Statins: Uses, common brands, and safety info

Statins are a class of medications that are used to treat elevated cholesterol levels. However, lowering cholesterol levels is not the only benefit associated with taking a statin. Statins may also be prescribed to prevent complications in those who have experienced a heart attack or stroke, or those who have diabetes. 

Continue reading to learn more about statins, their uses, and their side effects.

What are statins?

Statins, or HMG-CoA reductase inhibitors, are a class of drugs that are used to help lower cholesterol levels. Individuals who have elevated cholesterol levels may be prescribed a statin. A buildup of cholesterol in the arteries can block the flow of blood, which can increase the risk of a heart attack or stroke. 

Fat molecules, or lipids, in the blood, can encompass LDL cholesterol, HDL cholesterol, and triglycerides. LDL, or low-density lipoprotein cholesterol, is what is considered “bad” cholesterol while HDL, or high-density lipoprotein cholesterol, is what is considered “good” cholesterol. High levels of HDL cholesterol are associated with protective effects on heart health. High levels of triglycerides may increase the risk of heart attacks and strokes. Statins generally target LDL cholesterol levels.

Statins are cholesterol-lowering drugs that have been found to reduce the risk of heart attacks and strokes. They may be given as a preventative treatment to those with a high risk of heart attack or stroke. They may also be prescribed to prevent the recurrence of a cardiovascular event in individuals who have already had a heart attack or stroke. 

How do statins work?

Statins work by blocking the production of a liver enzyme that creates cholesterol. HMG-CoA reductase plays an important role in cholesterol production in the liver. When this enzyme is blocked, total cholesterol levels in the bloodstream are lowered. Statins can also lower LDL cholesterol levels by 30% to 50%. 

Statin drugs also help your body reabsorb cholesterol that has been deposited in the walls of the blood vessels (atherosclerosis). Your body needs some cholesterol to perform functions, such as digestion, hormone production, and vitamin absorption. As less cholesterol is produced from the liver, your body must seek alternate sources. This leads to the reabsorption of LDL-containing plaques in your arteries, which can help lower overall blood cholesterol levels. 

A healthcare provider may recommend lifestyle changes, such as eating a healthy diet low in saturated fats, regularly exercising, quitting smoking, and decreasing alcohol consumption, before prescribing a statin. These lifestyle changes are also recommended while being treated with a statin to help lower cholesterol levels. 

What are statins used for?

Statins are primarily used to treat high cholesterol levels (hyperlipidemia), which can help decrease the risk of cardiovascular complications from the following:

• Diabetes

• High blood pressure

• Obesity

• Heart attack 

• Stroke

• Peripheral arterial disease

• Familial hypercholesterolemia

If you don’t currently have a history of any of these conditions, your healthcare provider may recommend a statin for preventative measures if you are considered a high-risk individual. Statins are recommended if you have at least a 10% chance of developing cardiovascular disease over the next ten years. Your provider can provide screening that will help determine your risk level. Risk factors may include a poor diet, smoking, and low physical activity levels.

Who can take statins?

Adults

The American Heart Association recommends that adults at high risk for a heart attack and stroke take a statin. A blood test will be conducted to determine current cholesterol levels. Individuals with an LDL level of 190 mg/dL or higher, existing coronary heart disease, an age of 40 to 75 years old with Type 2 diabetes, or ages 40 to 75 years old with a 7.5% or higher risk of heart disease may be recommended to take a statin. 

Children

Statin therapy is approved for children with a family history of very elevated cholesterol levels (familial hypercholesterolemia). In general, statin use can be started in children aged 8 to 10 years of age but should be monitored carefully by a specialist. Currently, Mevacor (lovastatin), Zocor (simvastatin), Pravachol (pravastatin), Crestor (rosuvastatin), and Lipitor (atorvastatin) are approved for use in children by the U.S. Food and Drug Administration (FDA). Statin therapy should be started in tandem with lifestyle changes, including diet modification and increased physical activity. 

Seniors

Older individuals can safely take statins, and those with established cardiovascular disease should continue therapy with a statin medication. The dosage of some statin medications may be lower for seniors than for other age groups. 

Are statins safe?

In general, statins are safe to take. However, a few groups of people should avoid statins, and some medications should not be mixed with statins. 

Grapefruit juice should be avoided while taking statins. Grapefruit juice can block a liver enzyme that is responsible for processing and clearing statins from the body. This could lead to increased levels of the statin in the body. Increased statin levels in the body could increase the risk of adverse effects, such as myopathy (muscle weakness) and rhabdomyolysis (muscle tissue breakdown). In addition, the risk of adverse effects may be increased when statins are taken with the following medications: 

• Sporanox (itraconazole)

• Erythrocin (erythromycin)

• Serzone (nefazodone) 

• Sandimmune (cyclosporine) 

• Cardizem (diltiazem) 

• Calan (verapamil) 

Medications classified as bile acid sequestrants (examples include Colestid and Questran) may interfere with the absorption of statins. Take statins at least one hour before or four hours after taking a medication like Colestid or Questran. 

There may be an increased risk of bleeding when statins are taken with Coumadin (warfarin). However, this risk may be lower with the following statins compared to other statins:

• Lipitor (atorvastatin)

• Pravachol (pravastatin)

There is an increased risk of liver failure or rhabdomyolysis when statins are taken with Niaspan (niacin) or fibrates (Lopid or Tricor).

Taking St. John’s Wort with Mevacor (lovastatin) or Zocor (simvastatin) may lead to reduced statin levels, which can lead to decreased effectiveness of the statin treatment. 

Statin recalls

• Pravastatin recall, 2/6/2018

Statin restrictions

Adults with active liver disease or abnormal liver enzyme levels should not take statins. Talk to a healthcare provider about other possible warnings and precautions associated with the use of statins. 

Can you take statins while pregnant or breastfeeding?

Statin therapy is contraindicated during pregnancy. Women who may become pregnant will want to take precautions against pregnancy or avoid taking a statin if they wish to become pregnant. Women who are breastfeeding should also avoid taking statins. 

Are statins controlled substances?

No, statins are not controlled substances. 

Common statin side effects

The most common side effects of statins include:

• Headache

• Muscle aches

• Fatigue

• Fever

• Diarrhea

• Nausea

• Vomiting

• Stomach upset

• Rash

More severe but rare side effects of statins include:

• Severe muscle pain

• Rhabdomyolysis, or muscle breakdown

• Serious liver problems

Although rare, statins can cause a condition called rhabdomyolysis. Rhabdomyolysis results in life-threatening muscle damage. The breakdown of muscle tissue can lead to the release of a certain protein called myoglobin into the bloodstream, which can damage the kidneys. Symptoms of rhabdomyolysis include severe muscle pain, liver damage, and kidney failure.

The use of statins, especially in high doses, has also been associated with memory loss. However, this side effect is rare, and it is reversible after discontinuation of therapy. On the other hand, some studies have shown that statins are protective against dementia and Alzheimer’s disease. 

Serious side effects associated with statins are often rare and associated with high doses. This list of side effects is not comprehensive. Speaking with a healthcare professional is the best way to get a complete list of side effects in order to determine whether taking a stain is suitable for you. If you experience side effects with a certain statin, your doctor may recommend a different statin.

Tell your doctor if you have a history of any of the following before taking a statin:

• A known allergy to statins

• Liver disease or raised liver enzyme levels

• Other medications you are currently taking

• Pregnancy or a desire to become pregnant in the near future

• Breastfeeding

How much do statins cost?

Statins are generally affordable medications that are available in brand-name and generic formulations. Almost all Medicare and insurance plans will cover statins. Costs will vary depending on your insurance plan. Without insurance, the price can vary widely depending on the medication and quantity of tablets prescribed. However, using a prescription discount card from SingleCare may help reduce the cost of statins.