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How to take statins

Definition

Statins are medicines that help lower the amount of cholesterol and other fats in your blood. Statins work by:

• Lowering LDL (bad) cholesterol
• Raising HDL (good) cholesterol in your blood
• Lowering triglycerides, another type of fat in your blood

Statins block how your liver makes cholesterol. Cholesterol can stick to the walls of your arteries and narrow or block them.

Alternative Names

Antilipemic Agent; HMG-CoA reductase inhibitors; Atorvastatin (Lipitor); Simvastatin (Zocor); Lovastatin (Mevacor, Altoprev); Pitavastatin (Livalo, Zypitamag); Pravastatin (Pravachol); Rosuvastatin (Crestor); Fluvastatin (Lescol); Hyperlipidemia - statins; Hardening of the arteries - statins; Cholesterol - statins; Hypercholesterolemia - statins; Dyslipidemia - statins; Statin

How do Statins Help?

Improving your cholesterol levels can help protect you from heart disease, heart attack, and stroke.

Your health care provider will work with you to lower your cholesterol by improving your diet. If this is not successful, medicines to lower cholesterol may be the next step.

Statins are often the first medicine treatment for high cholesterol. Both adults and teenagers can take statins when needed.

What Statins are Right for you?

There are different brands of statin medicines, including less expensive, generic forms. For most people, any of the statin medicines will work to lower cholesterol levels. However, some people may need the more powerful types.

A statin may be prescribed along with other medicines. Combination tablets are also available. They include a statin plus medicine to manage another condition, such as high blood pressure.

How are Statins Taken?

Take your medicine as directed. The medicine comes in tablet or capsule form. Do not open capsules, or break or chew tablets, before taking the medicine.

Most people who take statins do so once a day. Some should be taken at night, but others can be taken anytime. They come in different doses, depending on how much you need to lower your cholesterol. Do not stop taking your medicine without talking with your provider first.

Read the label on the bottle carefully. Some brands should be taken with food. Others may be taken with or without food.

Store all of your medicines in a cool, dry place. Keep them where children cannot get to them.

You should follow a healthy diet while taking statins. This includes eating less fat in your diet. Other ways you can help your heart include:

• Getting regular exercise
• Managing stress
• Quitting smoking

What are the Risks?

Before you start taking statins, tell your provider if:

• You are pregnant, plan to become pregnant, or are breastfeeding. Pregnant and nursing mothers should not take statins.
• You have allergies to statins.
• You are taking other medicines.
• You have diabetes.
• You have liver disease. You should not take statins if you have certain acute or long-term (chronic) liver diseases.

Tell your provider about all of your medicines, supplements, vitamins, and herbs. Certain medicines may interact with statins. Be sure to tell your provider before taking any new medicines.

Overall, there is no need to avoid moderate amounts of grapefruit in the diet. An 8 ounce (240 milliliters) glass of grapefruit juice or one grapefruit can be safely consumed.

Regular blood tests will help you and your provider:

• See how well the medicine is working
• Monitor for side effects, such as liver problems

Possible Side Effects

Mild side effects may include:

• Muscle/joint aches
• Diarrhea
• Nausea
• Constipation
• Dizziness
• Headache
• Upset stomach
• Gas

Though rare, more serious side effects are possible. Your provider will monitor you for signs of these. Talk with your provider about the possible risks for:

• Liver damage
• Severe muscle problems
• Kidney damage
• High blood sugar or type 2 diabetes
• Memory loss
• Confusion

When to Call the Doctor

Tell your provider right away if you have:

• Muscle or joint pain or tenderness
• Weakness
• Fever
• Dark urine
• Other new symptoms

References

Aronson JK. HMG coenzyme-A reductase inhibitors. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier B.V.; 2016:763-780.

Genest J, Mora S, Libby P. Lipoprotein disorders and cardiovascular disease In: Libby, P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 27.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/ APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/30423393/.

Lee JW, Morris JK, Wald NJ. Grapefruit juice and statins. Am J Med. 2016;129(1):26-29. PMID: 26299317 pubmed.ncbi.nlm.nih.gov/26299317/.

O'Connor FG, Deuster PA. Rhabdomyolysis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 99.

Robinson JG. Disorders of lipid metabolism. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 190.

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