There are currently at least 5 statin drugs on the market in the U.S., including:
- Lovastatin (brand name: MEVACOR),
- Simvastatin (brand name: ZOCOR),
- Pravastatin (brand name: PRAVACHOL),
- Fluvastatin (brand name: LESCOL),
- Atorvastatin (brand name: LIPITOR), and
The major effect of the statins is to lower LDL-cholesterol levels, and they lower LDL-cholesterol more than other types of drugs. Statins inhibit an enzyme, HMG- CoA reductase, that controls the rate of cholesterol production in the body. These drugs lower cholesterol by slowing down the production of cholesterol and by increasing the liver's ability to remove the LDL-cholesterol already in the blood.
The large reductions in total and LDL-cholesterol produced by these drugs in research studies resulted in large reductions in heart attacks and heart disease deaths. Thanks to their track record in these studies and their ability to lower LDL-cholesterol, statins have become the drugs most often prescribed when a person with heart disease needs a cholesterol- lowering medicine.
Studies using statins have reported 20 to 60% lower LDL-cholesterol levels in patients on these drugs. Statins also produce a modest increase in HDL- cholesterol and reduce elevated triglyceride levels.
The statins are usually given in a single dose at the evening meal or at bedtime. It is important that these medications be given in the evening to take advantage of the fact that the body makes more cholesterol at night than during the day.
Results from the statins start to be seen after several weeks, with a maximum effect in 4 to 6 weeks. The statins are generally well tolerated by most patients, and serious side effects are rare. A few patients will experience an upset stomach, gas, constipation, and abdominal pain or cramps. These symptoms usually are mild to moderate in severity and generally go away as your body adjusts. Rarely a patient will develop abnormalities in blood tests of the liver. Also rare is the side effect of muscle problems. The symptoms are muscle soreness, pain, and weakness.
Statins may also strengthen bone tissue. Thus, people over 50 taking statins (to lower cholesterol) had fewer hip fractures, as was reported in 2000 in the Journal of the American Medical Association (JAMA).