Statins Effects – Side Effects of Cholesterol Medications


Side effects of cholesterol lowering medications have raised concerns & debates among both patients & doctors/scientists. Controversy around benefits of cholesterol lowering medication and links of elevated levels of cholesterol & heart disease is ongoing. The risk of liver & kidney damage, muscle damage, increased risk of cancer & other side effects of cholesterol lowering drugs are good reason why exercise & diet should be patient’s first resort for controlling cholesterol levels. For people who must take cholesterol lowering medications, the dose needs to be reduced to minimum by again exercise & diet. The main concern seems to be the overuse or underuse of the medication, despite of the evidence that high cholesterol level itself is not the most important factor of heart disease. It is, however, the ratio between total & HDL cholesterol levels.

Statins (HMG-CoA reductase inhibitors) are the most powerful lipid lowering agent discovered. Statins are also the most widely prescribed drugs available in the market. US guidelines for prescribing Statins are less strict compared to many other developed countries, which led to high rate of Statin prescriptions, however the mortality rate due to heart disease doesn’t seem to be less. For this reason many believe that Stains are overused. Due to the medication being relatively new to the market, long-term consequences of Stain use are not clear yet. Short term severe negative side effects of Statins are rare.

 

Statins Side Effects

  • Cancer
    The increased risk of developing cancer is one of the most critical findings on negative side effects of Statins. The possible risk of developing cancer is generally buried in fine print & rarely is mentioned or discussed. A significant number of animal studies suggest that all lipid lowering drugs are associated with increased risk of developing cancer. Fibrates and Fibric Acid Derivatives are rarely prescribed due to clear evidence of them causing high risk of developing cancer & higher mortality. In 9 of the 12 largest Statin studies there was reported 3% higher risk of developing new cancers for those taking Stains, compared to the placebo group.
  • Liver Damage
    Liver damage is another possible serious side effect that can be caused by Statins. Data from trials shows 32% more patients with serious elevations of liver enzymes when they take Statins.
  • Muscle Damage, Myopathy, Rhabdomyolysis
    Mild muscle pains, back pain, flu-like symptoms are common Stain side effects. There have been cases reported of Stain induced Myopathy, which involves severe muscle pains often associated with creatine kinase that is released from the muscle. Myopathy can develop into full blown Rhabdomyolysis (release of muscle fiber contents into the bloodstream), which can result in kidney damage and possible death. In fact, Cerivastatin (Baycol) was taken off the market by Bayer due to thousands of rhabdomyolysis cases and at least 31 deaths. Crestor is another Statin that is closely being watched as having possible association with cases of kidney failure.
    Statins are not recommended for people over 70 due to the high risk of Myopathy & Rhabdomyolysis & increased risk of cancer, in addition to trials showing no clear evidence in preventing heart attacks for this group of patients by Statin treatment.
  • Depression
    Depression or re-occurrence of depression is another possible side effect of Statins. This is explained as cholesterol being the essential building block of hormones & neurotransmitters, changes in level of which can trigger depression. I find this argument flawed, since it seems to imply that lowering the cholesterol level can cause depression, which means that lowering cholesterol through diet or exercise is likely to cause depression as well. Anyhow, statistics suggest that those previously treated with antidepressants are at 21% higher risk of recurrent depression after taking Statins.

 

Other possible Statin side effects include:

  • Joint pains
  • Memory problems
  • Abdominal pain
  • Gas
  • Upset Stomach
  • Diarrhea
  • Constipation
  • Impotence
  • Dizziness
  • Headache
  • Nausea
  • Itching
  • Fever, chills
  • Swelling
  • Weakness
  • Dark or red colored urine
  • Difficulty swallowing, breathing
  • Rash
  • Flushing
  • Sensitivity to light
  • Hives
  • Blisters
  • Hoarseness
  • Other side effects

 

There are 2 groups of stains available:

  1. Synthetic
    Atorvastatin
    Cerivastatin
    Fluvastatin
    Pitavastatin
    Rosuvastatin
  2. Fermentation-derived
    Lovastatin
    Mevastatin
    Pravastatin
    Simvastatin

 

FDA Warnings

  • Don’t use Statins if you’re pregnant or nursing.
  • Don’t use Statins if you have liver disease.
  • Drinking grapefruit juice (qt or more can affect Statin medications).
  • Those who use niacin, birth control pills, Nefazodone and HIV medicines need to talk to their doctors about the risks involved using Statins.
  • Use Statins with caution in case you are taking Gemfibrozil, Amiodarone, Verapamil, Fenofibrates, blood thinners (anticoagulants) as well.

 

 

References:

  1. Prescription for Dietary Wellness By Phyllis A. Balch
  2. Before You Take That Pill: Why the Drug Industry May Be Bad for Your Health By J. Douglas Bremner
  3. Worst pills, best pills: a consumer’s guide to avoiding drug-induced death … By Sidney M. Wolfe
  4. Evidence for Caution: Women and statin use By Harriet Rosenberg & Danielle Allard
  5. www.nlm.nih.gov
  6. www.fda.gov