Statins: Five Things You May Not Know About Your Cholesterol Med

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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HMG-CoA reductase inhibitors—better known as statins—are a group of medications used to treat high cholesterol. High cholesterol, if not treated with proper lifestyle modifications and/or medications, can result in life-threatening cardiovascular events like heart attack or stroke.

Your total cholesterol is made up of both “good” and “bad” parts as well as some other miscellaneous parts. The “good” part of your cholesterol is known as HDL, and the “bad” part of your cholesterol is known as LDL. Statins focus on lowering your LDL, and have been proven to lower LDL levels by as much as 45 percent depending on the drug and dosage, according to several studies supported by The American Heart Association.

Statins play a big role in the treatment of high cholesterol, and particularly following the update to the American Heart Association (AHA) recommendations in 2013, many, many people are taking one of these drugs. Even if you’ve been taking a statin for a while, there may be some things you aren’t aware of:

1.  Statins can cause muscle pain known as rhabdomyolysis

Rhabdomyolysis is caused by muscle injury, which leads to the breakdown of muscle tissue that can cause harm to the kidneys. It can result in kidney failure and in rare cases, death.

There are many causes of rhabdomyolysis, but it is one (uncommon) side effect of some statins.

Symptoms of rhabdomyolysis may include muscle pain or weakness, stomach pain, nausea, vomiting, fever, rapid heart rate, confusion, dehydration, dark red or brown urine, or reduced urine output.

Stay aware, but also know that this kind of muscle pain or weakness isn’t subtle, and this is a very rare reaction to a statin. Contact your doctor right away if you think you may be experiencing this side effect.

2.  Not all statins interact with grapefruits and grapefruit juice

Concerned about giving up grapefruit? Some statins don’t have an interaction and can still be safely taken with grapefruit and grapefruit juice, including:

3.  Some statins are available as generics

Now, you are probably aware of this one, but it’s good to know exactly which statins have generic equivalents, especially if you’ve been prescribed a brand-only drug like Crestor. Generics are more affordable than their expensive brand counterparts and equally effective. You can save by talking to your doctor about these generic statins:

On the other hand, if you’re taking one of these brand-only statins, know that they are not preferred by most insurance companies due to the high cost and availability of equally effective generics (you’ll also pay way more out-of-pocket if you’re paying cash):

4.  Statins can also improve good (HDL) cholesterol

Statins not only help lower the bad (LDL) cholesterol, but have also been shown to increase good HDL cholesterol. Statins can slightly increase your HDL level by up to 15 percent—though the ability to raise these levels does vary with each medication. Depending on how low your HDL levels are your doctor may put you on another medication specifically for this purpose (like Niacin) to really boost those levels.

5.  An over-the-counter product has been found to contain a statin

Red rice yeast, a traditional Chinese medication, is available over-the-counter (OTC) and has been suggested for use in lowering cholesterol.

Now, there are various types of red rice yeast available which can lead to confusion and misunderstanding—but one major issue is the small amount of the active ingredient lovastatin which has been found in some formulations. Lovastatin and red rice yeast have a very similar chemical make-up, which is why several brands were found to contain the prescription-only medication and taken off of the market by the FDA in 2007.

It’s always important to consult with your doctor or pharmacist before starting an OTC medication (especially if you are already on a prescription med), as there may be hidden dangers or drug interactions.

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