Side Effects of Statin Drugs for Cholesterol

Statins are the most commonly prescribed cholesterol-lowering medications that affect all aspects of the cholesterol profile.

Benefits of statins include:

• Lowering LDL and triglyceride levels
• Raising HDL levels
• Lowering the risk of heart disease
• Preventing subsequent heart attacks and strokes in patients who already have heart disease

Even amid the benefits that taking statins may have, some patients shy away from them because they think the side effects may cause more harm than good.

Are patients correct to avoid statins because of side effects?

Statins can benefit patients with a history of heart disease, but the trend of prescribing statins for healthy people to reduce risk may come to an end in light of a 2015 editorial published in the Prescriber medical journal. The report said that after taking statins for 5 years, only 0.5 percent of healthy people avoided a heart attack or stroke. The authors, a London cardiologist and a US physician professor, are calling for a complete rewrite of the American and British guidelines.

All statin drugs elevate liver enzymes to some degree, including aminotransferase (AST) and alanine aminotransferase (ALT), which your health care provider monitors before you begin statin therapy, three months after beginning statins, and least every six months while on statin therapy.

Those with elevated liver enzymes may not notice any symptoms.

Standard doses of statins elevate liver enzymes in about 1 percent of patients, usually within the first four months. The likelihood of this elevation increases in older people and in those taking other medications that might interact with statins or also raise liver enzymes.

This statin side effect is dose-dependent, which means that the higher the dose of statins you are taking, the more likely you will experience an increase in liver enzymes.

There are rare reports of liver failure and hepatitis associated with statins and elevated liver enzymes. Current studies have not been able to establish a definite link between statin use and liver disease.

Elevated liver enzyme levels go back to normal when you stop taking statins.

Myopathies, or muscle symptoms such as weakness and pain, are another side effect of statins.

Myopathies range from mild myalgias, or muscle pains, to a life-threatening condition known as rhabdomyolysis. The most common myopathy associated with statin use, myalgia, only occurs in about 1 out of every 1,000 patients taking statins.

The chance of experiencing this statin side effect increases as you get older, with higher doses and while taking certain other medications. These symptoms will usually appear within four months of initiating statin therapy.

Rhabdomyolysis, another myopathy that can occur with statin use, is extremely rare and deadly if not properly treated. It occurs in one person out of 10,000 individuals taking statins.

Symptoms of rhabdomyolysis include:

• Profound muscle pain
• Weakness
• Significantly increases amounts of creatinine phosphokinase

That's a decision you and your health care provider should make.

If you are taking statins for a current health condition, perhaps the side effects associated with statin use are relatively uncommon enough when you compare it to the benefits. 

If your health care provider suggests statins as a preventative measure, make sure you both have all the information you need, including new findings, to make an informed decision.