Class teaching about statins

Statins: Cholesterol Lowering Drugs

Statins are prescribed to lower the amount of cholesterol in the blood. Cholesterol is a substance that is produced by the liver. Statins work to inhibit that production by suppressing the enzyme HMG-CoA reductase (hydroxyl-methylglutaryl-coenzyme A reductase). Cholesterol is vital to every cell in your body. Also, by suppressing HMG-CoA reductase, statins block the production of Coenzyme Q10, another substance that is vital to the body.

When cholesterol levels are too high, the potential to develop atherosclerosis is high. This is a condition where the cholesterol forms plaques in the arteries, restricting blood flow. This increases the chance for a heart attack or a stroke. Cholesterol lowering drugs are given to reduce cholesterol and ostensibly reduce the risk of heart attack or stroke (although there is some controversy to this).

Atherosclerosis is a complicated process. It involves cholesterol, but also inflammation, insulin production, and even stress. Diet, exercise, and stress reduction are all important components to reducing your chance for a heart attack or stroke.

Cholesterol lowering drugs, of course, should not be taken during pregnancy. Side effects include headache, nausea, vomiting, constipation, diarrhea, or a rash. The most serious side effect includes weakness and muscle pain (discontinue the drug and call your doctor immediately if you experience these symptoms). It could be a sign of rhabdomyolysis (destruction of muscle); this can be fatal. Another serious side effect of cholesterol medication is liver failure.

When statins are taken in conjunction with certain other drugs the chance of developing rhabdomyolysis increases. These drugs include erythromycin, itraconazole, (Sporanox), protease inhibitors (used in treating AIDS), clarithromycin, (Biaxin), diltiazem, (Cardizem, Dilacor, Tiazac), and verapamli (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS). Drinking grapefruit juice is also to be avoided when taking statins. Fibric acid drugs, also taken to lower cholesterol are sometimes given with statins, but these do increase the chance of developing rhabdomyolysis.

Statins approved for sale in the US include:  atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor).