Statins

Statins are a type of medicine that help lower cholesterol and reduce the risk of heart attack or stroke. Read about the types of statins, how they work and their side effects.

In addition to statins there are cholesterol-absorbing inhibitor drugs. Ezetimibe is one that is available in New Zealand and is used to treat high cholesterol. It works by reducing the amount of cholesterol absorbed from food. It can be given with statins or as an alternative to statins if statins are not working or are not being well tolerated.

Types of statins

Statins currently available in New Zealand include:

• atorvastatin (Lorstat)    
• pravastatin (Clinect)
• rosuvastatin (Crestor, Viatris, Sandoz)
• simvastatin (Viatris, formerly Mylan).

How do they work?

Statins help lower ‘bad’ cholesterol (LDL cholesterol) in your blood by slowing down an enzyme in your liver that makes cholesterol. This means your liver makes less cholesterol and removes more from your blood. 

High cholesterol can lead to coronary artery disease, which increases your risk of heart attack or stroke. Statins help reduce this risk.

How well do statins work?

Statins are some of the most studied medicines for heart health. They safely lower LDL cholesterol and reduce the risk of heart attack and stroke, especially for people who are at higher risk.   

Cholesterol is measured in millimoles per litre (mmol/L). For every 1 mmol/L drop in LDL cholesterol, your risk of heart attack or stroke falls by about 20%. 

Taking your statin every day helps protect your heart, and the longer you take it, the more you reduce your risk.   

If you’ve already had a heart attack or stroke, statins lower your chance of another one. 

What are the side effects?

For many people, statins don’t cause side effects. When they do, the side effects are usually mild, such as muscle pain or weakness, and often settle with time. 

Serious side effects, such as rhabdomyolysis (severe muscle damage), are very rare. If you have extreme muscle or joint pain or weakness, contact your doctor as soon as possible. 

Taking a statin may slightly increase your risk of developing type 2 diabetes. This risk is very low, and the benefit of lowering your cholesterol to protect your heart usually outweighs this risk.   

Some medicines and health conditions can raise your risk of side effects. Tell your doctor or pharmacist about all the medicines you take and any health conditions you have, such as kidney or liver problems.  

If side effects bother you, talk to your doctor. They may adjust your dose or suggest a different statin. Don’t stop your medicine without talking to your doctor first. 

Visit Medsafe or Healthify for more information about your medicine, including side effects.

When to seek urgent help

Call 111 immediately if you have any of the following (these are very rare but serious reactions): 

• severe chest pain
• severe headache
• acute shortness of breath
• swelling of the face, mouth, lips or tongue (possible allergic reaction).

What happens if I miss a dose?

If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed one and take the next dose as usual. 

Do NOT take two doses at once. 

If you often forget to take your medicine, a daily reminder, such as an alarm on your phone, might help you remember.

What checks do I need?

You’ll need regular blood tests to check your cholesterol levels and liver.

What else do I need to know?

Most people will need to keep taking their statin long term. If you stop, your cholesterol levels may rise again, increasing your risk of heart attack or stroke.  

Timing

You should take your statin at the same time each day. Some work best if you take them in the evening or with food. Talk to your pharmacist about when is the best time to take your medicine.  

Pregnancy

Statins aren’t recommended in pregnancy or when you’re breastfeeding. If you’re pregnant or plan to become pregnant, contact your healthcare provider for advice. 

Vitamins and supplements

Tell your health professionals if you’re taking any: 

• supplements
• natural medicines
• vitamins
• alternative therapies. 

These can sometimes make your heart medication less effective.

Food and drink

Grapefruit and grapefruit juice can affect the way your liver processes some statins and increase side effects. Ask your doctor or pharmacist if you need to avoid or limit grapefruit with the statin you take.

What else can I do to reduce my risk?

Statins help reduce your risk of a heart attack or stroke, but they work best alongside healthy lifestyle habits. Managing your blood pressure and blood sugar, and making healthy choices like eating well, staying active, limiting alcohol and not smoking, all help lower your risk of heart attack and stroke.