The Side Effects of Statin Drugs
Statins are a class of drugs that work to lower the levels of cholesterol in the blood. This is achieved by reducing the production of cholesterol within the liver. Statins have the potential to inhibit the risks associated with atherosclerosis when used in conjunction with healthy lifestyle choices.
The benefits of statin drugs are not without potential risks; some of the risks may be minimized by avoiding negative drug interactions.
What Are Statins?
Statins are a class of cholesterol lowering drugs, which work by blocking the enzyme HMG Co-A reductase that is found in the liver. This enzyme is responsible for making cholesterol. By decreasing the production of cholesterol, statins help to prevent and treat atherosclerosis; a condition that causes plaque formation in the arteries and leads to artery blockage, as well as a reduction in blood supply to the tissues supporting the arteries. Additionally, statins can prevent atherosclerotic blood clots that form on plaques after a rupture has occurred and lessen the risk of a further obstruction and decrease in blood supply to the arteries.
One common health condition associated with atherosclerosis is obstructed blood supply to the arteries around the heart; the result can be heart attack or angina. Another condition occurs if clotting takes place on the plaque within the brain, resulting in a stroke. An additional condition occurs when clots forming on plaques in the leg arteries lead to pain and cramping while walking, a condition known as claudication. Statins work to minimize plaque in the arteries, decrease the size of existing plaques and stabilize the existing plaques making them less likely to rupture and cause clots. The result is treating and preventing heart attack, stroke, chest pain and claudication.
Who Can Statins Help?
The primary actions of statin drugs are to reduce cholesterol to normal levels and prevent the serious complications commonly associated with atherosclerosis. Risk factors that generally predispose people to the development of this condition are diabetes, aging, obesity, smoking, high blood pressure, inactive lifestyle, peripheral artery disease and a family history of heart attacks at a young age. Healthy lifestyle choices such as avoiding smoking, frequent exercise, healthy diet and minimizing alcohol consumption may help maximize the potential of statin drugs. Proper dosage will be determined by the individual and their practitioner; doses range from 5-80 milligrams depending on the medication.
Statin drugs differ in several important ways, the most obvious is in their ability to decrease cholesterol levels. Lipitor (atorvastatin) and Crestor (rosuvastatin) are two popular brands that are known to be the most effective in decreasing cholesterol.
Lescol (fluvastatin) is another popular brand that is considered the least effective. Another difference between statins is the level of interaction that occurs between them and other drugs. Increased potency of statin drugs due to drug interaction can lead to toxic states such as myopathy. Crestor (rosuvastatin) and Pravachol (pravastatin) are examples of two statin drugs that do not increase in potency in the blood due to the introduction of other drugs.
Statins also differ in the occurrence of rhabdomyolysis, which is a severe side effect of these drugs; this condition is an extreme form of myopathy that leads to severe muscle damage. Baycol was a popular statin removed from pharmacies across the world in 2001; it was shown to cause the occurrence of rhabdomyolysis 10-100 times more often than the other statin drugs. Individuals who are taking drugs known to cause this severe condition or drugs that elevate the potency of statin drugs in the blood may be at an increased risk of rhabdomyolysis.
Other popular statins are Mevacor (lovastatin), Zocor (simvastatin) and Livalo (pitavastatin).
Side Effects of Statins
Many people can take statin drugs without experiencing side effects; however, others may experience symptoms as a result of taking them. The side effects of statin drugs may commonly include headache, rash, muscle pain, vomiting, weakness, nausea, constipation, drowsiness, abdominal pain, insomnia, bloating and flushing of the skin.
There is also evidence linking the use of statin drugs to the development of Type II diabetes in some individuals, with a strong link to women who are postmenopausal. Any type of muscle pain or tenderness that cannot be explained should be reported to a physician as soon as possible as it could signify a serious side effect.
Severe Side Effects of Statins
The most severe side effects that may occur as a result of taking statin drugs are muscle problems leading to rhabdomyolysis and liver failure. Rhabdomyolysis typically begins as muscle pain or inflammation which can then transition to a decrease of muscle cells, kidney failure and death; this severe condition is rare, occurring only once out of 10,000 cases. Statin drugs can cause an increase in liver enzymes in some individuals; blood tests are recommended within 6 weeks of beginning the medication in an effort to avoid severe liver damage. If the elevation of liver enzymes is minimal, continuation of the medication is acceptable. Elevated levels can be quickly reversed by stopping the statins.
Drugs That May Interact with Statins
Statins have some significant drug interactions of which the user should be aware. The first important interaction involves the liver enzymes that play a key role in the elimination of statins from the body. Consumption of drugs that may interfere with these elimination enzymes may place the user at risk for increased levels of statin drugs within their blood, thus leading to the development of rhabdomyolysis. Examples of drugs that may interfere with the elimination process are protease inhibitors, diltiazem, erythromycin, verapamil and clarithromycin.
Another significant drug interaction occurs when statins are taken with niacin or fibric acid derivatives; these are common drugs used to treat high cholesterol. Both of these drug types alone increase the risk for liver failure and rhabdomyolysis, when they are taken in conjunction with a statin drug, the risk is further increased. Other drugs that may have a negative interaction with statin drugs are the antidepressant drug nefazodone and the immunosuppressant drug cyclosporine.
Additional Benefits of Statin Drugs
Statin drugs may provide benefits beyond the ability to lower cholesterol. Although further research is necessary before results are conclusive, statin drugs may reduce the risk of the following conditions: arthritis, Alzheimer’s disease and dementia, kidney disease and some types of cancer. Statins may also prove to be beneficial in controlling the physiological immune response of the body after an organ transplant; again, further research of this potential benefit is needed.
As stated, statins are beneficial in reducing the risk of heart attack by stabilizing plaques found in arteries around the heart and reducing their risk of rupture. Additionally, statins also lower blood pressure, help alleviate blood vessels and reduce the risk of blood clots. Because of these benefits, physicians have recently begun prescribing statins following certain kinds of strokes, as well as before and after angioplasty and coronary artery bypass surgery.
Statin drugs are effective in lowering high cholesterol and in the treating and preventing the conditions associated with it. Some individuals may experience side effects while taking this medication but many people tolerate it without problems. Certain drugs may present an increased risk when taken in conjunction with statin drugs; however, severe side effects are rare in occurrence. There may be additional benefits of statin drugs; these are being further researched.