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Statins are a group of medicines that can help lower rates of low-density lipoprotein (LDL) cholesterol (so called ‘bad cholesterol’) in the blood.
They do this by reducing the production of LDL cholesterol inside the liver.
Having high-rates of LDL cholesterol is potentially dangerous as it can lead to hardening and narrowing of the arteries, which is known as atherosclerosis.
Atherosclerosis increases the risk of more serious, and possibly life-threatening, conditions, such as:
Statin therapy is usually recommended in the following groups of people:
Read more about who should take statins.
Statins are not the only option for treating high cholesterol. Alternative treatments include:
Read more detailed information about treating high cholesterol.
Many people who take statins experience no or very few side effects.
Cases that involve more serious side effects, such as kidney failure, tend to get a great deal of media coverage, but these cases are rare. The British Heart Foundation reports than only 1 in every 10,000 people who take statins will experience a potentially dangerous side effect.
Also the risks of any side effects have to be balanced against the benefits of preventing serious conditions such as heart attack and stroke.
It is estimated that statins save 7,000 lives a year in the UK.
Statins can sometimes interact with other medicines and cause unpleasant reactions such as muscle damage. Some types can also interact with grapefruit juice.
It is very important to read the information leaflet that comes with your medication to see if there are any interactions you need to be aware of.
If in doubt contact your doctor or pharmacist for advice.
Read more about interactions with statins.
Statins may be recommended if:
Statins can also reduce your risk of having:
Statins cannot cure conditions such as coronary heart disease but they can help prevent them from getting worse.
If you have a history of a previous stroke or heart attack, they can also reduce the risk of you having a future stroke or heart attack.
Statins may also be recommended if you are currently healthy but have a higher than average risk of having heart disease in future.
The current recommendation is that you should be treated with statins if there is at least a 1 in 5 chance of you developing heart disease at some point in the next ten years.
Health professionals can make an assessment of your personal risk of developing heart disease based on the following factors:
A risk assessment is recommended for:
Statins may be recommended if blood tests show you have high levels of low-density lipoprotein (LDL) cholesterol (so called ‘bad cholesterol’) in your blood and lifestyle changes such as diet, exercise and stopping smoking have failed to reduce the levels.
Your lifestyle can increase your risk of developing high blood cholesterol. This includes:
There is also an inherited condition known as familial hypercholesterolaemia (FH). This can cause high cholesterol even in someone who eats healthily.
Read more about the causes of high cholesterol.
Statins should not be taken if you have severe liver disease or blood tests suggest your liver may not be working properly.
This is because your body uses the liver to remove statins from the body and if there is a serious problem with your liver it could lead to a dangerous build-up of statins.
Before you start taking a statin, your doctor should ensure your liver is in relatively good condition. This will involve a blood test to check for the liver enzyme (substance in the blood) serum transaminase.
The statin called simvastatin should not be taken if you are taking medicines that affect how the liver breaks it down. These include:
If you take these medicines and also need treatment for high cholesterol, you may take one of the other statins.
Statins should not be taken by women who are pregnant or breastfeeding as it is unclear whether it would be safe to do so.
If you do become pregnant when taking a statin you should contact your doctor for advice.
Statins should be taken with caution if you are at an increased risk of developing rare side effects where the tissues of your muscles become damaged and painful (myopathy), which can cause damage to your kidneys (rhabdomyolysis).
These risk factors include:
If one or more of these apply to you then you may need frequent monitoring for complications. A lower dose of statin may also be recommended.
If you have an underactive thyroid, treatment may be delayed until your thyroid function is restored to normal. This because an underactive thyroid can lead to an high cholesterol condition which could naturally drop when normal thyroid function is restored. Also, statins can cause muscle damage in people with an underactive thyroid.
Statins are generally well tolerated and most people will not experience any side effects.
Statins can occasionally cause inflammation (swelling) and damage to your muscles. Speak to your doctor if you experience muscle pain, tenderness or weakness that cannot be explained (for example, not due to physical work).
Your doctor will carry out a blood test to measure a substance in your blood called creatinine kinase (CK), which is released into the blood when your muscles are inflamed or damaged.
If the level of CK in your blood is more than five times the normal level, your doctor may advise you to stop taking the statin. (Regular exercise can sometime lead to a rise in CK so tell the doctor if you have been exercising a lot).
Once your CK level has returned to normal, your doctor may suggest you start taking the statin again, but at a lower dose.
Although side effects can vary between different statins, common side effects (affecting between 1 in 10 people and 1 in 100 people) can include:
Uncommon side effects of statins (affecting between 1 in 100 people and 1 in 1,000 people) include:
Rare side effects of statins (affecting less than 1 in 1,000 people) include:
This is not an exhaustive list and the pattern and frequency of side effects can vary depending on the type of statin you are taking. So you should carefully read the information leaflet that comes with your medication.
If you find certain side effects particularly troublesome you should talk to the doctor in charge of your care. Your dose may need to be adjusted or you may need a different type of statin.
While side effects can sometimes be troublesome it is important to also appreciate the very real benefits statins do provide.
Research has found that in high-risk groups for heart disease, for every eight people who take a statin, one of those people would have otherwise had a (possible fatal) heart attack or stroke.
Some antibiotics, including erythromycin, clarithromycin, itraconazole, ketoconazole and miconazole, can increase your risk of muscle damage if taken with atorvastatin or simvastatin.
Speak to your doctor if you are taking atorvastatin or simvastatin and need to take one of these antibiotics. Your doctor may advise you to stop taking atorvastatin or simvastatin or take a lower dose of the statin while you are on the course of antibiotics.
The antibiotic daptomycin should also not be taken in combination with any statin.
Statins can enhance the effect of warfarin, which may increase your risk of bleeding.
You should have regular blood tests to monitor the effect of your statin on the warfarin, especially when starting or stopping a statin or when changing the dose of statin.
Take statins as directed on the packet or patient information leaflet, or as directed by your doctor or pharmacist.
If you forget to take your dose of statin, take that dose as soon as you remember and then continue to take your course of statins as normal.
If you have to take two doses closer together than normal, there is an increased risk of side effects.
The patient information leaflet that comes with your medicine should give you advice on what to do. If you are still concerned, speak to your doctor or pharmacist.
Accidentally taking one extra dose of statins is unlikely to cause you harm. If you are concerned, speak to your doctor or pharmacist.
If you accidentally take more than one extra dose of your statins, contact your doctor.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.