Statins

Question 1

Statins: prescribed for

Answer 1

Hypercholesterolaemia (incl. familial), hypertriglyceridemia, prevention of cardiovascular events in those with atherosclerotic disease or diabetes

Question 2

Statins: Examples

Answer 2

Simvastatin, Atorvastatin, Pravastatin, Rosuvastatin

Question 3

Statins: mode of action

Answer 3

Competitively inhibits HMG CoA reductase — an enzyme involved in cholesterol (and COQ10) synthesis

Question 4

Statins: Contraindications

Answer 4

Pregnancy, breastfeeding, liver disease

Question 5

Statins: Caution

Answer 5

High alcohol intake, liver disease history

Question 6

Statins: Side effects

Answer 6

GIT disturbance, headaches, fatigue, insomnia, myositis (inflammation of muscles), statin-induced myopathy

Statin use can lead to rhabdomyolysis — the breakdown of muscle cells. This can result in kidney disease and even failure. Extra care needed with foods / supplements that may interfere with metabolism

Question 7

Statins: Interactions

Answer 7

Important interactions with other drugs, so do check your medicine resources!

• Grapefruit juice / pomegranate juice:

Significantly increases GI absorption of CYP3A4 substrates and increases peak levels of statins. This combination should be completely avoided

Question 8

Statins: Nutrient depletion

Answer 8

CoQ10 (watch for muscle pain / fatigue).

Question 9

Statins: Co-administration

Answer 9

Often prescribed alongside other drugs for the prevention of cardiovascular events. Important to check if your client is taking any other medication.

• Red yeast rice: A combination of mevinic acids and derivatives e.g., monacolin K (identical to the active in Lovastatin), and other constituents that exhibit cholesterol lowering activity. Combining with statins may increase overall side effects