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Statins
Expert reviewer Dr Tim Cripps, Consultant Cardiologist
Next review due April 2022
Statins are medicines that lower the amount of cholesterol in your blood.
Uses of statins
Your doctor may recommend statins if you:
- have already got, or have had a form of cardiovascular disease (CVD)
- are at an increased risk of developing CVD
CVD describes a number of conditions and diseases that affect your heart and blood vessels, including coronary heart disease, angina, heart attacks and stroke. These are caused by the narrowing of your arteries (atherosclerosis) which is linked to having high cholesterol.
If you have a history of CVD
If you have the following, statins can help prevent them from getting worse or from happening again.
- A heart attack or a stroke
- Peripheral arterial disease – a disease that causes your arteries to become narrowed
- A transient ischaemic attack (TIA, a ‘mini stroke’)
- Angina
If you’re at risk of developing CVD
Statins can also help stop CVD from developing in people who don’t currently have cardiovascular problems, but are at risk of getting them.
Your doctor can assess your risk of CVD by asking you a series of questions and carrying out some health checks. If your doctor thinks there’s at least a one in 10 chance of you having a heart attack or stroke over the next 10 years, they may recommend statins.
Your doctor may also advise you to take statins to prevent CVD if you have:
- type 1 or type 2 diabetes
- long-term kidney disease
- a genetic condition called familial hypercholesterolaemia (FH)
Usually, before your doctor suggests taking statins, they’ll encourage you to adapt your lifestyle to naturally lower your cholesterol level.
Statins aren’t suitable for everyone. Make sure your doctor knows about any other medical conditions you have or medicines you take. And if you're a woman, tell your doctor if you're hoping to become pregnant or if you're breastfeeding so they can take this into account. If your doctor recommends you take them, it’s your decision whether or not you do. Ask your doctor to go through the pros and cons and to discuss any alternatives with you.
Making a decision
The National Institute for Health and Care Excellence (NICE) has produced a patient decision aid. Looking at this, perhaps with family or friends, may help you make the best decision for you about whether you want to take statins or not.
In general, experts believe that the benefits of taking statins outweigh the harms. People who take statins because they’ve already got CVD (for instance, had a heart attack), get the greatest benefits.
How statins work
Statins work by lowering the amount of cholesterol in your blood.
Cholesterol is a type of fat made in your liver. It does a lot of important jobs that keep you healthy. However, if you have too much ‘bad’ cholesterol (low-density lipoprotein or LDL) in your blood, it can cause atherosclerosis. This is when fatty deposits build up on the walls of your arteries.
Statins reduce the amount of LDL cholesterol in your blood by slowing down the production of cholesterol by your liver. By reducing your cholesterol, statins can help to reduce your risk of having cardiovascular disease (CVD) events, such as a heart attack or stroke.
Besides lowering cholesterol, statins work in other ways which have beneficial effects on preventing CVD and other conditions. For instance, it’s thought that statins may have anti-inflammatory effects and may help strengthen and repair the walls of your blood vessels.
Types of statins
There are five types of statin available in the UK:
- atorvastatin (eg Lipitor)
- simvastatin (eg Zocor)
- rosuvastatin (eg Crestor)
- fluvastatin (eg. Lescol)
- pravastatin (eg Lipostat)
Your doctor will recommend the statin and the dose which is best for you in your particular circumstances. This will depend on your medical history, and how much your cholesterol needs to come down. Some statins lower blood cholesterol more than others. Most people are first prescribed atorvastatin.
You can buy certain low-dose statins from a pharmacy without a prescription from a doctor. Your pharmacist will talk to you about whether these are suitable for you. However, if you’re at high risk of having a heart attack or stroke, your doctor may prescribe a higher-dose statin for you.
Taking statins
Statins come as tablets or capsules which you take once a day, and at the same time every day. Atorvastatin and rosuvastatin can be taken at any time of the day, but the other statins should be taken in the evening. If you forget to take your tablet, wait till your next dose. If you take too much, contact your doctor or hospital for advice.
It’s important to carefully read the patient information which comes with your medicine. And if you have any questions about taking your medicine, you can ask your pharmacist.
Statins are a long-term treatment, which means you’ll need to continue taking them to get the benefits. You’ll need a check-up with your doctor after you’ve been taking a statin for three months, then again after a year. You may need blood tests, and your doctor may need to adjust the dose or type of statin you take.
Worried about your cholesterol? Get a picture of your current health and potential future health risks with one of our health assessments. Find out more today. Find out more about health assessments >
Worried about your cholesterol?Interactions of statins
Statins can react with some other medicines and products. You should speak with your doctor or pharmacist about any medicines you’re taking and before taking any other medicines or supplements.
You should also avoid grapefruit juice, as it can interact with statins and cause you problems. For information about drinking alcohol while taking statins see our FAQ: Can I drink alcohol while taking statins? below.
Side-effects of statins
You may have heard a lot about the possible side-effects of statins. All medicines can cause some side-effects, but most people who take statins have no problems.
We list some of the side-effects of statins here, but please also read the information that comes with your medicine carefully.
Common side-effects
One in 10 people may get side-effects such as:
- blocked nose, sore throat, nose bleeds
- headache
- nausea (feeling sick), diarrhoea, constipation, indigestion
- pain in your muscles, joints and back
Speak to your pharmacist if problems like these don’t settle. But do see your GP if you have any persistent or severe muscle pain.
Uncommon side-effects
One in 100 people may get side-effects such as:
- weight loss or weight gain
- sleep disturbances such as nightmares or insomnia
- dizziness
- blurred vision
- changes in sensation – for example, you might have numbness in your fingers or changes in taste sensation
- a rash
- feeling very tired
- neck pain or tired muscles
Give your new medicine a chance, but if you do feel that the statins are giving you side-effects, speak to your doctor. They may suggest stopping statins for a short while to see if the symptoms settle. Depending on what happens, your doctor may then reduce the dose of your current statin or switch to a different type of statin.
Serious side-effects and what to do
Rarely, statins can cause more serious problems. This may happen to one person in a 1,000 who takes statins. If any of the reactions below happens to you, stop taking the statin and contact your doctor immediately.
- Allergic reaction that causes your face, tongue and throat to swell and makes it hard to breathe.
- Blistering and swelling to your skin; this may be to your mouth, eyes or genitals and you may also have a fever.
- Pain, weakness and tenderness in your muscles with a high temperature and feeling generally unwell; this might be a sign of muscle damage.
For more information about muscle pain, see our FAQ about statins and muscle pain below.
Medicines checklist
Our handy medicines checklist helps you see what to check for before taking a medicine.
Bupa's medicines checklist PDF opens in a new window (0.8MB)
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What happens if I have muscle pain?
Muscle pain is one of the side-effects that a lot of people worry about getting. However, there have been lots of studies looking at side-effects of statins, and it seems that it’s actually quite unusual for them to cause muscle pain.
If you start getting pain, tenderness or weakness in your muscles after taking statins, you should tell your doctor. They may do a blood test to measure a substance called creatinine kinase (CK) in your blood.
Depending on your CK level results, your doctor may suggest you stay on your medicine if the side-effects don’t affect you too much. Or they may suggest you stop the statins and then re-introduce taking them with careful monitoring. If necessary, your doctor may suggest a different statin or a different type of medicine altogether. If your muscle symptoms continue, your doctor may refer you to a specialist at a lipids clinic.
If your muscle pains start after you’ve been on statins for more than three months, your doctor will probably look for other causes of the pain.
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Can I drink alcohol while taking statins?
If your doctor recommends you take statins, they’ll ask you how much alcohol you usually drink. If you are someone who drinks a lot of alcohol, then statins might not be suitable for you.
There is no general advice to avoid alcohol if you’re taking statins. But as always, it makes sense to stick to the recommended guidelines for the amount of alcohol you drink. If you want to know more about the possible risks of drinking alcohol and taking statins in your particular circumstances, contact your doctor.
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Are statins helpful for older people?
Doctors aren’t certain whether statins are always helpful for older people (aged 75 and over). It’s not clear yet whether they work as well in older people as they do in people under 75. Some side-effects of statins may be more common in older people. And since older people are more likely to be taking medicines for other long-term conditions, there’s been a concern about adding yet another medicine.
If you’re older, your doctor will be especially careful in looking at the risks and benefits when deciding to offer you statins. They’ll take into account your general health and any other medicines you’re taking. Your own wishes will also be important. Together, you and your doctor will make the decision that’s best for you. This may be to take a statin, but at a lower dose than a younger person would.
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Related information
High cholesterol
Cholesterol is a type of fat (lipid) made by your body and found in some foods.
Heart attack
You’re more at risk of a heart attack if you smoke, are inactive, obese, or have high blood pressure.
Stroke
Stroke is the third most common cause of death in the UK and the leading cause of severe disability.
Angina
Angina is when you have chest pain or an uncomfortable tight feeling in your chest.
Coronary heart disease
Find out how you can reduce the risk of heart disease by making some small changes.
High blood pressure (hypertension)
Peripheral arterial disease, also called peripheral vascular disease, is a condition in which the arteries (blood vessels) that carry blood to your limbs become narrowed.
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Other helpful websites
- Heart UK
www.heartuk.org.uk
0345 450 5988 - British Heart Foundation (BHF)
www.bhf.org.uk
0300 330 3311
- Heart UK
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Sources
- Hypercholesterolaemia. BMJ Best practice. bestpractice.bmj.com, last reviewed March 2019
- Lipid modification - CVD prevention. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2015
- Cardiovascular disease: risk assessment and reduction, including lipid modification. National Institute for Health and Care Excellence (NICE), last updated July 2016, published July 2014. www.nice.org.uk
- Risk estimation and the prevention of cardiovascular disease. Scottish Intercollegiate Guidelines Network, June 2017. www.sign.ac.uk
- Lipid-regulating drugs including statins. PatientPlus. www.patient.info/patientplus, last edited July 2014
- Overview of lipid metabolism. The MSD Manuals. www.msdmanuals.com, last full review/revision March 2018
- Cardiovascular medicine. Oxford Handbook of Clinical Medicine (online). Oxford Medicine Online. www.oxfordmedicine.com, published September 2017
- Statins. British Heart Foundation. www.bhf.org.uk, accessed April 2019
- Statins. Heart UK. www.heartuk.org.uk, accessed April 2019
- Collins R, Reith C, Emberson J, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet 2016; 388(10059):2532–561. Doi:10.1016/S0140-6736(16)31357-5
- Atorvastatin. eMC. www.medicines.org.uk, accessed April 2019
- Personal communication, Dr Tim Cripps, Consultant Cardiologist, April 2019
- Cardiovascular. Oxford Handbook of Geriatric Medicine (online). Oxford Medicine Online. www.oxfordmedicine.com, published February 2018
- Cholesterol Treatment Trialists’ Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet 2019; 393:407–15. Doi:10.1016/S0140-6736(18)31942-1
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Author information
Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, April 2019
Expert reviewer, Dr Tim Cripps, Consultant Cardiologist
Next review due April 2022
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