What are the side effects of statin drugs

What are statins?

Statins are a group of medications used to treat high cholesterol. They work by decreasing the levels of cholesterol in your blood, especially low-density lipoprotein (LDL) or “bad” cholesterol.

People with high LDL cholesterol are at an increased risk of developing cardiovascular disease. With this condition, cholesterol builds up in your arteries and can lead to angina, heart attack, or stroke. So, statins can be important in reducing these risks.

Your body actually needs some cholesterol to function well. Your body gets cholesterol by eating certain foods and by making it in your liver. However, dangers arise when your cholesterol levels get too high. Statins work to decrease cholesterol levels in your body.

Statins do this by blocking your body’s production of an enzyme called HMG-CoA reductase. This is the enzyme your liver needs to make cholesterol. Blocking this enzyme causes your liver to make less cholesterol, which makes it easier for your body to remove cholesterol that’s already in your blood. This lowers your cholesterol levels.

There are several real benefits to taking statins, and for many people, these benefits outweigh the drugs’ risks.

Statins for cholesterol

Who can benefit from taking a statin?

The Centers for Disease Control and Prevention (CDC) reports that people with the following conditions are likely to benefit most from statins:

• high risk of heart attack or stroke, for example due to high blood pressure
• previous heart attack or stroke
• high LDL cholesterol
• diabetes

Statins can reduce your risk of heart attack and stroke. The higher your risk, the more likely you are to benefit from statins. They can lower LDL cholesterol levels by as much as 60 percent, depending on which medication you’re taking and the dosage prescribed. In addition, statins help lower triglyceride levels and raise high-density lipoprotein (HDL), or “good“ cholesterol.

Other benefits of statins

Organ transplant recipients may be prescribed statins because statins reduce the risk of cardiovascular problems after transplant. These drugs may also help lower the chance of rejection after an organ transplant, according to a 2013 study. However, more research is needed in this area.

Statins have anti-inflammatory properties that affect blood vessels, the heart, and the brain. This effect could also contribute to lowering the risk of blood clots, heart attack, and stroke.

People who take statins should avoid grapefruit. Grapefruit can interact with certain statins, increasing the concentration of statins in your blood. This can make side effects worse.

This is especially true with lovastatin and simvastatin. Be sure to read the warnings that come with your medications. If you have questions, talk with your doctor or pharmacist. Read more about grapefruit and statins.

Most people can take statins without too many side effects, but side effects can occur. It‘s hard to say if one type of statin will cause more side effects for you than another. If you have lasting side effects, your doctor may be able to adjust your dosage or recommend a different statin.

According to the Food and Drug Administration (FDA), some of the more common side effects of statins include:

• muscle pain
• constipation
• diarrhea
• nausea
• headache

Other side effects reported by people taking statins include:

• weakness
• stomach pain or gas
• dizziness
• fatigue

Some people report sleep problems while taking statins, but research hasn‘t shown a clear connection.

These side effects are generally mild. However, statins can also cause more serious side effects. These include:

Muscle damage

Statins can cause muscle pains, especially in high doses. In rare cases, they can even cause muscle cells to break down. When that happens, your muscle cells release a protein called myoglobin into your bloodstream. This condition is called rhabdomyolysis. It can cause serious damage to your kidneys.

The risk of rhabdomyolysis is greater if you take certain other medications with statins, especially lovastatin or simvastatin. These other medications include:

• itraconazole, ketoconazole, and other azole antifungal medications
• atazanavir, ritonavir, and other protease inhibitor medications used to treat HIV
• cyclosporine (Restasis, Sandimmune), used after organ transplant and to treat some autoimmune conditions
• erythromycin, an antibiotic
• gemfibrozil (Lopid) and other fibrate drugs, used to improve cholesterol levels
• diltiazem and verapamil, used to lower blood pressure
• amiodarone, used to regulate heartbeat
• colchicine, used to treat gout
• nefazodone (Serzone), an antidepressant
• niacin (Niacor, Niaspan), used to improve cholesterol levels

Your doctor may adjust dosages or change medications in order to manage these potential side effects.

Liver damage

Liver damage is another potential side effect of statin therapy. Although it’s rare, effects on your liver can be serious.

Before you start taking a statin, your doctor will likely order liver function tests to check your liver enzymes. They may repeat the tests if you show symptoms of liver problems while taking the drug. These symptoms can include:

• jaundice (yellowing of the skin and whites of the eyes)
• dark urine
• pain in the upper right part of your abdomen

Increased risk of diabetes

In rare cases, statins may change how the body processes glucose (blood sugar). For this reason, statins can cause a small increase in your risk of developing type 2 diabetes. If you’re concerned about this risk, talk with your doctor.

Confusion or memory problems

According to the FDA, some people report having confusion or memory problems while taking a statin, although studies have shown conflicting results.

If you have these side effects, talk with your doctor. They may switch you to a different medication. These effects typically clear up within a few weeks after you stop taking the statin.

Not everyone who takes statins will experience side effects. But some people may be at higher risk of side effects than others, according to research.

Muscle symptoms are the most common statin side effect. Risk factors for statin-related muscle pain may include:

• hypothyroidism
• high levels of creatine phosphokinase (CPK), an enzyme in your body that supports muscle function
• over age 80
• being of East Asian descent
• being assigned female at birth
• small body size
• alcohol use disorder
• conditions that affect the liver and kidneys

If you have one or more diabetes risk factors, you may be at increased risk of developing diabetes while taking statins.

Demographic factors and statin side effects

Because most research on statins has involved middle-aged, white participants, there is less information available about side effects in people of color and older adult groups.

Some studies have indicated that people of East Asian descent may be more likely to experience side effects from statins.

But a large 2016 study with racially and ethnically diverse participants found that Asian people and Hispanic people experienced the same cholesterol-lowering benefits as white participants, as well as no increase in side effects.

The same study also grouped participants into categories of male and female, finding that the statin lowered LDL cholesterol equally well for both categories.

If you’re over age 75, some research suggests you may be at higher risk of muscle problems related to statins. But for many older adults, the benefits of statins for preventing heart attack and stroke outweigh this risk.

One study found that 75-year-olds who stopped taking statins had a 33 percent higher risk of being hospitalized for a cardiovascular event, versus those of the same age who continued to take statins.

It’s best to discuss potential benefits and side effects with your doctor to find out whether statins are right for you.

Taking a statin while following a balanced diet and getting regular exercise is a good way for many people to lower their cholesterol levels. If you have high cholesterol, ask your doctor if a statin would be a good choice for you.

Questions you might ask your doctor include:

• Am I taking any medications that might interact with a statin?
• What other benefits do you think a statin might provide for me?
• Do you have diet and exercise suggestions that might help me lower my cholesterol?