What are statins? Find out how these cholesterol-lowering medications work, as well as what side effects they may cause
Statins are a class of drugs that lower blood cholesterol, mainly low-density lipoprotein (LDL), also known as “bad” cholesterol.
Statins work mainly by lowering the activity of the key enzyme involved in cholesterol synthesis in the body (hydroxymethylglutaryl [HMG]-CoA reductase). They help stabilize plaque and prevent these fatty deposits from building up in the walls of the arteries and causing blockages that can lead to heart attack or stroke.
In the U.S., statins available in the market include:
Who should take statins?
Whether you need to take statins depends on your cholesterol levels and overall heart health. Cholesterol is the waxy substance found in the blood, and high levels of LDL or “bad” cholesterol can put you at risk of plaque buildup.
In the initial stages, a high LDL cholesterol level can be managed by lifestyle changes such as a healthy diet, exercise, and quitting smoking. However, if these measures fail or are not enough, your doctor may prescribe statins to lower your risk of developing cardiovascular disorders.
Pregnant or breastfeeding women should not take statins, and women trying to conceive must discontinue use. Generally, statins should be discontinued at least 6 weeks and preferably 12 weeks before planned conception.
What are the side effects of statins?
Side effects of statins include:
- Muscle damage or weakness: The most common side effect of statins is the development of statin-associated muscle symptoms (SAMS). SAMS may be felt as muscle soreness, weakness, or fatigue. Very rarely, statins may cause life-threatening muscle damage called rhabdomyolysis.
- Liver damage: Damage to the liver may cause loss of appetite, weakness, fatigue, pain in the abdomen, or yellowish discoloration of the skin and eyes.
- Kidney dysfunction: This is an uncommon side effect that may occur secondary to rhabdomyolysis (muscle damage). Kidney damage may present as altered urine output, swelling over the face or feet, pale skin, and weakness.
- Diabetes mellitus: Research suggests that statins affect the way glucose is used by the body, which may increase the risk of diabetes, particularly with intensive therapy. However, this shouldn’t discourage you from taking your statin if you have coexisting diabetes. Discuss with your doctor so they can adjust your dose accordingly.
- Neurological and behavioral issues: Research suggests that statins may be associated with mood changes such as irritability and aggression, depression, and memory impairment, although scientific evidence is insufficient to support this claim.
- Neuropathy: Some studies have suggested that statin use may cause neuropathy (nerve damage), although research is still inconclusive.
- Lupus: Statins have been associated with an autoimmune condition called lupus (drug-induced lupus) in some people.
If you develop side effects while you are on statins, contact your doctor. Your doctor will evaluate your condition and may prescribe you a different statin, modify the dose of the same statin, or prescribe another medication altogether.