Statins and cholesterol
When you have too much LDL cholesterol, it can build up in the walls of your arteries. This can lead to decreased blood flow. High LDL cholesterol is associated with an increased risk of coronary artery disease.
Statins work in two ways:
- They inhibit an enzyme that your body needs to produce cholesterol.
- They may also help reduce plaque that has built up in your arteries. This plaque is made up of cholesterol.
As a result, statins can help lower your risk of having a heart attack or stroke.
A variety of statins are available in brand name and generic form. Some common statins are:
- simvastatin (Zocor)
- lovastatin (Altoprev, Mevacor)
- fluvastatin (Lescol XL)
- atorvastatin (Lipitor)
- pitavastatin (Livalo)
- pravastatin (Pravachol)
- rosuvastatin (Crestor)
Most statins should be taken once every 24 hours. Depending on the particular medication and dosage, you may need to take your statin twice a day.
Certain statins work better when taken with a meal. Others work best when they’re taken at night. This is because the cholesterol-making enzyme is more active at night. Also, the half-life, or the amount of time it takes for half the dose to leave your body, of some statins is short.
Statins that you should take at night
Some statins have half-lives of less than six hours. These statins are best taken at night.
Simvastatin is an example of a statin that works better if taken in the evening. Studies show that when simvastatin is taken at night, there’s a greater reduction in LDL cholesterol than when it’s taken in the morning.
Lovastatin should be taken with dinner. However, the extended-release version of lovastatin, Altoprev, should be taken at bedtime.
Fluvastatin has a half-life of about three hours, so it should also be taken at night.
Statins you can take in the morning
Studies show that some of the newer statins can be just as effective when taken in the morning. HMG-CoA reductase inhibitors such as atorvastatin and rosuvastatin are more potent than older statins. They have half-lives of at least 14 hours.
Extended-release fluvastatin, or Lescol XL, can be taken at any time of day.
What you need to know about taking statins
The most important thing you need to know is that statins aren’t all the same. That’s why you should thoroughly read the materials that come with your prescription. Follow directions carefully for maximum effectiveness.
Your doctor knows your personal medical issues and is your best source for information. Always ask if your statin should be taken with food or at a specific time of day.
If time of day isn’t an issue with your statin, choose the time you’re most likely to remember to take it. Statins work best when taken at the same time each day. Once it becomes part of your routine, you’re less likely to forget.
Some substances can interact with statins
With some statins, drinking grapefruit juice, or eating grapefruit, is a bad idea. Grapefruit juice can cause that statin to stay in your body much longer, and the drug can build up. This can increase the risk of muscle breakdown, liver damage, and even kidney failure. If your prescription label doesn’t mention grapefruit juice, be sure to ask your doctor about it.
Statins can also interact with other medications, so tell your doctor about all the drugs you take. That includes supplements, over-the-counter medications, and prescription drugs.
You may have side effects
Statins can be effective in getting your cholesterol under control, but they come with risks. Some common side effects include muscle and joint aches, nausea, and headache.
Serious risks include damage to your muscles, kidneys, and liver. If you have type 2 diabetes, statins may increase your blood sugar levels.
If you experience side effects, it’s important that you tell your doctor. Sometimes, switching to another statin can help.
Other ways to help reduce cholesterol
While statins can be very effective in lowering LDL cholesterol, you can also manage your cholesterol using alternative treatments or through lifestyle modifications.
Diet plays an important role in blood cholesterol levels. Your diet should be packed with fruits, vegetables, whole grains, and fish. Try to reduce your intake of saturated and trans fats, and increase your intake of omega-3 fatty acids. You should also go easy on salt and refined carbohydrates.
Make exercise a part of your daily routine and try to sit less. You can also lower your risk for heart disease by not smoking and maintaining a healthy weight.
While statins are often prescribed when your cholesterol can’t be controlled through diet and exercise alone, it never hurts to eat well and exercise more.