Statins Explained: What They Do, Who May Need Them and Safety

Statins are among the most widely prescribed medicines for heart health. If your doctor has mentioned them, you may have questions. This article explains, in general terms, what the NHS says about statins. It is not personal advice. Only a doctor can decide whether a statin is right for you, and you should never stop one without speaking to a doctor or pharmacist first.

What are statins?

The NHS describes statins as medicines that lower cholesterol. High cholesterol raises the risk of heart problems and stroke, and statins can help prevent them. They are available on prescription.

How do they work?

According to the NHS, statins reduce the amount of cholesterol your body produces, which helps prevent cholesterol from building up in your blood vessels. They are usually taken long term. The NHS advises talking to a doctor or pharmacist before stopping, because stopping can affect your cholesterol levels.

Who may be offered statins?

The NHS says statins may be offered to:

• People at higher risk of cardiovascular disease when lifestyle changes alone have not helped or are unlikely to
• People who already have cardiovascular disease, to lower the risk of a heart attack or stroke

Groups the NHS lists as higher risk include people with a high QRISK score (an estimate of 10-year risk based on factors such as age, sex, ethnicity and cholesterol), people with diabetes, chronic kidney disease or inherited high cholesterol, and people aged 85 or over. A doctor assesses whether a statin is appropriate and which type to use.

Who should not take them?

The NHS says most people can take statins, but they are not suitable for people with severe liver disease, people who are pregnant or trying to conceive, or people of childbearing age who are not using contraception. Tell your doctor about your health conditions and your plans for pregnancy.

Possible side effects

The NHS lists common side effects, which not everyone gets. They include headaches, dizziness, feeling sick, tiredness or weakness, wind, constipation or diarrhoea, muscle pain and sleep problems. Some side effects are rare but serious, and the NHS says you may need to contact its 111 service for advice. Side effects can be reported through the Yellow Card scheme.

If side effects or interactions occur, the NHS says the doctor looks into the cause and may prescribe a different statin, adjust the dose, or recommend pausing or stopping treatment. If a statin cannot be used, there are other options that a doctor can discuss, such as other tablets and injections.

Interactions

The NHS says statins can interact with other medicines, herbal remedies such as St John's wort, certain antibiotics and antifungals, HIV medicines, warfarin, and grapefruit or grapefruit juice. Always read the leaflet that comes with your medicine, and ask a pharmacist or doctor if you are unsure. Tell every doctor and pharmacist about everything you take, including herbal remedies.

Statins and lifestyle

Statins are one part of looking after your heart. The NHS and the US CDC both stress healthy habits too, such as not smoking, eating a balanced diet, being active and keeping to a healthy weight. Medicine and lifestyle work alongside each other, and neither replaces the advice of your doctor.

When to see a doctor

Speak to your doctor or pharmacist if you have side effects, if you are unsure whether a medicine is safe to combine with your statin, or if you want to stop. Do not stop or change prescribed treatment without talking to your doctor.

Call emergency services at once for chest pain that does not stop, pain spreading to the arms, neck or jaw, or chest pain with sweating, sickness or breathlessness. The NHS says not to drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).