Statins medications are also known as HMG CoA reducatase inhibitors. HMG CoA reductase is an enzyme involved in cholesterol synthesis, and inhibiting, or inactivating, this enzyme results in lower levels of LDL and VLDL cholesterols, the so-called "bad" cholesterols. In addition, many of the statins offer the benefit of increasing HDL cholesterol, or "good" cholesterol; according to MayoClinic.com, this type of cholesterol binds to excess cholesterol and removes it from cells, resulting in lower risk of heart disease. However, statin use may also result in several important, potentially serious side effects.
Muscle Damage
Dr. Robert Rosenson, writing in the medical reference UpToDate, explains that as a class, statins generally have fewer side effects than other cholesterol-lowering drugs. However, side effects may occur, and an especially concerning one is that of muscle damage, also known as myopathy. Dr. Rosenson, summarizing several studies that have been done on the topic of muscle toxicity and statin use, reports that the muscle injury can range from mild to severe. On the mild end of the spectrum, patients may complain of feeling muscle soreness and a sense of achy muscles. On the severe end of the spectrum, patients may develop a condition called rhabdomyolyis, in which the fibers within the muscle actually break down. This results in the release of the muscle fiber contents--proteins called myoglobins--into the bloodstream. The myoglobins can in turn cause kidney damage or even kidney failure. Fortunately, according to MayoClinic.com, this severe amount of muscle damage is rare in people taking statins. Of note, higher doses are associated with a greater risk, and taking certain other medications with statins can increase the risk of rhabdomyolysis.
Liver Enzyme Elevations
Increases in certain liver enzymes called aminotransferases have been noted in some patients taking statin medications. Specifically, reports Dr. Rosenson in UpToDate, some studies have found that in 0.5 to 3 percent of cases, aminotransferase levels go up during the first few months of therapy with statins. This is generally related to the amount of statin medication a person is taking and often resolves within the first few months. A persistent elevation in liver enzymes is potentially dangerous, because it may lead to permanent liver damage. Patients who are on a statin and have constantly elevated enzymes may consider switching to a different cholesterol-lowering medication.
Rash
The staff at Mayo Clinic informs statin users that another possible effect is the potential for developing a rash in response to the drug. For some patients, this rash may be seen more as a flushing of the face. This effect is more likely when a statin is taken along with another cholesterol-lowering medication called niacin. Some patients take these two medications as a combination pill, while others take them as two separate medications. According to MayoClinic.com, patients who experience this annoying and potential uncomfortable side effect may benefit from taking an aspirin prior to taking the statin; however, patients are reminded to speak with their healthcare provider before making this change.
References
- UpToDate;" Statins: Actions, Side Effects, and Administration; R. Rosenson; June 2010
- Mayo Clinic: HDL Cholesterol
- Medline Plus: Rhabdomyolysis
- Mayo Clinic: Rhabdomyolysis from Statins: What's the Risk?
- Mayo Clinic: Statin Side Effects: Weigh the Benefits and Risks
