Statins are the main class of medication we use to lower cholesterol and prevent heart attacks. The first was invented in the mid-1980’s. The main ones available now (commercial brand names in parentheses) are:
- Pravastatin (Pravachol®) *
- Fluvastatin (Lescol®) *
- Lovastatin (Mevacor®) **
- Simvastatin (Zocor®) **
- Atorvastatin (Lipitor®) ***
- Rosuvastatin (Crestor®) ***
Asterisks (*) indicate strength. For patients with known coronary artery disease, we always use atorvastatin or rosuvastatin.
Statins can prevent heart attacks through ways that have nothing to do with cholesterol. We don’t understand this well, but know it from studies. So we may prescribe the medication to certain patients with normal cholesterol levels.
The medications tend to have no side effects in most patients. But some people develop muscle aches, or weakness in the shoulders & hips. In rare cases, the muscle aches can be due severe muscle breakdown called Rhabdomyolysis (also see our topic Muscle Aches for a logical way to address the possibility). It’s common for liver enzymes to be a little elevated by statins; in rare cases, if the tests come back 5 times higher than normal, we’d change it (or, if liver enzymes already high for another reason, then if they rise to 3 times that original baseline level).