If you have high cholesterol, chances are you’ve at least chatted about statins with your doctor.
Not only are they typically the first-line medication prescribed when lifestyle changes alone cannot manage high cholesterol, they’re also some of the most commonly used drugs in the world.
And for good reason: Statin therapy can reduce the risk of heart attack, stroke, and even death from cardiovascular disease by 25% or more. Still, like any medication, statins are not the right choice for everyone. They come with a risk of possible side effects, ranging from mild to severe, and certain people are more susceptible to these effects.
In this article, I’ll explain what statins are, the types of statins, and the different side effects that can occur when taking them. I’ll also go over who is most at risk for these side effects.
Everyone responds differently to different statins, and by working with your doctor or primary care provider, you can find the right treatment for you.
What Are Statins?
Statins are drugs that are used to help lower cholesterol levels. They work by blocking a liver enzyme needed to produce cholesterol.
Excess levels of cholesterol in the body can build up in the arteries and form fatty deposits called plaque, which can cause the arteries to narrow and become less flexible (a condition called atherosclerosis). This increases the risk of heart attack, stroke, coronary artery disease, and other heart problems.
Statins help decrease these risks by slowing the buildup of plaque. A doctor may prescribe a statin if lifestyle changes alone are insufficient at lowering high cholesterol.
However, statin therapy should always be used in collaboration with a healthy lifestyle (including improving diet and exercise) in order for them to be most effective.
Types of Statins
Several different types of statins are available and approved by the Food and Drug Administration (FDA).
All are prescribed to lower LDL (“bad cholesterol”) and triglycerides, increase HDL (“good cholesterol”), and, for people diagnosed with heart disease or at risk of the condition, to decrease the risk of stroke, heart attack, and the likelihood of heart surgery.
Five of the most common statins are below.
Simvastatin (Zocor, Flolipid) comes as a tablet or liquid suspension. Side effects may include:
Fluvastatin (Lescol) is available as a capsule or an extended-release tablet. Its side effects include:
- Stiff joints
- Memory loss
- Urinary tract infection (UTI)
Pravastatin (Pravachol) is a tablet that’s generally well tolerated. However, possible side effects include:
- Muscle pain
- Upper respiratory infection
Side Effects of Statins
Although serious side effects can happen with statin use, most often people experience mild side effects, if any.
The most common side effects of statin therapy are as follows.
Muscle pain or cramping
Mild to severe muscle pain or cramping is one of the most commonly reported side effects of statins. People who experience this report sore, tired, or weak muscles.
Though extremely rare, statins can also cause rhabdomyolysis, a life-threatening condition where the muscle tissue breaks down and releases proteins and electrolytes into the blood.
This can cause severe muscle pain and liver and kidney damage.
Rhabdomyolysis – which causes dark, tea-colored urine, general fatigue and malaise, and extremely sore muscles, especially in your legs, is more likely when taking high doses of statins or taking them in combination with other medications.
If you believe you might have rhabdomyolysis, head to the emergency room immediately.
Even at low doses, statins appear to cause general fatigue and fatigue with exertion such as physical activity.
This could impact how active a lifestyle someone can enjoy.
Increased diabetes risk
However, the risk is minimal compared to other risk factors of diabetes like obesity.
Many package inserts that come with statins list diarrhea as a possible side effect.
Everybody responds differently, so talk to your doctor if this is a concern.
Constipation and abdominal pain may also occur when taking statins.
Though rare, neurological effects such as confusion, forgetfulness, and memory loss have been reported as side effects of statins.
If they do occur, research shows that these neurological changes are rarely progressive or permanent.
Studies suggest that fever with the use of statins may be a sign of myopathy.
This group of disorders causes muscle weakness, cramps, spasms, and stiffness.
This is a more severe side effect that should be discussed with your doctor or provider.
Other side effects
A variety of other side effects can come as a result of using statins.
Though most are rare, this includes:
- Difficulty falling asleep or staying asleep
- Sinus pain
- Kidney and liver damage (especially when combined with alcohol)
Who Is Most at Risk for Statin Side Effects
While side effects are a possibility for anyone taking a statin, certain risk factors increase the chance of developing adverse reactions.
If any of the below applies to you, talk to your doctor about your risk for side effects before taking statins.
Though it’s unclear why, women are more likely than men to report experiencing side effects of statins and to stop taking the medication due to side effects.
Compared to younger adults, older adults are more likely to experience serious side effects from statins, including:
- Muscle aches, pains, or weakness
- Memory loss
This may be due to the fact that older adults often take multiple medications.
These other drugs may interact with statins.
Though you can still drink alcohol in moderation while taking statins, combining excessive drinking with the prescription increases the risk of myopathy.
Certain health conditions—including thyroid disease, metabolic syndrome, and genetic mutations linked to mitochondrial dysfunction—increase the risk of side effects from statins.
Additionally, medications used to treat these comorbidities can lead to drug interactions, which can also cause side effects.
Take multiple medications for high cholesterol
If you take more than one high-cholesterol medication, you are at a higher risk for statin side effects because you are increasing the number of drugs in your body.
It’s important to tell your doctor exactly which medications you are taking (for cholesterol or otherwise) to make sure that nothing will interact and that everything is dosed properly.
Research suggests that having a small body frame may lead to statin side effects related to myopathy.
This may also be true for people who have a low body mass index (BMI).
Kidney or liver disease
Because kidney and liver damage can be a side effect of taking statins, those who have kidney and liver disease may be more at risk for further damage.
However, recent research has shown that statins may be beneficial for those with chronic liver disease, so talk to your healthcare provider about your options.
When to See a Doctor
If you think you are experiencing side effects related to taking statins, check in with your doctor immediately—but don’t stop taking your medication unless they tell you to.
They may suggest altering your dosage or trying a different statin instead.
However, if you are experiencing severe pain or concerning symptoms, seek emergency care.
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