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 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.

The American Heart Association recommends statins for certain people. You and your doctor should consider statins for you if you:

  • have an LDL cholesterol level of 190 mg/dL or higher
  • already have cardiovascular disease
  • are 40–75 years old and have an increased risk of cardiovascular disease in the next 10 years
  • have diabetes, are 40–75 years old, and have an LDL level between 70 and 189 mg/dL

Keep reading: Guidelines on statins for high cholesterol »

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 in turn lowers your cholesterol levels.

Statins also work by making it easier for your body to absorb cholesterol that’s already built up in your arteries.

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

Clinical trials show that statins can lower LDL cholesterol levels by as much as 50 percent. Statins may also reduce your risk of heart attack and stroke. In addition, a 2010 study indicates that statins play a small role in lowering triglyceride levels and raising HDL (good) cholesterol.

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

These drugs may also help lower the chance of rejection after an organ transplant, according to an article in the Journal of Experimental Medicine. However, more research is needed in this area.

Statins are available under a variety of generic and brand names, including:

  • atorvastatin (Lipitor, Torvast)
  • fluvastatin (Lescol)
  • lovastatin (Mevacor, Altocor, Altoprev)
  • pitavastatin (Livalo, Pitava)
  • pravastatin (Pravachol, Selektine)
  • rosuvastatin (Crestor)
  • simvastatin (Lipex, Zocor)

Some combination medications also contain statins. Among them are:

  • amlodipine/atorvastatin (Caduet)
  • ezetimibe/simvastatin (Vytorin)

People who take statins should avoid grapefruit. Grapefruit can interact with certain statins and 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 to your doctor or pharmacist. You can also 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 than another. If you have persistent side effects, your doctor may be able to adjust your dosage or recommend a different statin.

Some of the more common side effects of statins include:

  • constipation
  • diarrhea
  • nausea

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 this condition is greater if you take certain other medications with statins, especially lovastatin or simvastatin. These other medications include:

  • certain antifungals such as itraconazole and ketoconazole
  • cyclosporine (Restasis, Sandimmune)
  • erythromycin (E.E.S., Erythrocin Stearate, and others)
  • gemfibrozil (Lopid)
  • nefazodone (Serzone)
  • niacin (Niacor, Niaspan)

Liver damage

Liver damage is another possible serious side effect of statin therapy. A sign of liver damage is an increase in liver enzymes. Before you start taking a statin, your doctor will likely do 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 your skin and the whites of your eyes), dark urine, and pain in the upper right part of your abdomen.

Increased risk of diabetes

Statins may also cause the glucose (sugar) levels in your blood to rise. This causes a slight increase in your risk of type 2 diabetes. If you’re concerned about this risk, talk to your doctor.

Read more: Statins and diabetes risk »

Confusion or memory problems

Some people may have confusion or memory problems while taking a statin, although research has shown conflicting results. If you have these side effects, talk to 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.

Taking a statin while following a healthy 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?