Statins

Published by Bupa's Health Information Team, May 2011.

This factsheet is for people taking statins, or who would like information about them.

Statins are medicines that lower the amount of cholesterol in the blood. This helps to reduce the risk of having a heart attack and stroke.

Why would I take statins?

You may be prescribed statins if you’re at risk of a heart attack or stroke. This may be if you have: 

• already had a heart attack or stroke
• peripheral artery disease – a disease that causes your arteries to become narrowed
• had a transient ischaemic attack (a ‘mini stroke’)
• angina
• high cholesterol
• diabetes
• high blood pressure

You may also be prescribed statins if someone in your immediate family (your parents or siblings) developed heart disease when they were aged under 55 (for men) or 65 (for women).

Your GP may also look at other factors to assess your risk of having a heart attack or stroke, such as your age and race. If he or she thinks there is at least a one in five chance of you having a heart attack or stroke over the next 10 years, you may also be advised to start taking a statin.

What are the main types of statin?

There are different types of statin. Statins differ in their ability to lower cholesterol and their side-effects. All types of statin work in the same way, but they have slightly different chemical structures. This means you may react differently to them. You may have to try different types of statin before you find the best one for you.

The newer types of statins, such as atorvastatin and rosuvastatin, are able to lower cholesterol more than older types such as simvastatin. However, many people don’t need these newer types to reach their target cholesterol. Your GP will prescribe the most suitable type of statin for you based on your individual needs and medical history.

How do statins work?

Cholesterol is a type of fat made by your body. It’s essential for good health and is found in every cell in your body. However, if you have too much cholesterol in your blood, especially a type called low-density lipoprotein (LDL) or ‘bad’ cholesterol, it can cause fatty deposits to build up on the walls of your arteries. This is known as atherosclerosis and narrows your arteries, which can result in a heart attack, stroke or blood vessel problems.

Statins work by reducing the amount of LDL cholesterol your body makes. They do this by blocking an enzyme in your liver that slows down the production of cholesterol. Lowering the LDL cholesterol in your blood helps to reduce your risk of heart attack and stroke.

How to take statins

You can buy certain low-dose statins from a pharmacy without a prescription from your GP. However, these aren’t suitable if you’re at high risk of heart attack and stroke.

If you’re at high risk of heart attack and stroke, you will be prescribed a higher dose statin by your GP. They are taken as tablets or capsules and usually need to be taken once a day. Your liver produces most of its cholesterol at night, so most statins should be taken in the evening before you go to bed.

Swallow the tablets whole, with a glass of water. Always take your medicines as your GP has told you and check with your GP or pharmacist if you’re not sure.

Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

Special care

Statins can sometimes affect your liver. Because of this, your GP may want to do a blood test to check how well your liver is working before you begin taking statins. He or she may repeat this test after a few months of taking the medicine. If your liver function is affected by the statin that you’re taking, your GP may prescribe a different statin or try a different type of medicine.

If you have problems with your liver or thyroid, speak to your GP before taking statins.

If you’re pregnant or breastfeeding, you won’t be able to take statins as they may harm your baby. If you’re taking statins and would like to try for a baby, speak to your GP first.

Side-effects of statins

Side-effects are the unwanted effects of taking a medicine. If you have side-effects, it’s important to talk to your GP or healthcare professional who prescribed your medicine before you stop taking it.

Most people who take statins don't have any side-effects. However, some people do report problems. These are usually mild, and most commonly include:

• stomach problems - including pain, wind, constipation, feeling sick and vomiting
• sleep disturbances
• headache
• dizziness
• depression
• extreme tiredness

Rarely, statins can cause more serious problems that affect your muscles and liver. Stop taking your statin and contact your GP immediately if you:

• have unexplained weight loss
  
• find it difficult to breathe
  
• develop a cough
  
• develop unexplained muscle pain or tenderness
  
• feel unwell and have a high temperature

This section does not include every possible side-effect of statins. Please read the patient information leaflet that comes with your medicine for more information.

Interaction of statins with other medicines

Check with your GP or pharmacist before you take any other medicines or herbal remedies at the same time as your statin.

Medicines that may interact with statins include those that act on your immune system, certain antibiotics, and certain types of medicine for your heart.

If you’re taking a type of statin called simvastatin, try not to have any grapefruit or grapefruit juice as this can increase your risk of getting side-effects.

Names of common statins

Examples of common statins are shown in the table below.

All medicines have a generic name. Many medicines also have one or more brand name. Generic names are in lower case, whereas brand names start with a capital letter.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.