Ask a Pharmacist

Struggling with Statins?

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Do you find yourself struggling with statins?

Why do I need a statin? Why are there so many with different names? Why did my doctor prescribe this brand name statin I can’t afford? What are the risks, side effects, and benefits of this medication? Why are they talking about cola-colored urine?

If you’re like most people, you have thought of these questions leaving your doctor’s office or pharmacy and might have forgotten to ask. You’re in the right place.

Here’s the scoop on statins:

Statins are drugs that lower what is known as “cholesterol,” which is found in the blood. A simple way of thinking of cholesterol is “blood fat.” To be healthy, you want your blood to flow through arteries and veins without leaving traces of fat behind. If traces of fat are left behind, it can cause the blood vessel to become blocked or obstructed. This increases the chances of heart attack and stroke because blood can no longer move easily through the vessel and a piece of fat can break free.

There are two types of cholesterol: HDL and LDL. HDL is what is known as “good” cholesterol. You can think of “H” for “high” meaning you want HDL to be high for good health. The bad cholesterol is known as LDL. You can think of “L” for “low” meaning you want LDL to be low for good health.

Your doctor probably put you on a statin because your LDL is too high and your HDL is too low, you have other conditions affecting your heart, you have diabetes, you are a smoker, or you have an increased risk of heart attack due to lifestyle factors. A statin can help reduce bad cholesterol levels in the blood, but works best in combination with a healthy diet and exercise.

There are several statins on the market that come as brand and generic medications. The brands tend to be expensive, but are usually interchangeable with the generics. If you have a question about affording your brand name statin medication, you can always ask your pharmacist or doctor about discount cards or alternatives you may be able to switch to.

Some of the most commonly prescribed statins that are approved for use in the U.S. include:

Lipitor (atorvastatin) and rosuvastatin (Crestor) are known as “moderate-intensity” to “high-intensity” statins. This means they are used when a greater decrease in LDL cholesterol is needed to achieve your cholesterol goal. The “low-intensity” to “moderate-intensity” statins are Zocor (simvastatin), Pravachol (pravastatin), Lescol (fluvastatin), and Livalo (pitavastatin). This means they are used when a smaller decrease in LDL cholesterol is needed to achieve your cholesterol goal.

When taking a statin be sure to watch out for:

  • Muscle pain or weakness – This might be a sign of muscle breakdown, which is extremely rare, but serious. Be sure to notify your provider right away!
  • Dark cola-urine – This is also a sign of muscle wasting that appears in the urine when the kidneys filters out the waste. Again, be sure to notify your provider right away!
  • Memory problems – Sometimes memory difficulties arise with statin use. If this happens, your dose may need to be adjusted. Normal memory function will return once a medication change is made.
  • Alcohol – Since alcohol is processed by the liver and so is the statin, this can overwhelm the liver and cause problems.
  • Grapefruit juice– Grapefruit juice is metabolized in the same way as your statin. This can also overwhelm the liver and is best avoided.

Additional Tips:

  • If you use multiple pharmacies, be sure to let your pharmacist known which other drugs you are taking and we can make sure everything is safe to take together.
  • Be sure to have a follow-up appointment with your provider 3 months after beginning the statin to make sure it is working for you.




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