Preventive Cardiology: StatinsEn Español (Spanish Version)
- Lovastatin (Altoprev, Mevacor)
- Simvastatin (Zocor)
- Pravastatin (Pravachol)
- Fluvastatin (Lescol)
- Atorvastatin (Lipitor)
- Rosuvastatin (Crestor)
Statins may be prescribed if you have:
If you already have cardiovascular disease, your doctor may recommend statins to reduce your risk of having a heart attack
. Some people may benefit from a statin even if they have no history of cardiovascular disease but are at high risk.
HMG-CoA reductase is an enzyme that helps your body make cholesterol. Statins help to block this enzyme, which in turn causes your body to make less cholesterol. When you make less cholesterol, your liver makes more LDL receptors, which attract LDL particles in the blood. This reduces the amount of LDL ("bad") cholesterol in your bloodstream. Lower LDL cholesterol levels also tend to lead to lower levels of triglycerides and higher HDL (“good”) cholesterol levels in the blood. Statins have anti-inflammatory effects on blood vessels which help reduce the formation of fatty plaque on blood vessel walls.
Statins can interact with many medicines. Below are some examples. But, you should talk to your doctor and pharmacist about the specific medicines that you are taking.
- Erythromycin (eg, Erythrocin)
- Protease inhibitors to treat HIV, such as indinavir
Statins can interact with certain foods, herbs, and supplements. Here are examples of potential interactions:
—increases the absorption of most statins, allowing potentially excessive levels to build up in the bloodstream
Chaparral, comfrey, and coltsfoot—may increase the risk of liver problems
St. John’s wort—may decrease blood levels of some statins
possibly increases the risk of developing a potentially fatal condition called
- Red yeast rice—contains a mixture of statins and should not be combined with statin drugs
If you would like to take herbs or supplements while taking a statin, check with your doctor first.
These conditions can affect how your body uses statins:
- Allergy or intolerance to statins or allergies to other substances, including food
- Obesity—can make statins less effective
- Positive changes in diet and exercise—may need a lower dose
If you have any of the following conditions, tell your doctor before you are prescribed statins:
- Alcohol abuse
- Liver disease
- Organ transplant and take medicine to prevent transplant rejection
- Recent major surgery
- Pregnant or breastfeeding—Statins are not recommended in pregnant or nursing women.
More common side effects include:
- Upset stomach
- Abdominal pain
- Flu-like symptoms
- Muscle pain
- Skin rash
Less common, but more serious side effects include:
- Liver problems
- Myopathy (muscle weakness)
- Kidney failure
- Memory problems and confusion
- Increased blood sugar levels
- Take only the amount of statin ordered by your doctor.
- Do not stop taking this medicine without first checking with your doctor.
- Tell your doctor or dentist about taking this medicine before having any kind of surgery, dental procedure, or emergency treatment.
American Heart Association
US Food and Drug Administration
Heart and Stroke Foundation of Canada
Amarenco P, Bogousslavsky J, Callahan A III, et al. High-dose atorvastatin after stroke or transient ischemic attack.
N Engl J Med
Grundy SM, Cleeman JL, Merz CN et al. National Heart, Lung, and Blood Institute, American College of Cardiology Foundation; American Heart Association. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines.
Keeping cholesterol under control. US Food and Drug Administration website. Available at:
. Accessed on January 28, 2003.
Lemaitre RN, Psaty B, Heckbert SR, et al. Therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) and associated risk of incident cardiovascular events in older adults.
Arch Intern Med
Middleton A, Binbrek AS, Fonseca FA, et al. Achieving 2003 European lipid goals with rosuvastatin and comparator statins in 6743 patients in real-life clinical practice: DISCOVERY meta-analysis.
Curr Med Res Opin
. 2006;22: 1181-91.
Stender S, Schuster H, Barter P, et al. Comparison of rosuvastatin with atorvastatin, simvastatin, and pravastatin in achieving cholesterol goals and improving plasma lipids in hypercholesterolaemic patients with or without the metabolic syndrome in the MERCURY I trial.
Diabetes Obes Metab.
Tahara N, Kai H, Ishibashi M, et al. Simvastatin attenuates plaque inflammation: evaluation by fuorodeoxyglucose positron emission tomography.
J Am Coll Cardiol
1/30/2009 DynaMed's Systematic Literature Surveillance
: Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients.
J Am Coll Cardiol.
Last Reviewed December 2012