Which statin is safest

And they work. Statin therapy reduces the risk for a heart attack or other cardiovascular event by as much as 48 percent , depending on the level of risk factors you have. In fact, statins are so effective that nearly 32 million Americans take them. Statins have been studied exhaustively due to their wide use. Statins are safe for most people, but there are differences between individual statins. So, which statin is safest? It depends on a variety of factors.

Some statins are safer for you if you have certain medical conditions. That is because there are known drug interactions between medications and individual statins. The amount, or dose, you need for a statin to be effective is a factor, too. Your risk is less with lower doses of most statins. According to a research review people who take simvastatin Zocor or pravastatin Pravachol may experience fewer side effects.

Guidelines issued by the American College of Cardiology and American Heart Association indicate that the benefits of a high-intensity statin outweigh the risks if:. If you need high-intensity statin therapy, your doctor is likely to prescribe atorvastatin Lipitor or rosuvastatin Crestor.

Azole antifungal meds are often prescribed for fungal infections such as thrush and vaginal yeast infections. The AAFP recommends avoiding lovastatin Mevacor, Altoprev and simvastatin Zocor if you are taking macrolide antibiotics for bacterial infections. If you take atorvastatin or pitavastatin, you may need a dose adjustment.

Cyclosporine Neoral is used to treat a number of conditions, including psoriasis and rheumatoid arthritis.

The AAFP recommends avoiding pitavastatin and pravastatin if you are taking cyclosporine. Food and Drug Administration. Accessed Jan. Rosenson RS. Statins: Actions, side effects and administration.

Rosenson RS, et al. Statin muscle-related adverse events. Ferri FF. Statin-induced muscle syndromes. In: Ferri's Clinical Advisor Philadelphia, Pa. Adhyaru BB, et al. Safety and efficacy of statin therapy. Nature Reviews Cardiology. Alonso R, et al. Diagnosis and management of statin intolerance. Journal of Atherosclerosis and Thrombosis. Mach F, et al. Adverse effects of statin therapy: Perception vs.

European Heart Journal. About cholesterol. American Heart Association. Statin intolerance. Rochester, Minn. Anyanwagu U, et al. Drug-induced diabetes mellitus: Evidence for statins and other drugs affecting glucose metabolism. Clinical Pharmacology and Therapeutics. Lopez-Jimenez F expert opinion. Mayo Clinic, Rochester, Minn. March 18, See also After a flood, are food and medicines safe to use? Arcus senilis: A sign of high cholesterol? Get moving Cholesterol concerns?

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Hypothyroidism underactive thyroid Is your diet hurting your heart? Nuts and your heart: Eating nuts for heart health Pomegranate juice: Can it lower cholesterol? In a few cases, the drugs simply don't work, but more often the reason is a side effect. The most common statin toxicity is liver inflammation.

Most patients with the problem don't even know they have it, but some develop abdominal distress, loss of appetite, or other symptoms. The other major side effect is muscle inflammation, which can be silent or cause cramps, fatigue, or heavy, aching muscles. Like liver inflammation, muscle damage can often be detected with a simple blood test; in this case, it's an abnormally high level of creatine phosphokinase CPK. It's the reason the statin drug cerivastatin Baycol was withdrawn from the market on August 8, , because of 31 cases of fatal rhabdomyolysis muscle damage.

Fortunately, the other statins have proved much safer. Other possible side effects include loss of concentration, sleep disturbance, nerve inflammation, nausea, diarrhea, and rash. A few men may also develop breast enlargement or impotence. It's a long list of side effects, but it shouldn't stop doctors from turning to a statin first when medication is needed to bring cholesterol into range.

Fortunately, most side effects are mild and disappear promptly when the statin is stopped. In some cases, the problems will resolve simply by reducing the dose or switching to another statin, but care is required. Still, all in all, the statins are the safest and best tolerated of all cholesterol-lowering medications.

Although most patients respond well to statin therapy, some don't. But don't reserve a bed in the Coronary Care Unit just because a statin is not right for you. In fact, many other helpful medications are available, and they can even be more effective than the statins for some cholesterol problems, particularly low levels of HDL, the "good" cholesterol. In a sense, everyone. That's because no cholesterol level is too good. But people with unhealthy levels should work hard to improve, while those with ideal results can afford to relax a bit.

Cholesterol is a crucial determinant of cardiovascular health, but it's only one. In fact, smoking is even more dangerous than unhealthy cholesterol levels, and high blood pressure, diabetes, and lack of exercise are nearly as harmful. Because each risk factor adds to the harm of others, people with the most risk need the most vigorous treatment. Table 2 see below shows how an individual's risk profile influences the choice of therapy.

With so many people in need and so many medications available, it's understandable that both doctors and their patients are tempted to rely on medications to improve unhealthy cholesterol levels.

That's a mistake. Instead, lifestyle therapy is the place to start. That means avoiding tobacco in all its forms. It also means choosing foods low in saturated fat, trans-fatty acids, and cholesterol while favoring foods that provide heart-healthy omega-3 and monounsaturated fats and large amounts of dietary fiber.

It also requires regular exercise, which can be as simple as walking at a moderate pace for at least 30 minutes nearly every day. And the combination of a good diet and regular exercise should help men achieve another important goal, weight control. Lifestyle therapy can improve cholesterol levels, and certain foods can provide extra help see "Foods that lower cholesterol" below.

It's important to keep up a good diet and exercise program even if you take medication. And if you can't take a statin, here is a rundown of other medications that can help; Table 3 see below summarizes their effects on blood lipids and compares them to the statins. A heart-healthy diet means more than simply avoiding harmful fats, simple sugars, and excess calories; it also means eating lots of whole grains, fruits, vegetables, nuts, and fish that provide vitamins, fiber, and omega-3 fats.

But some foods can provide extra help by actually lowering LDL "bad" cholesterol levels — and they work best in people with high cholesterol levels. Soluble fiber can lower cholesterol levels substantially. Other excellent sources include beans, barley, prunes, citrus fruits, apples, Brussels sprouts, broccoli, and apricots. Psyllium, a natural grain from India, is also rich in soluble fiber.

It is not part of the American diet, but you can get it in supplements such as Metamucil or Perdiem Fiber. Soy may have other health benefits as well. Try tofu, soy milk, soy flour, or soy-based meat substitutes to see if soy is right for you. Plant stanols sound exotic, but they are widely available in margarines such as Benecol and Take Control.

Several other foods may also help. Health nuts will be glad to know that nuts may help lower cholesterol levels, but it takes quite a lot of nuts to have an impact, and that means a lot of calories. Despite wide popularity, garlic has had mixed results in clinical trials. And although none of these foods will boost HDL cholesterol levels, one liquid food will do just that. It's alcohol — but like cholesterol-lowering drugs, it can have major side effects.