heart and blood vessel disease when deciding if you should take a statin medication. Some people get genes from their parents that make their bodies create more cholesterol than they need. Having diabetes, high blood pressure or high cholesterol and using tobacco products are all risk factors for getting heart disease.

Your provider will also consider your age, sex and family history when deciding if you need a statin. Adults and teens can take statins.

Providers prescribe statins for people who:

• Have high cholesterol (LDL above 190 mg/dL) and can’t reduce it by changing their eating and physical activity habits.
• Have an LDL above 160 mg/dL, a family history of early coronary artery disease and are 20 to 39 years old.
• Have a history of a stroke, heart attack or peripheral artery disease (PAD).
• Have diabetes and an LDL of at least 70 mg/dL and are 40 to 75 years old.
• Have an LDL of at least 70 mg/dL and a high risk of getting heart disease and are 40 to 75 years old.

What happens to your body when you take statins?

When you take statin drugs, your body makes less bad cholesterol. And that means less cholesterol buildup in your arteries. Blood flows through arteries more easily when they have less buildup inside them. Good blood flow means a smaller chance of a heart attack or stroke.

How common are statins?

Statins are some of the most common prescriptions in America. More than 92 million adults take them.

What are the advantages of statins?

Statins decrease your risk of having a stroke or heart attack because they cut down the amount of “bad” cholesterol in your blood. That cholesterol can make your arteries narrow (atherosclerosis), making it hard for your blood to circulate and putting you at risk for a heart attack or stroke.

Is there a downside to taking statins?

Yes. There’s a risk of side effects, and most people need to keep taking statin drugs for the rest of their lives.

Some people have an interaction with another medicine while taking statins. Whenever your provider considers prescribing medication for you, it’s important to tell them what else you’re taking. That includes other prescription drugs, medicines you buy without a prescription, vitamins, herbs, supplements and recreational drugs.

What are the side effects of statins?

Statin side effects may be mild to severe, including:

• Headache.
• Nausea.
• Dizziness.
• Gas.
• Diarrhea.
• Constipation.
• Achy muscles or joints.
• Confusion.
• Memory loss.
• Damage to your kidneys.
• Damage to your liver.
• Muscles breaking down (rhabdomyolysis).
• Type 2 diabetes or high blood sugar.

Most people don’t have side effects from statins and some side effects are rare.

If one type of statin gives you side effects, ask your provider if they can switch you to a different one. You may also want to ask your provider if you need to avoid grapefruit or pomegranate or their juices, or if it’s OK to have a small amount. These foods can make it hard for your body to break some statins down, allowing too much of the drug to build up in your body. This can give you more side effects.

What happens if you stop taking statins?

Your cholesterol level will go back up if you stop taking statins. You’ll probably need to keep taking them indefinitely.

What happens if you keep taking statins?

Your total cholesterol and LDL (bad cholesterol) numbers should come down, as well as your risk for heart attack and stroke.

When should I see my healthcare provider?

While you’re taking statins, you should contact your provider if your muscles or joints hurt or if you feel weak, have a fever, have jaundice or your urine is dark.

Do statins cause weight gain?

Yes, some researchers think statins can contribute to modest weight gain. Statin users may also eat more calories and fat because they have a false sense of security from good lipid panel results.

Who should avoid statins?

You should avoid statins if you’re pregnant, nursing or have certain types of liver disease. Let your provider know if you have diabetes. If you’re already at risk for diabetes, statins can add to your risk of getting it.

A note from Cleveland Clinic

So, your cholesterol is up and won’t budge despite your best efforts to get more physical activity and eat healthier foods. This is more common than you think. Sometimes, it takes a statin medication to bring cholesterol down. But even if you start taking a statin, remember that you’ll get the best results if you keep staying active and eating healthy while taking the medicine. Ask your provider if you have questions about ways to keep your heart healthy.