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Decades of research have established statins as a safe treatment to effectively lower cholesterol and improve health outcomes. Most people take these drugs without any adverse effects.
However, like all medications, there is some level of risk of side effects. The most common of these are muscle pain, known as myalgia, and fatigue. In the large clinical trials that proved the benefits of statins, about a quarter of people complained of myalgia, although most of these cases did not appear to be caused by the statin itself.
Statins are also linked to headaches, constipation, diarrhea, and sleep problems. Blood glucose may rise when you start a statin, which leads to a small risk of tipping your levels over into the range diagnosed as type 2 diabetes.
Rare cases of problems with confusion or memory loss may also occur, although there is not very good evidence that these are caused by statins. Any cognitive effects that occur do not appear to be permanent and can go away if you change or stop the statin drug you take.
Greater risk of side effects comes with taking multiple medicines to lower cholesterol, and for women, those with a smaller body frame. Also at increased risk are people age 80 or older, those with kidney or liver disease, and those with conditions such as hypothyroidism or neuromuscular disorders including amyotrophic lateral sclerosis.
Risk of side effects is also higher when you take certain classes of medication that interact with statins. These include the heart rhythm drug amiodarone (Pacerone), the cholesterol drug gemfibrozil (Lopid), HIV drugs like saquinavir and ritonavir (Norvir), and some antibiotic and antifungal medicines, such as clarithromycin and itraconazole (Sporanox).
Overall, the benefit outweighs the risk for most people. One analysis showed that for every 100 people taking a moderate-intensity statin, the treatment would cause about one generally mild episode of muscle pain or weakness in the first year and no extra cases after that. Over the course of 5 years, statins would prevent about five major vascular events, such as heart attacks, among people with pre-existing vascular disease and two and half major vascular events otherwise.
If problematic side effects arise, though, don't just stop your medication. Talk with your medical team, because switching to another statin drug or a lower dose can help. Vitamin D deficiency can influence muscle pain with statins; correcting this deficiency with supplements can reduce it.
Read previous installments in this series:
For Your Patients: Hypercholesterolemia: Understanding Your Diagnosis
For Your Patients: Why Do High Cholesterol Levels Matter?
For Your Patients: Who Gets Hypercholesterolemia?
For Your Patients: Screening and Diagnosis of High Cholesterol
For Your Patients: Understanding Inherited Cholesterol Disorders
For Your Patients: Daily Choices That Help Tackle Hypercholesterolemia
For Your Patients: What About Alternative Treatments and Supplements?
For Your Patients: Medication to Manage Cholesterol
"Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.