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Statins and Statin Combinations for High Cholesterol

Statins and Statin Combinations for High Cholesterol

Examples

Statins

Generic Name Brand Name
atorvastatin Lipitor
fluvastatin Lescol
lovastatin Altoprev, Mevacor
pitavastatin Livalo
pravastatin Pravachol
rosuvastatin Crestor
simvastatin Zocor

Statin combinations

Generic Name Brand Name
atorvastatin and amlodipine, a calcium channel blocker for high blood pressure Caduet
lovastatin and niacin (nicotinic acid) Advicor
simvastatin and ezetimibe, a cholesterol absorption inhibitor Vytorin
simvastatin and niacin (nicotinic acid) Simcor

How It Works

Statins block an enzyme the body needs to produce cholesterol . As a result, LDL ("bad") cholesterol levels in the blood go down, thereby lowering total blood cholesterol levels.

Statins may be taken alone or taken with other cholesterol medicines such as fibric acid derivatives, bile acid sequestrants, or nicotinic acid. Statins may also be combined with other types of medicines into one pill.

Why It Is Used

Statins are used to lower LDL cholesterol. Statins can help lower the risk of heart attack , stroke , and death in people who are at high risk of a heart attack or stroke.

Click here to view a Decision Point. High Cholesterol: Should I Take Statins?

How Well It Works

Statins and statin combinations can:

  • Lower the risk of heart attack. 1
  • Lower stroke risk. 1
  • Reduce LDL by 18% to 55%. 2 This means that if your LDL is 200, taking a statin could lower your LDL to between 164 and 90.
  • Increase HDL by 5% to 15%. 2 This means that if your HDL is 60, taking a statin could increase your HDL to between 63 and 69. The higher your HDL, the better. An HDL of 60 and higher is linked with a lower risk of heart disease.
  • Reduce triglycerides by 7% to 30%. 2 This means that if your triglycerides are 200, taking a statin could lower your triglycerides to between 186 and 140.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have hives.

Call your doctor right away if you have symptoms of a rare muscle problem called rhabdomyolysis :

  • Severe muscle pain, tenderness, or weakness.
  • Dark-colored urine.

Statins don't cause side effects in most people. When side effects happen, they tend to include minor problems like:

  • Muscle aches (not severe pain).
  • Upset stomach.
  • Feeling tired.
  • Headache.

These common side effects may be bothersome but are not serious. Serious side effects are rare. These include liver and muscle problems, diabetes, and temporary memory problems. 3

The side effects of statin medicines are more likely when higher doses are used.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Before taking this medicine, tell your doctor all of the medicines you are taking, including over-the-counter medicines, vitamins, or supplements.

If you have muscle aches when you start this medicine, tell your doctor. The aches may go away with time. Or you might be able to try a lower dose or a different statin medicine.

Be active and eat a cholesterol-lowering diet in addition to taking this medicine. Ask your doctor for advice on a diet that can help lower cholesterol. An example is the Therapeutic Lifestyle Changes (TLC) diet . For more information, see:

Click here to view an Actionset. High Cholesterol: Using the TLC Diet

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to take this medicine, talk to your doctor about how you can prevent pregnancy.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Drugs for lipids (2011). Treatment Guidelines From The Medical Letter, 9(103): 13–20.
  2. Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486–2497.
  3. Statin label changes (2012). Medical Letter on Drugs and Therapeutics, 54(1386): 21.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Specialist Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Last Revised June 29, 2012

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