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Overview

Statins are a class of medications typically prescribed to lower elevated cholesterol levels in the blood. That is why they are commonly known as cholesterol medications.

Statins work by inhibiting the enzyme responsible for cholesterol production in the liver. This, in turn, can reduce the amount of low-density lipoprotein (LDL) cholesterol in your body.

By lowering LDL cholesterol, often called “bad” cholesterol, statins help reduce the risk of atherosclerosis (buildup of fat on artery walls) and cardiovascular events such as heart attacks and stroke. Still, like all medications, cholesterol medications are not without potential side effects despite their effectiveness.

What are the side effects of cholesterol medications?

Man taking cholesterol meds with fewer side effects — Grace Cary/Getty Images

The most frequently reported side effects of statins include:

muscle pain and cramping
muscle weakness
fatigue (low energy)
upset stomach or nausea
headaches

Rare side effects of statins

While uncommon, more severe side effects of statin use may include:

liver disease
mental fatigue or confusion
kidney failure

Another rare but severe side effect of statins is rhabdomyolysis (or rhabdo). This involves a rapid and intense muscle breakdown that may lead to irreversible disability.

Which statins have fewer side effects?

Although experiences vary from one person to the next, all drugs have the potential to cause unwanted side effects.

However, some studies suggest that certain cholesterol medications may be less likely to cause significant side effects than others.

Pravastatin: Studies suggest that pravastatin (Pravachol) may have fewer muscle-related side effects, such as muscle pain or weakness, than other cholesterol medications. This may make it a consideration for people who are prone to muscle discomfort or have physically demanding jobs.
Fluvastatin: Another statin linked to fewer muscle-related side effects is fluvastatin (Lescol). Like pravastatin, it may be an option for people concerned about muscle discomfort.
Simvastatin: Among the generally well-tolerated cholesterol medications is simvastatin (Zocor). The drug may still cause side effects such as muscle pain and digestive issues, but these side effects may be milder compared with other statins.

While these medications may have fewer side effects in some people, individual responses may still vary. This means that you could still experience certain side effects if you take these medications.

How you respond to statins can be influenced by a variety of factors, such as:

your statin dosage
your family and medical history
your current health status
other medications you may be taking
your age

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What to do if you experience side effects from statins

If you experience any concerning side effects while taking statins, consider:

Not stopping statins abruptly: Unless your doctor tells you to, do not stop taking your statins suddenly. Discontinuing the medication without your doctor’s supervision may affect your cholesterol levels and overall health.
Monitoring symptoms: It’s a good idea to keep track of your symptoms and any changes over time. This information can help your doctor make informed decisions about your treatment and drug change needs.
Discussing alternatives: If side effects don’t ease or are intolerable, talk with your doctor about alternative treatment options. They can help you explore other options to manage your cholesterol while minimizing side effects.
Contacting a healthcare professional: Severe statin side effects require prompt medical attention. This includes symptoms such as:
- difficulty breathing
- severe muscle pain
- severe gastrointestinal distress

Does bempedoic acid have fewer side effects?

Bempedoic acid (Nexletol) is a newer medication to lower cholesterol levels. Doctors prescribe it for people who can’t tolerate statins or need additional cholesterol management.

However, while it has shown promise in reducing LDL cholesterol levels, bempedoic acid may also lead to side effects, although they may differ from those of statins.

When discussing bempedoic acid with a doctor, consider asking the following questions:

How does bempedoic acid work?
How is bempedoic different from statin medications?
What are the potential side effects of bempedoic?
How much and how often would I take it?
How do I take it if I use other medications or have other conditions?
How will you monitor my cholesterol progress if I take bempedoic and how often do I need to get tested?
How will you know if I need to make adjustments to my dosage?

You may also want to ask your healthcare professional about other ways to manage high cholesterol, including:

Summary

Although all medications can have side effects, research indicates that certain statins may have fewer side effects than others. Pravastatin and fluvastatin are associated with fewer muscle-related discomfort, while simvastatin may cause fewer gastrointestinal issues.

However, responses to cholesterol medicines can vary from person to person, and can be influenced by many factors.

Talk with your doctor to find out which cholesterol medications may work best for you and have the lowest risk of certain types of side effects. They can help you make an informed choice, weighing the benefits against the potential risks of high cholesterol.