(HMG-CoA Reductase Inhibitors)
Type of Medication3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, commonly referred to as statins
Medications and Their Commonly Used Brand NamesSome common statins include:
What They Are Prescribed ForConditions that may require statins:
- High cholesterol —hypercholesterolemia
- High triglycerides
- Help certain people decrease their risk of cardiovascular disease (CVD), stroke , and death if used along with diet and exercise
- Lower total cholesterol
- Lower LDL-cholesterol (bad cholesterol)
- Raise HDL-cholesterol (good cholesterol)
- Lower triglycerides
- Lower C-reactive protein levels—a marker of inflammation, which is thought to increase risk of CVD
How Statins WorkStatins block an enzyme in the liver (HMG-CoA reductase) that produces cholesterol. They are particularly effective at reducing LDL-cholesterol.
Precautions While Using These Medications
See Your Doctor RegularlyIt is important that your doctor check your progress. Regular visits will allow for dosage adjustments and to help monitor for any side effects.
Avoid PregnancyStatins should not be taken during pregnancy. Cholesterol production is essential for normal fetal development. Statins decrease cholesterol production and therefore may cause birth defects. Women who are able to become pregnant should use birth control while taking a statin drug. Tell your doctor if you think you might be pregnant or you are considering becoming pregnant. Also tell your doctor if you are breastfeeding, as statins may cause problems for a nursing baby.
Control Your WeightIf you are overweight or obese , losing weight may help decrease the need for or amount of medication. Check with your doctor about this.
Manage Your MedicationsTell your doctor about all the medications you take. Some medications should not be taken with statins, while others may require a different dosage level. Examples of these include:
- Antifungals, such as fluconazole, itraconazole, or ketoconazole
- Immunosuppresants, such as cyclosporine
- Digoxin—some statins may increase blood levels of digoxin, increasing the risk of side effects
- Macrolide antibiotics, such as erythromycin or clarithromycin
- Fibric acid derivatives, such as gemfibrozil
- Niacin or nicotinic acid—use of this type of medication with a statin may increase the risk of developing muscle problems
- Oral contraceptives/birth control pills—some statin drugs may increase the blood levels of the hormones in birth control pills, increasing the risk of side effects
- Antidepressants, such as nefazodone
Be Cautious With Certain ConditionsThe presence of other medical problems may affect the use of statins. Tell your doctor if you have any other medical problems, especially:
- Alcohol abuse
- Epilepsy that is not well controlled
- Electrolyte or metabolic enzyme deficiencies or disorders
- Liver disease or persistently high levels of liver enzymes—statin drugs may make liver problems worse
- Low blood pressure
- Organ transplant with therapy to prevent transplant rejection
- Kidney failure
- Recent major surgery or trauma , which may increase the risk of problems that may lead to kidney failure
- Impending surgery, including dental surgery or emergency treatment—be sure to tell the doctor or dentist treating you that you are taking a statin drug
Avoid Excessive AlcoholExcessive amounts of alcohol combined with statin drugs can have bad affects on the liver. Moderation in alcohol consumption is generally defined as one drink per day for women and two drinks per day for men.
Avoid Grapefruit JuiceGrapefruit juice appears to interfere with the metabolism of most statin drugs. It is best to avoid it during treatment.
Do Not Stop On Your OwnDo not stop taking your statin medication without first checking with your doctor. When you stop, your cholesterol levels may increase, and your doctor may want to use other ways to keep cholesterol levels within a more desirable range.
Mind Your Meals with LovastatinLovastatin works better when it is taken with food. If you are taking lovastatin once a day, take it with the evening meal. If you are taking more than one dose a day, take each dose with a meal or snack.If you are taking another kind of statin, ask the pharmacist if you need to take it with food.