Whelehans Pharmacy : common cholesterol medicine

Ask your pharmacist

Statins- the most commonly prescribed cholesterol medicine

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

This concludes my article last week on statins. While statins are not the only cholesterol lowering drug on the market, they are the most effective once tolerated.

How effective are statins?

A study published in the British Medical Journal in 2003 showed that on average, statins reduce LDL cholesterol by 1.8mmol/litre. This resulted in a 60% reduction in the risk of cardiovascular events such as heart attacks, clots and sudden cardiac death and a 17% reduction in the risk of stroke.

 

Which statin is best?

Studies show there is no major benefit of one statin over another.

Who should be prescribed statins?

Over 20% of Irish adults are at risk of coronary heart disease due to high cholesterol. There is some controversy on who should be prescribed statins. The general guideline for people who have no previous heart problems is that they should be used if cholesterol is high (over 6mmol/litre) and there is a cardiovascular risk of greater than 20% (can be worked out by your doctor). For those who have already suffered a cardiovascular event such as a stroke, statins are recommended if total cholesterol is over 3.5mmol/l. Guidelines state that they should be considered in all diabetic patients over 40.

Side effects

Like all medication, statins can cause side effects. The most serious side effect of statins is a muscle complaint called myalgia, characterised by muscle pain and weakness. If it occurs the statin should be stopped as it can lead to a potentially fatal condition called rhabdomyolysis. It is estimated that one in 1000 people using statins may suffer from myalgia and one in 10,000 may suffer from rhabdomyolysis. You should report to your doctor immediately if you suffer from muscle pain, tenderness or weakness while taking a statin. Muscle problems are reversible once the statin is stopped quickly.

Statins can also raise liver enzymes which can lead to liver problems. Doctors must do a liver function test for those starting statins. Current guidelines are to get a liver function test before starting a statin, 3 months after starting and again after 12 months.

Gastrointestinal effects (nausea, indigestion, constipation, diarrhoea and flatulence) are the most common side effects of statins. Headache, dizziness and rash occur less frequently. Sleep disturbance can occur, although it seems to be more of a problem with simvastatin and atorvastatin. The good news is that the majority of people who take statins have no problems and they are proven to save lives by preventing heart disease.

All statins now have equally effective but less expensive generics available. Always ask your pharmacist for the generic version..

Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended

This article is shortened to fit within Newspaper space limits. More detailed information and leaflets is available in Whelehans