pain or tenderness around the eyes and cheekbonesįor a complete list of side effects, please refer to the individual drug monographs.Despite their benefits, statins have been caught up in a storm of controversy, with critics questioning the safety and efficacy of the drugs after NHS guidelines advised that prescriptions should be extended to those at lower risk of heart attack.īut the new study suggests common side-effects of muscle pain and weakness are not a result of the drugs themselves, but rather patients’ negative beliefs about the medication – a phenomenon known as the nocebo effect. heartburn, indigestion, nausea or stomach discomfort.The most common side effects reported with statins include: Some statins, particularly those metabolized by CYP 3A4 (such as atorvastatin, pravastatin and simvastatin), can interact with several other drugs, such as clarithromycin, protease inhibitors, cyclosporine, gemfibrozil, oral contraceptives, and digoxin.įor a complete list of severe side effects, please refer to the individual drug monographs. These symptoms typically resolve with discontinuation. Rarely, statin use has been associated with memory loss, forgetfulness, amnesia, memory impairment, and confusion. People with active liver disease or who are pregnant or breastfeeding should not take statins. Some statins may not be suitable for some people including those with a recent history of stroke or transient ischemic attack ( TIA). Statins may also affect some diabetes markers (such as HbA1c or fasting glucose), and may not be suitable in those with liver or kidney disease. This may require a reduction in dosage or discontinuation. Rarely, statins may affect affect the liver or cause jaundice (a yellowing of the skin). Mild muscle pain is a common side effect of statins. Initial reports of muscle pain should be investigated by a doctor. People aged older than 65, taking certain medications (for example cyclosporine, itraconazole, or HIV antivirals), who drink more than two alcoholic drinks per day, or with kidney disease, appear to be more at risk of serious side effects. Serious muscle effects have been reported with statins, including rhabdomyolysis – this is the destruction of muscle cells. Statins are generally safe when used at recommended dosages. It is effective at low dosages and has minimal drug interactions. Pitavastatin has a similar effectiveness to atorvastatin but reportedly produces greater increases in HDL-cholesterol that are sustained over the long-term. Grapefruit juice should be avoided with these statins. Grapefruit juice increases levels of atorvastatin, lovastatin, and simvastatin, which may increase the risk of side effects. Atorvastatin and fluvastatin are considered the most cost-effective statins. Pravastatin and fluvastatin have a lower risk of drug interactions because they are not metabolized by cytochrome p450 3A4. Atorvastatin and fluvastatin are preferred in people with kidney disease. Statins differ in how effective they are at lowering total cholesterol, triglycerides, LDL-cholesterol, or increasing HDL-cholesterol how likely they are to interact with other medications and how safe they are for people with kidney disease.Ītorvastatin and simvastatin are the most effective at reducing LDL cholesterol levels. What are the differences between statins? Reduce the risk of further heart disease in people with type 2 diabetes or coronary artery disease.Reduce a person’s risk of having a heart attack or stroke or developing angina.Statins are most effective at lowering LDL-cholesterol (this is commonly referred to as “bad” cholesterol) Lower high cholesterol (also known as hyperlipidemia or dyslipidemia).Lowering cholesterol and other types of fats is important because research has shown that elevated levels of total cholesterol, LDL-cholesterol, triglycerides, and apolipoprotein B increase a person’s risk of developing heart disease or having a stroke. Most of the effects of statins, including the blocking of the HMG-CoA reductase enzyme) occurs in the liver. Statins also increase the number of LDL receptors on liver cells, which enhances the uptake and breakdown of LDL-cholesterol. Statins (also called HMG-CoA reductase inhibitors) block an enzyme called HMG-CoA reductase (3-hydroxy-3-methylglutaryl coenzyme A reductase) that is involved in the synthesis of mevalonate, a naturally occurring substance that is used by the body to make sterols, including cholesterol.īy inhibiting this enzyme, cholesterol and LDL-cholesterol production is decreased.
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