PEBC: What You Need to Know: Statins

Examples: Atorvastatin, rosuvastatin, pravastatin, lovastatin, fluvastatin, simvastatin

Indications:

Statins are a class of medications used for reducing LDL cholesterol (also has benefits in increasing HDL and lowering triglycerides). By reducing cholesterol, the risk of myocardial infarction decreases.

Dosing:

Most statins are dosed once daily in the evening because the body makes the most cholesterol at that time. Fluvastatin and lovastatin can be dosed twice daily and with food.

Adverse Effects:

Myalgias: muscle aches which affect proximal large muscle groups (biceps, thighs)

Rhabdomyolysis: severe form of myalgias with elevated creatine kinase, brown urine, excessive muscle breakdown

Elevated liver enzymes: uncommon but can be reversible

Other: rash, GI upset

Drug Interactions:

CYP 3A4 substrates: atorvastatin, lovastatin, simvastatin (watch out for inhibitors such as clarithromycin and grapefruit juice which can increase levels)

CYP 2C9 substrates: rosuvastatin, fluvastatin
Caution with fibrates due to risk of rhabdomyolysis, especially gemfibrozil.