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Statins Side Effects

Statins are drugs prescribed for millions of patients to lower high cholesterol levels and to reduce the risk of heart attack or stroke. Statins block the synthesis of cholesterol in the liver and effectively lower levels of LDL (bad) cholesterol. Since the introduction of the first statin, Mevacor, in 1987, other drug manufacturers have developed their own statin drugs including Zocor, Lipitor, Lescol, Pravachol and Crestor. As a class, statins are among the most widely used drugs. However, side effects of the drugs may be an issue for susceptible patients, especially since most people who are prescribed for statins will take them for the rest of their lives.

  1. Common side effects

    • Generally, statins are well tolerated. Common side effects may include headache, constipation, diarrhea, rash, stomach pain and muscle pain. The latter is the most common side effect, and may appear as a soreness or weakness in muscles. Usually the pain is mild; however in some cases it can be severe enough to interfere with ordinary activities such as walking or climbing stairs.

    Liver damage

    • Occasionally, statins elevate liver enzymes in patients. Mild enzyme increases are generally benign, and patients usually continue their treatment. More severe enzyme elevations are usually reversible upon discontinuation of the therapy. However, if left unchecked, severe liver enzymes may lead to permanent liver damage. For this reason, patients who take statins should have their liver enzymes checked periodically during their first year of treatment. Statins should not be given to patients with active or chronic liver disease.

    Muscle damage

    • In rare cases, statin-induced muscle breakdown can lead to release of muscle contents in the blood stream and development of rhabdomyolysis. In severe cases, this can lead to kidney failure and death. One statin, Baycol, was withdrawn from the market in 2001 after being implicated in over 60 deaths due to rhabdomyolysis.

    At risk patients

    • Certain individuals are at greater risk of developing side effects while on statins. Risk factors include taking multiple medications, having kidney or liver disease, having diabetes, having a smaller body frame, being 65 or older, and being female.

    Relieving side effects

    • To reduce statin side effects, doctors may recommend a number of different strategies. In some cases, lowering the dose may alleviate the problems. Switching to another statin drug also helps some patients. Doctors may also make changes in other medications that patients are taking. Finally, taking a break from statin therapy for 10 to 14 days may help determine if the problems are due to statins or something else.

    Conclusion

    • Statins are generally well tolerated, reflecting a favorable benefit to risk profile for most patients. According to Dr. Janet Armitage, who published a large review on statin safety in the British medical journal Lancet in 2007, "For most people, statins are safe and well-tolerated, and their widespread use has the potential to have a major effect on the global burden of cardiovascular disease".

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