Dr. Richard Hoffmann, Ask the Pharmacist, 02/07/12

Q: You have written several columns about the potential benefits of using a statin drug. What about statin side effects?

A: Statin drugs are very effective in reducing “bad” cholesterol (LDL) levels and are recommended for use in conjunction with diet and exercise to reduce the risk of heart attacks and strokes in patients with coronary heart disease, or those who are at high risk of coronary heart disease.

In the past, I have written columns about studies suggesting statin use may be associated with a lower risk of fatal prostate cancer and that it possibly lowers the risk of death in elderly patients hospitalized due to the flu, but more study is needed.

Besides lowering cholesterol levels, statin drugs have also been shown to have multiple effects, including anti-inflammatory and anti-blood clotting properties.

However, like all drugs, statins can also cause a number of side effects.

Two serious side effects of statins include muscle problems that can lead to kidney failure, and liver problems. Fortunately, these side effects are not common and can be monitored by the patient and physician. In addition, all statins are contraindicated during pregnancy due to the possibility of birth defects.

Other, more common side effects of statins include diarrhea, upset stomach, muscle and joint pain and alterations in some laboratory tests.

Many additional side effects and drug interactions can occur with statin use, so patients should get as much information as possible from their physician, pharmacist and other drug information sources.

As more study data becomes available, new side effects of statins may be identified. For example, recent study data associates statin use with lung problems in smokers and former smokers, while other data suggests the risk of diabetes may be greater in statin users.

As new information is discovered, the risk to benefit ratio of statins may change, but for now the potential benefits of statin therapy to reduce heart attacks and strokes in high-risk patients appear to outweigh the potential risks.

There are currently seven statin drugs available: atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor). Atorvastatin, lovastatin, pravastatin and simvastatin are also available as generic drugs.

Richard P. Hoffmann, Pharm.D., has been a pharmacist for more than 40 years. Send questions to him at 2960 E. Coventry Court, Hernando, FL 34442.