Statins are widely used cholesterol-lowering drugs that can reduce the risk of major heart-related health problems.
Though statins generally have a good safety profile, they can cause side effects in some people. Still, healthcare providers believe that the benefits of statins outweigh the risks related to side effects. There are options for managing side effects if they become bothersome.
What Are Statins?
Statin medications are used with diet and exercise to treat hypercholesteremia (high blood cholesterol levels).
Statins belong to the prescription drug class called hydroxymethylglutaryl-coenzyme A (HMG CoA) reductase enzyme inhibitors. They work to reduce the production of cholesterol in the liver.
Statins lower low-density lipoprotein (LDL) cholesterol, also known as bad cholesterol, and triglyceride levels in the blood. They also increase the concentration of high-density lipoprotein (HDL), also known as good cholesterol.
Statins are also widely used and have proved effective in preventing atherosclerotic vascular diseases, primarily by reducing plasma LDL concentrations.
The U.S. Food and Drug Administration (FDA)-approved and marketed single-ingredient products statins include:
Lipitor (atorvastatin)
Lescol XL (fluvastatin extended release)
Altoprev (lovastatin extended release)
Livalo (pitavastatin)
Crestor (rosuvastatin)
Zocor (simvastatin)
Other combination products include:
Advicor (lovastatin/niacin extended release)
Simcor (simvastatin/niacin extended release)
Vytorin (simvastatin/ezetimibe)
Side Effects of Statins
Statins have a good safety and efficacy profile for improving cholesterol levels. However, they can cause some side effects.
The benefits of taking statins generally outweigh the side effects, but they can still be bothersome for some people. In most cases, they are reversible but sometimes require stopping therapy for a while.
Some more common mild side effects of statins include:
Constipation
Diarrhea
Dizziness
Gas
Headache
Muscle/joint aches
Nausea
Upset stomach
Other potential reversible side effects include:
Memory loss and confusion
Increased blood sugar
Increased hemoglobin A1C enzyme levels
In some people, statins can cause a few severe side effects. However, these are generally uncommon. Some other rare severe side effects of statin include:
Liver damage
Kidney damage
Muscle disorders
Hemorrhagic strokes
The risks of these are rare and associated with higher drug doses. Healthcare providers believe that statins' benefits outweigh the risks of these side effects.
Muscle Pain and Soreness
Some people report mild muscle pain and soreness while taking statins. However, some studies suggest that most reports of muscle pain may not actually be due to the statin itself.
If the side effects become especially bothersome, your healthcare provider might reduce the dose.
Rarely, severe cases may involve a type of muscle disorder called rhabdomyolysis, which can cause the following symptoms:
Severe muscle cramps, aches, or pains
Dark-colored urine
Extreme weakness or fatigue
Risk Factors for Side Effects
Statins are relatively safe for most people. However, they are not recommended in certain cases. Some people are at an increased risk of side effects. This includes if you:
Take other medicines to lower cholesterol levels or drugs that interact with statins
Are pregnant
Are 80 years or older
Have kidney or liver disease
Consume alcohol in excess
Have hypothyroidism
Have a neuromuscular disorder, such as amyotrophic lateral sclerosis (ALS)
Drug and Food Interaction
Statins may interact with certain drugs and cause an increased risk of muscle injury:
Cholesterol-lowering drugs known as fibrates
Higher doses of niacin
Ranexa (ranolazine), used to treat angina
Colchicine, a medicine for treating gout
The FDA has updated the Lovastatin label for interactions with other drugs and their dose limitations to reduce the risk of muscle injury.
Follow a healthy diet while taking statins. This includes eating less fat in the diet.
Avoid drinking large amounts of grapefruit juice while taking statins. Excessive grapefruit juice consumption can raise the amount of the drug in the blood and increase the risk of muscle disorders. However, an 8-ounce (240-milliliter) glass of juice or one grapefruit can be safely consumed.
How to Manage Side Effects
In many cases, the benefits of statin therapy outweigh the risk of adverse effects. However, in some people, the side effects may be severe enough to drive healthcare providers to permit the discontinuation of statin drugs.
To relieve side effects that are believed to be caused by statins, discuss these steps with your healthcare provider:
Stopping statin therapy to reduce the side effects
Switching to another cholesterol-lowering drug
Reducing the dose
Making lifestyle changes to reduce cholesterol levels, such as eating a low-fat diet, doing regular exercise, and quitting smoking
Some also believe that taking coenzyme Q10 (coQ10) supplements can help fight muscle disease. However, the data on this has been mixed, and many studies don't indicate much benefit from taking CoQ10 supplements for this purpose.
Statins can lower the risk of a heart attack or stroke, and the risk of life-threatening side effects from statins is very low.
Summary
Statins are a widely used group of drugs that are generally well tolerated. Like any other type of drug, they may cause a few side effects in some people.
The side effects of statins, such as muscle pain, memory loss, or a slight increase in the risk of new-onset diabetes and the potentially increased risk of stroke, are negligible when compared with the benefits that the medication provides.
Tell your healthcare provider about any other drugs you take before taking statins.