Warning issued to millions on atorvastatin for high cholesterol

Warning issued to millions on atorvastatin for high cholesterol Pharmaceutical expert explained serious side effects when mixed with certain other medications A pharmaceutical expert has explained the side effects and potential issues with other drugs which make some people concerned about taking one of the most prescribed medications in the UK. An estimated 7 to 8 million adults take prescribed statins in the UK, making them one of the most commonly dispensed medicines by the NHS. Data from the National Institute for Health and Care Excellence (NICE) shows that over 5.3 million people are prescribed these cholesterol-lowering drugs in England alone. A pharmacist has explained the potential impacts of side effects from key drugs like atorvastatin - but emphasised that overall the benefits far outweigh the issues - but also said people need to be wary to watch for potential problems - and go back to their GP immediately if they are spotted - so action can be taken. Writing on The Conversation website, Dipa Kamdar Senior Lecturer in Pharmacy Practice, Kingston University said: “Like all medicines, statins have side effects. Common ones include headache, digestive upset and dizziness. More serious but uncommon or rare effects include liver inflammation and muscle problems. “One such condition is myopathy, meaning muscle pain or weakness with raised levels of creatine kinase, an enzyme released when muscle tissue is damaged. In very rare cases, severe muscle breakdown known as rhabdomyolysis can occur.” However overall among the population taking statins, Ms Kamdar said the main risks lie with other medication being take at the same time: “Large datasets show that most people tolerate statins well. When patients report muscle symptoms while taking statins, there is less than a 10% chance that the statin is actually the cause. Rhabdomyolysis is extremely rare, affecting only a few people per million users. The risk increases at very high doses or when statins are taken alongside medicines that interfere with how they are broken down.” On blood sugar she explained: “Statins can also cause a small rise in blood glucose, mainly affecting people with prediabetes or diabetes. However, because statins substantially reduce heart attack risk in these groups, the overall benefit outweighs this modest increase. Most side effects are reversible once treatment is stopped, whereas damage from heart attacks or strokes can be permanent.” Drug interactions Ms Kamdar said: “Drug interactions are another concern. Statins such as simvastatin and atorvastatin are broken down in the liver by enzymes known as CYP enzymes, particularly CYP3A4. When other medicines block these enzymes, statin levels in the blood can rise, increasing the risk of muscle-related side effects. “Important interactions include antifungal medications such as ketoconazole, certain antibiotics like erythromycin, immunosuppressants such as ciclosporin, and some heart drugs including amiodarone and diltiazem. “Even grapefruit can interfere with statin metabolism. It contains chemicals called furanocoumarins, which block CYP3A4 enzymes in the gut, allowing more statin to enter the bloodstream. Not all statins are affected to the same extent, so switching to a different statin could reduce this risk.” She said that statins are effective - but people need to actually change their lifestyles to handle cholesterol as well - and not just rely on medication. Losing weight it absolutely vital and is a ‘major cardiovascular risk factor’. Ms Kamdar said a review found that combining diet and exercise reduced body weight, improved cholesterol levels and lowered cardiometabolic risk: it reduces factors linked to heart disease and type 2 diabetes. National guidelines recommend reducing saturated fat intake to help lower LDL cholesterol. Saturated fats are commonly found in butter, fatty meats and processed foods. Replacing them with unsaturated fats, such as those found in olive oil, nuts and seeds, can improve cholesterol levels. Shifting towards plant-based proteins like beans, lentils and soy may also reduce reliance on red and processed meats. Research shows that higher fibre consumption is associated with better cholesterol levels and lower heart disease risk. Ms Kamdar added: “Ultimately, treatment decisions should be personalised, balancing cardiovascular risk, the proven benefits of statins, potential side effects and what lifestyle change is realistically achievable. “Statins have transformed cardiovascular care and saved millions of lives. Yet they remain controversial. Addressing poor diet, physical inactivity and obesity remains central to reducing the burden of heart disease in the long term.” To read the full article, click here.