The class of drugs known as the “statins” includes atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor). These medications are used for lowering blood cholesterol levels and have been shown to reduce the risk of adverse cardiovascular events such as heart attack and stroke. They are among the most effective and best tolerated medications for lowering cholesterol and are therefore widely used. Most patients will not experience any associated health risks with statins.
Effects on Muscles
The statins are known to affect the muscles in varying degrees of severity. About 1 to 6 percent of patients may experience muscle pain, weakness or joint pain. According to recommendations issued jointly by the American Heart Association, American College of Cardiology, and the National Heart, Lung, and Blood Institute, patients experiencing muscle pain should see their health care provider in order to obtain a creatine kinase (CK) blood test that checks for muscle damage. If the CK is normal or elevated at less than 10 times the normal value, it is not necessary to discontinue the statin, as the muscle pain may resolve. If muscle pain or weakness is accompanied by CK levels greater than 10 times the normal value, which occurs in less than 0.7 percent of patients, then the statin should be discontinued. After resolution of the problem, the same or a different statin may be restarted, often without further incident.
Rarely, patients will develop a serious condition called rhabdomyolysis which is marked by muscle pain or weakness, high CK levels, flu-like symptoms, malaise and brown urine signifying kidney problems. Rhabdomyolysis requires immediate aggressive attention. Certain conditions that increase the risk of muscle damage associated with the statins include advanced age (especially for women), small stature or frailty, chronic kidney problems, diabetes, hypothyroidism, and higher statin doses. Use of certain other drugs may also increase the risk as well as very large quantities of grapefruit juice.
Effects on Liver
The statins cause increases in blood tests that monitor liver function in up to 3 percent of patients, particularly at higher dosages. Symptoms of liver damage, such as yellowing of skin, tiredness, lack of appetite, are rare. The abnormal laboratory tests usually return to normal even with continued therapy. The risk of liver damage, however, is increased in alcoholics and persons with underlying liver damage.
Effects on Gastrointestinal Tract
Non-serious side effects such as diarrhea, stomach pain, gas, nausea and/or vomiting, constipation and heartburn occur in about 1 to 7 percent of patients taking statins.
About this Author
Kelly Wolfe is a registered pharmacist with 20 years of experience in the specialty field of drug information.
