Statins

What statins are for

Statins are used to lower high cholesterol levels and help stop your body producing too much cholesterol.

Cholesterol is a fatty substance in your blood that helps to make vitamin D and some of your hormones. If you produce too much cholesterol (high cholesterol), it can block blood vessels and stop them working properly.

High cholesterol can cause cardiovascular disease, a condition that affects the heart and blood vessels. This can cause heart attacks, strokes and peripheral arterial disease.

How statins work

Statins work by lowering the amount of cholesterol your body makes. This helps prevent the build-up of cholesterol in the blood vessels and keeps them working properly.

You'll usually take statins long term. This helps keep the risk of a heart attack or stroke as low as possible as you get older.

If you stop taking statins your cholesterol levels may be affected. Talk to a doctor or pharmacist before stopping.

Who may be offered statins

You may be offered statins if:

• you're at higher risk of getting cardiovascular disease and healthy lifestyle changes have not helped or are unlikely to help on their own
• you already have cardiovascular disease (to reduce the risk of having a heart attack or stroke)

You may be considered at higher risk of cardiovascular disease if:

• a health assessment (called QRISK) shows you may be at an increased risk of developing cardiovascular disease in the next 10 years – this is usually based on factors such as your age, sex, ethnicity and cholesterol levels
• you have a condition that puts you at risk of cardiovascular disease, such as diabetes, chronic kidney disease (CKD) or inherited high cholesterol (familial hypercholesterolaemia)
• you're aged 85 or over

Most people can take statins, but you should not take them if you:

• have severe liver disease
• are pregnant or trying to get pregnant
• are of childbearing age and are not using contraception

Types of statins

The main types of statins are:

• atorvastatin
• fluvastatin
• pravastatin
• rosuvastatin
• simvastatin

All statins are available on prescription. They come as a tablet you take once a day.

Alternatives to statins

There are other medicines available if you cannot take statins.

These include:

• other tablets – such as ezetimibe, fibrates and bempedoic acid
• inclisiran injections – such as alirocumab and evolocumab

Side effects of statins

Like all medicines, statins can cause side effects but not everyone gets them.

Common side effects

Some common side effects of statins include:

• headaches
• dizziness
• feeling sick
• feeling more tired or weaker than usual
• farting (flatulence)
• problems with pooing, such as constipation or diarrhoea
• muscle pain
• sleep problems

If you think your medicine is causing side effects, talk to a doctor. They may prescribe another statin or change your dose.

Other side effects

These are not all the possible side effects of statins. Some side effects are rare but serious, and you may need to contact 111 for advice.

Always check the information leaflet that comes with your medicine.

Taking statins with other medicines, herbal remedies, food and drink

Taking statins at the same time as other medicines, herbal remedies, or some types of food or drink can stop the medicines working properly or increase the risk of side effects.

For example, it can cause problems if you take statins with things such as:

• medicines for high blood pressure or blood vessels, such as amlodipine, verapamil or diltiazem
• antifungal medicines such as fluconazole
• certain antibiotics, such as clarithromycin and erythromycin
• HIV medicines
• warfarin or another medicine to help prevent blood clots
• ciclosporin – a medicine used to treat conditions such as psoriasis and rheumatoid arthritis
• colchicine – a medicine used to treat gout
• fusidic acid – a medicine used to treat skin infections
• herbal remedies such as St John's wort
• grapefruit or grapefruit juice, as it can increase side effects

If you take any of these, a doctor may prescribe an alternative statin, lower your current dose or recommend stopping the statin for a while.