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Statin side effects: Weigh the benefits and risks
Statin side effects can be uncomfortable, making it seem like the risks outweigh the benefits of these powerful cholesterol-lowering medications. Consider the risks and benefits.
By Mayo Clinic staffDoctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. Most people taking statins will take them for the rest of their lives, which can make statin side effects difficult to manage.
For some people, statin side effects can make it seem like the benefit of taking a statin isn't worth it. Before you decide to stop taking a statin, discover how statin side effects can be reduced.
What are statin side effects?
Muscle pain and damage
The most common statin side effect is muscle pain. You may feel this pain as a soreness, tiredness or weakness in your muscles. The pain can be a mild discomfort, or it can be severe enough to make your daily activities difficult. For example, you might find climbing stairs or walking to be uncomfortable or tiring.
Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis (rab-do-mi-OL-ih-sis). Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure and death. Rhabdomyolysis can occur when you take statins in combination with certain drugs, or if you take a high dose of statins.
Liver damage
Occasionally, statin use could cause your liver to increase its production of enzymes that help you digest food, drinks and medications. If the increase is only mild, you can continue to take the drug. If the increase is severe, you may need to stop taking the drug, which usually reverses the problem. Your doctor might suggest a different statin.
If left unchecked, increased liver enzymes may lead to permanent liver damage. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin, increase the risk of liver problems even more in people who take statins. Because liver problems may develop without symptoms, people who take statins should have their liver function tested about six weeks after they start taking statins, and then again every three to six months for the first year of treatment, particularly if their statin dose is increased, or they begin to take additional cholesterol-lowering medications.
Digestive problems
Some people taking a statin may develop nausea, gas, diarrhea or constipation after taking a statin. These side effects are rare. Most people who have these side effects already have other problems with their digestive system. Taking your statin medication in the evening with a meal can reduce digestive side effects.
Rash or flushing
You could develop a rash or flushing after you start taking a statin. If you take a statin and niacin, either in a combination pill such as Simcor or as two separate medications, you're more likely to have this side effect. Taking aspirin before taking your statin medication may help, but talk to your doctor first.
Neurological side effects
Some researchers have studied whether statins could be linked to memory loss or amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. Researchers have not found a link between statin use and either condition.
Who's at risk of developing statin side effects?
Not everyone who takes a statin will have side effects, but some people may be at a greater risk than are others. Risk factors include:
- Taking multiple medications to lower your cholesterol
- Being female
- Having a smaller body frame
- Being age 65 or older
- Having kidney or liver disease
- Having type 1 or 2 diabetes
What causes statin side effects?
It's unclear what causes statin side effects, especially muscle pain.
Statins work by slowing your body's production of cholesterol. Your body produces all the cholesterol it needs for digesting food and producing new cells on its own. When this natural production is slowed, your body begins to draw the cholesterol it needs from the food you eat, lowering your total cholesterol.
Statins may affect not only your liver's production of cholesterol, but also several enzymes in muscle cells that are responsible for muscle growth. The effects of statins on these cells may be the cause of muscle aches.
Next page(1 of 2)
- Rosenson RS. Muscle injury associated with lipid lowering drugs. http://www.uptodate.com/home/index.html. Accessed July 28, 2010.
- Sewright KA, et al. Statin myopathy: Incidence, risk factors and pathophysiology. Current Atherosclerosis Reports. 2007;9:389.
- Joy TR, et al. Narrative review: Statin-related myopathy. Annals of Internal Medicine. 2009;150:858.
- Backes JM, et al. Does simvastatin cause more myotoxicity compared with other statins? The Annals of Pharmacotherapy. 2009;43:2012.
- The SEARCH Collaborative Group. SLCO1B1 variants and statin-induced myopathy — A genomewide study. New England Journal of Medicine. 2008;359:789.
- Voora D, et al. The SLCO1B1*5 genetic variant is associated with statin-induced side effects. Journal of the American College of Cardiology. 2009;54:1609.
- Information on simvastatin and amiodarone. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm118869.htm. Accessed July 28, 2010.
- Schaars CF, et al. Effects of ubiquinone (coenzyme Q10) on myopathy in statin users. Current Opinion Lipidology. 2008;19:553.
- Marcoff L, et al. The role of coenzyme Q10 in statin-associated myopathy: A systematic review. Journal of the American College of Cardiology. 2007;49:2231.
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