Treatment

Statins are primarily prescribed for:

• High total cholesterol
• High LDL ("bad") cholesterol
• Low HDL ("good") cholesterol
• High triglyceride levels
• Coronary artery disease (CAD)

Prevention

If you already have cardiovascular disease, your doctor may recommend statins to reduce your risk of having a heart attack or stroke. Statin therapy may also be prescribed if you fall within a specific risk range for developing cardiovascular disease within 10-years. The risk can be assessed based on your cholesterol numbers and other risk factors. It can be done during a regular physical exam.

Drug Interactions

Statins can interact with many medications. Below are some examples. But, you should talk to your doctor and pharmacist about the specific medications that you are taking.

• Cyclosporine
• Erythromycin
• Gemfibrozil
• Nefazodone
• Verapamil
• Digoxin
• Protease inhibitors to treat HIV, such as indinavir, nelfinavir, ritonavir, saquinavir

Other Interactions

Statins can interact with certain foods, herbs, and supplements. Here are examples of potential interactions:

• Grapefruit juice —may increase the absorption of most statins, allowing potentially excessive levels to build up in the bloodstream
• Chaparral, comfrey, and coltsfoot—may increase the risk of liver problems
• St. John’s wort—may decrease blood levels of some statins
• Vitamin B3— possibly increases the risk of developing a potentially fatal condition called rhabdomyolysis
• Red yeast rice—contains a mixture of statins and should not be combined with statin drugs

If you would like to take herbs or supplements while taking a statin, check with your doctor first.

Other Potential Concerns

These conditions can affect how your body uses statins:

• Allergy or intolerance to statins or allergies to other substances, including food
• Obesity—can make statins less effective
• Positive changes in diet and exercise—may need a lower dose

If you have any of the following conditions, tell your doctor before you are prescribed statins:

• Alcohol use disorder
• Liver disease
• Organ transplant and take medication to prevent transplant rejection
• Recent major surgery
• Pregnant or breastfeeding—Statins are not recommended in pregnant or nursing women.

Common Side Effects

More common side effects include:

• Gas
• Upset stomach
• Abdominal pain
• Diarrhea
• Constipation
• Headache
• Flu-like symptoms
• Fatigue
• Muscle pain
• Skin rash

Less Common Side Effects

Less common, but more serious side effects include:

• Liver problems
• Myopathy (muscle weakness)
• Rhabdomyolysis
• Kidney failure
• Memory problems and confusion
• Increased blood glucose levels