Statin: What the Cholesterol Medicine Class Does
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Statin

Also called statins, HMG-CoA reductase inhibitor, lovastatin, monacolin K · Reviewed

Definition: Statins are a group of medicines that lower cholesterol by blocking a key enzyme the liver uses to make it. MedlinePlus says they are the most common medicines for high cholesterol, that they lower LDL cholesterol and help the liver clear LDL already in the blood, and that studies show they lower the risk of heart attack and stroke in people with high LDL.

Known risks, as MedlinePlus lists them

  • A small rise in the risk of type 2 diabetes, mainly in people already at high risk.
  • Abnormal liver enzyme results, with real liver damage very rare.
  • Muscle pain or damage, which is uncommon and in rare cases can harm the kidneys.
  • Interactions with some foods and medicines. Grapefruit changes how the liver breaks down some statins.

MedlinePlus says statins are not taken during pregnancy or breastfeeding, and warns against stopping one without talking to the prescriber.

Red yeast rice and other add-ons

NCCIH says red yeast rice can contain monacolin K, which is chemically the same as the statin lovastatin, and that the FDA does not allow products with added or enhanced lovastatin to be sold as supplements. Products vary from almost none to more. Newer cholesterol medicines are often added on top of a statin: the FOURIER trial of Repatha, a PCSK9 inhibitor, enrolled people already on statin therapy.

Why it matters for your log

A lipid panel is only useful next to what changed before it. Logging the start date, any switch, and supplements such as red yeast rice or niacin makes the next result easier to read.

Read more on Dose Track: Red yeast rice and statins · Niacin and statins · Grapefruit and medicines · Cholesterol

General education drawn from labels and published studies, not personal medical advice. Your prescriber, pharmacist and the label that came with your product are the final word.
LDL cholesterolLDL cholesterol (low-density lipoprotein) is the cholesterol carried in LDL particles, which move fat… Lipid panelA lipid panel , or lipid profile, is a blood test that measures the fats in your blood: LDL ("bad")… PCSK9 inhibitorA PCSK9 inhibitor is an injected cholesterol medicine that blocks PCSK9, a protein that makes the liver… HDL cholesterolHDL cholesterol is cholesterol carried by high-density lipoproteins. MedlinePlus calls it the "good"… TriglyceridesTriglycerides are the most common type of fat in the body. MedlinePlus explains that they come from fats… CYP3A4CYP3A4 is an enzyme in the body that breaks down many medicines. Drugs and foods that block it…

Frequently asked questions

How do statins lower cholesterol?+
MedlinePlus says they slow how much cholesterol the liver makes and help the liver remove LDL already in the blood.
Is red yeast rice a statin?+
It can contain monacolin K, which NCCIH says is chemically the same as lovastatin. The amount varies widely between products, and the FDA does not allow added lovastatin in supplements.

Sources

  1. MedlinePlus (NIH): Statins
  2. NCI Dictionary of Cancer Terms: statin
  3. NCCIH (NIH): Red yeast rice
  4. Sabatine et al. Evolocumab and clinical outcomes in patients with cardiovascular disease (FOURIER). N Engl J Med 2017

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