An estimated 25 million Americans take statins to decrease high blood cholesterol and reduce their risk of heart disease, heart attack and stroke. While the vast majority of patients tolerate statins quite well, some experience adverse side effects. These may range from mildly uncomfortable to severe and debilitating. It's important to be aware of the signs of side effects associated with statins and to discuss new symptoms with a doctor as soon as they arise.
Risk Factors
Female patients and those over the age of 65 are more likely to experience adverse side effects. Also at risk are patients taking more than one type of cholesterol-lowering medication (such as gemfibrozil or niacin), diabetics and individuals with kidney or liver disease.
Patients can reduce their risk by avoiding medications that increase blood levels of the statin. These include the cholesterol-reducer gemfibrozil (Lopid), niacin, erythromycin, cyclosporine and certain antifungals. Grapefruit juice includes a compound that inhibits the breakdown of statins and should be consumed in moderation.
Muscle Effects
The most common side effect of statin treatment is muscle myalgia, or muscle ache and soreness. This may be difficult to pinpoint as a side effect of the medication, especially in elderly patients. These aches may worsen with exercise. In some cases, statins can cause a more serious inflammation of muscle, known as myositis. Myositis can be detected by a simple blood test for the CK enzyme.
Rhabdomyolysis is a rare but life-threatening side effect that actually causes muscle cells to break down. It affects only one in 10,000 patients taking statins and is more common in those taking high doses of medication or more than one type of cholesterol-lowering drug in combination. Rhabdomyolysis is characterized by extreme muscle pain and weakness throughout the body and dark colored urine and, if untreated, can progress rapidly to kidney failure, and death.
Liver Effects
Statins may cause the liver to produce high levels of certain enzymes. When this occurs, it may lead to permanent liver damage over time. According to Dr Michael Rocco, liver damage can occur without any symptoms and doctors will monitor liver function closely when a patient. Before beginning a new patient on statin treatment, doctors often perform a blood test to obtain baseline information about liver enzyme levels. Liver enzymes will be checked several weeks after beginning the medication and then periodically over the first year. After this the levels may be monitored annually or after any changes in dose or medication type.
Other Adverse Reactions
Less commonly, patients taking statins report adverse effects on the digestive system including nausea, diarrhea or constipation. These may be alleviated by taking the medication at a different time of day or with food. Some patients taking a statin in combination with niacin experience a rash or flushing.
Solutions
Adverse reactions to statins should be discussed with a doctor before any changes to the treatment plan are made. For most patients, the benefits of statin medication outweigh the side effects. Adverse side effects can usually be relieved by lowering the dosage or changing the type of medication. A doctor may recommend a short break in the treatment to determine whether the side effects are truly caused by the statin or another underlying health issue. Coenzyme Q has been reported to alleviate the side effects of statins although more studies are needed. Patients should consult their doctor before supplementing with Coenzyme Q since it may interact with other medications.
