Statins

Question 1

What are the brand and generic names of statins?

Answer 1

• Simvastatin (Zocor)
• Atorvastatin (Lipitor)
• Pravastain
• Rosuvastatin (Crestor)

Question 2

What is the method of action of statins?

Answer 2

• Inhibits HMG CoA reductase
• = Decrease cholesterol production in the liver
• = ↑ clearance of LDL cholesterol from the blood
• Indirectly ↓ triglycerides
• Indirectly ↑ HDL cholesterol

Question 3

What are the indications of statins?

Answer 3

• Primary and secondary prevention of cardiovascular disease
• First line treatment for hyperlipidaemia – inc. primary hypercholesterolemia, mixed dyslipidaemia, familial hypercholesterolemia

Question 4

What are the contraindications of statins?

Answer 4

• Hepatic impairment
• Renal impairment – dose reduction
• Pregancy/breastfeeding

Question 5

What are the side effects of statins?

Answer 5

• Headache
• GI upset
• Muscle aches/myopathy/rhabdomyolysis (rare)
• ↑ in liver enzymes (can lead to drug induced hepatitis but this is rare)

Question 6

What are the interactions with statins?

Answer 6

• Cytochrome P450 inhibitors e.g. amiodarone, diltiazem, itraconazole, macrolids, protease inhibitors - ↑ plasma levels
• Amlodipine
• Clarithromycin/erythromycin – stop during duration of use as ↑ plasma levels

Question 7

What organ eliminates statins?

Answer 7

Kidney

Question 8

What patient information should be given to those taking statins?

Answer 8

• Best taken in the evening as greatest effect when dietary intake is at its lowest
• Keep alcohol intake to a minimum
• Avoid grapefruit juice – inhibits cytochrome P450 enzymes (Simvastatin and atorvastatin only)