Statins

Statins are cholesterol – lowering agents (lipid lowering drugs) and are currently recommended for all patients with a cholesterol level above 5.0 mmol/litre, although this level is dropping as time goes by due to new evidence from clinical trials. The aim is that total blood cholesterol should be reduced to at least 5.0mmol/litre. There is evidence that lowering total cholesterol by 20-25% reduces coronary risk (if combined with a proper diet and exercise)

They work by blocking the synthesis of cholesterol in the liver, especially the more dangerous type of cholesterol. They are started after liver function has been assessed, and regular liver function tests have to be done.

Examples of statins are: Atorvastatin, Fluvastatin, Pravastatin, and Simvastatin. The usual dose is one tablet a day.

A rare side- effect of this medication is inflammation of the muscles (myositis).

• Atorvastatin (Lipitor)
• Fluvastatin (Lescol)
• Pravastatin (Lipostat)
• Simvastatin (Zocor)

Contra-indications

Statins are contra-indicated in active liver disease and in pregnancy.

They should be used with caution in those with a history of liver disease or high alcohol intake.

(Liver functions test should be carried out on people who take both fibrates and statins).

Side effects

Both fibrates and statins can cause inflammation of the muscle (myositis) and this effect would be increased if statins and fibrates are used together. This should only be done under specialist supervision.

Gastro-intestinal effects- such as nausea, abdominal pain and sickness can occur, as can hypersensitivity and rash (rarely).