MedicineNet.com
About Us | Privacy Policy | Site Map
October 11, 2008
  MedicineNet home Picture Slideshows Diseases and conditions Symptoms and signs Procedures and tests Medications Health and Living Health news and views MedTerms medical dictionary  
Font Size
A
A
A

Statins (cont.)

Are there differences among statins?

Statins differ in several ways. The most obvious difference is in their ability to reduce cholesterol. Currently, atorvastatin (Lipitor) and rosuvastatin (Crestor) are the most potent, and fluvastatin (Lescol) is the least potent.

The statins also differ in how strongly they interact with other drugs. Specifically, pravastatin (Pravachol) and rosuvastatin (Crestor) levels in the body are less likely to be elevated by other drugs that may be taken at the same time as the statins. This is so because the enzymes in the liver that eliminate pravastatin and rosuvastatin are not blocked by many of the drugs that block the enzymes that eliminate other statins. This prevents the levels of pravastatin and rosuvastatin from rising and leading to increased toxicity such as myopathy (inflammation of the muscles). For example, in scientific studies, patients who took both verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS) and simvastatin (Zocor) experienced myopathy 10 times more often than patients who received simvastatin alone because verapamil increased the blood levels of simvastatin.

Statins differ in the frequency with which they cause a severe type of myopathy called rhabdomyolysis, in which muscles are severely damaged. Cerivastatin (Baycol) was withdrawn from pharmacies worldwide because it caused rhabdomyolysis 10 to 100 times more often than other statins. Rhabdomyolysis may occur more often in patients taking statins with drugs that also cause rhabdomyolysis or drugs that increase the blood concentration of the statin.

What are the side effects of statins?

The most common side effects are:

The most serious (but fortunately rare) side effects are liver failure and rhabdomyolysis. Rhabdomyolysis is a serious side effect in which there is damage to muscles. Rhabdomyolysis often begins as muscle pain and can progress to loss of muscle cells, kidney failure, and death. It occurs more often when statins are used in combination with other drugs that themselves cause rhabdomyolysis or with drugs that prevent the elimination of statins and raise the levels of statins in the blood. Since rhabdomyolysis may be fatal, unexplained joint or muscle pain that occurs while taking statins should be brought to the attention of a healthcare provider for evaluation. Statins must not be used during pregnancy because of the risk of serious adverse effects to the developing fetus.

With which drugs do statins interact?

Statins have some important drug interactions. The first type of interaction involves the enzymes responsible for the elimination of statins by the liver. Liver enzymes (specifically, the cytochrome P-450 liver enzymes) are responsible for eliminating all statins from the body with the exception of pravastatin and rosuvastatin. Therefore, drugs that block the action of these liver enzymes increase the levels of simvastatin, lovastatin, fluvastatin, and atorvastatin (but not pravastatin or rosuvastatin) in the blood and can lead to the development of rhabdomyolysis. Drugs or agents that block these enzymes include:

Another important drug interaction occurs between statins and niacin or fibric acids, for example, gemfibrozil (Lopid), clofibrate (Atromid-S), and fenofibrate (Tricor). Niacin and the fibric acid drugs can cause rhabdomyolysis or liver failure when used alone, and combining them with statins increases the likelihood of rhabdomyolysis or liver failure. Nevertheless, fibric acids and niacin are often used with caution in combination with most statins. Cholestyramine (Questran) as well as colestipol (Colestid) bind statins in the intestine and reduce their absorption into the body. To prevent this binding within the intestine, statins should be taken one hour before or four hours after cholestyramine or colestipol.




Report Problems to the Food and Drug Administration

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


Printer-Friendly Format  |  Email to a Friend


space Related health and medical articles From the Doctors at MedicineNet.com MedicineNet Doctors recommend space
space
MedicineNet Doctors Recommend
  • atorvastatin, Lipitor - Describes the medication atorvastatin (Lipitor) a drug used for the treatment of high cholesterol, triglyceride levels, and prevention of heart attack, strokes, congestive heart failure, and heart disease. Article includes descriptions, uses, drug interactions, and side effects. Source:MedicineNet
  • Cholesterol - Learn about cholesterol and how to lower LDL cholesterol. Read in-depth cholesterol information on a low cholesterol diet, normal ratio (levels), treatment for high cholesterol and more. Source:MedicineNet
  • Cataract Surgery - Get information about cataract surgery. Learn how it's performed, what to expect before and after surgery, risks, complications and the causes and diagnosis of cataracts. Source:MedicineNet
  • Read 98 more Statins related articles ...
Latest Medical News
space

Back to Medications Index





Topics Related to Statins


Statins
RSS FeedSpecialty RSS       Add to My Yahoo! What is this?

Cholesterol GuidelinesCholesterol Guidelines
Think you know all there is to know about cholesterol? Learn the cholesterol guidelines: the good, bad, and that other one. See more WebMD Videos »












Health categories:

Slideshows | Diseases & Conditions | Symptoms & Signs | Procedures & Tests | Medications | Health & Living | News & Views | Medical Dictionary

Popular health centers:

Allergies | Arthritis | Cancer | Diabetes | Digestion | Healthy Kids | Heart | Men's Health | Mental Health | Women's Health | More...

Publications:

ePublications (PDFs) | XML News via RSS | Audio Podcasts | Email Newsletters

MedicineNet.com:

About Us | Privacy Policy | Search Help | Site Map | WebMD® | Medscape® | eMedicine® | eMedicineHealth® | RxList®

HON Code We comply with the HONcode standard for health trust worthy information:
verify here.

©1996-2008 MedicineNet, Inc. All rights reserved. Notices and Legal Disclaimer.
MedicineNet does not provide medical advice, diagnosis or treatment. See additional information.