April 18, 2024

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How long will side effects occur if long-term use of statins?

How long will side effects occur if long-term use of statins?



How long will side effects occur if long-term use of statins? Statins are the most important drugs for the treatment of coronary heart disease and atherosclerotic plaques. Not only can they stabilize the plaques and prevent them from rupturing and forming thrombi, some studies have even shown that they can shrink the plaques.

But many people still have concerns about the side effects of statins. How long does it take for statins to have side effects? What should I do if side effects occur?




Effect on liver function


1. Increased transaminase


All statins have side effects that slightly increase transaminase, the incidence is about 0.5% to 2.0%, and they usually appear within 3 months after the start of treatment.


There is no increase in transaminase after taking it for more than 3 months, which generally indicates a good tolerance. If the dose is not increased, there is generally no increase in transaminase.


Among all statins, atorvastatin, lovastatin and simvastatin have the greatest impact on liver function, which is related to the dose taken.


2. Take the same liver protection medicine?

Many people worry that statins will cause liver damage, so it is not advisable to take some liver protection medicines when taking statins.

First, there is currently no evidence that liver-protecting drugs can reduce liver damage caused by statins; second, liver-protecting drugs are also drugs, and some drugs are also metabolized by the liver and kidneys, which are a burden on the liver itself.


3. What should I do if there is elevated transaminase?

It can be observed that transaminase does not exceed 3 times the normal value. If it exceeds 3 times, the dose can be reduced, or the liver can be replaced with drugs such as rosuvastatin.



Muscle damage

1. Symptoms of muscle damage

Studies have shown that the incidence of muscle injury symptoms caused by statins is 0.1% to 0.2%, and patients know that when they take statins, the incidence of muscle injury symptoms is 7% to 29%. In other words, a large part of the symptoms are due to the patient’s subjective adverse reactions due to concerns about side effects.

Muscle symptoms of statins generally occur within 4 to 6 weeks of taking statins. The absence of side effects for more than 6 weeks indicates that the patient tolerates it well.


2. What should I do if there is muscle damage?

In the presence of muscle damage, the dose can be reduced or replaced with drugs that have less impact on muscle damage, such as fluvastatin and pravastatin.




Effects on blood sugar

1. Increase fasting blood sugar

Part of statin therapy is related to a small increase in fasting blood glucose.

A meta-analysis showed that long-term use of statin treatment can increase one diabetic patient per 1,000 patients, but it also prevents cardiovascular events in 5 patients. And most test results show that statins only increase glycosylated hemoglobin and do not increase the symptoms of diabetic patients.

Therefore, it is not difficult to see from various experiments that although statins have a small increase in the risk of fasting blood glucose, they can have a net benefit to protect patients from cardiovascular events.


2. Abnormal blood sugar occurs when taking statins

It is possible to replace statin drugs such as pravastatin and pitavastatin that have less effect on blood sugar.




Impact on kidney function

Except for pravastatin and rosuvastatin, which are hydrophilic and metabolized by the kidney, other statins are metabolized in the liver. There is no evidence that statins can cause kidney damage. There are even studies showing that statins can protect kidney function.

However, for patients with renal insufficiency, it is reasonable to check the renal function and calculate the glomerular filtration rate before taking the statin to approve the dose or reduce the dose of the statin.



Statins and stroke

At present, only the SPARCL study believes that patients with a history of stroke have a slight increase in hemorrhagic stroke after taking statins; however, a large number of evidence-based medical studies have not confirmed that the reduction of LDL-C is associated with an increased risk of cerebral hemorrhage.

Moreover, studies have shown that statin therapy reduces the risk of ischemic stroke by 26% for every 1 mmol/L reduction in low-density lipoprotein cholesterol. Therefore, stroke patients can take statins normally.


(source:internet, reference only)

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