Night Cholesterol Statin Guidelines

Cholesterol, a fatty substance found in the cells of your body and which is needed for your body to function properly, can become a risk factor in developing heart disease if the levels of certain kinds of cholesterol in your blood become too high. Statins are powerful drugs that can help lower your cholesterol, but guidelines are helpful in taking them.

Cholesterol and Lipoproteins

• Particles called lipoproteins transport cholesterol through your blood. These lipoproteins are classified by density. Low-density lipoprotein (LDL-C) is defined as "bad" cholesterol, and high-density lipoprotein (HDL-C) is known as "good" cholesterol. High levels of low-density lipoproteins help create a cholesterol level that increases the risk for coronary artery disease, while high levels of "good" lipoproteins decrease it.

  Cholesterol can be decreased by a low-fat high-fiber diet and regular exercise; but if these are not sufficient, cholesterol-lowering medications called statins may help. Currently prescribed statins include: Lipitor, Lescol, Mevacor, Zocor, Pravachol and Crestor.

How do Statins Work to Lower Bad Cholesterol?

• Statins work to block a key enzyme inside your liver cells that creates cholesterol. Because your liver needs cholesterol to function, when the key enzyme is blocked, it responds by absorbing additional existing LDL-C from your bloodstream, thus lowering your "bad" cholesterol level.

Guideline for When to take a Statin

• Your doctor will most likely prescribe one pill, taken at the same time each day. Because the key enzyme in your liver manufactures more cholesterol at night, as opposed to the day, a statin drug works best if taken at night, either with your evening meal or at bedtime. If you miss a dose, do not double your dose the next day, but rather continue with a normal regimen.

  Taking your statin at night with dinner, or just after dinner can make it more easily digestible and reduce gastrointestinal side effects of stomach pain, bloating and bowel irregularity.

Guideline for Dealing with Statin-Related Muscle Pain

• Common side effects of statins are muscle pain (myalgia) and soreness (myositis), muscle weakness, leg and foot cramps and, rarely, severe muscle damage (rhabdomyolysis).

  If you have muscle pain or cramps at night while taking statins, adding foods high in potassium to your diet may help. A warm bath or shower, followed by a gentle leg or foot massage before going to bed, may help prevent leg cramps. If you still have muscle pain, do not take over-the-counter analgesics, as they can be contra-indicated with statin medications, according to most product literature.

Interaction Guideline for Taking Statins

• While you are on statins, you should not have grapefruit, even if you take the statin at night and the grapefruit in the morning. Other medications that may interact with statins include antibiotics such as erythromycin and clarithromycin, which increase risk of myositis; medications for irregular heart rhythms, such as Cordarone or Vytorin; anti-fungals; anti-depressants; and immunosuppressants.

  If you have an existing liver condition or disease, your liver will need to be monitored, as another rare, but serious, side effect to use of statins is liver toxicity that may lead to permanent liver damage.