Statins, also known as HMG-CoA reductase inhibitors, are drugs that lower blood cholesterol, according to the National Institutes of Health. High cholesterol levels can narrow or block the flow of blood in the arteries. Statins reduce the amount of cholesterol produced in the liver and, therefore, can slow the formation of plaque within the arteries. While statins are considered to be generally safe for most people, adverse reactions that can occur.
Benefits
Statins are the most-often prescribed drugs for heart disease and high cholesterol. According to the National Heart, Lung and Blood Institute, statins can reduce levels of LDL-cholesterol, the bad cholesterol, by 20 to 60 percent and increase levels of HDL-cholesterol, the good cholesterol. Statins have reduced the number of heart attacks and deaths from heart disease.
Types
According to the National Heart, Lung and Blood Institute, the statins available for use in the U.S. include Lipitor, Mevacor, Zocor, Pravachol and Lescol. Lipitor is the top-selling drug, with sales of $7.5 billion in 2009, according to IMS Health. The Food and Drug Administration approved Mevacor in 1987, Zocor and Pravachol in 1991, Lescol in 1993 and Lipitor in 1996. According to research published in Current Opinion in Lipidology, each statin has unique structural properties that can control different aspects of heart disease, particularly in high-cardiovascular-risk patients.
Warnings
Statins can cause pain, tenderness and weakness in the muscles. According to the article "How Do You Know If You Have Rhabdomyolysis from Statin Use?" statins can cause rhabdomyolysis, a rare and life-threatening side effect that breaks down muscle cells and releases a protein called myoglobin into the blood that causes fatigue, dark red urine, kidney damage, failure and even death. Statins taken with other drugs such as Lopid, niacin, cyclosporine and antifungal medications can increase the risk of rhabdomyolysis.
Baycol, an FDA-approved statin in 1997, was removed from the market in 2001 because of 52 deaths and close to 400 non-fatal cases from drug-related rhabdomyolysis, according to research in Current Controlled Trials in Cardiovascular Medicine. Rhabdomyolysis is 10 times more likely to occur in patients using Baycol rather than other statins. Nonetheless, statins on the market today still have this risk.
Statins can cause an overproduction of liver enzymes, which can lead to permanent liver damage without symptoms. When taken with other cholesterol-lowering drugs, such as Lopid and niacin, statins can increase the risk of liver problems. Statins, such as Lipitor, can also increase incidence of stroke.
Other Side Effects
Most patients tolerate statins just fine. However, some patients can experience gastrointestinal effects such as an upset stomach, abdominal pain, cramps, gas and constipation. These symptoms usually are mild to moderate in severity and are temporary as the body adjusts to the drug.
Dosage
A single dose of a statin is taken in the evening at dinner or bedtime because the body manufactures most cholesterol at night. Results of reduced blood cholesterol levels can occur within six to eight weeks. Dosage levels can change based on results of an LDL-cholesterol test.
References
- IMS Health: Top 15 U.S. Pharmaceutical Products by Sales
- Food and Drug administration: FDA Approved Drug Products
- "Current Opinion in Lipidology"; Do Structural Differences in Statins; Arnaboldi, L.; Aug 2010
- Mayo Clinic: How Do You Know If You Have Rhabdomyolysis from Statin Use?
- "Current Control Trials Cardiovasc Med"; Withdrawal Cerivastatin from World Market; Furberg, C.D.; 2001
