Are you taking statins for cholesterol? That’s good on the part that you are controlling cholesterol levels but on the other side you may met with few of the side effects which should be closely monitored. Even though we can observe very few side effects of statins used for high cholesterol treatment, still they are significant and serious.
The first thing we have to consider is how statins were prescribed to you. Normally they are given to reduce LDL cholesterol levels in the body to reach LDL goal in order to decrease the risk of developing CHD in next 10 years.
So your prescription may include any of the following statins.
Among these the last three drugs are long acting and widely prescribed for treating atherosclerosis. For example, atorvastatin can be prescribed at dose of 10 mg, 20 mg or 40 mg once a day based on the extent of reduction in LDL cholesterol levels required to achieve the goal in the treatment.
For example, in a patient with no or single risk factor the LDL levels should be maintained below 160 mg/dL.
So, the dose of statin will be fixed based on the risk factors in the patient and goal to achieve. Sometimes we need combination of statins with other cholesterol lowering drugs such as ezetimibe and nictonic acid.
Now we will see the important side effects of statins and why these drugs even efficiently reducing cholesterol levels but still stand as bottle neck in the continuation of therapy.
Gastrointestinal and neuronal reactions are the common side effects of statins that observed in most of the patients.
You may feel few side effects like headache, stiffness of neck, constipation, abdominal pain, nausea, vomiting, dizziness and flushing.
All these side effects of statins are not that much significant and they can be tolerated well within the recommended dose.
It’s not unnatural to think that statins affect liver as it acts as their primary target of action. Statins decreased cholesterol biosynthesis in liver by inhibiting HMG CO-A reductase enzyme.
As they act on liver, on term use they may affect liver functionality resulting in elevated liver enzymes and liver failure.
So the patients taking statins should undergo frequent check up for liver functionality tests (LFT) to assess the development of liver failure.
When you take statins for a longer period you may develop some muscle pain that gives an alarm of possible side effect of statins.
You may observe sever pain in the muscle, fatigue and leaning of the muscle all indicating that statins are on the way to produce their side effects.
Another related side effect of statins is inflammation of muscle. Even though these drugs are not directly related to inflammatory reactions, still they can affect muscle producing a damage and inflammation.
This is a not observed in all the patients treated with statins, but it is one of the significant side effect to be considered.
Serum creatine kinase levels are elevated indicating the inflammatory response in the muscle. For the same reason, fibrates are not generally combined with statins as this combination increases mysositis further.
One of the important side effects of statins is disintegration of skeletal muscle that results in loss muscle mass and muscle dissolution.
This serious condition is known as rhabdomyolysis which is irreversible making a check for use of statins.
Fortunately, this side effect of statins is again not common and rarely found in the patients. Again fibrates can also produce rhabdomyolysis hence not preferred to be used with statins.
How the kidney is affected?
You know that metabolic activities of muscle are closely related with kidney. Proteins that are released from the muscle after disintegration are released in to the blood and eliminated out of the body by kidney.
Since statins produce muscle damage, the urinary protein levels may increase resulting in high load to the kidneys. This may result in kidney failure and very serious to consider.
That’s why serum creatine kinase levels should be checked in patients with developing muscle pain in order to prevent kidney failure.
This is very important side effects of statins that gives complete contraindication in pregnancy. Statins can cross the placenta and can produce significant toxicity to the fetus. Hence these drugs are classified as pregnancy category X and should not be given to the pregnant women.
Hence among the side effects of statins, muscle pain, myositis and liver failure are important to be considered in the patients. Liver functionality should be checked on long term treatment with statins and even before starting therapy. Again any symptoms of muscle pain, muscle weakness should be properly attended to prevent further damage. Finally these drugs should be avoided in pregnant and breast feeding women.